Written Answers Nos. 1617-1636
1617. Deputy Matt Carthy asked the Minister for Health the inpatient services and inpatient surgical services that are available at Nenagh hospital; the number of days that a patient can remain at the hospital; and if he will make a statement on the matter. [1860/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1618. Deputy Matt Carthy asked the Minister for Health the inpatient services and inpatient surgical services that are available at Ennis hospital; the number of days that a patient can remain at the hospital; and if he will make a statement on the matter. [1861/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1619. Deputy Matt Carthy asked the Minister for Health the inpatient services and inpatient surgical services that are available at Bantry hospital; the number of days that a patient can remain at the hospital; and if he will make a statement on the matter. [1862/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1620. Deputy Matt Carthy asked the Minister for Health the inpatient services and inpatient surgical services that are available at Mallow hospital; the number of days that a patient can remain at the hospital; and if he will make a statement on the matter. [1863/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1621. Deputy Matt Carthy asked the Minister for Health the inpatient services and inpatient surgical services that are available at Dundalk hospital; the number of days that a patient can remain at the hospital; and if he will make a statement on the matter. [1864/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1622. Deputy Matt Carthy asked the Minister for Health the inpatient services and inpatient surgical services that are available at Ballinasloe hospital; the number of days that a patient can remain at the hospital; and if he will make a statement on the matter. [1865/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1623. Deputy Matt Carthy asked the Minister for Health the inpatient services and inpatient surgical services that are available at Clonmel hospital; the number of days that a patient can remain at the hospital; and if he will make a statement on the matter. [1866/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1625. Deputy Alan Kelly asked the Minister for Health when construction of the Tullow primacy care centre, serving Tullow, Rathvilly and Hacketstown, will commence; the current status of the project; and if he will make a statement on the matter. [1868/23]
View answerAs the Health Service Executive (HSE) holds responsibility for the provision, along with the maintenance and operation of Primary Care Centres, I have asked the HSE to respond directly to the Deputy as soon as possible.
1626. Deputy Willie O'Dea asked the Minister for Health if he will provide statistics on excess mortality rates in Ireland for each of the years 2019 to 2022; if there is a clear and significant increase in excess mortality, if he intends to initiate an investigation into the causes of these excess deaths; and if he will make a statement on the matter. [1870/23]
View answerThe Department of Health does not produce estimates of excess mortality. However, the Department closely monitors estimates of excess mortality which are published by a range of different sources.
Ireland continues to participate in EuroMOMO, a European mortality monitoring activity, aiming to detect and measure excess deaths related to seasonal influenza, pandemics and other public health threats. In addition, the Department of Health and the HSE keep under review a range of population health and epidemiological indicators to assess the impact of health threats in Ireland.
Excess mortality is an epidemiological indicator which can provide information on the burden of mortality. It compares actual mortality rates, with some baseline for ‘expected’ mortality. Excess mortality can be used to estimate the impact of seasonal influenza, heatwaves, natural disasters, COVID-19 etc. on mortality rates. Estimates of excess mortality provide an estimate whether deaths were above or below the ‘expected’ level but there may be a number of different factors contributing to this.
There is no single source of data on excess mortality. A large number of different methodologies have been developed and refined by organisations and academics internationally to attempt to estimate levels of excess mortality. Work in this field has increased during the COVID-19 pandemic.
Estimation methods vary in relation to, for example, the years used to estimate the baseline, the extent to which demographic change (population growth, ageing etc) is taken into account, the models used for estimation. Different sources can also report excess mortality using different indicators e.g. as the percentage difference from a ‘baseline’, a z-score, a rate per 100,000 population, a number of excess deaths. All estimates include caveats on the methodology and some provide estimates within a range.
Given the differences in methodology, the Department of Health monitors and reviews a wide number of different sources for estimates of excess mortality. It is not therefore possible to provide a single set of statistics on excess mortality. Below is data from a number of sources which are monitored by the Department:
EuroMOMO
EuroMOMO www.euromomo.eu/ is a European mortality monitoring activity, aiming to detect and measure excess deaths related to seasonal influenza, pandemics and other public health threats. It has been reporting excess mortality data since 2016. Official national mortality statistics are provided weekly from the 29 European countries or subnational regions in the EuroMOMO collaborative network.
