Written Answers Nos. 61-80
61. Deputy Violet-Anne Wynne asked the Minister for Health the action that will now be taken following the successful passage of the motion regarding Targeted Investment in the Health Service in Dáil Éireann; and if he will make a statement on the matter. [26691/23]
View answerAwaiting reply from the Department.
62. Deputy Holly Cairns asked the Minister for Health the actions he is taking to ensure employees of Section 39 organisations receive the same pay and conditions as their counterparts employed in the HSE. [26393/23]
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. 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 took place at the Workplace Relations Commission on 15 May. A further up engagement is due to take place on 12 June. As this is an ongoing Industrial Relations process, it would be inappropriate to comment any further at this point.
It is important to note that none of the organisations who are attending these exploratory talks at the WRC are the employers of the staff in question.
The Department notes that this is a cross-sectoral issue and cannot be taken in isolation.
63. Deputy David Cullinane asked the Minister for Health the timeframe for the commencement of services at the new National Children's Hospital; the estimated costs and target completion date; and if he will make a statement on the matter. [26721/23]
View answerThe New Children’s Hospital (NCH) project comprises the main hospital on a shared campus at St James’s, and two Outpatient and Urgent Care Centres at Connolly and Tallaght hospitals. Both satellite centres are now open and successfully delivering a new model of ambulatory and urgent care for children and adolescents in the Greater Dublin Area.
I am fully committed to ensuring the New Children’s Hospital at St. James’s is completed as quickly as possible on behalf of children and their families.
Works are progressing well on the main site, with the construction and equipping phase now over 85% complete against contract value. The large glass biome, that envelopes the panoramic lifts providing intuitive access to all areas of the building, is complete, as well as the rooflights and ward end glazing to the Level 4 Rainbow Garden. Landscaping and tree planting is underway in the outdoor areas. The elevated helipad space is progressing into the final stages of assembly, with helipad structure completed. The major focus in 2023 continues to be the internal fit-out and commissioning of mechanical and electrical services. The first of the 4,600 clinical rooms have been completed and the remaining rooms will follow in a planned sequence.
Government has been previously advised that the project and programme will take longer and therefore cost more. The last construction programme received from the main contractor, BAM, suggests substantial completion on the build could be achieved by March 2024. The National Paediatric Hospital Development Board (NPHDB) continues to engage with the contractor to secure an updated and compliant programme, as required under the construction contract, to get certainty on this substantial completion date and to focus on ensuring that everything possible is being done to complete the construction project as soon as possible. Following substantial completion the hospital will be handed over to Children’s Health Ireland (CHI) for a period of operational commissioning. Planning for the complex process of commissioning over 6,150 spaces to be ready to accommodate services for patients, post substantial completion, is well advanced.
There remain risks beyond the control of the NPHDB and the contractor to the timeline, arising from Brexit, the global pandemic, the invasion of Ukraine and its impact on supply chains, global supply chain difficulties more generally, including shortages of construction raw materials, and the current inflationary pressures on energy and material costs.
In 2018, the previous Government approved a capital budget of €1.433bn for the NCH project. This included the capital costs for the main hospital at St. James’s Hospital campus, the two satellite centres, equipment for the three sites, and the construction of the carpark and retail spaces. €1.3bn has been drawn down to date against this budget.
Additional costs in relation to the integration and transfer of services of the three hospitals to the new sites brings the total programme cost to €1.73bn. This includes investment in ICT, a new Electronic Health Record system, and the Children's Hospital Integration Programme, (the merging of three paediatric hospitals), including commissioning. Detailed planning around the commissioning, staff training and transfer of services to the new hospital is well advanced.
A number of items were not included in this investment figure, as there was no price certainty for them and nor can there be, for some, for the duration of the project. These include construction inflation, the impact of unforeseen events (e.g. Covid-19), statutory changes, the contractor’s right to claim for additional true costs in line with public works contract provisions, and implementation of the 2019 PwC report recommendations.
