Written Answers Nos. 613-628
613. Deputy Matt Carthy asked the Minister for Health when a person (details supplied) will be provided with the home help support, already allocated, so that he can return home from nursing home care; and if he will make a statement on the matter. [22502/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
614. Deputy Michael McNamara asked the Minister for Health if mask-wearing in health facilities such as hospitals reduces transmission of Covid-19 and/or RSV; if he will outline any evidential basis for same; and if he will outline the rationale for the recent decision to no longer require the wearing of facemasks in such settings. [22523/23]
View answerThe Deputy will be aware of the recent announcement from the WHO that "COVID-19 is now an established and ongoing health issue which no longer constitutes a public health emergency of international concern (PHEIC)”.
Current public health advice continues to be informed by World Health Organization (WHO) and European Centre for Disease Prevention and Control (ECDC) guidance, as published.
Infection Prevention and Control (IPC) in healthcare settings is an operational responsibility of the HSE. The HSE’s full updated evidence-based recommendations regarding Personal Protective Equipment (PPE) in healthcare settings, including the use of face masks, can be found here:
www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/infectionpreventionandcontrolguidance/ppe/.
healthservice.hse.ie/staff/covid-19-staff-support/ppe-guidance-for-staff/#:~:text=When%20to%20wear%20a%20facemask,confirmed%20COVID%2D19%2Frespiratory%20illness.
The Deputy will note from this guidance:
‘As part of Standard Precautions, it is the responsibility of every healthcare worker to undertake a point of care risk assessment prior to performing a clinical care task, as this will inform the level of infection prevention and control (IPC) precautions needed, including the choice of appropriate PPE’.
I wish to assure the Deputy that Department of Health, through the Office of the Chief Medical Officer, will continue to monitor COVID-19 and other circulating viruses carefully.
615. Deputy Niall Collins asked the Minister for Health his views on patients’ access to genetic testing (details supplied); and if he will make a statement on the matter. [22524/23]
View answerThe Government and I are fully committed to improving genetics services in Ireland, including at Children’s Health Ireland (CHI) at Crumlin. One of the key ambitions the National Strategy for Accelerating Genetics and Genomics Medicine in Ireland, launched in December 2022, is to build a strong national genetics service. This will be a patient and family-centred service that can be accessed equitably across the country and across the lifespan of patients. The Strategy outlines a plan to achieve this ambition by improving the evidence-base and infrastructure supporting genetic testing in Ireland. In 2023, the HSE will begin developing a National Testing Directory for genetics and genomics, which will map the current genetic tests conducted across Ireland and provide a more transparent process to referrals. This development, therefore, will be a key steppingstone to improving national genetic testing and ultimately help reduce wait time. The Strategy also outlines a plan to build a strong genetic workforce for the future. This will be achieved by not only recruiting new staff, but training and development for a future workforce, and professional development for current staff within the health service. To start implementing the Strategy in 2023 I approved €2.7 million including the appointment of key staff. These appointments included a National Director for Genetics and Genomics, a Bioinformatics Lab Director, two clinical genetic consultants and six genetic counsellors.
In addition to expanding a broad genetics and genomics service, I have also supported several key measures in rare diseases. My Department has worked with the National Rare Disease Office to facilitate Irish entry into 18 European Reference Networks (ERNs) for rare diseases and support an EU Joint Action for the integration of ERNs into the national system. These ERNs include representation from five academic hospitals and three universities. This represents a significant achievement by the health service, to drive innovation, training and clinical research for highly specialised care. The Department has also progressed Irish entry into Horizon Europe Partnerships on Rare Disease and Personalised Medicine. Participation in ERNs and Horizon Europe Partnerships ensure greater coordination and sharing of best practices in key areas such as genetic testing with European partners. Finally, I have recently announced a plan to develop a revised National Rare Disease Plan. This Plan will be a key step in progressing an improved overall service for individuals living with a rare disease.
616. Deputy Éamon Ó Cuív asked the Minister for Health the rate of payment made to private nursing homes, under the nursing home subvention scheme (fair deal), broken down by health region, in tabular form; the reason for the disparity in payments in each region, if any; and if he will make a statement on the matter. [22525/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
617. Deputy Éamon Ó Cuív asked the Minister for Health the rate of payment made to HSE nursing homes under the nursing home subvention scheme, broken down by health region, in tabular form; the reason for the disparity in payments in each region, if any; and if he will make a statement on the matter. [22526/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
618. Deputy Éamon Ó Cuív asked the Minister for Health if a court challenge has been taken against the HSE, his Department, him or all three in relation to differentiated payments between private and HSE nursing homes under the nursing home subvention scheme (fair deal); if so, the stage this case is at; and if he will make a statement on the matter. [22527/23]
View answerThe Department of Health wishes to advise the Deputy that at this time, there have been no court challenges taken against the Minister or Department of Health regarding the differentiated payments between private and HSE nursing homes under the Nursing Home Support Scheme (Fair Deal) in this jurisdiction. The query was also referred to the HSE for direct response.
