Written Answers Nos. 1413-1432
1413. Deputy Fergus O'Dowd asked the Minister for Health the total amount of moneys provided by the HSE to dentists under the dental treatment services scheme contracts for services provided to medical card holders by county in each of the years 2018 to 2022 and to date in 2023; and if he will make a statement on the matter. [1152/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1414. Deputy Chris Andrews asked the Minister for Health when a person (details supplied) will receive the pandemic recognition payment. [1157/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly.
1415. Deputy Sean Fleming asked the Minister for Health the current position in relation to private dental practices which no longer offer services to medical card holders; if there has been any further update on this service being resumed in the near future; and if he will make a statement on the matter. [1163/23]
View answerThe Dental Treatment Services Scheme (DTSS) provides dental care, free of charge, to medical card holders aged 16 and over. Services available annually and on demand include an examination including preventative elements, two fillings, emergency extractions, and a scale and polish. Since May 1st 2022, there has been additional prevention treatments included and a 40-60% increase in fees across most treatment items. More complex care, such as dentures, and a broader range of treatments for patients with additional needs and high-risk patients are also available.
The DTSS is a “choice of dentist” scheme which does not require the patient to register with a particular dentist and enables medical card holders to attend any DTSS contractor directly without recourse to the HSE. Where access to a dentist is difficult, local HSE services assist patients who make enquires and make lists of DTSS contractors available to medical card holders. In exceptional circumstances the HSE directly assists patients to access emergency dental treatment by contacting private contractors or arranging treatment through HSE-employed dentists.
I am aware that there are some towns with no or very few DTSS dentists that have sufficient capacity to accept new patients. For this reason, €5 million of additional funding has been allocated through Budget 2023 on a one-off basis to support the HSE Public Dental Service to provide care this year, including through a HSE ‘safety- net’ service for adult medical card holders who are in need of emergency care and are still struggling to access a local dentist.
1416. Deputy Pádraig O'Sullivan asked the Minister for Health when a person (details supplied) will receive their reimbursement under the cross-Border directive scheme; and if he will make a statement on the matter. [1165/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1417. Deputy Brian Stanley asked the Minister for Health the counties in CHO 8 which have an ‘access officer’ assigned to oversee and ensure that those with a disability have easy access to all services. [1166/23]
View answerAs this question refers to service matters, I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
1418. Deputy Mark Ward asked the Minister for Health the status of the disposal of land by the Department of Education to his Department to provide a primary health care centre in Collinstown, Dublin 22; and if he will make a statement on the matter. [1169/23]
View answerAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
1419. Deputy Cian O'Callaghan asked the Minister for Health the status of the strategic assessment report for the new emergency department at Beaumont Hospital; and if he will make a statement on the matter. [1174/23]
View answerAs outlined in response to Oral PQ no. 4 on the 8th December 2022, the proposed new Emergency Department (ED), including reconfiguration of the existing ED, at Beaumont Hospital is a large and complex proposal, which is in the early stages of design development.
The delivery of capital projects is a dynamic process and is subject to the successful completion of the various approval stages, in line with the new lifecycle approach of the updated Public Spending Code (PSC).
The HSE has appointed a design team and, whilst it is in early stages of development, the Design Report is now completed. The design team will continue through this design process including the statutory planning applications.
In parallel to this work, the HSE is drafting a Strategic Assessment Report (SAR). It is expected this SAR will be submitted to the Department of Health in early 2023. It has yet to be submitted by the HSE.
If the SAR satisfies the requirements of the Public Spending Code, a preliminary business case can be developed, building on the work of the design team.
Given the impact of construction inflation and supply chain issues in the construction sector arising from the pandemic and the war in Ukraine, the proposals could potentially cost over €100m. For all projects proposed in excess of €100m Government is the approving authority.
The preliminary business case would then be reviewed under the Public Spending Code and submitted to Government for approval. This approval would enable the HSE to proceed to develop a procurement strategy and tender documents for the new ED.
Unfortunately, the timeline for the new ED cannot estimated be made until after the completion of a tender competition and submission of the Final Business case to Government for approval.
1420. Deputy Richard Bruton asked the Minister for Health if the indexation-up of outstanding amounts under the fair deal scheme is being reviewed in view of the fact that the rate of inflation is now far in excess of interest rates and the cost to the State of funding the outstanding amounts; and if he will make a statement on the matter. [1181/23]
View answerFunding to support people to access services in the nursing home 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 Nursing Homes Support Scheme (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 cost of residential care to the State was approximately €1.4 billion in 2022, including contributions from residents. Budget 2023 saw over €40 million in additional funding for the NHSS which will provide for an uplift in the maximum prices chargeable by private and voluntary nursing homes, as negotiated.
