Written Answers Nos. 16-35
16. Deputy Mark Ward asked the Minister for Health for an update on extending of CAMHS services to young people up to the age of 25 years, as set out in Sharing the Vision; if there is a timeline for this extension of services; the training that will made available for staff in this transition; and if he will make a statement on the matter. [18207/23]
View answerRecommendation 36 of Sharing the Vision: A Mental Health Policy for All outlines that appropriate supports should be provided for on an interim basis to service users transitioning from CAMHS to General Adult Mental Health Services and that the age of transition should be moved from 18 to 25.
To this end, a Youth Mental Health Transitions Specialist Group has been established by the HSE to progress Recommendation 36 of Sharing the Vision. This Group convened in September 2021 and has met regularly since.
To work towards the delivery of this recommendation, two working groups were established with oversight provided by the Specialist Group. Workstream 1 is focused on the development of an enhanced transitions plan (including implementation plan) to support individuals transitioning from CAMHS to General Adult Mental Health Services at 18 years. Staff training, engagement, and support, is a key principle under which recommendations of this workstream will be delivered.
Workstream 2 is working towards the development of a reconfiguration plan, including prioritised and phased recommended actions, to plan for the provision of age-appropriate specialist mental health services up to age 25. Detailed actions have been developed by the workstreams, with associated timelines to measure progress and implementation.
The Specialist Group has progressed discussions on developing recommendations to provide age-appropriate mental health services for young people in a phased manner. This process has involved extensive consultation nationally and internationally and the commissioning of the University of Galway to conduct research to support the work of the group.
The HSE Specialist Group updates the Sharing the Vision National Implementation Monitoring Committee (NIMC) regularly submitting quarterly Status Reports on Transition, including associated timelines. The phased 2022-2024 milestones and outputs for Recommendation 36 are set out in the Sharing the Vision Implementation Plan 2022-2024.
17. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he and his Department have identified blockages in the delivery of health services in order to ensure a seamless access to health services, including accident and emergencies, GPs and all public health services without restriction; the action(s) already taken in this regard; the anticipated remedial effect(s); and if he will make a statement on the matter. [18530/23]
View answer19. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he and his Department continue to monitor, assess and remedy any shortcomings in the delivery of health services whether in regard to access to home care, general medical services, capacity requirements in whatever area, with a view to resolution in the short term in order to make the health services in this country a more attractive place to work; and if he will make a statement on the matter. [18531/23]
View answerI propose to take Questions Nos. 17 and 19 together.
A top priority for Government is to increase access to health services. The record growth in the health budget over successive budgets coupled with the expansion of the workforce is evidence of this commitment.
We are delivering this increased access through an unprecedented expansion in the capacity of our public health service in parallel with significant healthcare reforms.
The Deputy will know, from the Programme for Government and Sláintecare, that this Government is focused on the need to increase capacity across our health service and we are addressing this in a comprehensive way across all of our services.
Specific initiatives developed to enhance access to health services include increases in bed capacity, the implementation of the Waiting List Action Plan, the development of a three-year urgent and emergency care improvement programme, increasing home-care hours through enhanced investment and initiatives to support and increase numbers of GPs.
I have also deployed HSE Specialist teams to implement solutions in hospitals where there are issues impacting on access to services.
These actions are taking place in parallel with changes to the way health services are provided. These changes include the reform of Primary Care services through the Enhanced Community Care Programme, the establishment of Regional Health Areas and the implementation of the public-only consultant contract.
One of the key factors in increasing access is the continued growth and development of our workforce. Thanks to successive large increases in the health budget there are 19,369 more people working in our health service than there were at the beginning of 2020. This is an increase of 16%. A priority in the HSE is to attract and retain essential talent to meet the needs of our health service now and in the future.
18. Deputy Bríd Smith asked the Minister for Health if he can report on the review of the legislation on the Termination of Pregnancy Act; if he will bring proposals to Cabinet on foot of the review; and if he will make a statement on the matter. [17654/23]
View answerAs the Deputy is aware, the Review of the operation of the Health(Regulation of Termination of Pregnancy) Act 2018 commenced in line with statutory and Government commitments in December 2021.
The purpose of the Review was to assess the effectiveness of the operation of the legislation.
