Written Answers Nos. 199-219
199. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 610 of 16 May 2022, the date on which the sign-off form and further information will be available to healthcare assistants working in Ireland under the general employment permit; and if he will make a statement on the matter. [25095/23]
View answerThe Department of Enterprise Trade and Employment provided access to the General Employment Permit for the role of Health Care Assistant in June 2021. The framework agreed with the Department of Health included the requirement for the permit holder to achieve a relevant Level 5 Quality and Qualifications Ireland (QQI) qualification after two years employment in the State.
Responding to the need whereby some Health Care Assistant staff who are availing of the employment permits framework have other qualifications, at Levels 6, 7 or 8, aligned to the care industry but not as Health Care Assistants it was decided that a comparable healthcare qualification as outlined in the Quality and Qualifications Ireland (QQI) NARIC Ireland framework would be acceptable for employment permit purposes if the clinical lead in the organisation or the employer provides assurances that the staff member has demonstrated the skills, experience, and knowledge to carry out the role competently as compared to those staff members with the QQI L5 qualification. A “sign-off” from the clinical lead in the organisation or employer is required. The Department of Health is engaging with Department of Enterprise Trade and Employment (DETE) on the development of an appropriate form for submission to DETE to accompany applications for renewals of health care assistant employment permits. This engagement is at an advanced stage, and, although I am not able to provide the date the form will be available to the Deputy it is expected that the standard form and further information will be available soon.
200. Deputy Michael Healy-Rae asked the Minister for Health if he will provide funding for national physiotherapy services (details supplied); and if he will make a statement on the matter. [25105/23]
View answerThe Sláintecare Integration Fund formed part of the Sláintecare Action Plan 2019, which established the building blocks for a significant shift in the way in which health services are delivered in Ireland. Budget 2019 provided €20 million for the establishment of a ring-fenced Sláintecare Integration Fund or SIF, to support service delivery which focuses on prevention, community care and integration of care across all health and social care settings.
The SIF Round 1 supported 123 HSE and NGO sector projects, to test and evaluate innovative models of care providing a ‘proof of concept’ with a view to mainstreaming and scaling of successful projects through the annual budget estimates process.
The selection criteria for funding were:
• To encourage innovations in the shift of care to the community or provide hospital avoidance measures;
• To scale and share examples of best practice and processes for chronic disease management and care of older people;
• To promote the engagement and empowerment of citizens in the care of their own health.
Successful SIF projects were mainstreamed via NSP 2021 and 2022 at an estimated cost of €24 million.
The MS Ireland “Active Neuro” project was mainstreamed with ringfenced funding allocated in Budget 2022 to the HSE to continue the project in 2022, and this has continued in 2023.
Any consideration for whether, and how best, to expand this service within the HSE, would be matter for the HSE to consider and to make a business case to the Department of Health, as part of the annual Estimates process in advance of the Budget later in the year.
201. Deputy Holly Cairns asked the Minister for Health if he will provide details of the waiting lists for endometriosis clinics in each CHO, including a breakdown of the amount of time individuals are waiting; and if he will make a statement on the matter. [25119/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible
202. Deputy Holly Cairns asked the Minister for Health if he will provide details of the waiting lists for pain clinics in each CHO, including a breakdown of the amount of time individuals are waiting; and if he will make a statement on the matter. [25120/23]
View answerIt is recognised that waiting times for many scheduled appointments and procedures were too long before and have been made worse by the Covid-19 pandemic. The Department of Health continues to work with the HSE and the National Treatment Purchase Fund (NTPF) to identify ways to improve access to care. On 7 March, I published the 2023 Waiting List Action Plan, which is the next stage of a new multi-annual approach to sustainably reduce and reform hospital waiting lists, and builds on the foundational work done through the short-term Waiting List Action Plan between September and December 2021, which was followed by the first full year Waiting List Action Plan for 2022, both having reversed the annual trend of rising waiting lists.
