Thursday, 1 Jun 2023

Written Answers Nos. 41-60

Departmental Reports

Questions (41)

Mattie McGrath

Question:

41. Deputy Mattie McGrath asked the Minister for Health his views on whether it is appropriate for the secretary general of his Department to publicly reject the majority of the findings of a report regarding the abandoned secondment of a former chief medical officer, especially in light of An Tánaiste's support for the report's conclusions, which he described as conclusive and unassailable (details supplied); and if he will make a statement on the matter. [19936/23]

Awaiting reply from the Department.

Hospital Staff

Questions (42)

Pearse Doherty

Question:

42. Deputy Pearse Doherty asked the Minister for Health the plans that are being put in place to address understaffing in Letterkenny General Hospital; and if he will make a statement on the matter. [26679/23]

Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Pharmacy Services

Questions (43)

Alan Dillon

Question:

43. Deputy Alan Dillon asked the Minister for Health if he will consider expanding the role of pharmacists in the Irish health system to include the prescription of some medicines under agreed protocols with GPs to alleviate long GP waiting lists; and if he will make a statement on the matter. [26667/23]

Written answers

Minister for Health

I appreciate the value and importance of pharmacists and pharmacies in conserving, protecting and enhancing the health of our citizens. I recognise that the provision of pharmacy care and service has the potential to be optimised and to evolve, and I am open to consideration of any scheme or proposal that is evidence based to support best patient outcomes, and realise the effective and efficient operation of our health services.

The current regulatory framework in respect of the control of medicines is based on Directive 2001/83/EC, the Irish Medicines Board Act 1995, as amended and the suite of regulations made under this Act. The Medicinal Products (Prescription and Control of Supply) Regulations 2003 as amended provide the comprehensive detail of the current supply system in place. Any proposed evidence based policy change would need to be reviewed in the context of this framework, to establish any necessary legislative, administrative and governance frameworks which would need to be modified to deliver the changes required.

My department is open to engaging with any interested stakeholders in examining any proposals that are evidence based. I look forward to continue to work with key Stakeholders to ensure opportunities are realised in the area of Pharmacy for both the pharmacist, health and social care system and the patient.

Healthcare Infrastructure Provision

Questions (44)

Alan Farrell

Question:

44. Deputy Alan Farrell asked the Minister for Health if he will detail the considerations his Department is giving to the development of an elective hospital in north Dublin as detailed in the HSE Capital Plan; and if he will make a statement on the matter. [26757/23]

Written answers

Minister for Health

The Government is committed to delivering new national standalone Elective Hospitals in Cork, Dublin and Galway, which will enable separation of scheduled and unscheduled care. The new Hospitals will cater for low complexity / high volume cases and will see a large number of patients every day across a range of disciplines. Once established, the Elective Hospitals will provide some 977,700 procedures annually – representing a step change in the way elective care is delivered in Ireland. In December 2022, the Government approved the next stage of the Enhanced Provision of Elective Care Programme and identified preferred sites for the development of new Elective Hospitals in Cork and Galway. The Preliminary Business Case for Dublin is currently being finalised. This includes site selection, with options on publicly-owned lands within the health estate under consideration. Following the required internal and external assurance processes the Preliminary Business Case will be submitted for Government approval-in-principle at Gate 1 of the Public Spending Code. If approved, this will allow the HSE to commence the detailed design stage for Dublin. In the shorter term, the HSE is developing Surgical Hubs to address current waiting times for a narrower set of procedures. These are modelled on the very successful Reeves Centre at Tallaght University Hospital. The Surgical Hubs will be developed in Cork, Galway, Limerick, Dublin (2 locations) and Waterford. On 26 May, the Government announced 4 of the 6 locations for the new Surgical Hubs. The site of the Surgical Hub for north Dublin will be finalised and announced soon. The HSE expects the new hubs to be operational in the next 12-18 months.

Nursing Homes

Questions (45)

Colm Burke

Question:

45. Deputy Colm Burke asked the Minister for Health if he will confirm that the 240 beds which have been lost in public nursing homes and community hospitals in the Cork-Kerry region due to reconfiguration in the past four years, will be replaced by the end of 2023; and if he will make a statement on the matter. [26605/23]

Written answers

Minister of State at the Department of Health

As this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Health Services Staff

Questions (46)

Matt Carthy

Question:

46. Deputy Matt Carthy asked the Minister for Health the number of workers in the healthcare sector who applied for the pandemic unemployment bonus but have yet to receive payment; the number who were determined not to qualify; and the number of appeals received in relation to same. [26742/23]

Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.

