Written Answers Nos. 1626-1640
1626. Deputy Maurice Quinlivan asked the Minister for Health about the case of a person (details supplied) who was referred by the Infectious Disease and OPAT Clinic at University Hospital Limerick for a CT scan and has since received an appointment for 3 May 2023 to discuss her CT Scan results despite not having had her CT scan; and if he will make a statement on the matter. [17535/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1627. Deputy Sean Sherlock asked the Minister for Health when a person (details supplied) in County Cork who was referred in 2018 will have a date for cataract surgery assigned to him. [17544/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1628. Deputy Emer Higgins asked the Minister for Health what care pathways are in place for under 18s requiring gender affirming care as a result of clinical psychologist diagnosed gender dysphoria; and if he will make a statement on the matter. [17546/23]
View answerAs this PQ refers to service delivery, I have referred this PQ to the HSE for direct reply.
1629. Deputy Emer Higgins asked the Minister for Health in the context of a person under 18 years of age who has been diagnosed with gender dysphoria by a clinical psychologist; what to do when they do not have access to a psychiatrist or endocrinologist due to a lack of care pathways; and if he will make a statement on the matter. [17547/23]
View answerIn 2020, a steering committee was established to address specific issues in relation to the development of transgender healthcare services. The committee had a wide range of stakeholders from the agencies involved in delivering care, as well as service user representatives, including a representative from TENI.
Further to the Cass Interim Report on the Tavistock Clinic, the HSE held an event recently with Dr Hillary Cass, which was attended by a wide range of stakeholders from the HSE, the Department of Health, Children’s Heath Ireland, the Ireland East Hospital Group and others involved in providing services for under 18's.
The HSE is committed to developing a seamless and integrated service for those with gender identity issues on an ongoing basis, with the support of all relevant stakeholders, and are focused on providing a high quality and safe service to an often extremely vulnerable patient group. Throughout this process, the HSE will be consulting with a wide range of stakeholders in the development of the new model of care. Including those who provide and use these services, and advocacy groups.
I am committed to the development by the HSE of a well-governed and patient-centred health care service for adults and children in the transgender community.
1630. Deputy Jennifer Murnane O'Connor asked the Minister for Health if there are plans to support GPs and dentists to begin to take on new patients covered by medical cards; and if he will make a statement on the matter. [17551/23]
View answerUnder the GMS scheme, the HSE contracts GPs to provide medical services without charge to medical card and GP visit card holders. Currently there are 2,539 GPs contracted to provide services under the GMS Scheme. Where a person who holds a medical card or GP visit card experiences difficulty in finding a GP to accept them as a patient, the person concerned having unsuccessfully applied to at least three GPs in the area (or fewer if there are fewer GPs in the area) can apply to the HSE National Medical Card Unit which has the power to assign that person to a GP's GMS patient list.
The Government is aware of the workforce issues currently facing general practice and is working to increase in the number of GPs working in the State, improving access to GP services for patients throughout the country.
Under the 2019 GP Agreement additional annual expenditure provided for general practice has been increased now by €211.6m. This provides for significant increases in capitation fees for participating GMS GPs, and new fees and subsidies for additional services. Improvements to GP’s maternity and paternity leave arrangements and a support for GPs in disadvantaged urban areas have been provided for, and the supports for rural GP practices have also been increased.
The number of doctors entering GP training has increased approximately ten percent year on year from 2019, rising from 193 in 2019 to 258 in 2022, and a further large increase is planned for this year. Following the transfer of responsibility for GP training from the HSE to the Irish College of General Practitioners (ICGP), it is aimed to have 350 training places available for new entrants per year by 2026.
Furthermore, I recently published the Terms of Reference for a Strategic review of General Practice which is to commence shortly and will be completed this year. The review, with input from key stakeholders, will examine the broad range of issues affecting general practice, and will set out the measures necessary to deliver a more sustainable general practice.
In regard to dentists, the Dental Treatment Services Scheme (DTSS) provides dental care, free of charge, to medical card holders aged 16 and over. Since May 1st 2022, there has been additional prevention treatments included and a 40-60% increase in fees for contractors across most treatment items. Since these measures came into effect, both the numbers of treatments and patients being seen have increased.