The 2023 Plan sets out the priorities to continue to address waiting lists this year. The 30 actions in the Plan, which are governed by the Waiting List Task Force, focus on delivering capacity, reforming scheduled care and enabling scheduled care reform.
For 2023, funding totalling €443 million is being allocated to tackle Waiting Lists with €363 million of this being allocated to the 2023 Waiting List Action Plan, to implement longer term reforms and provide additional public and private activity to clear backlogs exacerbated during the pandemic. This will reduce hospital waiting lists by 10% in 2023 as well as continuing to significantly reduce waiting times in line with Sláintecare recommendations. The remaining €80 million of the €443 million is being targeted at various measures to alleviate community/primary care waiting lists.
With this ambitious 2023 Waiting List Action Plan, my Department, the HSE and the NTPF are taking the next steps in the multi-annual approach towards achieving our vision of a world-class public healthcare system in which everyone has timely and transparent access to high-quality scheduled care, where and when they need it, in line with Sláintecare reforms.
The attached document, provided to my Department by the NTPF, shows the Inpatient & Daycase (IPDC) and Outpatient waiting lists for Pain Relief by Hospital Group.
203. Deputy Holly Cairns asked the Minister for Health if he will provide an update on a person (details supplied) awaiting a clinical appointment. [25121/23]
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 HSE to respond to the Deputy directly, as soon as possible.
204. Deputy Holly Cairns asked the Minister for Health the steps he is taking in response to a care centre (details supplied) withdrawing from the fair deal scheme at the end of May unless the national treatment purchase fund, NTPF, provides increased funding; and if he will make a statement on the matter. [25122/23]
View answer205. Deputy Holly Cairns asked the Minister for Health the steps he is taking with regard to a nursing home (details supplied) that will exit the fair deal scheme at the end of May if the NTPF does not increase payments to it. [25123/23]
View answerI propose to take Questions Nos. 204 and 205 together.
Fair Deal was designed to protect and support vulnerable older people, to ensure equal access to nursing home care based on what they could afford. This gives certainty to people and families. Government funding for Fair Deal is to support vulnerable older people at a time in their lives where full time care is essential.Overall, €1.4 billion of the total Health Budget was allocated last year to support over 22,700 people under Fair Deal. This will increase to nearly €1.5 billion for 2023, and I am cognisant that the budget has to support all residents under the Nursing Home Support Scheme (NHSS) for the full calendar year.
It is important that nursing homes manage potential cost pressures in line with their regulatory and contractual responsibilities, maintaining their quality of care so that residents’ lived experience and comfort is not affected.
The Government is conscious of the financial challenges faced by the nursing home sector, especially smaller and voluntary nursing homes that may not have access to the same economies of scale as larger homes or groups. The Government has provided substantial support to the private and voluntary nursing home sector over the course of the pandemic. Over €149m of financial support has been provided to private and voluntary nursing homes through the COVID-19 Temporary Assistance Payment Scheme (TAPS) and the provision of free PPE and oxygen to private nursing homes continues, costing approximately €75 million to date.
A new €10 million scheme (TIPS) was established last year to support private and voluntary nursing homes with increases in energy costs, covering 75% of year-on-year cost increases up to a monthly cap of €5,250 per nursing home. This scheme was extended to March 2023 and is now under review for a second extension to end of June 2023.
In addition, other options to support nursing homes are also being explored, such as to help with the often costly nature of compliance for nursing homes under necessary HIQA regulations.
Private and most voluntary nursing homes agree the price that they can charge for a Fair Deal resident with the designated State agency, the National Treatment Purchase Fund (NTPF). Maximum prices for individual nursing homes are agreed with the NTPF following negotiations and based on the NTPF’s cost criteria such as costs reasonably incurred by the nursing home, local market prices, historic prices and overall budgetary capacity.