General Practitioner Services

Questions (47)

Richard Bruton

Question:

47. Deputy Richard Bruton asked the Minister for Health if he will outline his ambitions for the development of GP care and the challenges in meeting them. [26595/23]

Written answers

Minister for Health

The Government is committed to the continued development of general practice to ensure patients across the country continue to have access to GP services and that general practice is sustainable in all areas into the future.

I recently published the Terms of Reference for a Strategic review of General Practice which is to be completed this year. The Review will examine the issues affecting general practice including GP training, GP capacity, Out of Hours services reform, the eHealth Agenda, and the financial support model for general practice. The Review will then identify the arrangements necessary to improve the current system of GP care as part of a primary care-focused health service and in line with the Sláintecare vision on access.

The Government is aware of the challenges facing general practice, particularly in relation to workforce issues and limited access to GP services in certain areas, and has already taken a number of actions in increase the number of GPs working throughout the State.

Under the 2019 GP Agreement additional annual expenditure provided for general practice has been increased now by €211.6m. The Agreement provides for an increase in capitation fees for participating GPs, additional services, improved family arrangements as well as a targeted €2 million fund to support practices in deprived urban areas.

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.

In addition, the HSE is currently working with the ICGP on a programme to bring 100 non-EU GPs to Ireland in 2023 to help improve access to GP services, particularly in areas with limited access. These new additional posts will work in general practice for a 2-year period following which they will be able to take up a GMS contract. The programme commenced with 25 posts having started in January and is progressing to meet the target of 100 additional non-EU GP placements by year end.

Cancer Services

Questions (48)

Peadar Tóibín

Question:

48. Deputy Peadar Tóibín asked the Minister for Health if his attention has been drawn to a differential in cancer survival rates between patients diagnosed in the public and private health services in the State; and if so, if he will provide details on the differential. [25791/23]

Written answers

Minister for Health

Successive National Cancer Strategies have delivered continuing improvements in outcomes for Irish cancer patients in terms of earlier diagnosis, better treatment, and improved rates of survival. This Government’s commitment to implementation of the National Cancer Strategy is evidenced by significant investment in recent years. €20m new development funding was allocated to cancer services and €15m was allocated for new cancer drugs in both 2021 and 2022. This increased total funding for cancer services to €139m in 2022.

Effective prevention, early diagnosis, access to quality treatment, survivorship, patient involvement, and safe high-quality patient-centred care are key aims of the National Cancer Strategy. The Government has already initiated policy to improve our nation’s health through 'Healthy Ireland - A Framework for Improved Health and Wellbeing 2013-2025', which sets the overarching context in which a focus on cancer prevention will be driven as a cornerstone of this Strategy. The National Cancer Control Programme (NCCP) has published the 'Early Diagnosis of Symptomatic Cancer Plan 2022-2025', which aims to increase the number of symptomatic cancers that are diagnosed at early stage disease.

The model of care for hospital cancer treatment is centred on eight Designated Cancer Centres serving a defined population and geographic area. The centralisation of specialist services into Designated Cancer Centres aims to optimise patient outcomes, through case volume, multidisciplinary working and infrastructural supports.

The National Cancer Registry (NCRI) published a report in 2019, Cancer care and survival in relation to centralisation of Irish cancer services: an analysis of National Cancer Registry data 1994-2015 . This report provides comparisons of five-year cancer-specific survival between three categories of hospitals (designated centres, other public hospitals, and private hospitals), based on where patients were first treated or diagnosed. Comparisons are made for cancers of the oesophagus, stomach, rectum, pancreas, lung, breast, prostate, and brain/central nervous system.

The report found that cause-specific survival of patients improved over time, both nationally and within most hospital categories, for the majority of the cancers and other tumours analysed. There were differences in survival rates between designated centres and private hospitals, depending on the cancer or tumour-type involved.

A number of factors may influence and help explain differences seen in survival, such as stage differences and, to a lesser degree, deprivation status of the patient. The report notes that differences in the appropriateness or quality of treatment and unmeasured differences in general patient health affecting suitability for treatment may contribute to survival differences between hospital categories.