The Review comprised two phases. The first phase of the Review was an evidence and information gathering exercise which consisted of a public consultation, and research into the operation of the Act from the perspectives of both services users and service providers.
The second phase of the Review was led by an independent chair, Ms Marie O’Shea, B.L. who assessed the extent to which the objectives of the 2018 Act have been achieved, analysing in that regard the findings of the three strands of information from the first phase. The Chair also drew on the findings of other relevant peer-reviewed research and consulted with stakeholders as necessary before providing conclusions.
I can confirm that I have received the final Report of the Review in recent weeks. I would like to take this opportunity to thank the independent Chair, Marie O’Shea, for her dedication and hard work in preparing this extensive Report. I would also like to acknowledge and thank the stakeholders, service providers, services users, and the public for their input into this important document.
I had a productive meeting with the Chair in relation to her recommendations and have also had discussions with clinicians leading out on service delivery. Having reviewed the Report in detail I believe it is a good Report, which makes a range of recommendations most of which are operational in nature, with some proposing legislative change.
This comprehensive document is currently being examined in my Department and a memo will be brought to Government in the coming weeks.
Subject to Government approval, I expect to be in a position to publish the Review shortly thereafter.
20. Deputy Rose Conway-Walsh asked the Minister for Health to provide an update on any progress he has made in returning dentists to the DTSS; the total number of dentists in the system in 2020 and 2023; and if he will make a statement on the matter. [19034/23]
View answerThe Dental Treatment Services Scheme provides care to adult medical holders over 16 years. In April 2020 there were 1651 DTSS contractors registered on the Scheme. This declined to 1253 in April 2022. I approved measures from May 2022 providing for increased preventative care and increasing the fees paid to dentists for most treatment items by 40-60%. This has improved access, and both the numbers of patients and treatments have increased since May.
However, medical card holders in some areas continue to have difficulty accessing care. Therefore, I have allocated €5 million this year to support the HSE Public Dental Service to provide emergency care to adult medical card holders who are having difficulty accessing a local dentist. This funding is part of an additional €15m to improve oral healthcare services this year, which will also help to address waiting lists.
Fundamentally the scheme needs to be modernised and so I have funded the appointment of clinical leadership and reform leadership roles to progress this review of the scheme aligned with the National Oral Health Policy; Smile agus Sláinte.
There are people with medical cards throughout the country who could and should be treated under the DTSS. I am asking dentists to work with me on the basis of the very significant fee increase I have already given and provide care for their DTSS patients, recognising that we are committed to moving towards a more modern service.
21. Deputy Mark Ward asked the Minister for Health his views on the increase in CAMHS waiting lists since June 2020; the measure that are being taken to reduce CAMHS waiting lists; and if he will make a statement on the matter. [18208/23]
View answerThis Government remains committed to developing all aspects of mental health services nationally, including CAMHS. Over €1.2 billion has been provided this year for mental health, and dedicated funding for CAMHS is administered as part of the overall HSE Mental Health allocation each year. A central priority is to improve access to CAMHS and to reduce waiting times.
CAMHS teams receive and triage nearly 21,000 referrals annually and deliver 225,000 appointments for children and young people requiring assessment and intervention each year. Demand for CAMHS services have increased nationally over recent years. Between 2020 and 2021, CAMH services experienced a 33% increase in demand, while simultaneously seeing 21% more cases during the same period.
CAMHS waiting times are also impacted by a variety of factors, including but not limited to staff recruitment and retention challenges, and the capacity in other parts of the system to provide more appropriate services.
The waiting list to access CAMH services has increased from 2,755 in December 2020 to 4,434 at end February 2023. While these waiting times are concerning, it should be noted that access to CAMHS is based on prioritised clinical assessment, and in 2022 almost 93% of urgent referrals were responded to within three days.
All aspects of CAMHS are being developed under the HSE Service Plan 2023. In addition, a waiting list initiative is also underway through the Waiting List Action Plan, specifically targeting areas where children and young people are experiencing long waiting times.