Definitive updates or outturn forecasts costs cannot be provided, as there is a live, commercially sensitive contract in place. Discussion of any costs outside of the approved budget, hypothetical or otherwise, could adversely affect the NPHDB’s commercial engagements, contractual relationships and consequently the project itself.
Whilst there is a focus on the capital project and its delivery, we must not lose sight of the fact that the NCH project will deliver world class facilities that will improve and prioritise medical outcomes for the nation’s sickest children, while bringing about transformational change to the delivery of healthcare for the children of Ireland for generations to come.
64. Deputy David Cullinane asked the Minister for Health when CORU will complete the regulation of allied health and social care professions, such as, but not limited to, psychologists, in line with its statutory obligations. [26722/23]
View answerSet up under the Health and Social Care Professionals Act 2005 (as amended) CORU is made up of the Health and Social Care Professionals Council and the Registration Boards. To date, registers have opened for eleven of the seventeen professions designated for regulation by CORU. These include: Dietitians/dieticians; Medical Scientists; Occupational Therapists; Optometrists & Dispensing Opticians; Physiotherapists/Physical Therapists; Podiatrists/Chiropodists; Radiographers; Social Workers and Speech and Language Therapists.
CORU is continuing the substantial work required to open the registers for the remaining designated professions of Social Care Workers; Counsellors and Psychotherapists; Clinical Biochemists; Psychologists and Orthoptists and ensure public protection of service users in Ireland.
The Social Care Workers Register will open on 30th November 2023. This will begin a 2-year transition period for existing practitioners to apply to register with CORU. On 30th November 2025, the title 'Social Care Worker' will become a legally protected title in Ireland.
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 a lack of consensus on how to proceed with regulation. Having reached an impasse, CORU wrote to me on behalf of the PSRB seeking guidance on how to proceed. I wrote to CORU in August 2022 requesting the PSRB consider a dual stream and phased approach to regulating the profession, which would allow the PSRB to prioritise regulating 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 24th 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.
Counsellors and Psychotherapists were designated for regulation by my predecessor through S.I. No. 170 in 2018. The Counsellors and Psychotherapists Registration Board (CPRB) was established in 2019. The ongoing work of the CPRB 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. The work of the Counsellors and Psychotherapists Registration Board, like the PSRB, is significantly more challenging than it is for registration boards of some of the more established professions owing to the different and complex pathways into these professions, the variety of titles used, and the variety and number of courses and course providers.
To date, the following progress has been made by the Counsellors and Psychotherapists Registration Board:
• Identification, verification and comprehensive assessment of legacy/historical qualifications to determine if they are appropriate for transitioning existing practitioners onto the respective registers (when open);
• Scoping and research on the regulation of counsellors and psychotherapists internationally has been conducted;
• Approval of draft education and training standards which will issue for public consultation in the Autumn of 2023.
Owing to the significant body of preparatory work that these registration boards are required to undertake; it is not possible to say with any degree of accuracy when the professions will be fully regulated. I would anticipate that these registration boards will require several years to complete their work.
Clinical Biochemists and Orthoptists are professions which are designated for regulation by CORU under the Act. However, registration boards have not yet been established for Clinical Biochemists and Orthoptists but their regulation will be progressed in due course.
65. Deputy Thomas Pringle asked the Minister for Health if he will outline the policy that regulates our health services' international cooperation, in light of the National Ambulance Service's recent trip to Israel's national emergency medical service; and if he will make a statement on the matter. [26676/23]
View answerInternational engagement in the health sector takes place across a wide range of areas and at all levels, from ministerial and official to technical and clinical. I am very supportive of Ireland’s international engagement in the health area and the clear benefit it brings, from exchange of expertise and best practice to helping address shared challenges. Much of this engagement takes place in multilateral settings including through the European Union and World Health Organisation. In the case of bilateral engagement, observations may be sought from the Department of Health, which links with the Department of Foreign Affairs as appropriate, to ensure a proposed engagement is compatible with Government policy positions. This was the case with the recent study visit by the National Ambulance Service to Israel’s national Emergency Medical Service.