It should be noted that all comparisons are based on hospital category, not on patient status, i.e. whether the patient's care is publicly funded or privately insured. Therefore, figures for cancer centres, and to a lesser extent other public hospitals, include any private patients whose first treatment/diagnosis was in a public hospital.

A full copy of the report including a summary table detailing cause-specific survival of cancer patients diagnosed 2008-2014, by category of hospital where first treated or diagnosed, can be viewed and downloaded from the NCRI:

www.ncri.ie/sites/ncri/files/pubs/CancerCentralisation_NCRI_Jan2019_fullreport_29012019_final.pdf.

Emergency Departments

Questions (49)

Peadar Tóibín

Question:

49. Deputy Peadar Tóibín asked the Minister for Health the total number of persons who left the emergency department of Our Lady of Lourdes Hospital, Drogheda, without being seen, in each of the past ten years; and if he will make a statement on the matter. [25790/23]

Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Vaccination Programme

Questions (50)

Marc Ó Cathasaigh

Question:

50. Deputy Marc Ó Cathasaigh asked the Minister for Health if his Department will consider the creation of a no-fault vaccine injury compensation scheme as exists in other jurisdictions; and if he will make a statement on the matter. [26672/23]

Written answers

Minister for Health

My Department and the HSE work continuously to monitor and improve patient safety, reduce incidents of harm and to minimise risk.

Government recently approved the establishment of an Interdepartmental Working Group to examine the rising cost of health-related claims and consider mechanisms to reduce costs. The Group will examine the rising cost of clinical negligence claims in the health system, with a particular focus on high value claims, and identify measures that could be put in place to reduce future costs. The Group is chaired independently by an expert healthcare professional, Dr Rhona Mahony, and is comprised of membership from across key Government Departments and Agencies.

With respect to vaccination, patients concerned with a possible side-effect or adverse reaction following a vaccination should, in the first instance, consult with their medical practitioner who can refer them as necessary to appropriate services following clinical assessment.

It should also be noted that vaccines can only be approved and used if they comply with all the requirements of quality, safety and efficacy set out in relevant EU pharmaceutical legislation. Any authorised vaccine will be subject to ongoing monitoring in Ireland by the Health Products Regulatory Authority (HPRA). The latest safety updates from the HPRA regarding COVID-19 vaccinations are available on the HPRA’s website: www.hpra.ie/homepage/medicines/covid-19-updates/covid-19-vaccine-communications.

Regarding a vaccine damage compensation scheme, during the pandemic, all available Department of Health resources were devoted to the Public Health response. This has meant that work in this area could not be progressed. Further scoping work is required to inform decision-making in this area. This remains under consideration by my Department.

Care of the Elderly

Questions (51)

Rose Conway-Walsh

Question:

51. Deputy Rose Conway-Walsh asked the Minister for Health if he will outline plans to reopen community beds in Mayo and increase home help provision; and if he will make a statement on the matter. [26716/23]

Written answers

Minister of State at the Department of Health

As these are operational matters, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Substance Misuse

Questions (52)

Brendan Griffin

Question:

52. Deputy Brendan Griffin asked the Minister for Health if he will consider a campaign to highlight the negative personal health effects of cocaine use; if his Department can provide up-to-date statistics on the prevalence of patients with conditions related to cocaine use; and if he will make a statement on the matter. [26670/23]

Written answers

Minister of State at the Department of Health (Deputy Hildegarde Naughton)

Cocaine is a stimulant type drug that can make people feel more alert, energetic and confident. It can cause significant health risks and long terms harms such as dependency. The effects of cocaine start quickly but are short lived meaning they wear off quickly which can lead a person to re-dose. Cocaine causes the release of the chemical dopamine in brain circuits which results in a euphoric feeling or ‘high’. The high is sometimes followed by what is known as a ‘crash’ or ‘comedown’ where the person can feel very low.

A comprehensive factsheet on cocaine use in Ireland is available from the Health Research Board HRB Document Template (drugsandalcohol.ie).