The Health Protection Surveillance Centre (HPSC) submits weekly data on behalf of Ireland based on deaths registered with the General Register Office (GRO). The EuroMOMO methodology is explained here www.euromomo.eu/how-it-works/methods/
EuroMOMO publishes estimates of excess mortality on a weekly basis. Graphs for all participating countries including Ireland are available here www.euromomo.eu/graphs-and-maps EuroMOMO estimates of excess mortality are based on z-scores and indicate if mortality in a week is within the normal range or if there is a ‘substantial increase’ above baseline.
(Chart 1 from Euromomo.eu). In the period 2019 – 2022, EuroMOMO shows that Ireland experienced a ‘substantial increase’ (that is moderate or high excess mortality) in two periods – during weeks 14-17 2020 and during weeks 2–6 2021. EuroMOMO estimates that Ireland has not experienced a ‘substantial increase’ in mortality during 2022. During the 2019-2022 period, there were also a number of weeks when mortality in Ireland was below the normal range.
EuroMOMO estimates that a number of European countries did experience high excess mortality during summer 2022 influenced by excessive heat e.g. Spain, Germany, England, Portugal.
Eurostat
Eurostat publishes monthly estimates of excess mortality for EU countries. This data only incudes estimates from January 2020 onwards and does not include data for 2019. The purpose is to estimate the impact of the COVID-19 pandemic on mortality in the EU.
Eurostat use the following methodology, ‘The excess mortality indicator simply takes the number of people who died from any cause, in a given period, and compares it with a historical baseline from previous years in a period which was not affected by the pandemic. In this case, the baseline consists of the average number of deaths that occurred in each month during the period 2016-2019’.
In relation to data for Ireland, it is important to note the following caveat provided by Eurostat, ‘Data from Ireland were not included in the first phase of the excess mortality release: official timely data were not available because deaths in Ireland can be registered up to three months after the date of death. Because of the COVID-19 pandemic, the Central Statistics Office (CSO) of Ireland began to explore experimental ways of obtaining up-to-date mortality data. At the end of April 2021, CSO started publishing a time series from October 2019 until the most recent weeks, using death notices (see CSO website). For the purpose of this release, Eurostat is comparing the new 2020-2021 web-scraped series with a 2016-2019 baseline built using official data. CSO is periodically assessing the quality of these data.’
Therefore, in the estimates for Ireland the latest monthly data on deaths (from the new web-scaped series (provide by the CSO from rip.ie)) is compared with official mortality data based on death registrations with the GRO for the baseline 2016-2019 period and caution is required in interpreting this indicator.
The latest data is available here ec.europa.eu/eurostat/statistics-explained/index.php?title=Excess_mortality_-_statistics#Excess_mortality_in_the_EU_between_January_2020_and_October_2022
(Chart 2 from Eurostat.eu). Eurostat report excess mortality as the percentage difference between the mortality in a particular month and the baseline (average 2016-2019). Based on the Eurostat methodology, it is estimated that Ireland experienced excess mortality of 20% or more above baseline in April 2020 and January 2021. Ireland is estimated to have experienced excess mortality of 10-20% in February 2021, July-November 2021 and May-October 2022. Ireland is estimated to have experienced mortality below the baseline in 9 of the 34 months between January 2020 and October 2022.
CSO
The CSO has published a number of experimental analyses as part of their ‘Frontier Series’ using data from the website www.RIP.ie as a more-timely source of trends in mortality. These are not official mortality statistics. The CSO have estimated monthly excess mortality.
The latest release was published on 24 February 2022 examining data to the end of 2021. ‘Measuring Mortality Using Public Data Sources 2019-2021 (October 2019 - December 2021)’ which is available here www.cso.ie/en/releasesandpublications/fb/b-mpds/measuringmortalityusingpublicdatasources2019-2021october2019-december2021/. The CSO provide a number of methodological caveats to their analysis.
