Written Answers Nos. 1144-1159
1144. Deputy Réada Cronin asked the Minister for Health his plans to offer financial support for practical home assistance, such as cleaning, to healthcare workers suffering from long-Covid, whose infection was contracted in the line of duty, including where PPE provided and depended on was inadequate, and now are debilitated to the degree they cannot work; and if he will make a statement on the matter. [27367/23]
View answer1145. Deputy Réada Cronin asked the Minister for Health his plans to assist healthcare workers who developed long-Covid from infection contracted in the line of duty, including in situations whereby they lacked sufficient PPE, and who are debilitated to the degree they are no longer able to work; and if he will make a statement on the matter. [27368/23]
View answerI propose to take Questions Nos. 1144 and 1145 together.
The Department of Public Expenditure, NDP Delivery and Reform's (DPENDR) Special leave with Pay for COVID-19 (SLWP) was introduced in lieu of sick leave for those with confirmed COVID-19 to assist in the prevention of the possible onward spread of COVID-19 in the work premises. This applies only to newly confirmed cases of COVID-19 recommended to stay at home as per current public health guidance (currently 5 days stay at home).
For certain employees who remain unfit to attend the workplace and are suffering from Long-Covid, a temporary Scheme, specific to the public health service was introduced to provide for Paid Leave for Public Health Service Employees unfit for work post Covid infection.
I am acutely aware that the temporary Scheme is due to conclude at the end of this month and I am committed to providing support. Sanction has been sought from the DPENDR to extend the existing Scheme and their response is awaited.
At present, those who remain unwell beyond the 30th June may utilise the provisions of the Public Service Sick Leave Scheme.
Additional supports for HSE staff are available from both the Occupational and the Employee Assistance Service teams.
1146. Deputy Carol Nolan asked the Minister for Health further to Parliamentary Question No. 466 of 18 May 2023, if he will confirm that the reduction in the definition of the threshold of foetal viability from 24 weeks to 23 weeks for the purposes of the Civil Registration Act 2004 will also apply to the definition of viability in the Health (Regulation of Termination of Pregnancy) Act 2018; if he will outline what amendments to the Act existing policy he proposes in order to implement this change; and if he will make a statement on the matter. [27372/23]
View answerThe Health (Regulation of Termination of Pregnancy) Act 2018 defines viability as "the point in a pregnancy at which, in the reasonable opinion of a medical practitioner, the foetus is capable of survival outside the uterus without extraordinary life-sustaining measures.” There are no plans to include a specific gestation period in the definition at this time.
1147. Deputy Jennifer Murnane O'Connor asked the Minister for Health if there are any plans to add an illness to the long-term illness scheme, medical card or drugs payment scheme for medications for an illness (details supplied); and if he will make a statement on the matter. [27377/23]
View answer1149. Deputy Jennifer Murnane O'Connor asked the Minister for Health if there are any plans to add an illness to the long- term illness scheme under the terms of mental illness, medical card or drugs payment scheme for medications for an illness (details supplied); and if he will make a statement on the matter. [27380/23]
View answerI propose to take Questions Nos. 1147 and 1149 together.
The Long-Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in 1971, 1973 and 1975, prescribing 16 illnesses covered by the scheme.
These are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide.
Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
Statutory Instrument No. 277 of 1971 put the following limitation on the operation of the Scheme:
"Arrangements for the supply of drugs and medicines to persons suffering from mental illness in pursuance of section 59 (3) of the Act shall be made only in respect of persons under the age of 16 years."
Therefore, the limitation on age currently applies to persons eligible for the LTI Scheme under the category of "mental illness", including those diagnosed with ADHD. However, it is important to remember that the LTI Scheme exists within a wider eligibility framework.
This Government has put a significant focus on improving access to and the affordability of healthcare services, advancing substantial policy, legislation and investment to deliver expanded eligibility.
In 2022, a range of measures were delivered including the abolition of public in-patient charges for children, reductions in the Drug Payment Scheme threshold to €80 per month, and the introduction of free contraception for women aged 17-25.