Information about cocaine, its effects and harm reduction advice is available on Drugs.ie Cocaine Information and Risk Reduction - Drug and Alcohol Information and Support in Ireland - Drugs.ie

In response to an increase in the use of cocaine powder and crack, the HSE and the Ana Liffey Drugs Project have developed a campaign to reduce the harms associated with cocaine use. This includes information and harm reduction resources for people who use drugs and healthcare professionals, and is available here Cocaine - Drug and Alcohol Information and Support in Ireland - Drugs.ie

Data from the National Drug Treatment Reporting System shows that in 2021 there were 3,248 cases presenting for treatment of cocaine. Crack cocaine accounted for 16.9% of all cases treated for cocaine as a main problem. Treatment services have responded to the increase in cocaine use in society by providing a growing number of people with appropriate care. 

While there is not a specific replacement medication for cocaine, many people require treatment for comorbid conditions, such as depression, anxiety and in some cases, psychosis. The principle treatment approach for cocaine use is psychological in nature.

Developing harm reduction responses and integrated care pathways for high-risk drug users including the use of cocaine and ‘crack’ cocaine is a strategic priority for the National Drugs Strategy for the period 2021-2025. This initiative will also contribute to a whole-of-government response to the social determinants and consequences of drug use in disadvantaged communities.   

In January 2022, the Department of Health announced €850,000 in recurring funding for an HSE-led initiative to reduce the health-related harms associated with the use of cocaine and ‘crack’ cocaine, with a further €500,000 awarded in 2023 .  The funding supports models of best practice in cocaine treatment, including the development of training programmes for addiction service staff nationally, and the establishment of targeted interventions in disadvantaged communities worst affected by cocaine and ‘crack’ cocaine.  Initiatives were funded in four CHOs - CHO 3, CHO 4, CHO 7 and CHO 9.

I am committed to supporting initiatives to reduce the harms associated with cocaine use.

Mental Health Services

Questions (53)

John Brady

Question:

53. Deputy John Brady asked the Minister for Health if he will provide a reply to the recent response to the report from the Ombudsman for Children’s Office on Child Mental Health titled ‘A Piece of My Mind’; and if he will make a statement on the matter. [26081/23]

Written answers

Minister of State at the Department of Health

The Government remains committed to the development of all aspects of mental health services nationally, including those for children and young people. The total allocation for mental health services in 2023 is over €1.2 billion. This is another record budget for mental health services. A key objective is to improve access and address CAMHS waiting lists, in light of increasing demand and case complexity.

The Government welcomes the publication by the Ombudsman for Children’s Office (OCO) of the A Piece of My Mind report which helps us further understand the challenges that may exist in the provision of youth mental health services.

Minister Butler has met recently with the Ombudsman for Children to discuss youth mental health, including capacity challenges.

Evidence shows that only 2% of children and young people need the support of the specialist CAMHS multidisciplinary teams. Access is on basis of prioritised clinical assessment. Between 2020 and 2021, referral rates into CAMHS increased by 33%, while the number of new cases seen increased by 21% in that same period. 93% of urgent referrals to CAMHS have been responded to within three working days, exceeding the 90% target. 225,000 appointments were facilitated by CAMHS multidisciplinary teams during 2022.

Last month, Minister Butler completed a series of three high-level roundtables bringing together Department of Health, the HSE, and other key stakeholders across the youth mental health area to drive improvement in CAMHS with a focus on executive leadership, clinical expertise, and service provision.

While the Ombudsman’s report highlights some of the negative aspects of CAMHS, we must not lose sight of the tremendous work carried out by our specialist CAMH service and staff that benefits so many vulnerable young people and their families.

The Programme for Government commits to improve all aspects of CAMHS in line with Sharing the Vision and Connecting for Life, and the annual HSE Service Plans.

All aspects of CAMHS will be developed under the HSE Service Plan 2023, including a new post of Youth Mental Health Lead at Assistant National Director level, and a new Clinical Lead for Youth Mental Health, for the HSE to provide more integrated services overall. Recruitment is underway.

In collaboration with local CAMHS services, a waiting list initiative is underway specifically targeting areas where children and young people have waited longer than nine months.

Overall, there has been an increase of 91 in Mental Health service staffing numbers from 10,362 in December 2021 to 10,453 in December 2022.

The HSE increased staffing in community CAMHS from 388.76 WTEs in 2011 to 659 in December 2021.