66. Deputy Paul McAuliffe asked the Minister for Health if he will provide an update on the Finglas primary care centre; and if he will make a statement on the matter. [26697/23]
View answerFinglas has long been identified as a priority location for the development of a Primary Care Centre (PCC) due to the population level, care requirements for the community and the HSE Sláintecare programme which will provide care for patients closer to their home.
Finglas PCC is included in the Capital Plan 2023. A design team has been engaged for the project, the preliminary design (Stage 1) report is expected to be completed by end Q2 2023.
The Finglas PCC will be located on a block of land between Cappagh Road, Cardiffsbridge Road, Wellmount Avenue and Fergal’s Lane. These lands offer an opportunity to provide and enhance facilities for the local community in Finglas.
The legal process to transfer the land is in progress and the HSE are engaging with all parties to complete the necessary property transactions. It is anticipated this process will be concluded in the second half of 2023, which will facilitate further progress through design and planning stages of the project including the submission of a planning application in due course.
Upon completion of the legal process to transfer the land, the HSE will be able to give a further update on the status of the proposed primary care centre in Finglas.
67. Deputy Gino Kenny asked the Minister for Health if he is aware it is almost ten years since the HSE has reviewed medical card eligibility on medical grounds, and the effectiveness of the system of assessment for a discretionary medical card; and if he will make a statement on the matter. [26574/23]
View answerMedical Card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE, which assesses each application on a qualifying financial threshold.
The issue of granting medical or GP visit cards based on having a particular disease or condition was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.
However, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.
I can assure the Deputy that, to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues under review and any changes are considered in the context of Government policy and other issues which may be relevant.
68. Deputy David Cullinane asked the Minister for Health his plans to bring forward new professional regulations for the dental profession in line with the requests of their representative body; and if he will make a statement on the matter. [26719/23]
View answerThe Dental Council's Code of Practice for Dentists currently requires that all practising dentists should be able to provide evidence that they have undertaken sufficient continuing professional development and personal development to keep their clinical knowledge and skills up to date. Although this requirement is not set down in legislation, the obligation to maintain CPD does exist and can be raised as part of a fitness to practice claim against a practitioner. The custom to participate in CPD is well established in Ireland amongst the profession.
The Department is supportive of maintaining professional competency, to which CPD contributes, however it is essential that any legally mandatory model of CPD will be proportionate and pragmatic to impose the minimum restrictions on practice. In view of this, and as required by Directive (EU) 2018/958 which considers the proportionality of new regulations of professions, a rigorous proportionality assessment and public consultation must be carried out and the outcome of this assessment cannot be predetermined.
Dental practices are in the main small to medium sized enterprises (SMEs). Meeting the requirements of legally required CPD is a considerable burden for SME’s. This will also require consultation and a thorough impact assessment.
The introduction of a legally mandatory model of CPD will be a significant step. To ensure the implementation of this change is successful it will be important to take a pragmatic stepwise approach and put in place a framework of support to facilitate the dental profession in taking this step.
In the circumstances it is not possible to give a definitive timeline on introducing mandatory CPD for the dental profession.
69. Deputy Sean Sherlock asked the Minister for Health if he is aware of the concept and practice of social prescribing; and if his Department will support budgetary measures to make the practice widespread. [19391/23]
View answerEvidence shows that social isolation is a significant issue for population health, with links to multiple chronic health conditions. The pandemic was a major contributory factor to increases in social isolation and the 2021 Healthy Ireland Survey, carried out while significant restrictions were still in place, found a significant increase in isolation and a decrease in the proportion of the population reporting positive mental health. Some 81% reported lower levels of social connectedness and 30% reported worsening mental health since the start of the pandemic.
Social prescribing is a key means of linking patients, through primary care, with community-based supports, including arts and creativity, physical activity, group supports, green activity and computerised therapy. It has been shown to result in positive emotional, cognitive and social outcomes, and to reduce social exclusion for disadvantaged, isolated, lonely and vulnerable people, many of whom live with depression and anxiety.