The significant investment in Budget 2023 builds on these measures and facilitates better access to affordable, high-quality healthcare for people at a time when the cost-of-living crisis is impacting on everyone. In 2023 this will mean:
- an expansion of GP care without charges to people earning no more than the median household income,
- all public in-patient hospital charges abolished since 17 April 2023,
- an extension of free contraception to 26-year-old women since 1 Jan 2023, and further extension to 27-30 years old women from 1 September 2023.
These measures continue to create a health and social care service that offers affordable access to quality healthcare.
People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card under the General Medical Services (GMS) Scheme. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. Medical card eligibility is primarily based on an assessment of means and is not granted on the basis of any particular condition.
In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
Under the Drug Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
Individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
1148. Deputy Réada Cronin asked the Minister for Health what plans his Department has, and if it is working with the Department of Social Protection, to ensure the SLWP scheme continues for HCWs who contracted Covid in the workplace and are now suffering serious, long-term debility, such debility affecting their career, their financial, psychological and physical health; and if he will make a statement on the matter. [27378/23]
View answerThe Department of Public Expenditure NDP Delivery and Reform Special leave with Pay for COVID-19 (SLWP) was introduced in lieu of sick leave for those with confirmed COVID-19 to assist in the prevention of the possible onward spread of COVID-19 in the work premises. This applies only to newly confirmed cases of COVID-19 recommended to stay at home as per current public health guidance (currently 5 days stay at home).
For certain employees who remain unfit to attend the workplace and are suffering from long-Covid, a temporary Scheme, specific to the public health service was introduced to provide for Paid Leave for Public Health Service Employees unfit for work post Covid infection. The temporary Scheme is due to conclude at the end of this month. At present, those who remain unwell beyond that date may utilise the provisions of the Public Service Sick Leave Scheme.
I am acutely aware of the issues experienced by public health sector employees in respect of this matter, and I am committed to providing support. I have asked officials to look at options in this regard.
The EU Advisory Committee on Health & Safety have recommended the recognition of Covid as an occupational illness in health and social care settings. I understand that Minister Humphreys has committed to reviewing the EU Committee recommendation regarding the occupational recognition of Covid in respect of the Department of Social Protection Benefits Schemes, and the list of prescribed diseases/illnesses set out in the Social Welfare Consolidation Act 2005. The outcome of this review is awaited.
1150. Deputy Paul Kehoe asked the Minister for Health the reason that some health insurance companies do not cover the drug, pembro; the way that a patient can avail of it if their health provider does not cover payment of the drug; and if he will make a statement on the matter. [27410/23]
View answerIn Ireland we have a voluntary, community rated private health insurance market.
The Government, including the Minister for Health, do not have a direct role in the day-to-day commercial decisions of any health insurer.
Consumers are advised to check their policies and contact their health insurer to ensure they understand the treatments that are available and the terms and conditions of their policies.
The Health Insurance Authority (HIA) is the statutory regulator of the private health insurance market in Ireland. Their functions include the provision of information to consumers regarding their rights and health insurance plans and benefits.
The HIA provides a free online comparison tool which allows any health insurance customer to assess what plans are currently active in the market. They also provide a customer phone line where people can call with specific queries.
As this is also an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1151. Deputy Michael Healy-Rae asked the Minister for Health the status of an urgent hospital appointment for a child (details supplied); and if he will make a statement on the matter. [27428/23]
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 Health Service Executive to respond to the Deputy directly, as soon as possible.
1152. Deputy Joan Collins asked the Minister for Health if he will follow up on a request by a person (details supplied) for immediate access to CAMHS. [27456/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1153. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) cannot get a letter from their consultant in Monaghan General Hospital; and if he will make a statement on the matter. [27468/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
1155. Deputy Brendan Howlin asked the Minister for Health if he will review the refusal of a home care package for a person (details supplied) who has a variety of obvious and serious needs but is under the age of 65 years; and if he will make a statement on the matter. [27472/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1156. Deputy Niamh Smyth asked the Minister for Health if a surgery appointment will be expedited for a person (details supplied); and if he will make a statement on the matter. [27474/23]
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 Health Service Executive to respond to the Deputy directly, as soon as possible.