The HSE is fully utilising opportunities offered by telehealth technologies to mitigate recruitment challenges and modernise delivery of mental health care.

The 35 recommendations arising from the Maskey report reviewing South Kerry CAMHS care will help improve all aspects of CAMHS care nationally. The latest HSE implementation framework contains a total of 63 actions (local and national) against the 35 recommendations. The 35 recommendations led to 63 actions, 19 of which (national and local) have been implemented, with others underway.

To provide assurance to those who use CAMHS, the HSE has commissioned independent national audits in relation to: prescribing practice, compliance with Operational Guidelines, and research into service user experiences of CAMHS.

The Mental Health Commission are also undertaking an audit of all 75 CAMHS teams. An Interim Report was published on 23 January last covering 5 of the 9 CHOs. The Government and the HSE has accepted the findings and recommendations of the recently published Interim Report of the Commission and is progressing consequent actions as appropriate. The final Mental Health Commission Report is expected around May.

10 new CAMHS beds are planned to open at the new Portrane Hospital and 20 new CAMHS beds are planned for the National Children’s Hospital.

Young people with mild to moderate mental health difficulties can access support at Primary Care level either through the HSE or through a range of organisations fully or partially funded by the HSE. Organisations that provide education and other support/clinical interventions at primary care level for young people and their families include Jigsaw, My Mind, Turn2Me and SpunOut.

The HSE provides around €137 million to CAMHS annually. In addition, it provided over €80 million to community-based mental health organisations in 2022 and a significant proportion of this was dedicated to those supporting child and young people.

Text 50808, funded by the HSE, provides immediate support for people going through mental health or emotional crisis. By the end of last year, the service was providing over 5,000 ‘conversations’ per month to support people of all ages.

Health Strategies

Questions (54)

David Cullinane

Question:

54. Deputy David Cullinane asked the Minister for Health his plans to introduce a national hearing strategy; and if he will make a statement on the matter. [26720/23]

Written answers

Minister for Health

The National Audiology Review Group Report, published by the Health Services Executive (HSE) in 2011, identified shortcomings in the audiology services available at the time (including access issues, poor information, inadequate staffing, and unacceptable waiting times) and made recommendations to address these issues.

While most of these recommendations have been implemented, and the remaining recommendations are being progressed, there is still work to do in relation to the community audiology waiting lists. These have been exacerbated by the COVID-19 pandemic and the HSE is actively looking at all options to increase activity and minimise patient wait times nationally. Activity has now returned to pre-pandemic levels.

The rollout of a National Audiology Clinical Management system for community and acute services is facilitating accurate data collection, including for the purposes of waiting list management.

The World Health Organisation’s World Report on Hearing published in March 2021 recommends, among other things, that governments develop a comprehensive people-centred hearing care plan within their national health care plan.

The HSE published revised Best Practice Guidelines for the Provision of Hearing Aid Services for Adults in Ireland on the 7 February 2023. The HSE also published Quality Standards for Paediatric Community Audiology Services on the 13 October 2022. These standards are sequenced to reflect the patient pathway.

In light of the recent development of best practice guidelines and standards, the Department is examining further with the HSE the need for an additional hearing care plan. The Department continues to liaise with the HSE to improve health outcomes for all those suffering from hearing loss.

Primary Care Centres

Questions (55)

Catherine Connolly

Question:

55. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Question No. 1569 of 18 April 2023, the status of the development of a primary care centre on Inisbofin; the status of the land transfer process; the expected timeline for the completion of the land transfer; the progress to-date on the appointment of a design service for the primary care centre; and if he will make a statement on the matter. [26571/23]

Written answers

Minister for Health

As 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.

Covid-19 Pandemic

Questions (56)

Marc Ó Cathasaigh

Question:

56. Deputy Marc Ó Cathasaigh asked the Minister for Health if his Department plans to expand capacity in respect to the impact of long-Covid on those impacted, either in terms of clinical research or the provision of services; and if he will make a statement on the matter. [26673/23]

Written answers

Minister for Health

As the matter raised is a service delivery matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.

Hospital Waiting Lists

Questions (57)

Gino Kenny

Question:

57. Deputy Gino Kenny asked the Minister for Health if he is aware that an organisation (details supplied) recently reported that over 1.1 million people are waiting for some form of hospital care, with 888,600 people on National Treatment Purchase Fund waiting list and a further 250,000 people waiting for diagnostics; and if he will make a statement on the matter. [26576/23]

Written answers

Minister for Health

It 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 the 7th 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.

