Written Answers Nos. 694-712
694. Deputy Emer Higgins asked the Minister for Health if consideration will be given to extending the free cervical screening service to women over 65 years who have previously had an abnormal result from a cervical smear test or who have been recommended to continue getting regular smears by their general practitioner; and if he will make a statement on the matter. [48469/22]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
695. Deputy Duncan Smith asked the Minister for Health if the recent development of rooms and offices in a hospital (details supplied) will open soon; the reason for the delay; the purpose for which the rooms will be used; and if he will make a statement on the matter. [48481/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
696. Deputy Kathleen Funchion asked the Minister for Health if certain foods are covered under the medical card, such as non-gluten foods due to their high cost; and if he will make a statement on the matter. [48482/22]
View answerThe Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines and medical items, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
In line with the 2013 Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the formal Reimbursement list. In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact.
Gluten-free products were removed from the list of reimbursable items under the General Medical Services (GMS) scheme, with several other products, in September 2012. The marketplace has evolved whereby such products are widely available in supermarkets at a more reasonable price than was historically costed to the State when they were available in pharmacies through the statutory schemes, and without incurring the further extra costs of a dispensing fee. There are currently no plans to reinstate these products on the list of reimbursable items under the GMS and other community drug schemes.
However, possession of a medical card may assist with other medical services. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. Medical card eligibility is primarily based on an assessment of means and is not granted on the basis of any particular condition.
In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.
Under the Drug Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
A person can claim tax relief for certain food products if they have specific dietary requirements due to a medical condition. This applies to persons with coeliac disease where they require gluten free foods specifically manufactured to be gluten free. Details of this scheme are available at www.revenue.ie/en/personal-tax-credits-reliefs-and-exemptions/health-and-age/health-expenses/additional-diet-expenses-for-coeliacs-and-diabetics.aspx.
697. Deputy Richard Boyd Barrett asked the Minister for Health when the funding for public fertility treatment will commence; if he will provide a definitive date for when persons can access public treatment; and if he will make a statement on the matter. [48501/22]
View answerAs the Deputy might be aware, a commitment to “introduce a publicly funded model of care for fertility treatment” is included in the Programme for Government. The Model of Care for Infertility was developed by the Department of Health in conjunction with the HSE’s National Women & Infants Health Programme (NWIHP) in order to ensure that infertility issues are addressed through the public health system at the lowest level of clinical intervention necessary. This Model of Care comprises three stages, starting in primary care (i.e., GPs) and extending into secondary care (i.e., Regional Fertility Hubs) and then, where necessary, tertiary care (i.e., IVF, and other advanced assisted human reproduction (AHR) treatments), with patients being referred onwards through structured pathways. Phase One of the roll-out of the Model of Care has involved the establishment, at secondary care level, of Regional Fertility Hubs within maternity networks, in order to facilitate the management of a significant proportion of patients presenting with infertility issues at this level of intervention. The completion of Phase One of the roll-out, envisaged before the end of this year, will result in fully operational Regional Fertility Hubs in each of the six Regional Health Areas across the country.
Phase Two of the roll-out of the Model of Care will see the introduction of tertiary infertility services, including IVF, provided through the public health system. In this regard, funding was secured in Budget 2023 to support access to advanced AHR treatments, including, crucially, to allow the commencement of Phase Two of the roll-out of the Model of Care. This investment will facilitate the first steps to be taken towards the provision of a complete publicly-provided fertility service, which is the ultimate objective of Government. In particular, it will allow the historic development of the first National Advanced AHR Centre, delivering IVF and ICSI through a wholly public clinic. This is scheduled to open in the early part of 2024 and will provide a nationwide service, with all six Regional Fertility Hubs having equity of access for onward referral to it, via a shared care pathway. Subject to the provision of additional funding in future, it is envisaged that additional National Advanced AHR Centres will be developed and become operational on a phased basis elsewhere in the country. The 2023 allocation will also be utilised to support the Regional Fertility Hubs in order to expand their scope of services next year by introducing the provision of IUI (intrauterine insemination), a significant, yet less complex and less intrusive, component of AHR treatment. Separately, as an interim measure, I have instructed that some funding be made available to support access to advanced AHR treatment via private providers from September 2023. My officials, in conjunction with NWIHP, are now planning for the operationalisation of both the publicly- and privately- provided service, including the development of a national eligibility framework, as well as determining how the interim funding for private treatments will be provided to individual eligible patients. I expect that this process will involve, where appropriate, engagement with relevant stakeholder groups. Overall, my Department and the Government is fully committed, through the full implementation of the Model of Care for Infertility, to ensuring that patients always receive care at the appropriate level of clinical intervention and then those requiring, and eligible for, advanced AHR treatment such as IVF will be able to access same through the public health system. The underlying aim of the policy to provide a model of funding for AHR, within the broader AHR regulatory framework, is to improve accessibility to AHR treatments, while at the same time embedding safe and appropriate clinical practice and ensuring the cost-effective use of public resources.
