Written Answers Nos. 1114-1133
1114. Deputy Michael Moynihan asked the Minister for Health the number of front-line workers who have received the pandemic bonus payment to date; when all payments are expected to issue to frontline workers eligible for the payment; and if he will make a statement on the matter. [54924/22]
View answerFirstly I would like to thank all healthcare workers for their extraordinary efforts during the COVID-19 pandemic.
The Government announced a COVID-19 pandemic recognition payment for certain front-line public sector healthcare workers, to recognise their unique role during the pandemic. To date, over 124,000 workers have received the payment, and payments to eligible HSE and Section 38 staff are substantially complete.
Certain non-HSE/Section 38 healthcare employees are also covered by the Government Decision. These include 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 front-line Covid-19 exposed environments in the HSE;
6. Paramedics employed by Dublin Fire Brigade to deliver services on behalf of the HSE.
The HSE and KOSI Corp are currently progressing the roll-out to eligible staff in cohorts 1-4 above. Information on the process involved has now been provided by the HSE and KOSI Corp to relevant organisations.
The Department of Health has transferred funding to the Department of Defence and Dublin City Council to enable payments to eligible staff in cohorts 5 and 6 above, and payments to these staff will be arranged by their respective organisations.
1115. Deputy Brendan Griffin asked the Minister for Health if a business (details supplied) requires a licence to sell vapes. [54926/22]
View answerAt present a licence is not required to sell nicotine inhaling products such as e-cigarettes. The Public Health (Tobacco and Nicotine Inhaling Products) Bill, which is currently being drafted, will introduce such a requirement.
1116. Deputy Neale Richmond asked the Minister for Health if he has considered funding the counselling psychology doctorate programme; and if he will make a statement on the matter. [54930/22]
View answerThe total allocation for mental health services in 2023 is over €1.2 billion, which is another record budget for mental health services. This significant investment will enable implementation of many of the short and medium-term measures in our national mental health policy, Sharing the Vision. It will enhance the provision of mental health supports across a broad continuum from mental health promotion, prevention and early intervention, to acute and specialist mental health service delivery. The funding will enable us to continue to deliver our vital services to as many people as possible, as we move into 2023.
In relation to the HSE Mental Health care programme, €750,000 has been provided in Budget 2023 to support counselling psychology training places. This funding demonstrates the Government’s commitment to strengthen access to psychology training. Engagement continues with the Psychological Society of Ireland (PSI) to progress this initiative. Further detailed discussions are now taking place between the Department and HSE to progress both this and wider commitments of the 2023 Budget in the context of preparing the HSE Service Plan 2023.
1117. Deputy Paul Kehoe asked the Minister for Health if the nursing home support scheme will take a property into account (details supplied); and if he will make a statement on the matter. [54931/22]
View answerParticipants in the Nursing Homes Support Scheme contribute a proportion of their income and the value of their assets towards their cost of care. Couples are assessed jointly but the value of their assets and income that is assessed is halved: participants contribute up to 80% of their income (40% if part of a couple) and 7.5% per annum of the value of their assets (3.75% if part of a couple). The first €36,000 in assets (€72,000 if part of a couple) is excluded from assessment.
The Nursing Homes Support Scheme Act (2009) defines a couple as two persons married to each other or cohabiting - inclusive of same-sex or opposite-sex couples - for a period of 3 years or more.
Participants in the scheme who own property/land-based assets in the State also have access to Ancillary State Support, or the Nursing Home Loan, which is an optional feature of the Fair Deal Scheme. It is a loan advanced by the HSE to help people meet the portion of their contribution to the cost of care that is based on property/land-based assets, most typically against the personal residence. If an individual secures Ancillary State Support, they will not need to contribute against the value of the relevant property during their time on the scheme, unless the property is sold during that time.
It should be noted that the capital value of an individual’s principal private residence is only included in the financial assessment for the first three years of their time in care. This is known as the three-year cap, which is intended to protect the value of a principal private residence.
Last year, the Department of Health introduced the Nursing Homes Support Scheme (Amendment) Act 2021, which became operational in October 2021. This introduced a three-year cap on contributions from family farm and business assets, provided that a family successor is appointed to run the asset for at least 6 years. The Act also extended the three-year cap to the proceeds of sale of a principal residence, which means that, from the fourth year in care onwards and provided the house was sold while the person is in care, a nursing home resident may sell their principal private residence without incurring additional costs.