(Chart 3 from Cso.ie). The CSO methodology is based on death notices which appeared on rip.ie. It compares a 4-year average baseline (2016-2019) with death notices during 2020 and 2021. It estimates excess death notices of 10% or greater in April 2020, January-February 2021 and August-November 2021. The CSO has not published analysis for 2022.
The Lancet
A study published in The Lancet in April 2022 indicated that excess mortality rates varied substantially in western Europe, with estimated rates in some countries almost as high as those for countries in other global regions.
Ireland was among several European countries (including Iceland, Norway, and Cyprus) which had some of the lowest rates in the world, at less than 50 excess deaths per 100,000 population. Based on the Lancet publication, which does include a number of methodological caveats, Ireland had the third lowest estimated excess mortality rate amongst western European countries for the relevant study period (1 January 2020 to 31 December 2021). www.thelancet.com/article/S0140-6736(21)02796-3/fulltext
WHO
WHO published (5 May 2022) a report estimating ‘Global excess deaths associated with COVID-19, January 2020 - December 2021’. This report estimated excess mortality associated directly (due to the disease) or indirectly with the COVID-19 pandemic (e.g. due to the pandemic’s impact on health systems and society) between 1 January 2020 and 31 December 2021. The report is available here www.who.int/data/stories/global-excess-deaths-associated-with-covid-19-january-2020-december-2021
(Chart 4 Department of Health from WHO). The WHO report estimated that Ireland had an excess all-cause mortality rate of 9 (95% confidence interval of -1 to 17) per 100,000 population in 2020 and 50 (95% confidence interval of 40 to 60) per 100,000 population in 2021. The estimated average excess all-cause mortality rate for Ireland 2020-2021 is 29 (range 23 to 36) per 100,000 population. In Ireland the highest excess deaths were recorded in April 2020 and January 2021. Ireland experienced mortality below what would be predicted based on the WHO model during ten of the 24 months of 2020 and 2021.
The WHO report indicated that Ireland appears to have experienced lower excess mortality during the COVID-19 pandemic than many other countries in Europe and globally.
In a follow-up paper by Msemburi et al published in Nature in December 2022 entitled ‘The WHO estimates of excess mortality associated with the COVID-19 pandemic’, the authors note that in general, one can rarely simply look at the excess rate and associated rankings and make statements concerning the manner in which a country dealt with the pandemic, as there are many factors at play. These include: the age structure of the population, the population density and cultural practices, the government responses during different periods of the epidemic, how the population responded to government actions, and the infectiousness and fatality rates of the various variants that were present at different times.
However, these authors analysed WHO mortality data and report a comprehensive and consistent measurement of the impact of the COVID-19 pandemic by estimating excess deaths, by month, for 2020 and 2021. The authors describe a measure known as a P-score. The P-score is defined as the ratio of the excess to the expected deaths, expressed as a percentage. The P-score implicitly considers both the size and the age structure of the population.
This analysis shows Ireland had one of the lowest P-score rates in the EU, with only five other EU/EEA countries having a similar or lower rate. The report also highlights the comprehensiveness of the Irish all-cause mortality data.
There is a very clear national commitment to continue to learn from our experience of the COVID-19 pandemic and to ensure that our public health-led approach evolves as necessary, reflecting national and international evidence and learning.
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. This will help ensure that we are in a better, stronger position if another pandemic or another similar type emergency arrives. It is intended that this will be established in 2023. The Terms of Reference and working arrangements of an evaluation process would be a matter for Government.
1627. Deputy Bernard J. Durkan asked the Minister for Health if an application for the fair deal scheme can be reassessed in the case of a person (details supplied); and if he will make a statement on the matter. [1891/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1628. Deputy Colm Burke asked the Minister for Health if the eligibility criteria under the drugs payment scheme will be widened for the drug known as saxenda in order that patients who meet two of four criteria (details supplied) will meet the requirements of the scheme; and if he will make a statement on the matter. [1895/23]
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.
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.
The HSE considers the NCPE assessment, the outputs from commercial engagements, patient interest group submissions, and any other pertinent information in advance of making a reimbursement decision.
The HSE has approved reimbursement for Liraglutide (Saxenda®) 6 mg/ml solution for injection in pre-filled pen under the community drug schemes from 1st January 2023.
