Written Answers Nos. 405-410
405. Deputy Bernard J. Durkan asked the Minister for Health the extent to which any shortcomings in the health services such as overcrowding at accident and emergency departments, lack of adequate accommodation, insufficient numbers of staff at various levels have been addressed throughout the health services, with a view to meeting the concerns of the public and internal staff; and if he will make a statement on the matter. [18867/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
406. Deputy Bernard J. Durkan asked the Minister for Health the extent to which women's health specifically remains central to the provision and delivery of a reliable level and quality of health services in all areas throughout Ireland; and if he will make a statement on the matter. [18868/23]
View answerProgressing women’s health is a priority for myself and for this Government. We made a strong commitment to Promoting Women’s Health in the Programme for Government 2020 and are fully committed to the continued development and improvement of women’s health services and to working with women and girls to improve their health and experiences of healthcare across the whole life cycle.
Underscoring our commitment to women’s health was the establishment of a Women’s Health Taskforce in September 2019 to improve both health outcomes and experiences of healthcare for women and girls. The Women’s Health Taskforce continues to work with the National Women’s Council of Ireland and the European Institute of Women’s Health to prioritise different issues each year with the aim of improving women’s health outcomes and experiences. Critical to this work is the process of listening to women - the Taskforce has so far listened to, engaged with and worked with thousands of women and hundreds of organisations representing women and girls across the country and commits to continued listening.
The Women’s Health Action Plan 2022-23 was published on 8 March 2022, marking International Women’s Day. The Action Plan identifies key actions to improve health outcomes and experiences for women in Ireland. It provides the foundation to address women’s whole health and help ensure that action on women’s health looks beyond reproductive health to make a real difference to women’s lives.
Prioritisation of women’s health is further supported through the significant investment contained within Budget 2022 and 2023, which allocated €31m and €69.2m respectively in funding for new developments in Women's Health. This includes:
2022:
• €8.66 million additional funding for the National Maternity Strategy.
• €9 million to fund access to free contraception for women aged 17-25.
• €5.3 million to grow access to “see and treat” gynaecology clinics; specialist menopause clinics; and specialist endometriosis services.
• €1.34 million to support initial establishment of a perinatal genetics service.
• €0.71m investment in tackling period poverty for the first time.
• €0.54million to establish an expert Obstetric Event Support Team to support services and sites that report severe maternity incidents
• €0.25m additional investment in Sexual Assault Treatment Units.
• €10m Women’s Health Fund, supporting implementation of key priorities for women's health.
• 2023:
• €11.7 million to provide access to publicly funded IVF treatment.
• Elimination of VAT on HRT and period products.
• Expansion of the Free Contraception Scheme to cover women aged 30 and under.
• €10million investment in the Women’s Health Fund to continue support for women’s health priority areas.
• €0.9m investment in the development of Women’s Health Hubs, for the holistic provision of women’s healthcare.
Prioritisation of women’s health in our service provision is seen in the completed and ongoing work happening to improve healthcare for women across the country. There have been a number of key developments since the establishment of the Women’s Health Taskforce and the Women’s Health Action Plan 2022-23.
• Contraception: A scheme to provide free contraception to women aged 17-25 was launched successfully on 14 September 2022 and was expanded to include 26-year-olds on 1 January 2023. Budget 2023 has allocated funding to support the scheme and work is underway expand it to women under 30 in 2023.
• Menopause: 6 Specialist Menopause Clinics to treat complex symptoms of Menopause, with 5/6 clinics currently open and operational. A GP Quick Reference Guide on Menopause was launched in October 2022 to support primary care practitioners in treating menopause and referring patients to Specialist Clinics. The first National Menopause Awareness Campaign (Radio, Online, Print, TV) was launched by the Department of Health to raise awareness and “lift the taboo” around menopause. Gov.ie/menopause was launched as a one-stop shop for information about menopause and its symptoms as well as advice on proactive management. Removal of VAT from HRT in Budget 2023.
• Fertility: 6 Regional Fertility Hubs are being established to provided tailored, low-level intervention for patients with fertility issues. Investment to support publicly-fund Assisted Human Reproduction has also been allocated and will see the first National Advanced AHR Centre established.