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 report reference by the Deputy is based on the National Treatment Purchase Fund's April 2023 waiting list figures for acute public hospitals published on 12th May and a diagnostic waiting list report of Q1 2023. The waiting list figure of 888,600 quoted is a consolidated high-level figure that includes just over 706,000 patients who are waiting for an appointment for their procedure or their first outpatient consultation. It also includes 96,827 patients under surveillance or receiving a course of treatments who have received their first treatment but will require further treatment; 29,691 patients who have received an appointment for their procedure within the next six weeks; 55,566 patients who are receiving treatment through an outsourcing or insourcing arrangement and patients who temporarily cannot proceed with their care for clinical, personal or social reasons.

In relation to diagnostics waiting lists a pilot project commenced in 2016 by the HSE Acute Hospitals Division to progress the collection of national radiology waiting list data. In Q1 2023, there were a total of 250,021 patients reported on the waiting list for CT, MRI and Ultrasound from all sites, this represents all outpatients waiting, urgent, semi urgent, routine and planned/surveillance (where diagnostic access is planned at particular time intervals).

The information that is currently being collected is presently being tested and validated at hospital, hospital group and national level and as such should not be used/reported without the context of the caveats set out below:

Data is subject to inclusions and exclusions which are documented in the Data Profile Document. This document is available from Acute Operations and has been circulated to all Hospital Groups.

Data contains urgent, routine and surveillance/planned activity which is currently not broken down in detail, as such this includes surveillance/planned activity which may not be exceeding planned date.

Data is still undergoing validation at Hospital and Hospital Group level. Data does not take into account local nuances at site level (Site profile developed to support understanding of same).

The purpose of this aggregate data is to provide a National Level overview of the number of patients waiting for modalities of CT, MRI and Ultrasound.

This report is not intended to be used for the active management of hospital diagnostics waiting list, local reports and mechanisms should continue to be used for the management of diagnostics waiting lists at hospital level.

Health Promotion

Questions (58)

Ruairí Ó Murchú

Question:

58. Deputy Ruairí Ó Murchú asked the Minister for Health when the review of the impact of the sugar tax will be conducted and published; and if he will make a statement on the matter. [25897/23]

Written answers

Minister of State at the Department of Health

A Healthy Weight for Ireland, the Obesity Policy and Action Plan (OPAP), was launched in September 2016 under the auspices of the Healthy Ireland Framework (Healthy Ireland: A Framework for Improved Health and Wellbeing 2013-2025). It was developed in recognition of the growing need for a co-ordinated policy response to the increasing problem of obesity in Ireland and the increasing burden placed on individuals and society.

OPAP covers a 10-year period up to 2025 and aims to reverse obesity trends, prevent health complications, and reduce the overall burden for individuals, families, the health system, and the wider society and economy. It recognises that obesity is a complex, multi-faceted problem and needs a multi-pronged solution, with every sector of society playing its part. Childhood obesity is a key priority under OPAP, as is reducing the inequalities seen in obesity rates, where children (and adults) from lower socioeconomic groups have higher levels of obesity. OPAP is well aligned with the World Health Organisation in terms of the breadth of policy measures that have been introduced or are being considered in order to address the obesity epidemic.

With regard to fiscal measures as a policy option to address obesity, in its “Foundations for the Future” report published in 2022, the Commission on Taxation and Welfare recognised that the taxation system is “one of a number of policy tools that can be used to support better public health” and made recommendations that the Government develop fiscal measures to encourage a reduction in the consumption of ultra-processed foods, support reformulation measures to reduce the harm of such foods and promote healthier eating.

Under OPAP, commitment was given to “develop proposals for a levy on sugar-sweetened drinks”, “develop proposals on the rollout of evidence-based fiscal measures to support healthy eating and lifestyles” and “review the evidence…for fiscal measures on products that are high in fat, sugar and salt.”

Following a proposal developed by this Department in consultation with stakeholders, the Department of Finance introduced the Sugar-Sweetened Drinks Tax (SSDT) in 2018. The SSDT has now been in operation for more than four years. Initial indications are that the tax has had a positive impact, particularly in terms of encouraging drinks producers to reduce the sugar content in their products. A more comprehensive analysis of the effects of the tax is needed in order to inform any further fiscal policy considerations, and the Department has commenced an evaluation of the measure.