22. Deputy Richard Bruton asked the Minister for Health if he has received a work plan from the National Treatment Purchase Fund on its waiting list initiative plans for 2023; and if he will indicate the key targets. [18547/23]
View answerThe 2023 Waiting List Action Plan was published on 7th March and is the next stage of the multi-annual approach to reduce and reform waiting lists and times. It allocates €363 million in funding across 30 actions to be implemented by the HSE and NTPF to reduce acute scheduled care waiting lists by 10% this year and to continue implementing long-term reforms.
Under the Plan, additional once-off funding of €50 million was provided to the NTPF, bringing its 2023 budget to €150 million for addressing hospital waiting lists. NTPF waiting list activity will encompass support for public hospitals to treat more patients, commissioning care in private hospitals, administrative and clinical validation, data quality, and systems and process development.
In 2023, the NTPF targets under the Plan are to arrange 110,000 new OPD appointments, 40,000 IPDC procedures and 18,500 GI scopes in public and private hospitals. In addition, the NTPF will aim to arrange 65,000 diagnostics and carry out administrative validation that is estimated to remove 146,100 people from waiting lists.
While the NTPF will seek to arrange over 150 different types of procedures in public and private hospitals, there will be a focus on 20 high-volume procedures, including cataracts, hip and knee replacements, for which the NTPF will offer treatment for all clinically suitable patients waiting more than three months.
23. Deputy Robert Troy asked the Minister for Health when changes will be made to the fair deal scheme to incentivise long-term nursing home patients to rent out their homes; and if he will make a statement on the matter. [17945/23]
View answerEffective from 1 November 2022, the amount of rental income that nursing home residents can retain under the Fair Deal from renting their principle private residence increased from 20% to 60%.
Prior to the November 2022 changes being implemented, participants in the Fair Deal scheme were able to rent out their homes or other assets, but rental income was subject to assessment at 80% like all other income, such as pension income.
Recognising that this may act as a disincentive against renting out a property, the Government approved a policy change to the Nursing Homes Support Scheme “Fair Deal”, to remove a disincentive for applicants to the Scheme to rent out their principal residence after they have entered long term residential care. The rate of assessment for rental income from a principal residence is reduced from 80% to 40%.
The measure is currently under review and we await the outcome of the review process.
Any rental income accrued from property that is not a principal private residence will continue to be assessed at 80%.
This policy change addresses the commitments made under Housing For All Action 19.8. The change was made through a Committee-Stage amendment to the Department of Housing, Local Government and Heritage’s Regulation of Providers of Building Works and Building Control (Amendment) Bill 2022 which is in operation as of 1 November.
24. Deputy Martin Browne asked the Minister for Health if the site on which St. Patrick’s Hospital, Cashel, County Tipperary is located is suitable for the development of a new 60-bed residential care centre at St. Patrick's Hospital; the other site options being explored for this purpose (details supplied); when it was decided that other site options would be considered; what prompted the exploration of an alternative site; when a decision on the future development; and if he will make a statement on the matter. [18485/23]
View answerAs a response to the pandemic residents from St. Patrick’s Hospital were moved to facilities on Our Lady’s Hospital campus in June 2020, now named Cashel Residential Services.
This is registered under HIQA for 3 years from June 2020. The three-year registration is now due for renewal and HSE are engaged with HIQA regarding reregistration.
I, my Department and the HSE are committed to the development of a new Community Nursing Unit (CNU) for older persons for Cashel.
Provision has been made in the Capital Programme 2023 to progress a 60 bed CNU for Cashel.
HSE advise that the existing hospital site is not suitable for the new 60 bedded CNU. HSE also advise that the site is very limited in size. Challenges regarding the amount of parking space and access to the building have been identified.
A site within Cashel town is currently being reviewed by HSE for suitability for a new CNU. This review is expected to be completed in Q2 2023.
Additionally, the Public Private Partnership build in Clonmel has commenced with a completion date of Q4 2024 which will provide a 50 bedded CNU.
An assessment and rehabilitation unit, and a day hospital for Older Persons Services, continues to operate at St. Patrick’s Hospital.
25. Deputy Gino Kenny asked the Minister for Health why PCR testing centres have been closed despite a recent uptick in infections and hospital admissions; and if he will make a statement on the matter. [17658/23]
View answerThe public health advice is that testing for COVID-19 is no longer recommended for most of the population.