1118. Deputy Michael Healy-Rae asked the Minister for Health the status of surgery for a person (details supplied); and if he will make a statement on the matter. [54952/22]
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.
1119. Deputy Danny Healy-Rae asked the Minister for Health if he will provide adequate resources for a service (details supplied); and if he will make a statement on the matter. [54956/22]
View answerProviders of long-term residential care who participate in the Nursing Homes Support Scheme (NHSS) can, from this week, obtain additional funding supports to help meet increased energy costs due to inflation through the Temporary Inflation Payments Scheme (TIPS). Eligible private and voluntary nursing homes can claim 75% of their heating and electricity increases up to a maximum payment of €5,250 per month per nursing home. The aim of the new scheme (TIPS) is to alleviate pressures put on nursing homes by an increase in energy prices and the new scheme will run in parallel with the Temporary Assistance Payment Scheme. The Temporary Inflation Payment Scheme will be kept under review and further funding of these supports will be looked at towards the end of this year.
Prior to Budget Day I stated that my priority was to secure additional funding for Budget 2023 to ensure the continuation of all services to a high standard. Long-term residential care will be supported through additional funding for the NHSS to maintain services and manage inflationary increases. The additional energy supports were announced as part of Budget 2023. A total of €10 million in funding will be made available specifically for nursing homes, drawn from the €100 million once-off fund that has been allocated to support community-based health and social care service providers for 2022 cost increases related to energy inflation.
Budget 2023 also saw an additional €180 million of funding for services for older people for winter 2022 and into 2023, building on unprecedented increases of recent years. This will bring investment in these services to over €2.4 billion in 2023, including nearly €12 million of new developments.
The Government has provided substantial supports to the nursing home sector over the course of the pandemic. Over €145 million has been claimed by nursing homes under the Temporary Assistance Payment Scheme (TAPS) since its introduction in 2020. The Government has now agreed to extend TAPS to the end of the year by maintaining the availability of Outbreak Assistance support.
Implementation of Policy Reviews
Funding to support people to access services in the sector continues to be provided in line with the long-established statutory mechanisms under the Nursing Homes Support Scheme Act 2009. This is the mechanism established by the Oireachtas to provide for the processes relating to funding under the NHSS and the negotiation of prices for services for private and voluntary providers with the designated State agency, the National Treatment Purchase Fund (NTPF). Maximum prices for individual nursing homes are agreed with the NTPF following negotiations and based on the NTPF’s cost criteria. These criteria include costs reasonably incurred by the nursing home, local market prices, historic prices and overall budgetary capacity.
The NTPF carry out this role independently under the NHSS Act 2009. The NTPF has statutory independence, and there is no role for Ministers or the Department of Health in these negotiations. The Department of Health published a review of the NTPF pricing system in June 2021.
The Review of the Pricing System for Long Term Residential Care Facilities was carried out under the oversight of a steering group with representation from various departments and agencies. The group made four recommendations, which are now being taken forward by the Department of Health and NTPF.
There are differences in the cost of care between public and private homes, with public, HSE-run nursing homes (Community Nursing Units) generally having a higher cost of care. The main driver of the difference between public and private nursing homes is the resident ratios and a different balance between nursing and other health care staff, with more nursing staff in HSE-run nursing homes. The HSE is staffed to deliver more complex care, typically with a higher nursing ratio per resident and a different skill mix to private nursing homes.
A Value for Money (VFM) Review on Nursing Home Care Costs has also been carried out under the direction of a Steering Committee with an independent chair. The VFM Review sought to identify, quantify and analyse the reasons for any cost differential between private/voluntary and public nursing homes and, following analysis, to make recommendations for improving the value for money obtained by the Health sector. The review was published in December 2021 and can be viewed by following this link: www.gov.ie/en/publication/3859f-a-value-for-money-review-of-nursing-home-care-costs/
Among the issues raised were the pay costs of staff in nursing homes, the dependency levels of residents, energy costs, and medical supplies charges to the NHSS. The report found that the cost differential is largely driven by variances in staff-to-resident ratios and the skill mix in public and private nursing homes. However, the review also found that establishing like-for-like comparisons was complex and not always possible, especially when considering differences in dependency levels.
The VFM Review made nine recommendations which the Department continues to take forward.