Overall, 425 private nursing homes negotiate with the NTPF. The Department of Health and I have regular interaction with the NTPF and met them recently to discuss ways to support the sector, where necessary and appropriate, to complement the normal process of negotiating rate increases when contracts are renewed. Nursing homes which had a scheduled renegotiation of their Deed of Agreement with the NTPF this year have seen a significant uplift.Budget 2023 saw an over €40 million in additional funding for the Nursing Home Support Scheme (NHSS) which will provide for an uplift in the maximum prices chargeable by private and voluntary nursing homes, as negotiated.
The NTPF carry out this role independently under the Nursing Homes Support Scheme Act 2009. It will be appreciated that particulars of all such negotiations and reviews are a matter between the nursing home and the NTPF. The NTPF has statutory independence, and there is no role for Ministers or the Department of Health in negotiations with individual nursing homes.
There is no other mechanism for funding from the public purse for nursing home residents outside the NHSS (Fair Deal). I would encourage continued engagement between nursing home providers and the NTPF.
The Department of Health continues to work with the NTPF to take forward the recommended actions that emerged from the review of the NTPF pricing system published in June 2021.
It is important to note that the HSE is statutory provider of last resort and will always step in where a resident’s needs are sufficiently complex that they are not able to be cared for elsewhere in the community. The HSE needs to be equipped to deliver that kind of complex care.
Ensuring that the welfare and safety of residents is secured when nursing homes close is of the utmost importance. It is essential that when nursing homes are intending to close or cease participating in the NHSS, residents and their families must be consulted with and given appropriate notice so that new homes can be found and they can be moved in a safe, planned way.
206. Deputy Michael Healy-Rae asked the Minister for Health if he will provide an update on multiple sclerosis care investment (details supplied); and if he will make a statement on the matter. [25126/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
207. Deputy Cathal Crowe asked the Minister for Health if he will directly intervene in the case of a patient (details supplied) seeking assistance in the treatment abroad scheme; and if he will make a statement on the matter. [25156/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
208. Deputy Alan Farrell asked the Minister for Health if the Covid recognition payment will be extended to the staff of an organisation (details supplied) who worked throughout the pandemic; and if he will make a statement on the matter. [25176/23]
View answerLast year the Government announced a once-off, ex-gratia COVID-19 pandemic recognition payment for certain frontline public sector healthcare workers, to recognise their unique role during the pandemic. Eligibility criteria for the payment were set following significant consideration and consultation.
While the Department does not comment on individual cases, I can confirm that in order to receive the recognition payment, staff must have:
• Been in COVID vaccination cohorts 1 or 2, and
• Worked ordinarily onsite in a COVID-19 exposed healthcare environment, and
• Worked for at least 4 weeks in the 1/3/2020 – 30/6/2021 period, and
• Worked in a HSE/Section 38 organisation, or one of the following:
1. Private Sector Nursing Homes and Hospices (e.g. Private, Voluntary,Section 39 etc.);
2. Section 39 long-term residential care facilities for people with disabilities, working on-site;
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. Members of the Defence Forces redeployed 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.
Only those staff who meet all of the above eligibility criteria are covered for this payment. I appreciate that many other workers, volunteers, and other citizens, provided important services during this most difficult time. While this is not questioned, it is important to recognise that this in itself is not sufficient to be considered eligible for this payment.
The Government appreciates that those organisations and staff who are not encompassed for this particular payment may feel disappointed. It was tough to draw a line on this matter, but the Government based its decision on the risks which eligible frontline workers faced, following careful consideration. While undoubtedly immense efforts have been made by other healthcare staff 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 throughout the pandemic, including those who worked in the very acutely affected environments above.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. As of February this year, there is a new permanent public holiday established to mark Imbolc/St Brigid’s Day.Finally I want to again express my sincere gratitude to all healthcare workers for their efforts during what has been a challenging period for our health services.