In 2021, following pilots in a number of regions of the country, the HSE published its Social Prescribing Framework to set out a common approach to the mainstreaming, integration and delivery of social prescribing across the organisation. Social Prescribing is a key part of health service provision and is being integrated across Community Healthcare Networks in line with the HSE Social Prescribing Framework and is also identified as a priority in the HSE Mental Health Promotion Plan Stronger Together.
Social prescribing is receiving very significant annual funding and supports from this Government and is delivered by the HSE and community partners. It received a total allocation of €2.68 million in 2023, increasing the number of link workers to 40 across the country. 19 of these link workers are located within the Sláintecare Healthy Communities Programme areas. By Q4 2023 there will be a social prescribing service in every county in Ireland. All of these services are delivered by community and voluntary organisations in partnership with the HSE. For a list of HSE funded social prescribing services see allirelandsocialprescribing.ie/members-map/.
Sláintecare Healthy Communities (SHC) is a cross-Government initiative that delivers health and wellbeing services and supports to 19 community areas of greatest need across Ireland. Social Prescribing is integrated into the Healthy Communities programme and is being provided in each community via local development companies and family resource centres. Social Prescribing Link Workers in each SHC area empower individuals to access local services to improve their mental health and wellbeing. To enable this, the link workers establish strong relationships with a range of health services locally, including primary care, mental health, community dieticians, self-management support programmes etc. At present. across the 19 areas, there are approximately 500 new open social prescribing cases per quarter.
The HSE Integrated Care Programme for Older Persons (ICPOP) programme have set up and will provide a specialist service to older people, similar to services provided by Social Prescribing Link Workers – known as a Community Connector. This is a specialist service for a specific cohort of older patients upon discharge from ICPOP and is being piloted across the HSE (one per CHO).
HSE Health & Wellbeing are putting multiple supports in place for standardised and nationwide implementation of social prescribing as follows:
• An HSE Social Prescribing Advisory Group has been established to provide direction and guidance for its implementation and integration within the HSE. The Group includes HSE cross sectoral colleagues, link workers, managers of host organisations and a service user.
• An e-learning module for Health Professionals on social prescribing is in the final stages of development and will be available on HSELand in the coming months.
• An Outcomes Framework for social prescribing is being established by the HSE, based on measures of mental wellbeing and social connectedness.
Post-pandemic, with vaccines and sensible precautions, and as reconnecting with others has numerous physical and mental health benefits, Healthy Ireland developed a nationwide media campaign, launched on 1st March 2023, aimed at older people to encourage them to rebuild their social connections and re-integrate into their communities. It is now safe for older people to reconnect with the world, to say “Hello Again World”, make up for lost time and re-establish important connections with their community.
Social prescribing is a key element of that reconnection process - further information on social prescribing and how to access it, including via self-referral, is available on the HSE website, under social prescribing.
70. Deputy Brendan Griffin asked the Minister for Health the progress that has been made over the past 25 years on smoking rates; and if he will make a statement on the matter. [26671/23]
View answerAccording to SLÁN Survey 1998, 33% of respondents reported being current smokers. The 2022 Healthy Ireland Survey reported that 18% of the population are current smokers.
Much of this progress is attributable to the tobacco control measures introduced over the past number of years. Achievements made in this area in recent decades include:
• A ban on sale of tobacco products to individuals under 18 years of age (2001) - (Health (Miscellaneous Provisions) Act 2001)
• Work-place smoking ban (2004)
• Ban on the advertising of tobacco products in accordance with Directive 2003/33/EC (2004)
• A ban on packets containing less than 20 cigarettes (2007)
• A ban on the sale of confectionaries that resemble cigarettes (2007)
• A ban on the point of sale display and point of sale advertising of tobacco products (2009)
• A requirement for all tobacco products to be stored within a closed container which can only be accessed by the retailer (2009)
• A requirement for all retailers who wish to sell tobacco products to register with the National Tobacco Control Office (2009)
• A prohibition on self-service vending machines except in licensed premises or in registered clubs (2009)
• Combined text and photo warnings (graphic warnings) (2013)
• Development of National Policy Tobacco Free Ireland (2013)
• Social marketing and media campaigns, establishment of a National Smokers Quitline, social media and online cessation supports (on-going)
• Development of smoking cessation services (on-going)
• Nicotine Replacement Therapy available free to all medical card holders (ongoing)
• Increased excise duty on tobacco products (on-going)
• A ban on smoking in cars where children are present. (2016)
• Adoption and transposition of the EU Tobacco products Directive (2016).