It is a top priority for myself and for the Government to improve patient access to oral healthcare services, both in the short term through the introduction of such measures, and in the long term through transformational reform of oral healthcare services in Ireland. This reform will be achieved through implementation of the National Oral Health Policy.
1631. Deputy Jennifer Murnane O'Connor asked the Minister for Health when Tullow, County Carlow will get a primary care centre; and if he will make a statement on the matter. [17552/23]
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.
1632. Deputy Jennifer Murnane O'Connor asked the Minister for Health for an update on the payment of the pandemic bonus; if all eligible to receive the payment have done so; the number in receipt of the payment by county; and if he will make a statement on the matter. [17553/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
1633. Deputy Jennifer Murnane O'Connor asked the Minister for Health what steps are being taken regarding the GMS dentistry service to provide a service for medical card holders which satisfies all stakeholders; and if he will make a statement on the matter. [17554/23]
View answerThe Dental Treatment Services Scheme (DTSS) provides dental care, free of charge, to medical card holders aged 16 and over. Since May 1st 2022, there has been additional prevention treatments included and a 40-60% increase in fees across most treatment items. Since these measures came into effect, both the numbers of treatments and patients being seen have increased.
I am aware that there are some towns with no or limited DTSS dentists that have sufficient capacity to accept new patients. Where access to a dentist is difficult, local HSE services assist patients who make enquiries and make lists of DTSS contractors available to medical card holders. In exceptional circumstances, the HSE assists patients to access emergency dental treatment by directly contacting private contractors or arranging treatment to be provided by HSE-employed dentists.
An additional allocation of €15 million has been made in Budget 2023 to enhance the provision of oral healthcare services. This includes €5 million allocated on a once-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 having difficulty accessing a local dentist.
The Government recognises that substantive reform of the DTSS is required, as set out in the National Oral Health Policy. The Department is working closely with the HSE to ensure the establishment of focused implementation structures for the Policy to drive implementation. These implementation structures include the need for new clinical leadership and reform leadership posts in the HSE for which resources will be provided. These implementation structures will help to substantively reform the provision of public oral healthcare services to all ages, in line with the National Oral Health Policy. This will include work on planning new services for medical card holders.
While it will take a number of years to bring reform to complete fruition, there will be an early emphasis in implementation on addressing the current issues, including the reform of the provision of services for medical card holders.
1634. Deputy Jennifer Murnane O'Connor asked the Minister for Health the steps his Department is taking to shorten significant delays in waiting lists for dental treatments for school children which require general anaesthesia to provide a service that assists the most vulnerable in society; and if he will make a statement on the matter. [17555/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1635. Deputy Jennifer Murnane O'Connor asked the Minister for Health the number of public only dentists in or serving County Carlow; the number of dentists in Carlow participating in the dental treatment services scheme/medical card scheme; and if he will make a statement on the matter. [17556/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1636. Deputy Jennifer Murnane O'Connor asked the Minister for Health if the €750,000 funding announced for trainee counselling psychologists will include support for current trainees or only those who begin their training in the 2023-2024 academic year; and if he will make a statement on the matter. [17558/23]
View answerAs the Deputy is aware, €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.
I am focussed on supporting counselling psychology students in an equitable way and that delivers value for money. The structure of this funding is currently being finalised by officials in the Department. The approach will be based on best practice and knowledge gained from other health and social care funded training models.
Further detailed discussions are now taking place between the Department and HSE to progress this. I hope to be in a position to announce the details shortly for academic year 2023-2024.