Self-referral for PCR testing and ordering of antigen tests by the general public is closed. Routine serial testing in long-term residential care facilities has finished although it is available when necessary for managing an outbreak. Testing continues in acute settings according to the prevailing advice there.
We are no longer doing extensive testing and tracing of infection. This is because of the high level of vaccine-induced and naturally acquired population immunity in Ireland. This is mitigating against the worst impacts of infection for most people.
Covid-19 is still with us. Anybody with symptoms of a respiratory infection, such as Covid-19, should follow the public health advice. They should stay at home until 48 hours after the symptoms are mostly or fully gone.
We can now focus on managing the severe impacts of COVID-19 in those people most vulnerable to its effects. Anybody with concerns about an underlying condition or their level of risk should seek advice from their doctor. GPs can provide swabbing for COVID-19 in certain circumstances, such as when treatment with Paxlovid is being considered.
The COVID-19 situation is kept under continuing review by the Chief Medical Officer. This includes on-going assessment of current and future threats to population health.
26. Deputy Denis Naughten asked the Minister for Health the timeline for the establishment post-acute and long-Covid clinics within each hospital group; the reason for the delay; and if he will make a statement on the matter. [16902/23]
View answerDespite all the progress in relation to COVId19, I am very aware that Long COVID is still causing suffering. To ensure that people who need care have access to it, the HSE is currently implementing a plan to provide Long COVID services nationally. The investment in this service has trebled in 2023 to 6.6 million euro.
Many patients with symptoms of Long Covid are successfully managed by GPs however, for some, further assessment and supports are required. The new national service includes six new Long COVID clinics and eight Post-Acute clinics, the first priority being to have at least one Long COVID and one Post-Acute COVID clinic established in each Hospital Group.
I am advised by the HSE that to date, all six new Long COVID clinics, and six out of eight new post-acute clinics, along with a neurology clinic, located at Saint James’s Hospital, have been established. The HSE is working to establish the agreed remaining clinics. I am aware of some recruitment delays in fully staffing the service. I have been assured that patients are being treated within existing resources until the clinics are fully staffed.
My Department and the HSE will continue to review evidence on all aspects of COVID-19 including Long COVID, to ensure a full national service is in place for those who need it.
27. Deputy Duncan Smith asked the Minister for Health his views on reports his Department is seeking to change access to codeine-based medicines from over the counter to prescription supply; and if he will make a statement on the matter. [18477/23]
View answerAs a painkiller codeine is most often used in combination with other analgesics such as paracetamol or ibuprofen. But there is a potential for misuse. Codeine is therefore a controlled drug under the Misuse of Drugs Acts 1977 and 1984.
Low dose preparations are regulated as a Schedule 5 controlled drug. Medicinal products that contain low doses of codeine are available without a medical prescription but only though a pharmacy.
The PSI, as the pharmacy regulator, has extensive guidance in place for retail pharmacy businesses on the supply and sale of these products.
Any potential change to the prescription requirements for codeine containing medicinal products must be supported by sufficient evidence.
The Health Products Regulatory Authority are the competent authority for medicines in Ireland. They are currently conducting an independent review examining the method of sale and supply of codeine-containing medications.
Once this review is completed, my officials will engage with the HPRA and other stakeholder to assess the recommendations made. This assessment will include the recent recommendations from the European Medicines Agency's (EMA) Pharmacovigilance Risk Assessment Committee (PRAC). There will be full consideration given to any policy changes that may be required regarding the regulation of codeine-containing medicinal products.
28. Deputy Colm Burke asked the Minister for Health the action his Department is taking to address the current critical shortage of dentists across the private sector and public service in Ireland, in view that at least 500 extra dentists are needed to meet the needs of a rising population and to replace retiring dentists as per this report (details supplied); and if he will make a statement on the matter. [18473/23]
View answerI have met with Minster Harris and have requested significant increases in the number of dentists we train to address dental workforce capacity issues. The Higher Education Authority is undertaking a process to identify a set of options for Government from higher education institutions interested in building capacity in Dentistry, among other areas. Aligned with Departmental policy regarding self sufficiency and to address the current imbalance of domestic ( incl. EU/ UK vs non-EU) students vs non-EU students, dental schools need to have a 75:25 ratio of domestic vs non-EU students. Superimposed on this rebalancing there needs to be an additional 10-20% on the number of college places made available to dental students in the longer term.