• Gynaecology: A network of 21 “see and treat” ambulatory gynaecology clinics are in development, where an estimated 70% of general gynaecology referrals are suitable for management. 12 Ambulatory Gynae Clinics are currently open and operational, with additional clinics in development. The national network will improve access to services and help to reduce the requirement for multiple gynaecology appointments, ensuring sustainability of service provision into the future given the significant waiting lists for this specialty; and will, ultimately, help improve clinical outcomes.
• Endometriosis: Delivering two, first-of-their-kind, Specialist Endometriosis Centres for complex care located in Cork University Maternity Hospital and Tallaght University Hospital. A National Framework for Endometriosis care is being developed, which sets out for the first time a defined clinical care pathway for women with endometriosis. In 2022, the Women's Health Fund invested in five additional interdisciplinary teams to support holistic treatment of endometriosis within the maternity networks. These will form a network of regional endometriosis hub services that will co-ordinate care within their respective Hospital Groups and support the complex services in Tallaght and Cork.
• Maternity: €8.66m was allocated to the National Maternity Strategy in 2022, providing for further development of community midwifery services, expansion of breastfeeding supports, improved access to allied and specialised services and strengthened training and education supports for staff. This investment is also improving the infrastructure of our maternity services by providing additional home-from-home birthing suites and upgrades to theatres and wards.
• Mental Health: The Women’s Health Fund provided investment in 2022 to support a range of services for women and girls, including digital mental health services access, improving perinatal mental health supports, enhancing specialist eating disorder supports, providing targeted mental health supports for marginalised women and women in addiction and responding to the needs of young girls at risk of developing psychosis.
• The Women’s Health Fund has invested in a range of service areas, responding to the needs of women in year. Areas include cancer screening and immunisation, primary care supports, maternity services and postnatal hubs, gynaecology, mental health and supports for marginalised groups.
• Period Poverty: Removal of VAT from period products in Budget 2023. Funding of €714,000 was allocated for period poverty initiatives in Budget 2022, this funding was then increased in 2023 to €814,000. This funding supports period dignity measures rolled out in partnership with the HSE, local authorities and NGOs. The Healthy Ireland Survey, 2022, included a module on menstrual health and period poverty, finding that 51% of women currently having periods experience disruption to participating in daily life (work, school, sports, social events) as a result of symptoms, and that 24% have experience of period poverty.
In the longer-term, through a population health approach championed in the Sláintecare report, we will be planning services around the health and social care needs of our entire population. Factors that will inform this include age, socioeconomic status, disability status, health care utilisation patterns, ethnicity, and gender. The insights gained from this will form an evidence base that will inform future service planning, workforce planning, review of eligibility, and capital planning. The service needs of women will be considered as part of all this.
Implementation of the services listed above represents significant development and advancement for women's health nationwide, but this remains a work in progress. I am committed to the full implementation of the Women's Health Action Plan 2022-23 and will continue to drive progress in all areas of women's health to fulfil its mandate into the future.
407. Deputy Bernard J. Durkan asked the Minister for Health the priorities of his Department in the current year with a view to ensuring a high quality of hospital and community care service at all levels; the extent to which particular areas of sensitivity are being targeted with a view to resolution; and if he will make a statement on the matter. [18869/23]
View answerMy Department’s overall priority in 2023 is to progress the programme of strategic reform set out in the Programme for Government and Sláintecare so as to ensure the provision of a public health service which provides people with access to high quality, affordable care when they need it. A summary of the main priorities for 2023 in the acute hospital and community care services is provided below.
One of the top priorities this year is the full delivery of the Waiting List Action Plan, which was launched in March 2023 as the next stage of the multi-annual approach to reducing waiting lists and waiting times. My Department is also fast-tracking the development of new elective surgical hubs in Cork, Dublin, Galway, Limerick and Waterford to address shorter term capacity demands. There will also be a continued emphasis on Women’s Health in 2023, including progressing the implementation of the National Maternity Strategy and the further development of gynaecology services. The implementation of other important national strategies will also be progressed, including the National Cancer Strategy, the National Trauma Strategy, Strategic Reform of Pre-Hospital Emergency Care and the Strategic Plan for Critical Care. Furthermore, 2023 will see progress on the reform of Paediatric Services in preparation for the transition to the New Children’s Hospital, as well as the development and reform of Organ Donation and Transplant Services.