This product is approved for reimbursement on the basis of managed access. Reimbursement under the community drug schemes is for adults prescribed Liraglutide (Saxenda®) 6 mg/ml solution for injection in pre-filled pen as an adjunct to a reduced-calorie diet and increased physical activity for weight management, with an initial body mass index of 35 kg/m2 with prediabetes and high-risk of cardiovascular disease.
The relevant circular (002/23) from the HSE can be accessed at: www.hse.ie/eng/staff/pcrs/circulars/pharmacy/pharmacy-circular-002-23-saxenda.pdf.
1629. Deputy Robert Troy asked the Minister for Health the reason that staff in dental practices have not yet been eligible for the HSE Covid bonus payment; and if he has plans to rectify this matter. [1900/23]
View answerLast year, the Government announced a once-off, ex-gratia COVID-19 pandemic recognition payment for frontline public sector healthcare workers, to recognise their unique role during the pandemic. Following extensive engagement with healthcare unions on the matter, on 19th April last the HSE published eligibility guidelines and FAQs, as apply to the HSE and Section 38 agencies, which are available on its website: www.hse.ie/eng/staff/resources/hr-circulars/hr-circular-012-2022-pandemic-special-recognition-payment.html. Certain specific other cohorts are covered for the payment, as detailed below:
1. Private Sector/Independent Nursing Homes and Hospices
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. Redeployed members of Department of Defence to work in frontline Covid-19 exposed environments in the HSE;
6. Paramedic staff employed by Dublin Fire Brigade to deliver services on behalf of the HSE.
The cohorts listed above are the only ones in scope for this payment, and there are no plans to expand the list of included cohorts, which was prepared on foot of careful consideration by the Government. I am mindful of other workers who played an important role during this challenging period in sustaining important services. It was very difficult to draw a line on this matter, but the Government based its decision on the risks which eligible healthcare workers faced.
While undoubtedly immense efforts have been made by other healthcare staff, other sectors and by the general public since the onset of this pandemic, it is right that the Government pursue this course to recognise those at greatest risk in the performance of their duties.
Settings which were not unavoidably-COVID-19-exposed environments are not considered to be covered by the Government decision. For certain settings, service users with COVID-19, COVID-like symptoms, close contact, and/or foreign travel history could be advised not to attend. Service users in such settings may have been advised to postpone or to phone/consult online instead in some instances. In light of the potential to advise some service users not to attend, these types of environment are considered to have been much more controllable to prevent COVID-19 exposure, compared to eligible environments (such as nursing homes, acute hospital wards, etc).
The Government notes that some private sector healthcare employers have already recognised their frontline workers for their extraordinary efforts during the pandemic. I would encourage those other private sector healthcare employers who have not done so to adopt appropriate measures to recognise their employees.
In recognition of the efforts of all workers, volunteers, and the general public during the COVID-19 pandemic, and in remembrance of people who lost their lives due to the COVID-19 pandemic, the Government announced a public holiday which took place on 18 March 2022. From February this year there will also be a new permanent public holiday established to mark Imbolc/St Brigid’s Day.
1630. Deputy Niamh Smyth asked the Minister for Health the reason that a person (details supplied) has been waiting so long for surgery in St. James’s Hospital; and if he will make a statement on the matter. [1901/23]
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.
1631. Deputy Neasa Hourigan asked the Minister for Health if he is in receipt of the independent review of the legislation on Health (Regulation of Termination of Pregnancy) Act 2018. [1907/23]
View answerThe Minister for Health commenced the Review of the operation of the Health (Regulation of Termination of Pregnancy) Act 2018 in line with statutory and Government commitments.
The Review is assessing the effectiveness of the operation of the legislation and will be conducted in a fair and transparent manner.
The Review is being led by an independent Chair Marie O’Shea and comprises of 2 main phases. As part of the first phase of the review, information, and evidence on the operation of the Act has been collected from women who use the service, and from health professionals that provide the service; the views of the public were also sought.
A very substantial amount of work has been completed to date and very informative data collected, which is feeding into the review.