1120. Deputy Michael Lowry asked the Minister for Health if he will provide a breakdown of the number of persons who were refused access to FreeStyle Libre devices in each of the years 2019 to 2021 and to date in 2022; and if he will make a statement on the matter. [54957/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1121. Deputy Michael Lowry asked the Minister for Health if he will provide details of the total spend on blood glucose test strips for persons with diabetes under the long-term illness scheme for each of the years 2019 to 2021 and to date in 2022, in tabular form; and if he will make a statement on the matter. [54958/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1122. Deputy Robert Troy asked the Minister for Health if he will ensure that a HPV vaccine is provided to a person (details supplied). [54969/22]
View answerThe immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The committee's recommendations are based on the prevalence of the relevant disease in Ireland and international best practice in relation to immunisation.
The ages at which vaccines are recommended in the immunisation schedule are chosen by the NIAC in order to give each child the best possible protection against vaccine preventable diseases. As the HPV vaccine is preventative it is intended to be administered, if possible, before a person becomes exposed to HPV infection.
Therefore, the gender-neutral HPV vaccination programme targets all girls and boys in first year of secondary school to provide maximum coverage.
In October 2021, my Department asked the National Immunisation Advisory Committee to consider the clinical effectiveness of providing the HPV vaccine to:
- girls and boys in secondary school who were eligible to receive HPV vaccine in 1st year but who did not receive it; and
- women up to the age of 25 years who have left secondary school and who did not receive the vaccine when eligible.
The NIAC submitted advices in relation to the HPV Vaccination Programme to the Department which noted that HPV vaccination should be prioritised for unvaccinated second level students and females under the age of 25 years.
In line with the NIAC's advice, I asked the HSE to facilitate and operationalise the Laura Brennan HPV Vaccine Catch-Up Programme.
This programme, which is expected to launch in mid-November 2022, will offer free HPV vaccines to all boys and girls in second level education who were previously eligible to receive the HPV vaccine and who have not yet, for whatever reason, received it.
Young women, up to the age of 25, who have now left secondary school, and who did not receive the vaccine, will also be eligible to receive the vaccine as part of the catch-up programme.
Further details on the campaign and how eligible people can register their interest will be made available in due course.
In addition to the announcement of the catch up programme, NIAC have issued new recommendations in relation to HPV vaccine dosage. The advice is available at the following link: www.hse.ie/eng/health/immunisation/hcpinfo/guidelines/chapter10.pdf
It is recommended that you consult with your General Practitioner in relation to this advice.
1123. Deputy Duncan Smith asked the Minister for Health the length of the contract for wheelchair maintenance that an organisation (details supplied) has with the HSE; the oversight mechanisms, if any, that are in place in relation to the performance of the contract; the value of the organisation’s contract for wheelchair maintenance in the State; and if he will make a statement on the matter. [54991/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1124. Deputy Fergus O'Dowd asked the Minister for Health the actual circumstances, criteria and protocols that were applied by HSE when it requested assistance from the Defence Forces for nursing homes and residential care facilities during phase 1 of the Covid-19 pandemic; the internal process and procedure followed by the HSE in seeking such assistance; the administrative level of such sign-off within the HSE; the reason that Defence Forces assistance subsequently was not sought by the HSE for Dealgan House, given that HSE staff within CHO8 raised the need with HSE colleagues in CHO8 regarding the need for Defence Forces support in Dealgan during the first wave of Covid-19; the level; the location in which the decision made not to seek assistance; and if he will make a statement on the matter. [54992/22]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1125. Deputy Richard O'Donoghue asked the Minister for Health if orthodontic treatment for children under the age of 16 can be expedited as children are suffering because of the lack of care; and if he will make a statement on the matter. [55020/22]
View answerThe HSE provides orthodontic treatment to those who have the greatest level of need and have been assessed and referred for treatment before their 16th birthday. I am aware of that there are currently significant delays in accessing this service and that the HSE has put in place a number of measures to address waiting times. These include prioritisation of the filling of permanent vacancies, treatment waiting list initiatives, services improvement initiatives and access to orthodontic services outside the jurisdiction.
A current HSE procurement framework in orthodontics covers grade 4 patients (children and young people) who can been seen in community settings and have been waiting 4 years or more to commence treatment following assessment. Patients meeting these criteria can avail of treatments with a private Specialist Orthodontist. The grade 4 HSE procurement mechanism received additional funding of €4.1m in 2022 as part of the Waiting List Action Plan. Over 1600 Grade 4 patients have been taken off the orthodontic treatment waiting list this year through this initiative, which will continue in 2023.