619. Deputy Éamon Ó Cuív asked the Minister for Health whether there are discussions taking place about a new WHO international agreement that would oblige Ireland to follow a course set out by WHO in the event of another pandemic; whether it is intended to place any such agreement before Dáil Éireann for debate and ratification; and if he will make a statement on the matter. [22528/23]
View answerThe COVID-19 pandemic demonstrated that the global status quo in terms of pandemic preparedness and response is not acceptable and needs revision and as such, Ireland strongly supports a multilateral approach to global health issues with the World Health Organisation (WHO) in a central leadership role.
On 1 December 2021, the members of the WHO reached consensus to begin the process to negotiate a convention, agreement, or other international instrument to strengthen pandemic prevention, preparedness and response. Put simply, the aim of such an instrument is to protect public health and to help save lives in the event of future pandemics.
An Intergovernmental Negotiating Body was established and met for the first time on 24 February 2022. The Intergovernmental Negotiating Body has met five times to date and is due to meet again in July to progress work on drafting the agreement. A progress report will be delivered to the 76th World Health Assembly later this month, with the aim of adopting the instrument by 2024.
As provided for in the Irish Constitution, the conclusion of an international agreement is an exercise of the executive power of the State in connection with its external relations and is therefore concluded by or on the authority of the Government. In practice this means that Government approval must be sought for the signature, ratification, or approval of every international agreement.
As the proposed instrument on pandemic prevention, preparedness and response is currently in the very early stages of negotiation, it is not possible at this time to determine the precise legal ramifications of the instrument, nor has it been determined what form the instrument shall take.
The requirements of the Irish Constitution will, of course, be respected in Ireland’s position towards the negotiations and my Department will engage with the Office of the Attorney General in relation to any concerns that may arise in this regard.
620. Deputy Éamon Ó Cuív asked the Minister for Health whether it is intended to appoint a project team to manage the development of the three major proposed health projects on the Newcastle Road site of GUH, namely the emergency department, women and children project, the replacement laboratories project and the cancer care centre, to ensure a co-ordinated development of the site; whether it is intended to progress with these three projects as speedily as possible in view of the urgent requirement that all three proceed; and if he will make a statement on the matter. [22533/23]
View answerAt any one time there are multiple capital investment projects underway on the University Hospital Galway (UHG) campus involving different design teams and different works contractors. Overall co-ordination for all works / projects on the campus is achieved through close working relationships locally between HSE Capital & Estates, Saolta Hospital Group and management at Galway University Hospitals.
Strategies to mitigate any potential disruption to services while delivering capital works projects on a live, and extremely busy, hospital site are developed in advance of construction works and during the project lifecycle as part of an overall risk assessment.
In addition to current live projects there are a number of large, complex and significant infrastructural investment proposals for the UHG campus currently at an early stage of design and development in line with the provisions of capital works management framework and the Public Spending Code (PSC). These include proposals for replacement laboratories, a new emergency department, women and children’s block replacement (ED) and a new regional cancer centre at the UHG site.
All proposals being progressed must be compliant with the PSC. The final decision to proceed with the construction of a given project cannot be made until the tender process has been completed and the costings reviewed to ensure that the proposal remains affordable and delivers value for money. The PSC was updated by Circular 06/2023 in March of this year. Key changes to the PSC including an increase to thresholds for major projects and overall streamlining of the requirements for all capital projects at different stages in the project lifecycle.
Strategic Assessment Reports (SARs) have been completed by the HSE for the three proposals referenced above. In line with the requirements of the updated PSC, combined SAR and Preliminary Business Cases (PBC) will be developed for the ED and Cancer Centre proposals for external review at Stage 1, SAR/PBC – Approval in Principle. As the cost of replacement laboratories is likely to fall below the updated threshold of €200m for Major Capital Projects, it no longer must go through the full rigour of the PSC and external review. The streamlining of the PSC has the potential to further expedite the delivery of this proposal.
While they are three independent projects, the potential locations of the ED and Women & Children’s Block project and the replacement Laboratories are sufficiently distanced from each other on the UHG site that they could be developed concurrently without affecting the delivery of services, subject to the fulfilment of PSC requirements and the availability of funding within the Department’s National Development Plan capital envelope. The replacement laboratories, a significant development in its own right, is an enabling project for the Cancer Centre proposals and therefore and is currently envisaged as proceeding to construction ahead of the Cancer Centre development.