• Standardised Packaging of Tobacco Products (2017)
• Publication of National Clinical Guideline on Stop Smoking. (2022)
• Removal of VAT from all forms of Nicotine Replacement Therapy (2022)
The Public Health (Tobacco Products and Nicotine Inhaling Products) Bill is expected to be enacted this year. The Bill will:
• Introduce a strict licensing system for the retail sale of tobacco products and nicotine inhaling products.
• Introduce new restrictions on the sale of tobacco products and nicotine inhaling products and further restrictions on the advertising of nicotine inhaling products.
• Provide additional enforcement powers to the Environmental Health Service for the new measures in the Bill and for all previous Tobacco Control Acts.
71. Deputy Éamon Ó Cuív asked the Minister for Health the input the Government and he will have into the naming of the new Children’s Hospital, Dublin, in view of the large amount of Exchequer funding involved in the project; if it is intended to propose that the new children’s hospital on the site of St. James’s Hospital would be named after Dr. Kathleen Lynn, in view of the pioneering work she did for children’s health; and if he will make a statement on the matter. [25486/23]
View answerThe New Children’s Hospital project remains the most significant capital investment programmeundertaken in the healthcare system in Ireland. It will provide world-class, state of the art facilities where our healthcare professionals will deliver optimal care, leading to better health outcomes for all. This is a much-needed and much-deserved investment in our children and young people. I acknowledge the importance of the naming of the New Children’s Hospital, which is a key enabler in the strategic reform of healthcare services for children and young people for generations to come.Children’s Health Ireland is undertaking a branding process, following which the Government will be making a decision on the naming of the New Children’s Hospital in due course.
72. Deputy Aindrias Moynihan asked the Minister for Health when the new expanded criteria to qualify for a GP card will be in place; the reason for delay in this being implemented; and if he will make a statement on the matter. [26706/23]
View answerThe 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. Approximately 400,000 additional individuals are estimated to become eligible for a GP visit card under this expansion.
My Department and the HSE are engaged in intensive discussions with the IMO in relation to the concerns they have expressed around the roll-out of this increase in eligibility. These talks, which include engagement on the best use of the additional funding provided in Budget 2023 to support capacity in general practice, are currently ongoing. In the meantime, the necessary planning and administrative development work to provide for the expansion is well advanced in preparation for the commencement of the expansion.
Information in relation to the commencement of the expansion and further operational information will be provided when available.
Furthermore, it is intended to commence the expansion of GP care without charges to all children aged 6 and 7 as early as possible. My officials and the HSE have made preparations for this expansion and engagement is ongoing with the IMO in relation to the necessary fee structures for this service.
73. Deputy Gino Kenny asked the Minister for Health if he is aware that a professor of palliative medicine at the National University of Ireland, Galway recently said the medical cannabis access programme was a welcome step, but is still not working for many patients; if he will immediately publish a long-awaited review into the medicinal cannabis access programme; and if he will make a statement on the matter. [26573/23]
View answerThe Medical Cannabis Access Programme (MCAP) was commenced in 2021 following the recommendations in the Health Products Regulatory Authority (HPRA) report “Cannabis for Medical Use – A Scientific Review” which was published in 2017.
The programme is operated by the Primary Care Reimbursement Service of the HSE.
The 2017 report stated that there was an absence of scientific data demonstrating the effectiveness (efficacy) of cannabis products and that the safety of cannabis as a medical treatment was not well characterised.
In particular, there was insufficient information on its safety during long term use for the treatment of chronic medical conditions, such as those for which there is a public interest.
The report also stated that if cannabis products that are not capable of being authorised as medicines, were to be made available through an access programme, that patients and healthcare professionals must recognise the limitations of the programme in assuring the safety, quality and effectiveness, as compared with what would be expected for an authorised medicine.