The Government remains conscious of the financial challenges faced by the Nursing Home sector, particularly in terms of inflationary cost increases. I encourage all eligible providers to avail of the €10m Temporary Inflation Payment Scheme (TIPS) which covers up to 75% of year-on-year energy and heating cost increases in private and voluntary nursing homes up to a monthly cap of €5,250 per month per nursing home over the period of July to December 2022 (up to €31,500 per nursing home for 2022).
Since the start of the pandemic, private and voluntary nursing homes have received a wide range of non-financial supports, including over €72m in free PPE and oxygen, as well as over €145m of financial support through the Temporary Assistance Payment Scheme (TAPS). The TAPS COVID-19 Outbreak Assistance was also extended to the end of 2022.
The Department of Health is currently considering extension of the Temporary Assistance Payment Scheme (TAPS) COVID-19 Outbreak Assistance to the end of March 2023 and extension of the timeframe of the Temporary Inflation Payment Scheme (TIPS). Any further extension or expansion of either scheme will be kept under review.
I am currently in discussions with Departmental officials to examine ways in which funding can also continue to be used to provide support, where necessary and appropriate, to those nursing homes who are not scheduled to renegotiate their Deeds of Agreement this year. Other options to support nursing homes are also being explored.
1422. Deputy Pauline Tully asked the Minister for Health if he will provide this Deputy with the Children's Disability Network Team Staff Census and Workforce Review 2022; and if he will make a statement on the matter. [1186/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1423. Deputy Richard Bruton asked the Minister for Health if he intends to extend the enhanced travel and subsistence scheme for student nurses and midwives to student doctors also known as medical students, who face the same costs in relation to meals, subsistence, scrubs purchase, laundering and travel to placement sites; and if he will make a statement on the matter. [1197/23]
View answerStudent Doctors do not receive an allowance to support time spent on placement as part of their course. There are no plans to change this.
The Deputy may be aware that across the health and social care disciplines, there are a large number of students on placement in hospital and healthcare settings, approximately a third of which are final year students. The length of placements and the activities performed during these placements vary between the disciplines. These students are not employees therefore not paid, and in many cases the nature of the placement can, in the main, be limited to participation in an observing and a learning capacity.
Uniquely for student nurses and midwives there is, in the final year, a paid salary when they are specifically employed on an internship placement. Student nurses and midwives’ final year internship placement consists of a continual 36-week rostered clinical placement, including annual leave. The internship placement is a paid placement as the student nurses and midwives take a reduced caseload. During these placements, students are under supervision and are considered as 0.5 WTE of the workforce. In addition, Intern students can be allocated across all shift patterns including nights, weekends and 12-hour days.
Clinical practice placements form 50% of the overall education programme requirements for student nurses and midwives, where 100% attendance at supernumerary practice placement (45 weeks) is mandatory to complete the degree programme. The enhanced travel and subsistence scheme for student nurses and midwives undertaking supernumerary clinical placement arose following recommendation from the McHugh Report which was an examination of the existing arrangements regarding additional travel, subsistence and accommodation requirements of student nurses and midwives on clinical placement specifically. Supernumerary students are not included in the staffing complement and are not in receipt of a salary. They learn under the supervision of a registered nurse/midwife and are not accountable for patient care. Again, given the unique requirements of these training programmes attendance at many placement sites is required, some of which are at a distance to base training hospital and the current allowance is to contribute to the cost of alternative accommodation / travel.
Some practice placement locations are not accessible by public transport and require student nurses and midwives to travel by car or make personal arrangements. There are considerable variances in the distances students are required to travel to attend mandatory practice placements depending on the undergraduate programme they are undertaking and the location of that programme.
1424. Deputy Richard Bruton asked the Minister for Health if, as part of the Government's commitment to retaining doctors in Ireland, a medical intern doctor job will be made available to every eligible graduating doctor in an Irish medical school in 2023 similar to that which was offered during the Covid-19 pandemic. [1198/23]
View answerPolicy regarding the allocation of medical intern places was put in place in 2016 to ensure that CAO entry medical graduates are guaranteed an internship post following completion of their medical degree. It is a priority that CAO graduates have access to an internship in order that they may qualify as a doctor, obtain full registration with the Medical Council of Ireland, and chose to seek permanent employment in the Irish Health Services.
This protects the State investment in the undergraduate education of medical students. In addition, it supports Ireland’s commitment under the World Health Organization’s Global Code on the Recruitment of International Health Personnel to strive for self-sufficiency in the domestic training of doctors. Under this policy all eligible CAO applicants have been allocated an intern post since 2016.