209. Deputy Alan Farrell asked the Minister for Health if he will confirm whether the HSE has written to all schools to advise to which primary care centre for dental services each school has been attached; and if he will make a statement on the matter. [25177/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
210. Deputy Alan Farrell asked the Minister for Health if all schools with special classes have been contacted by the HSE to advise that their pupils attending the special classes are given priority for dental services; and if he will make a statement on the matter. [25178/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
211. Deputy Róisín Shortall asked the Minister for Health if he is aware of the appeal of the decision to exclude certain workers in an organisation (details supplied) from the Covid recognition payment; if officials from his Department or the HSE are dealing with this appeal; his views on the exclusion of these workers; and if he will make a statement on the matter. [25183/23]
View answerLast year the Government announced a once-off, ex-gratia COVID-19 pandemic recognition payment for certain frontline public sector healthcare workers, to recognise their unique role during the pandemic. Eligibility criteria for the payment were set following significant consideration and consultation.
While the Department does not comment on individual cases, I can confirm that in order to receive the recognition payment, staff must have:
• Been in COVID vaccination cohorts 1 or 2, and
• Worked ordinarily onsite in a COVID-19 exposed healthcare environment, and
• Worked for at least 4 weeks in the 1/3/2020 – 30/6/2021 period, and
• Worked in a HSE/Section 38 organisation, or one of the following:
1. Private Sector Nursing Homes and Hospices (e.g. Private, Voluntary,Section 39 etc.);
2. Section 39 long-term residential care facilities for people with disabilities, working on-site;
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. Members of the Defence Forces redeployed 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.
Only those staff who meet all of the above eligibility criteria are covered for this payment. I appreciate that many other workers, volunteers, and other citizens, provided important services during this most difficult time. While this is not questioned, it is important to recognise that this in itself is not sufficient to be considered eligible for this payment.
The Government appreciates that those organisations and staff who are not encompassed for this particular payment may feel disappointed. It was tough to draw a line on this matter, but the Government based its decision on the risks which eligible frontline workers faced, following careful consideration. While undoubtedly immense efforts have been made by other healthcare staff 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 throughout the pandemic, including those who worked in the very acutely affected environments above.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.Finally I want to again express my sincere gratitude to all healthcare workers for their efforts during what has been a challenging period for our health services.
212. Deputy Paul Kehoe asked the Minister for Health if there are specific articles in the Health and Social Care Professionals Act 2005 that prevent the title of psychologist being a protected title under the Act; and if he will make a statement on the matter. [25186/23]
View answerAs the Deputy will be aware, CORU is Ireland’s multi-profession health and social care regulator. CORU’s role is to protect the public by regulating the health and social care professions designated under the Health and Social Care Professionals Act 2005 (as amended), including setting the standards that health and social care professionals must meet to be eligible for registration and maintaining registers of persons who meet those standards.
Seventeen health and social care professions are designated under the Health and Social Care Professionals Act for regulation by CORU. There are currently registers open for ten professions and CORU is continuing the substantial work required to open the registers for the remaining designated professions of Social Care Workers; Psychologists; Counsellors and Psychotherapists; Clinical Biochemists; and Orthoptists.
The Psychologists Registration Board (PSRB) was established in 2017. The work of the PSRB includes consideration of the titles to be protected, the minimum qualifications to be required of existing practitioners, the qualifications that will be required for future graduates, and drafting the Standards of Proficiency and Criteria for Education and Training Programmes.
Regulating a new profession is a complex and lengthy process, requiring careful consideration and preparatory work to ensure that it is effective in protecting the public. Psychology has been a uniquely challenging profession to regulate due to the diversity of its specialisms (for example clinical psychology, counselling psychology, occupational and work psychology, sports and performance psychology) and the fact that there is no common education pathway or standards for entry to the profession.
In 2020 a public consultation on the draft Standards of Proficiency and Criteria for Education and Training Programmes developed for the profession revealed significant issues and a lack of consensus on how to proceed with regulation. Key areas of disagreement among the profession are around the minimum level of qualification required for entry to the profession, the number of placement hours, and the appropriateness of practice placement settings.