The HEA has requested both current dental schools to submit proposals to expand capacity and also sought proposals for new dental schools. We await the outcome of the HEA process and welcome the opportunities to expand capacity.
The Dental Council have introduced a registration process regarding refugee and temporary dentists who are currently living in Ireland and wish to practise here. The Dental Council have advised that it is doing everything it can to expedite the registration of all such dentists to enable them to contribute to our workforce.
The Dental Council have reported an increase in the numbers of dentists registering since 2016:then there were 2,949 and now there are 3,492 on the register.
29. Deputy Duncan Smith asked the Minister for Health following the Government's support for the Labour Party motion on community and voluntary sector workers, if he will provide an update on his plans to ensure pay parity, given the vital role these workers play in healthcare in Ireland; and if he will make a statement on the matter. [18474/23]
View answerFirstly, I would like to acknowledge the important role that Section 39 organisations and staff play in our health sector. They have a key role in providing services to people with disabilities and older people.
A process of engagement to examine the pay of workers in Community and Voluntary organisations was committed to by the Government in October 2022 during the Private Members Motion referenced by the Deputy.
While the Government has committed to a process, it is worth noting that Section 39 organisations are privately owned and run, and the terms and conditions of employment of staff in these organisations are ultimately between the employer and the employee.
On 17 April, officials from the Department of Health, the HSE, the Department of Children, Equality, Disability, Integration and Youth, and Tusla met with union representatives under the auspices of the Workplace Relations Commission. This engagement sought to understand and explore the scope of the unions' claim for pay rises for Community and Voluntary sector workers. A follow up engagement is expected to take place later in May.
It must be noted that this is a cross-sectoral issue and cannot be taken in isolation.
30. Deputy Denis Naughten asked the Minister for Health his plans to fit out the empty surgical day ward at Roscommon University Hospital; and if he will make a statement on the matter. [16901/23]
View answerRoscommon University Hospital currently has a 12 bed Surgical Day Ward, which is co-located with a medical inpatient ward. It is proposed to relocate the Surgical Day ward in an area adjacent to the Operating Theatre and Endoscopy Unit. As part of this proposal, it is planned that the vacated surgical day ward area in its current location would be used to increase medical inpatient beds. A plan for this is currently under review by HSE Estates before progressing to the design team phase, and this will be progressed in 2023.
The Government is committed to the ongoing development of regional hospitals, and there has been significant additional investment in staffing at RUH in recent years, with a 37.9% increase in staffing numbers since 2018. This includes an additional 72 nurses and midwives. As at February 2023, over 436 staff were employed at RUH. The budget allocation for RUH in 2023 is €31.1 million, an increase of 15.6% from 2018.
31. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Question No. 129 of 16 February 2023, the status of the review by his Department of the Strategic Assessment Report for the new emergency department in University Hospital Galway; if the SAR examination has been completed to date; if the SAR has been submitted to the Department of Public Expenditure, National Development Plan Delivery and Reform for review; the expected timeline for the proposal to be developed into a Preliminary Business Case; and if he will make a statement on the matter. [17292/23]
View answerI am pleased to confirm that the Strategic Assessment Report reviews by my Department and the Department of Public Expenditure, NDP Review and Reform, for the proposed Emergency Department, Women & Children’s block at UHG, have been completed.
On 29 March 2023, Minister O’Donohoe updated and shortened the Public Spending Code for capital investments. The SAR stage has now been subsumed into a single SAR/Preliminary Business Case (PBC) document.
Since the SAR review for the Galway proposal has already been completed, the output of the reviews will be shared with the HSE to ensure that the new SAR/PBC is as robust as possible.
The HSE has undertaken work in parallel to the SAR to support the expedient development of the PBC and is now considering the implications of the recent PSC changes.
The timeline for the completion of the SAR/PBC cannot yet be estimated as the outputs of the SAR review and PSC changes will have to be incorporated by the HSE.
When the new SAR/PBC is finalised it will be subject to further review and Government consent before it can proceed to the pre-tender stage.