Applicants for a medical internship are applying for an employment position in the HSE. They are recruited directly by the HSE, as their employer. The HSE applies the Employment Permits legislation in the recruitment for intern posts. In compliance with the Employment Permits Act an order of merit based on work permit status is applied whereby all eligible CAO entrants to Irish medical schools who are work permit exempt are guaranteed an intern post. Remaining posts are allocated to all remaining eligible EEA applicants, followed by all remaining eligible non-EEA applicants.
The number of medical intern places is determined by medical workforce planning requirements. In 2021 I requested the HSE to provide an increase of 120 permanent additional medical intern posts from July 2021 onwards. This represented an increase of 16% on the previous pre pandemic level of medical intern intake and reflects a more sustainable level of internships post COVID-19.
There were 854 medical Intern posts available for the 2022/23 training year. This number is aligned with the number of training posts available at the next stage of medical postgraduate training pathway and medical workforce demand estimates.
1425. Deputy Paul Kehoe asked the Minister for Health the current status of the HSE pension for a person (details supplied); and if he will make a statement on the matter. [1201/23]
View answerAs this is an operational matter for the Health Service Executive, I have asked the HSE to reply directly to the Deputy.
1426. Deputy Catherine Murphy asked the Minister for Health the number of whole-time equivalent vacant nursing posts at Naas General Hospital as of 4 January 2023; and when these vacancies will be filled in tabular form. [1204/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1427. Deputy Catherine Murphy asked the Minister for Health the estimated full-year cost to fund four additional contingence clinics to tackle the wait list for surgery through specialised small units and enable general access to pelvic physiotherapy when required. [1206/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1428. Deputy Richard Bruton asked the Minister for Health if there are plans to address the urgent need to recruit additional staff for children's disability network teams in order to address lengthy waiting lists for early intervention in the north Dublin area; and if he will make a statement on the matter. [1232/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1429. Deputy Martin Browne asked the Minister for Health the role that Nenagh Hospital can play in meeting the demand for emergency department treatment given the record number of presentations to UHL recently. [1237/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1430. Deputy Martin Browne asked the Minister for Health the measures that he is taking and intends to take to enable Shannondoc to meet the demand for its services as witnessed over the Christmas period; the measures that he is taking to ensure that it is accessible in a timely manner, enabling it to take pressure off UHL’s emergency department; his views on the issues that people have experienced recently when trying to contact Shannondoc; and if he will make a statement on the matter. [1238/23]
View answer1529. Deputy Fergus O'Dowd asked the Minister for Health if he will provide details on the way that he and his Department are actively engaging with the providers of the North East Doctor on Call service to address the major pressures on the current service which is leaving many persons unable to access out of hours GPs (details supplied); and if he will make a statement on the matter. [1625/23]
View answerI propose to take Questions Nos. 1430 and 1529 together.
GP out of hours co-operatives are private organisations. The HSE provides significant funding to support out of hours co-operative services through service level agreements. The HSE maintains contact with all out of hours service providers.
In preparation for the increased demand for general practitioner services over the winter period, the HSE Winter Plan 2022/23 provides an additional €10 million in funding to support general practice including GP out-of-hours services. Additional GP supports have been made available to enable GPs to extend existing clinics or run additional clinics practices during weekday evenings and Saturday mornings.
The funding for GP out of hours service providers through a grant arrangement, which was introduced from March 2020, has been increased and additional funding is being provided to co-operatives to enable them to roster additional doctors, local GPs and locum doctors, in out of hour treatment centres from 6pm to 10pm. This will allow more patients to be seen by GP out of hours co-operatives, helping reduce the number of persons attending Emergency Departments.
1431. Deputy Barry Cowen asked the Minister for Health if he will provide an update on the case of a person (details supplied); and when the person can expect an appointment. [1243/23]
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.
1432. Deputy Pearse Doherty asked the Minister for Health if the supplementary medications and treatment required for chronic Lyme disease will be covered by the general medical scheme and the drug treatment scheme; and if he will make a statement on the matter. [1244/23]
View answerThe Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
In line with the 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. Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.
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. HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE). The Minister for Health has no role in these decisions.
Lyme disease is a tick-borne infection that occurs when recreational or occupation activities result in tick bites from an infected tick. It is relatively rare with estimations that a small proportion of ticks in Ireland are infected.
All patients symptomatic of Lyme disease should be treated with appropriate antibiotics. Appropriate antibiotics minimise the likelihood of the development of late stage infection and long-term complications of Lyme disease through a) post-exposure prophylaxis or b) early treatment of erythema migrans.
Further information can be found at: www.hse.ie/eng/services/list/2/gp/antibiotic-prescribing/conditions-and-treatments/skin-soft-tissue/lyme-disease/.
The following treatments, as outlined on the HSE webpage below, are available on the Reimbursement List for the treatment of Lyme Disease:
- Doxycycline
- Amoxicillin
- Azithromycin