698. Deputy Claire Kerrane asked the Minister for Health the number of recommendations that have been actioned with regard to a report on mental health services in County Roscommon; and if he will make a statement on the matter. [48506/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
701. Deputy Joe Carey asked the Minister for Health the directive or clinical recommendations that the HSE gives its medical consultants for prescribing insulin pumps for adults diagnosed with type 1 diabetes; and if he will make a statement on the matter. [48510/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
704. Deputy Matt Shanahan asked the Minister for Health the number of medical doctors presently registered to work in the State by gender (details supplied); and if he will make a statement on the matter. [48520/22]
View answerAs the Deputy may be aware the Medical Council recently published its 2021 Workforce Intelligence Report. The report indicates that in June 2021, 21,680 doctors renewed their registration with the Council. Of those doctors who renewed their annual registration 18,424 (84.9%) were reported to be clinically active and working in Ireland. Of these 18,424 doctors, 8,653 (47%) were female and 9,771 (53%) were male.
There is ongoing work in my Department in relation to medical workforce planning and the findings of the Medical Council Report will form an important part of this work. My Department works in collaboration with the National Doctors Training and Planning (NDTP) Office of the HSE in relation to initiatives aimed at increasing opportunities for training and career progression.
705. Deputy Alan Dillon asked the Minister for Health the number of dental practices in County Mayo that accepted medical card patients in tabular form; and if he will make a statement on the matter. [48525/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
706. Deputy John McGuinness asked the Minister for Health when agency staff and section 39 employees will be paid the €1,000 Covid bonus; and if he will make a statement on the matter. [48529/22]
View answerThe HSE and the Department are currently examining progressing the rollout to the list of 6 non-HSE/non-Section 38 organisation types covered by the Government Decision. This measure will be ring fenced to staff working ordinarily onsite in COVID-19 exposed healthcare environments.
It is hoped that information will be published shortly for those certain non-HSE/Section 38 healthcare employees that are covered by the Government Decision and the process available to their employers to implement this measure for their eligible staff. This shall cover eligible staff in:
1. Private Sector Nursing Homes and Hospices (e.g. Private, Voluntary, Section 39 etc.);
2. Eligible staff working on-site in Section 39 long-term residential care facilities for people with disabilities;
3. Agency roles working in the HSE;
4. Health Care Support Assistants (also known as home help / home care / home support) contracted to the HSE;
5. Members of the Defence Forces redeployed to work in frontline Covid-19 exposed environments in the HSE;
6. Paramedics employed by Dublin Fire Brigade to deliver services on behalf of the HSE.
The above 6 areas only are covered by this Government Decision and all eligible workers will be paid in accordance with the overarching eligibility criteria in place.
Rolling out the payment to eligible employees of those specific non-HSE/Section 38 organisations covered by the government decision is a complex task, particularly as these employees are not normally paid by the public health service, duplicate payments need to be avoided, and there are many organisations to be covered, but this work is being given priority attention.
708. Deputy Johnny Mythen asked the Minister for Health the complaint mechanisms that are available to families that lost loved ones in nursing homes during the Covid-19 pandemic; and if he will make a statement on the matter. [48547/22]
View answerI recognise how difficult it has been for the families of nursing home residents who died during this pandemic, which has presented one of the greatest and most wide-ranging public health challenges internationally in recent history. Throughout the pandemic, the overall national response to COVID-19 has had a specific and sustained focus on older persons, particularly those resident in nursing homes.
The Health Act 2007, as amended, provides the overarching regulatory framework for the nursing home sector with further detailed requirements set out in Registration Regulations, Care and Welfare Regulations and Quality Standards. Under the Health Act 2007, as amended, and related Regulations, the registered provider is responsible and accountable for the quality of care and safety of residents in nursing homes (designated centres) and all nursing homes are required to have a clear complaints procedure in place. Part 10 of the Care and Welfare Regulations sets out the requirements in this regard. The person-in-charge of the nursing home will be able to provide information on the complaints process in place in the nursing home and assistance on how to make a complaint. If a complainant is unhappy with the response received, he or she can appeal the decision as provided for in the Regulations.
The Office of the Ombudsman can also examine complaints relating to the administrative actions of nursing homes. The Office of the Ombudsman normally only deals with a complaint once the individual has already gone through the complaints procedure of the nursing home concerned.
In cases of complaint about a healthcare professional, the resident or family can also complain directly to the employee's professional regulatory body, for example the Nursing and Midwifery Board or the Irish Medical Council.