1637. Deputy Jennifer Murnane O'Connor asked the Minister for Health the status of the establishment of the inquiry into the historical licensing and prescribing of sodium valproate; the timeline that he is working towards in establishing this inquiry; and if he will make a statement on the matter. [17563/23]
View answerWhen I met with the patient groups involved with this issue, I supported their call for an inquiry into sodium valproate and I committed to making that happen. The delay in establishing this inquiry is as frustrating for me as for those impacted. During 2022 the Terms of Reference were agreed after close consultation with patient groups. However, after further cross Departmental engagement these needed to be re-drafted to ensure the inquiry could be delivered in a meaningful way within a reasonable timeframe. I am aware that amended Terms of Reference have been prepared, again with input from patient representatives. Steps are being taken within my Department to complete the policy documentation required to support this inquiry and to bring a memo to government seeking approval for the inquiry to commence. Completion of this work is important for me and I am committed to commencing this inquiry as soon as it is appropriate to do so.
This inquiry will be designed to give a voice to patients and their families while looking at the use of sodium valproate in Ireland since it was first licensed. It is important that enough time and resources are invested in completing this work. There are many factors to consider, and I want to ensure that the inquiry established delivers and allows those impacted to tell their story and my officials are working to ensure that this will be facilitated.
I would like to inform the Deputy that in parallel to the work on the inquiry a Valproate Stakeholder Group has been established by the Department to assess current systems in place around valproate use in women of childbearing potential. The Sodium Valproate Stakeholder Group met in November 2022, and recently held its second meeting. I look forward to monitoring the outcome of the work of this group.
1638. Deputy Pádraig O'Sullivan asked the Minister for Health for an update on the provision of adult ADHD services in CH04 - Cork covering North Lee, South Lee and North Cork; when these services will be fully in place; and if he will make a statement on the matter. [17570/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1639. Deputy Alan Farrell asked the Minister for Health the efforts his Department is making to develop multidisciplinary teams within GP services; and if he will make a statement on the matter. [17573/23]
View answer1640. Deputy Alan Farrell asked the Minister for Health the efforts his Department is making to increase the number of general practice nurses in the State; and if he will make a statement on the matter. [17574/23]
View answerI propose to take Questions Nos. 1639 and 1640 together.
GPs are private practitioners, and while most hold a GMS contract with the HSE for the provision of GP services without charge to medical card and GP visit card holders, as private practitioners GPs manage their own practices and may employ practice staff as they see fit and as suitable to the particular needs of their practice.
Under the GMS scheme, GPs are paid a subsidy towards the cost of employing a practice nurse and/or a practice secretary. The rate payable depends on the GP's GMS panel size and the level of experience of the nurse or secretary. A practice manager subsidy is also available. In addition, GPs working in rural areas who meet the qualifying criteria will qualify for an annual rural support allowance, a support is also available to GPs working in urban areas of deprivation, and contributions are made towards locum costs for various GP leave arrangements.
Furthermore, as provided for in Budget 2023, a significant package of additional practice supports is being prepared in the context of the expansion of eligibility for GP care without charges to people who earn the median household income or less.
There are currently approximately over 2,000 practice nurses in Ireland, although a portion of these work part-time in general practice. Practice nurses pay a key role in general practice and provide a wide range of services to patients. I'm delighted that University College Dublin have recently launched, with support from my Department and funding under Sláintecare, a new graduate diploma in Primary Care Nursing Practice. On a pilot two year basis, 60 students are to commence this course in September. The programme acknowledges the important role of practice nurses and nurses in primary care, and helps develops career pathways in general practice.
The Enhanced Community Care (ECC) programme also provides for patients to be referred by GPs on to other healthcare professionals as necessary, with care being provided locally in the community. Community Healthcare Networks facilitate the provision of multidisciplinary care to patients requiring access to primary care services such as occupational therapy, physiotherapy, speech and language therapy, psychology, dietetics, podiatry, and public health nursing services in the community setting. Referral by GPs to these services ensures that patients receive multidisciplinary care through an integrated and co-ordinated approach by these health and social care professionals.
I recently published the Terms of Reference for a Strategic review of General Practice which is to commence shortly and to be completed this year. The review, with input from stakeholders, will examine the broad range of issues affecting general practice, and will set out the measures necessary to deliver a better general practice. Capacity in general practice, the expansion and support of the GP team, and consideration for the development of other roles that would improve service delivery, are areas to be examined under the review.