621. Deputy Neasa Hourigan asked the Minister for Health further to Parliamentary Question No. 170 of 9 February 2022, if the HSE is continuing with plans to relocate acute mental health care for the north Cork HSE catchment from unit 4 in St. Stephen’s Hospital to the Mercy University Hospital; if so, if he will provide a timeframe on this proposal; the clinical rationale for this, given that the Mercy Hospital is a longer distance from north Cork and will therefore involve additional challenges for visiting families; if there has been consultation with ground-level clinicians and family and service-user groups from north Cork on these proposals; and if he will make a statement on the matter. [22537/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
622. Deputy Neasa Hourigan asked the Minister for Health further to Parliamentary Question No. 599 of 25 April 2023, the reason an initial €4 million costing of a rebuild of the Carraig Mór mental health facility in Cork, announced in May 2021, has since increased to €14 million; and if he will make a statement on the matter. [22538/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
623. Deputy Neasa Hourigan asked the Minister for Health if the HSE will consider establishing community mental health residences in Cobh and Youghal, as well as Midleton, to bring the combined Midleton/Youghal and Cobh/Glenville HSE sectors up to the recommended allocation of 30 residential placements per 100,000 population as set out in A Vision for Change and to bring east Cork in line with the north Cork HSE catchment which currently has 42 community residential placements spread across the towns of Fermoy, Mallow and Kanturk, serving a very similar population size; and if he will make a statement on the matter. [22539/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
624. Deputy Rose Conway-Walsh asked the Minister for Health the number of high-dependency places in the public nursing home sector; and if he will make a statement on the matter. [22544/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
625. Deputy Seán Canney asked the Minister for Health if he is aware that a person who has entered long-term care and who has agreed to rent out their home is assessed on the double for this income by having the rental income assessed and also the notional income by having the value of the house assessed; and if he will make a statement on the matter. [22550/23]
View answerThe Nursing Home Support Scheme (NHSS), commonly referred to as 'Fair Deal', is a system of financial support for people who require long-term residential care. The primary legislation underpinning the NHSS is the Nursing Home Support Scheme Act 2009. Participants in the NHSS contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone, and that people are cared for in the most appropriate settings.
Participants within the NHSS contribute up to 80% of their income (40% if part of a couple) and 7.5% per annum of the value of their assets (3.75% if part of a couple). The first €36,000 (€72,000 if part of a couple) is excluded from assessment. The value of a person's principal residence is only assessed for contributions for their first three years on the scheme.
Assets assessed include cash assets as well as non-cash assets such as the principal private residence, other property and land, including farmland.
For the purposes of financial assessment, income includes:
- Earnings, including income from farming or business activities
- Pension income
- Social welfare benefits/allowances
- Rental income
- Income from holding an office or directorship
- Income from fees, commissions, dividends or interest
- Any income which you have deprived yourself of in the five years prior to application
Transferred assets and income, defined as assets or income transferred to another person up to five years before a person's application to the scheme, are also assessed.
Within the NHSS, the asset value of a resident's home, known in the Scheme as the "principal residence", is also assessed for 3 years, with 7.5% of its value going towards the cost of care (3.75% in the case of a couple). After a person has been in care for 3 years , the value of this property is no longer assessed. This is called the 3 year cap. In practice, this generally reduces the nursing home fees of those maintaining their home, from year four onwards. The Nursing Homes Support Scheme Amendment Act (2021) now extends the 3-year cap to cover the proceeds of sale, so that a person will be able to sell their home without incurring additional fees from their fourth year in long-term residential care onwards. This applies even if the home is sold before 3 years in care; the proceeds of sale will be assessed up to the 3-year point, but excluded from assessment after that.
Rental
Effective 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 this change being implemented, participants in the Fair Deal scheme were able to rent out their homes or other assets, however 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%. This means that for someone renting out their principal residence, they retain 60% of the income accrued from that rental and 40% is assessed under Fair Deal
Under the terms of the amended legislation, this policy change will be reviewed after six months of operation at the end of April 2023, with the intention for further amendment after that point if necessary and examining any unintended consequences and potential safeguarding issues. To date, 30 properties have been rented out since this policy change last November.
It should be noted that 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.
626. Deputy Michael Healy-Rae asked the Minister for Health the reason there have been difficulties experienced by home support workers with the pay and expense system (details supplied); when the matters will be rectified; and if he will make a statement on the matter. [22556/23]
View answerI have asked the HSE to respond directly to the Deputy on this matter.
627. Deputy Duncan Smith asked the Minister for Health when the scheme for GP-only cards for households earning under €46,000 per year will be operational; and if he will make a statement on the matter. [22577/23]
View answer734. Deputy Brian Stanley asked the Minister for Health when the commitment given in Budget 2023 to give GP medical cards to those with an income of less than the median wage will be implemented. [23193/23]
View answerI propose to take Questions Nos. 627 and 734 together.
The Government is committed to the extension of GP visit card eligibility to those who earn the median household income or less, as announced in Budget 2023.
In total, approximately 400,000 additional individuals are estimated to become eligible under this expansion. This measure will remove the cost of accessing GP care from those for whom cost is most likely to prevent access; helping reduce the cost of living for young adults and young families in particular.
The necessary planning and administrative development work to provide for the expansion is well advanced in preparation for the commencement of the expansion. Officials from my Department and the HSE are currently engaged in intensive discussions with the IMO regarding the expansion and in particular the IMO concerns on the impact of increased eligibility on general practice and the best use of the additional funding provided in Budget 2023 to support capacity in general practice.
Information in relation to the commencement of the expansion and operational information will be provided when available.
628. Deputy Neasa Hourigan asked the Minister for Health the mental health supports available to those hoarding and support for decluttering, either through his Department or through the HSE; and if he will make a statement on the matter. [22581/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