One of the main priorities this year in the area of Primary Care is the continued implementation of the Enhanced Community Care (ECC) Programme, which integrates health care responses between acute and community settings and re-orients the focus of service delivery towards primary and community care. Work will also continue on the delivery of the GP direct referral pathway to diagnostics, so that patients can access these tests quickly and without seeing a consultant or having to attend hospital.
A further priority in 2023 is to continue to progress community healthcare initiatives in the area of older persons services (including dementia care). Funding has been provided this year for the continued development of home support services, in order to help older people and people with disabilities to live well and safely in their own homes and communities.
In the area of mental health, implementation of Sharing the Vision, the national mental health strategy, and Connecting for Life, the national suicide reduction strategy, will continue in 2023. A particular area of attention for my Department and the HSE is to improve access to the Child and Adolescent Mental Health Service (CAMHS) and to reduce waiting lists. Accordingly, additional funding has been provided under Budget 2023 to allow for a continued focus on waiting list reduction.
The HSE’s National Service Plan for 2023 sets out in full the type and volume of services that the HSE will provide this year, and I refer the Deputy to the NSP for more detailed information.
408. Deputy Bernard J. Durkan asked the Minister for Health his plans to continue the ongoing need to upgrade the health services to meet the needs of an increasing population including the shortage of GPs, the need to retain staff at all levels and the ability to meet any challenges that might arise throughout the year; and if he will make a statement on the matter. [18870/23]
View answerThe Government is committed to the implementation of Regional Health Areas (RHAs), as outlined in the Programme for Government. The establishment of RHAs involves the creation of six regional organisations with full responsibility for the planning and delivery of hospital, community, and social care services within their respective areas. These new arrangements will improve the health service’s ability to deliver more joined-up, integrated care for patients that is planned and funded in line with regional and local needs.
It is proposed to undertake detailed profiling of health and social care needs to establish a basis for population planning and the development of integrated care plans. An IGEES Spending Review has recently been published which outlines a model proposal for informing the allocation of funding and resourcing according to population needs.
In relation to the availability of GPs, the Government has undertaken several measures to improve the number of GPs working in the State and ensure patients continue to have access to GP services across 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 also been provided for. In addition, the enhanced supports package for rural GP practices was increased by 10%.
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.
There has been unprecedented growth in all staff categories in the Health Service over recent years. In February the total workforce stands at 139,186 WTE. This is an increase of 1,441 WTE from December figures. In 2020, 2021 and 2022 the HSE achieved the three largest increases in the workforce since the foundation of the HSE. This expansion is continuing in 2023 with an expected growth of 6,000 WTE. There are 19,369 more WTE working in our health service than there were at the beginning of 2020. This includes 6,201 nurses and midwives; 3,047 health and social care professionals; and 1,805 doctors and dentists. Work is ongoing to improve retention policies, speed up recruitment processes and to add more educational places to expand the workforce to the largest extent possible.
The Department and the HSE are working together to increase the supply of healthcare professionals across all professions. The HSE is focused on retention of existing HSE staff and maximising the number of health care graduates from Irish colleges entering the public health services.
The HSE are targeting all nursing, midwifery and health and social care graduates across all Irish colleges with the offer of permanent positions in the HSE, together with competitive relocation packages to entice our graduates from previous years home.
The HSE is expanding its international reach with innovations such as the development of the Medical Consultant Hub which is promoted internationally and also developing attraction strategies specific to each grade category and the strategies will include promoting the full extent of career opportunities available within the HSE.
409. Deputy Bernard J. Durkan asked the Minister for Health when a full medical card might be provided in the case of a person (details supplied); and if he will make a statement on the matter. [18871/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
410. Deputy Bernard J. Durkan asked the Minister for Health the reason a person (details supplied) cannot qualify for a full medical card; and if he will make a statement on the matter. [18873/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