A literature review was carried out by the Department to make an assessment of the potential approaches to evaluate the impact of the tax. Further work on the analysis of the impact of the measure is expected to be carried out in the coming months and it is the intention of the Department to publish the findings.

The outcome of this analysis will assist the Department of Health in terms of examining and considering any possible further measures, in consultation with the Department of Finance.

Health Services

Questions (59)

David Stanton

Question:

59. Deputy David Stanton asked the Minister for Health the ways that he is encouraging and supporting the reduction of paper-based systems in the health service; and if he will make a statement on the matter. [26613/23]

Written answers

Minister for Health

Thank you for your question Deputy. Whilst there are various mechanisms whereby we can support the reduction in paper-based systems used in the health service, including fundamental redesign of processes, the most obvious way to transition away from paper is to modernise the health system through the digitisation of processes and procedures. There are clinical and non clinical areas across the health service that will benefit from this approach and when such systems are deployed this also acts as a catalyst to revisit existing and legacy processes so that we gain the true benefit associated with applying digital technologies to the services that we provide to patients and how we manage the health service operationally.

Examples of where paper based processes are being replaced from across the health service include the use of electronic referrals from GPs to hospitals, the elimination of paper scripts in the community - a change introduced as a means of improving social distancing by avoiding unnecessary visits to GP surgeries for repeat prescriptions during the pandemic, the electronic transfer of laboratory test results from hospitals that previously would have been issued by post, the use of Patient Administration Systems across all our hospitals, the deployment of clinical, departmental systems such as those used in ICU, our National Imaging System that has mostly eliminated the use of film entirely, using digital images instead, Electronic Health Record system deployments at maternity hospitals and at our largest hospital, St James Hospital Dublin, and the national integrated financial system that is currently well advanced with 80% of all transactions managed by this system by 2025.

As we plan for the future and continue to invest in clinical and operational systems, we will see a steady reduction in our reliance on paper based systems. Such developments will need to be equally matched by our investment in security and sophisticated disaster recovery systems and processes that are critical as we transition from paper to digital.

Health Services Staff

Questions (60)

Duncan Smith

Question:

60. Deputy Duncan Smith asked the Minister for Health the actions he has taken to ensure the implementation of the recommendations contained in the Review of Role and Functions for Health Care Assistants, published in December 2018; and if he will make a statement on the matter. [26662/23]

Written answers

Minister for Health

In 2016, the Department of Health requested the HSE to establish a working group with an independent chair to conduct a comprehensive review of the role and function of the Health Care Assistant in the Health Service. This work was completed under the leadership of Mr. Sean McHugh and the report ‘Review of Role and Function of HealthCare Assistants (HCAs)’ was published in December 2018.

The Covid 19 Pandemic delayed the work associated with progressing the recommendations. However dedicated resources have been secured by the HSE to roll out this programme of work which is planned to be delivered in three phases. An Oversight group with an independent chair, Mr. Ray McGee has been established to provide governance and strategic oversight to this programme. All relevant stakeholders including Nursing and HCA staff representative bodies were invited and are members of this oversight group and various other work streams.

The overall principle of the work is to provide standardisation of many areas associated with the HCA role and national oversight of the grade. The recommendations in this report are categorised under four sections and work streams have been established accordingly.

The ‘Role & Function’ workstream is presently working on standardising the job descriptions for HCAs working in different sectors namely acute, community (primary care), mental health, older persons, and disabilities. The work is to ensure that the Job specification is future focused.

The ‘Training & Development’ workstream has collated information on all training modules and modular extensions delivered through the 23 Centre for Nursing and Midwifery Education (CNME) and is working on gathering information on Lifelong Learning opportunities that exist for HCAS.

The role of the ‘Data’ workstream is to ensure that all relevant information related to this staff grade is recorded appropriately and that there is a national oversight of this information.

The ‘communication and stakeholder engagement’ workstream’s role is to ensure that the work completed thus far in this programme is communicated to the services, HCAs and the wider Health Service including the Department of Health.

This work will assist the 22,000 HCAs working in HSE and Section 38 organisations.