The Report found that if the policy decision was to make cannabis available for medical purposes, it should recognise patient need, but be evidence based.
The Report advised, that treatment with cannabis is only permitted under a controlled access programme for the treatment of patients with one of three stated conditions while being under expert medical supervision.
The three stated conditions are:
a. Spasticity associated with multiple sclerosis resistant to all standard therapies and interventions whilst under expert medical supervision;
b. Intractable nausea and vomiting associated with chemotherapy, despite the use of standard anti-emetic regimes whilst under expert medical supervision;
c. Severe, refractory (treatment-resistant) epilepsy that has failed to respond to standard anticonvulsant medications whilst under expert medical supervision.
To date the 43 patients have availed of the MCAP and since the end 0f 2016 300 licences have issued for the treatment of of 75 individual patients, some for conditions other than those covered by the MCAP.
The MCAP review is underway and should be completed by year's end.
74. Deputy Mark Ward asked the Minister for Health the plans that are in place to increase access to early intervention psychosis services in 2023; and if he will make a statement on the matter. [26406/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
75. Deputy Pádraig Mac Lochlainn asked the Minister for Health if he is aware of the crisis in Letterkenny University Hospital with the recent loss of consultant endocrinologists, and the impact this will have on the already unacceptable waiting lists for diabetes patients in County Donegal; and if he will urgently intervene to ensure that these positions are replaced as soon as possible and that overall diabetes care services at the hospital are reviewed and resourced to the standard required. [26391/23]
View answerI have asked the Health Service Executive to respond to the Deputy directly in relation to the service matters arising from this question as soon as possible.
I wish to assure the Deputy of the continued commitment to developing diabetes services in Letterkenny and throughout the country.
I am aware of the upcoming staffing changes in Letterkenny University Hospital. I want to recognise that Consultant recruitment can be a challenge. I recently visited LUH and discussed this issue with local management.
LUH has approval for two hospital-based consultant endocrinologists. One of these posts is currently vacant, the other is in place until August. LUH is actively recruiting to fill the Endocrinologist vacancies. In the interim, it is exploring all options to maximise the level of cover provided and ensure continuity of care for diabetic patients.
An additional Consultant Endocrinologist has recently been appointed under the ECC programme in Donegal. This is a shared post between LUH and Donegal CHO that will provide greater integrated services for Diabetes patients in Donegal. A Consultant general physician, with a special interest in Diabetes, has been working with LUH for a number of years and remains in place. The Diabetes service at LUH includes three Clinical Nurse Specialists, an Advanced Nurse Practitioner (ANP) for the paediatric service, a recently appointed ANP for Diabetes in pregnancy and a podiatrist, and an additional podiatrist is currently also being recruited.
HSE National HR have recently been engaging with LUH to assist in the recruitment of a number of consultant posts. I have instructed the HSE to engage with LUH in a similar manner to assist in the recruitment of the 2 vacant Consultant Endocrinology posts.
Budget 2023 provides funding for a number of initiatives aimed at improved patient care, including the development of a National Diabetes Register and the commencement of a National Paediatric Audit of Type 1 diabetes.
Funding has been provided through recent HSE NSPs to expand the permanent health workforce, and significant recruitment has been undertaken to support hospital-based diabetes services.
76. Deputy Thomas Gould asked the Minister for Health the actions being taken to address the GP crisis in Cork city. [26660/23]
View answerGPs are self-employed practitioners and therefore may establish practices at a place of their own choosing. There is no prescribed ratio of GPs to patients and the State does not regulate the number of GPs that can set up in a town or community.
Under the GMS scheme, the HSE contracts GPs to provide medical services without charge to medical card and GP visit card holders. Currently there are 2,539 GPs contracted to provide services under the GMS Scheme. Where a vacancy arises in a practice with a GMS contract, the HSE becomes actively involved in the recruitment process to find a replacement GP. While recruitment is ongoing, the HSE puts in place a locum or other appropriate arrangement to maintain GP services to the communities in question. As of this month, there are 30 GMS vacancies, approximately 1 percent of the total number of panels, including one vacancy in Cork city.