The Chair is awaiting key research from a study, CORALE, being carried out at Trinity College Dublin, that is examining Section 22 of the Act regarding conscientious objection. This research is underway, with input from lawyers, hospital doctors, GPs and strategic managers. The data will inform the Review. However, as this data will only become available in January 2023, there has been a slight set back in completion time. The opinion of the Chair is that this data is vitally important, given that it will assist in ?understanding how section 22 is operating.
It is the intention that the review will be made available to the Minister no later than the 7th February 2023.
1632. Deputy Pádraig Mac Lochlainn asked the Minister for Health when an application for the special recognition pandemic payment award will be processed for staff at a nursing home (details supplied); and if he will make a statement on the matter. [1908/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
1633. Deputy Róisín Shortall asked the Minister for Health if consideration is being given to extending access to paxlovid to groups at the highest risk of serious illness or death from Covid-19, without the need for a positive Covid-19 test or symptoms of Covid-19; if his attention has been drawn to the decision in France to change the criteria for prescribing paxlovid (details supplied); his views on same; and if he will make a statement on the matter. [1914/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1634. Deputy Éamon Ó Cuív asked the Minister for Health the arrangements, if any, that will be in place to offer significantly reduced or free car parking in the National Children’s Hospital for families bringing children to hospital for frequent or prolonged stays; and if he will make a statement on the matter. [1931/23]
View answerAccess to the children's hospital at the St James's campus is well served by public transport, however the plans and design for the hospital recognise the need of families to access the hospital by car.
The plans for the hospital provide for 1,000 car parking spaces, of which 675 will be dedicated for use by families, three times the number of spaces currently available at the three Dublin children's hospitals combined. The car park will be located in the basement of the new children’s hospital.
I am cognisant of the financial implications of parking costs for patients and their families, particularly for those with long-term illnesses.
The Programme for Government: Our Shared Future, makes a commitment to introducing a maximum daily car parking charge for patients and visitors at all hospitals, where possible, and to introduce flexible passes in all public hospitals for patients and their families.
This commitment is informing the procurement process for the car park operator at the New Children’s Hospital.
1635. Deputy Éamon Ó Cuív asked the Minister for Health the number of annual inpatient cases attending the Mater hospital for cancer services in the years 2019 to 2021, in tabular form; and if he will make a statement on the matter. [1932/23]
View answerThe details requested by the Deputy are supplied in the table. In the period 2019-2021, the Hospital In-Patient Enquiry data from the Healthcare Pricing Office reports that there was an average of 2,509 discharges per year of inpatients with a principal diagnosis code indicating a neoplasm at the Mater Misericordiae Hospital, while a further 6,406 discharges on average per year have attended for neoplasm appointments on a day case basis.
|
- |
Total Inpatient and Day Case discharges with a principal diagnosis of 'Neoplasm' at the Mater Misericordiae University Hospital, 2019 - 2021 |
|||
|
|
2019 |
2020 |
2021 |
Average annual discharges for 2019-2021 |
|
Inpatient |
2,650 |
2,279 |
2,598 |
2,509 |
|
Day Case |
6,591 |
6,068 |
6,558 |
6,406 |
|
Total |
9,241 |
8,347 |
9,156 |
8,915 |
1636. Deputy Paul Murphy asked the Minister for Health if dentists who are struck off in the UK are permitted to practise in Ireland; the vetting procedures followed by the Dental Council of Ireland prior to registering dentists who are qualified abroad; if dentists are required to practise under the same name by which they registered with the Dental Council; and if he will make a statement on the matter. [1934/23]
View answerUnder Section 27(3) of the Dentists Act 1985, the Dental Council can refuse to register someone who is otherwise entitled to be registered on the grounds they are unfit to practise.
While a decision on a matter like this would ultimately be a matter for the Council and would depend on the circumstances concerned, the Dental Council advise it is unlikely that a dentist who has been erased for a misconduct issue in another jurisdiction would be registered by the Council. The Dental Council carries out a check on the good standing of all applicants for registration for all jurisdictions where the dentist practiced prior to applying for registration.
Dentists are obliged to practice under their registered name.