The option of the Northern Ireland Planned Healthcare Scheme may be available to patients, whereby patients can choose to go to Northern Ireland for treatment. This option is managed through a National Service and has a separate funding structure to the Orthodontic Service.
1126. Deputy Michael Ring asked the Minister for Health the reason that a pain treatment has been denied to a person (details supplied) in County Mayo; if this decision will be reviewed; and if he will make a statement on the matter. [55051/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1127. Deputy John McGuinness asked the Minister for Health if he will confirm the rate per kilometre paid by the HSE to patients who use their own car to attend dialysis sessions/appointments; if the rate will be increased given the increase in the costs of travel; if the payment to those making such a claim is issued in a timely manner; the number of patients availing of the scheme; the number of claims outstanding for a month or more; and if he will make a statement on the matter. [55055/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1128. Deputy Pa Daly asked the Minister for Health when an appointment will issue for a person (details supplied). [55068/22]
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.
1129. Deputy Brendan Smith asked the Minister for Health if he will ensure that medical card income eligibility limits are increased in view of anomalies that may arise (details supplied); and if he will make a statement on the matter. [55069/22]
View answerFor persons aged 70 or older, the medical card assessment is based on gross income. The weekly gross income thresholds for eligibility to a medical card for those aged 70 and over were increased in November 2020 and are currently €550 per week for a single person and €1,050 for a couple.
However, It should be noted that those aged over 70 can also be assessed under the general means tested scheme where there are particularly high costs, e.g., medication, nursing home fees. In addition, Deputy may be aware that, since 2015, every individual aged 70 and over has automatic eligibility for a GP visit card.
The general means tested medical card thresholds are based on an applicant’s household income after tax and the deduction of PRSI and the Universal Social Charge. The means assessment determines an applicant’s eligibility allowing for taking account of one’s eligible expenses from their income. The over 80s allowance, where payable is not included in the assessment process. Examples of allowable expenses include rent, mortgage, insurance, nursing home costs.
However, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.
It is important to note that certain social welfare payments are not included in the means assessment for a medical card. Where income is from a social welfare payment such as a pension and other sources, some of the social welfare payments are assessed.
In situations where a person’s sole income is derived from a social welfare payment, even where this payment is in excess of the current income thresholds, the person will be awarded a medical card.
I can assure the Deputy that, to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues, including the current medical card income thresholds under review and any changes are considered in the context of Government policy and other issues which may be relevant.
1130. Deputy John McGuinness asked the Minister for Health if he will confirm the date of the High Court decision in the case of a person (details supplied); if the full extent of the court decision has been honoured by the State from the decision date to date; the current status of the services available to the person and in particular speech and language therapy, OT, music therapy and sensory integration; if his attention has been drawn to any protocol or guidelines set down by the HSE that may prevent the current service provider, procured by the HSE, in carrying out the contract for services; and if he will make a statement on the matter. [55070/22]
View answerThe Department of Health has honoured its obligations under the terms of the financial settlement that was ruled by the High Court in 2012.
As to the current status of services, the Health Service Executive has been requested to respond to the Deputy directly in this regard.
1131. Deputy David Cullinane asked the Minister for Health the waiting lists for eye care with the HSE, by age cohort and length of wait, in tabular form; and if he will make a statement on the matter. [55082/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1132. Deputy David Cullinane asked the Minister for Health the out-of-hours GP services which are contracted or in operation; the number of GPs with contracts; the number of GPs actively making claims, by month to date in 2022, in tabular form; and if he will make a statement on the matter. [55088/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1133. Deputy David Cullinane asked the Minister for Health if he has received the independent evaluation of the Health (Regulation of Termination of Pregnancy) Act 2015, commissioned by a university (details supplied); if he will publish this report; and if he will make a statement on the matter. [55089/22]
View answerThe Review of the Health (Regulation of Termination of Pregnancy) Act 2018 commenced in line with statutory and Government commitments in December 2021.
The Review will assess the effectiveness of the operation of the legislation and will be conducted in a fair and transparent manner.
The Review has 2 main phases. The first phase is comprised of a three-part approach to appraise the operation of the Act, with strands focusing on service users, service providers and a public consultation.
The second phase of the Review is being led by an independent Chair, Marie O’Shea BL, who will assess the extent to which the objectives of the 2018 Act have been achieved, analysing in that regard the findings of the three major research inputs from the first phase.
A final report will be submitted to me, as Minister in late 2022 for my consideration.