The Government is aware of the workforce issues currently facing general practice and is working to ensure patients across the country continue to have access to GP services.
Under the 2019 GP Agreement the additional annual expenditure provided for general practice has been increased now by €211.6m. This provides for significant increases in capitation fees for participating GMS GPs, and new fees and subsidies for additional services. Improvements to GP’s maternity and paternity leave arrangements and a support for GPs in disadvantaged urban areas, have also been provided for, as well as a 10 percent increase in the enhanced supports package for rural GP practices.
The number of doctors entering GP training has been increased approximately ten percent year on year from 2019, rising from 193 in 2019 to 258 in 2022, and a further large increase to 285 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 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 General Medical Services 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.
Furthermore, I recently published the Terms of Reference for a Strategic review of General Practice which will commence shortly and is to be completed this year. The review, with input from key stakeholders, will examine the broad range of issues affecting general practice including issues around GP capacity, and will set out the measures necessary to deliver a better general practice.
77. Deputy Duncan Smith asked the Minister for Health the number of procedures that have been cancelled at Beaumont Hospital to date in 2023; the reasons for the cancellations; and if he will make a statement on the matter. [26665/23]
View answerI fully acknowledge the distress and inconvenience for patients and their families when elective procedures are cancelled, particularly for clinically urgent procedures. While every effort is made to avoid cancellation or postponement of planned procedures, the HSE has advised that planned procedures and operations can be postponed or cancelled for a variety of reasons including capacity issues due to increased scheduled and unscheduled care demand.
Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
78. Deputy Duncan Smith asked the Minister for Health the actions he can take to ensure that a residential treatment and rehabilitation centre (details supplied) in Athenry, County Galway, remains open and operational, following fears of the closure of the only addiction treatment centre in the west of Ireland; and if he will make a statement on the matter. [26664/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
79. Deputy Alan Dillon asked the Minister for Health when construction will recommence on Ballyhaunis primary care centre; and if he will make a statement on the matter. [26666/23]
View answerAs the Health Service Executive (HSE) holds responsibility for the provision, along with the maintenance and operation of Primary Care Centres, I have asked the HSE to reply to the deputy as soon as possible.
80. Deputy Brendan Smith asked the Minister for Health if he will provide an update on the independent Radiation Therapist Review; how this review will align with the National Cancer Strategy; if the review will include measures to tackle the vacancies of radiotherapists across the country; and if he will make a statement on the matter. [26696/23]
View answerFirstly, I would like to acknowledge the incredibly important role of Radiation Therapists in the provision of cancer services in this country.
The independent review of the Radiation Therapist profession was agreed between the HSE, Department of Health and SIPTU, under the auspices of the WRC. This strategic review will consider issues such as organisation structure, career development in line with Health and Social Care Professional Frameworks, strategic workforce planning and recruitment and retention strategies.
The Radiation Therapist review will support the objectives of the National Cancer Strategy 2017-2026 and help address the increasing and more complex demand for radiation oncology. Cancer cases are increasing in line with our ageing and growing population, and the NCCP estimates that up to 60% of patients will require radiation oncology for primary treatment and palliative care in coming years.
Over €2 million has been provided for enhancing radiotherapy services, including the continued rollout of new and innovative forms of radiotherapy. Stereotactic Ablative Radiotherapy (SABR), a form of highly targeted radiotherapy has been expanded since its introduction and has been delivered for more than 1,200 patients over the years 2018 to 2022. Recruitment and resource planning for the new radiation oncology centre in Galway was also supported through this funding.
Additionally, in line with the National Plan for Radiation Oncology, public sector radiation oncology facilities in Dublin, Cork and Galway will be expanded to meet patient demand and a planned National Programme of Equipment Refreshment and Replacement will be implemented across the Strategy period.
The Radiation Therapist review commenced in December 2022 and is currently underway.
All outcomes of the review will be given due consideration by the Department of Health. Implementation of any recommendations from the review are subject to approval from the Departments of Health and Public Expenditure and Reform in line with public service pay policy.