Having reached an impasse, CORU wrote to me on behalf of the PSRB in September 2021 seeking guidance on how to proceed. Having considered the matter with due regard to the complexity of this profession, its diverse specialisms (including non-health and social care specialisms), the lack of consensus among the profession on how to proceed, and risks to the public of delays in opening a register, I wrote to CORU in August 2022 requesting that the PSRB consider a dual-stream and phased approach to regulating the profession. This approach will allow the PSRB to prioritise regulating the psychology specialisms which present the greatest risk to public safety, while simultaneously continuing to work towards the long-term objective of protecting the title of ‘psychologist’.
CORU wrote to wrote to me on 3 March 2023 with the PSRB’s recommendations on which specialisms should be prioritised for regulation, using an evidence and risk-based methodology. I have accepted the PSRB’s recommendations to prioritise regulation of clinical, counselling, and educational psychology. On 24 April 2023 I wrote to CORU requesting the PSRB to proceed to immediately regulate these three specialisms, while progressing work to protect the title of psychologist in parallel.
CORU, the PSRB, and my Department are fully committed to delivering regulation of this very important profession through protection of the title of ‘psychologist’.
213. Deputy Catherine Murphy asked the Minister for Health if he will clarify whether the clinical director of Cork University Maternity Hospital and of maternity services in the region are two separate roles; if there is an amalgamated salary for the roles or if the salary is derived from multiple sources; and if he will provide a breakdown of annual payments for the roles. [25241/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
214. Deputy Alan Kelly asked the Minister for Health the number of WTE ophthalmology registrars working in Cork University Hospital in the years of 2022 and to date in 2023, in tabular form. [25253/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
215. Deputy Alan Kelly asked the Minister for Health the number of WTE consultant rheumatologists based at University Hospital Limerick in the years of 2022 and to date in 2023, in tabular form. [25254/23]
View answerAs this is an administrative matter for the Health Service Executive, the HSE has been asked to respond directly to the Deputy.
216. Deputy Alan Kelly asked the Minister for Health how the additional €8.8 million will be spent on primary care services during 2023. [25255/23]
View answerThe development of primary care services – alongside social and community care more broadly – is central to this Government's determination to deliver a high-quality, integrated and cost-effective health care system.
In addition to annual funding of €195 million allocated in Budget 2022 for the recruitment of staff and implementation of the Enhanced Community Care (ECC) Programme, a further €8.8 million was allocated in Budget 2023 to Primary Care for new developments.
€5m of this funding is being invested in new measures within oral healthcare services, with €4.75m of this being used to develop and roll-out comprehensive oral healthcare packages for children from 0-7 years, as part of the implementation of the National Oral Health Policy, Smile Agus Sláinte. To help address orthodontics waiting lists, €0.25m is a non-pay allocation to support four new consultant orthodontists to provide care to patients.
€2.3 million was provisioned to implement a number of initiatives aimed at improving diabetes care, including commencing the development of a National Diabetes Registry and the commencement of a National Paediatric Audit of Type 1 Diabetes, and two further initiatives related to gestational diabetes. These initiatives focus on improving our information on diabetes patients and health services and improving the provision of care for gestational diabetes.
€1 million was also secured to commence a pilot to test a Framework for Safe Nurse Staffing and Skill Mix in community care settings. The pilot is yet to commence as the research team are undertaking an international review of the evidence.
€0.4 million has been allocated to Community Intervention Teams (CIT’s) to increase HSCP staffing in the teams to support hospital discharge, and €0.1 million was allocated to develop and implement the Model of Care for Long COVID this year.
217. Deputy Alan Kelly asked the Minister for Health the number of WTE clinical nurse specialists in anticoagulation that are based in each hospital part of the South/SouthWest Hospital Group in the years of 2021, 2022 and to date in 2023, in tabular form. [25256/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
218. Deputy Alan Kelly asked the Minister for Health the number of WTE ICU nurses in University Hospital Limerick in the years of 2021, 2022 and to date in 2023, in tabular form; if this number will be further increased; and if so, when. [25257/23]
View answer
219. Deputy Alan Kelly asked the Minister for Health the number of WTE consultant spinal surgeons based at the Mater Hospital in the years of 2022 and to date in 2023, in tabular form. [25258/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