These welcome PSC reforms can have a positive impact on the timeline for major capital projects, including this project at UHG, to proceed through the stages of the project life cycle in a timely and efficient manner.
32. Deputy Éamon Ó Cuív asked the Minister for Health the progress made in providing a new community nursing home in Clifden, County Galway; the reason for the delay with this; and if he will make a statement on the matter. [18201/23]
View answerI would like to advise the Deputy that HSE Community Healthcare West are committed to a new 40-bed build community nursing unit (CNU) in Clifden. The HSE are committed to providing services to older people that meet the demand for services in the short and longer term for the people in Galway.
The new 40-bed CNU build will amalgamate the residential services currently provided in Clifden District Hospital and St. Anne’s CNU. At present, it is envisaged that the CNU will consist of long-stay and short-stay beds, as well as dementia specific beds and respite beds.
I would like to inform the Deputy that the local HSE Estates have submitted a request to HSE Corporate Estates to progress to planning stage. A Public Spending Code review must be undertaken before local HSE Estates can proceed further. It is envisaged that the application will be submitted to Galway County Council for planning in the coming months.
In the meantime, Older Peoples Services in HSE Community Healthcare West are committed to providing services for respite, short-stay and ICPOP admissions at Clifden District Hospital.
33. Deputy Bríd Smith asked the Minister for Health if he can detail the position in relation to public health teams; if the number of public health doctors have been increased; the plans to ensure same are resourced to deal with any future public health crisis such as a pandemic; and if he will make a statement on the matter. [17655/23]
View answerThere has been significant progress made in relation to enhancements to our Public Health workforce.
As agreed between the Department of Health, the HSE and the IMO in April 2021, a fully reformed model for public health including 84 Consultant posts is being implemented on a phased basis. The first phase, recruitment of 34 WTE posts at Consultant in Public Health Medicine level, is complete. Recruitment of Phase 2 (30 WTE) Consultant posts is progressing well with 19 posts in various stages of contracting to short-listing. Preparation for Phase 3 (20 WTE) of the programme is underway. It is intended that the 84 Consultant posts will be in place before the end of 2023.
There has also been extensive progress made in the area of broader Public Health workforce recruitment which will make up the multidisciplinary teams (MDTs) as part of the Consultant-led Public Health programme as envisaged by the Crowe Horwath Report. Since 2020 we have almost doubled the Public Health workforce as promised by the Government with the recruitment of over 237 new WTEs at posts including public health doctors, nurses, scientists, and support staff.
Alongside this recruitment, six new Public Health Areas have been established aligned to future Sláintecare areas, led by Area Directors of Public Health and delivering a Consultant-led Public Health service in line with the Hub-and-Spoke model. The HSE has also made progress towards procurement of an Outbreak Case and Incident Management System, a key enabler of a national health protection service.
Additional resources have also been provided to the HSE to ensure enhancements are put in place to existing infectious disease surveillance systems in the Health Protection Surveillance Centre (HPSC). This will ensure effective monitoring and signalling of what is happening with the virus at population level, so that we can greater understand disease transmission and severity along with population immunity and risk. Following provision of additional resources in Budget 2023, eighty nine new posts in disease surveillance are being created with 42 of these already recruited.
This has enabled expansion of GP Sentinel Surveillance, with 90 GP practices now participating in the scheme. In addition, a Biostatistics and Modelling Unit is being established in the HPSC. Wastewater Surveillance and Whole Genome Sequencing programmes are in place and operational.
My Department and the HSE are fully committed to the full implementation of the new Public Health Model by December 2023.
34. Deputy Joe Carey asked the Minister for Health if he will outline his plans to advance the fast-tracking of the development of two additional 96-bed ward blocks at University Hospital Limerick under the National Development Plan to address in-patient bed capacity shortage in the mid-west region; and if he will make a statement on the matter. [10302/23]
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.
35. Deputy Colm Burke asked the Minister for Health the action his Department is taking to deal with the shortage of community beds in the Cork/Kerry region in view of the fact that 240 beds have been removed from the system in the past four years, and also taking into account that beds are being occupied in Cork University Hospital by patients who could have been discharged over three months ago into appropriate care in the community, and this delay in discharge is preventing the admission of patients to the hospital; and if he will make a statement on the matter. [18472/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