For those nursing homes that are under the aegis of the Health Service Executive (HSE), there is a HSE-wide complaints process. Details of this process can be accessed on the HSE website at www.healthcomplaints.ie.
Separately, HIQA welcomes information in relation to designated centres that come within its regulatory remit. As a regulator, HIQA has no legal role in examining individual complaints, however, the Authority does take into account all information it receives, including complaints from the public, when carrying out inspections and this range of information informs a risk-based approach to regulation.
Currently, my Department is examining complaints processes across the nursing home sector including information on best practice, the level of standardisation, and the views of key stakeholders including residents and families, with a view to determining the need to further develop enablers such as policy, legislative and/or guidance instruments to strengthen and enhance current arrangements.
In tandem with this work, the Patient Advocacy Service (PAS), which currently supports residents in HSE-operated nursing homes to make complaints, will begin its rollout to private nursing homes at the end of 2022. This is in line with a Programme for Government commitment to examine extending the remit of the Patient Advocacy Service to residents of long-term residential care facilities.
709. Deputy Johnny Mythen asked the Minister for Health if he will consider adapting a mechanism similar to the independent public inquiry to examine the Covid-19 pandemic in the UK; and if he will make a statement on the matter. [48548/22]
View answerThe Deputy is advised that Ireland’s has pursued a public health-led, whole of society response to the management of COVID-19. Throughout the pandemic, the response has been underpinned by our core national priorities of protecting the most vulnerable in society from the severe impacts of the disease, minimising the burden on the healthcare system, and continuing to keep schools and childcare facilities open.
The COVID-19 pandemic is not over. The Office of the Chief Medical Officer continues to closely monitor the epidemiological profile of the disease and provide advice in relation to ongoing decision-making processes in respect of the pandemic. The importance of ongoing vigilance in the context of the COVID-19 pandemic, and specifically in relation to the autumn/winter 2022/2023 period, has been signalled through international guidance. Work has been underway in my Department with regard to preparedness and contingency planning for the coming winter season, which is traditionally a very challenging time for our health and social services.
Government has previously acknowledged the importance of reviewing the response to the pandemic. Since the beginning of the response, there has been a clear national commitment to continue to learn from the pandemic and, where necessary, to ensure that the public health-led approach evolves, as evidence and learning materialises.
The Department of Health has taken an adaptive approach to the elements of the response falling within its remit. It has continuously worked to capture and to apply lessons learned from the national and international COVID-19 response to date. The Department has demonstrated its commitment to learning lessons from pandemic response across multiple domains to date.
In May 2020, Government established the Nursing Home Expert Panel which examined and advised on the COVID-19 response in long-term residential healthcare settings. The Expert Panel’s report was published on 19th August 2020 is available here. The Fourth Progress Report on implementation of the recommendations of Expert Panel is available here.
In January 2022, a Public Health Reform Expert Advisory Group (PHREAG) commenced its work with Terms of Reference approved by Government. It was tasked with identifying learnings from the public health components of the response to the COVID-19 pandemic in Ireland and internationally with a view towards strengthening public health including health protection generally and future public health threat and pandemic preparedness specifically. Further details on the PHREAG are available here.
In April 2022, the Minister for Health established the COVID-19 Advisory Group (CAG), to consider and advise on how best to maximise Ireland’s medium to long-term preparedness for future challenges posed by COVID-19. The CAG has considered lessons learned from the pandemic in its work. The recommendations of the CAG, with relevant World Health Organization (WHO), European Centre for Disease Prevention and Control (ECDC), and European Commission guidance, have informed my Department’s strategic approach to the management of COVID-19 for autumn/winter 2022/2023.
The Taoiseach has indicated that a comprehensive evaluation of how the country managed COVID-19 will provide an opportunity to learn lessons from our experiences in dealing with a pandemic over the past two years. This will help ensure that we are in a better, stronger position if another pandemic or another similar type emergency arrives. Consideration is being given as to what the best model for this evaluation will be.
710. Deputy Niamh Smyth asked the Minister for Health the reason that a person (details supplied) remains waiting for their cataract operation; and if he will make a statement on the matter. [48574/22]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
711. Deputy Aengus Ó Snodaigh asked the Minister for Health the reason that the review by his Department into services provided by radiation therapists stalled given that there has been no review of the service and working conditions in the past 20 years; and if he will make a statement on the matter. [48576/22]
View answerAn independent radiation therapist review has been agreed under the auspices of the WRC. Discussions are ongoing between the parties to finalise a Terms of Reference and appoint an independent chair.
As this is an ongoing Industrial Relations process it would be inappropriate to comment further at this stage.
712. Deputy Peter Burke asked the Minister for Health if he will advise on a payment for a person (details supplied). [48579/22]
View answerAs this is an operational matter for the Health Service Executive, the HSE has been requested to respond directly to the Deputy.