1157. Deputy David Cullinane asked the Minister for Health the reason the HSE has not published a Performance Profile or Management Data Report since its September 2022 publications; if he can provide both the Performance Profile and Management Data Report for the most recently available quarterly and monthly periods respectively; and if he will make a statement on the matter. [27482/23]
View answerThe HSE’s Performance Profile and Management Data Reports for the October-December 2022 period will be finalised once the Comptroller and Auditor General concludes his audit of the HSE’s 2022 Annual Financial Statements (AFS). The audit is scheduled to be concluded in the coming weeks, after which the AFS will be laid before the Oireachtas and published on the HSE website.
Publication of the Performance Profile and Management Data Reports for the October-December 2022 period will follow as soon as possible afterwards. Subsequent to this, publication of the January-March 2023 reports is expected.
1158. Deputy David Cullinane asked the Minister for Health the number and details of all approved consultant posts by discipline, speciality, and clinical site grouped and totalled by Hospital Group/CHO respectively providing the numbers filled listed on each of the following basis as permanent, temporary, locum or agency basis; the total number of vacant consultant posts (including those vacant and newly created and currently under recruitment) similarly grouped as above, in tabular form; the length of time the vacant posts have remained vacant; and if he will make a statement on the matter. [27483/23]
View answerAs this is an administrative matter for the Health Service Executive, the HSE has been asked to respond directly to the Deputy.
1159. Deputy Marc MacSharry asked the Minister for Health the legislative measures that are in place to ensure parents of an adult child residing with them with a diagnosis of paranoid schizophrenia or other such mental illness which may have a tendency to violence or violent attacks, or be a danger to their parents in the event of such an attack, are informed of the said danger and diagnosis if their adult child chooses to conceal the said diagnosis; and if he will make a statement on the matter. [27481/23]
View answerI am very supportive of family involvement in a person’s mental health care and treatment. I believe that it should be encouraged and supported to the greatest extent possible, with the person’s consent.
It is important that family members are involved to the greatest extent possible in a person’s mental health treatment and care as outcomes are likely to be better for the individual concerned. Involvement is also key to supporting family members themselves. While healthcare professionals can receive information on a person's medical history and behaviour from family members and loved ones, if the person refuses to consent to their medical information being shared, their wishes generally must be respected.
Where consent is concerned, mental health treatment is treated no differently to any other medical speciality. It is at the discretion of the individual as to what and how much information they allow a doctor or service to disclose to their family members. The safeguarding of patient confidentiality is a fundamental principle of medical ethics. Confidentiality is both a person’s right and a doctor’s duty.
Notwithstanding the fact that doctors have a responsibility to protect people in their care, there are circumstances where it may be necessary to disclose information about a person where they are at serious risk of harm to themselves or others and this includes, for example, where a person is at risk of violence or abuse. Medical Council guidelines specifically allow for this to happen and that course of action has always been available to doctors.
A person's multidisciplinary team should continue to engage with them on the matter of consenting to sharing information on their mental health difficulty with family and loved ones; just because someone refuses to consent to sharing this information on one day does not mean that they will refuse at a later point when their condition may have improved. For this reason, consent should be an ongoing conversation between the person and their multidisciplinary team.
In addition, existing provisions within the Mental Health Act on involuntary detention provide a basis for the protection of a person or others around them, where there is risk of serious and immediate harm. Of course, prediction of risk is not always easy.
Sharing the Vision, Ireland’s national mental health policy, clearly states that there is a role for family, carers and supporters in a person’s care and treatment. The Department recognises the importance of involving family members as much as possible in a person’s treatment, with the consent of the person, and supports ongoing measures to enhance family member involvement through legislation and policy, and through mental health service provision.
The Deputy may be aware that a new Mental Health Bill is currently being drafted by the Office of Parliamentary Counsel, generally in line with the General Scheme of a Bill published in July 2021. The new Bill will promote the involvement of family members and loved ones, with the consent of the individual concerned, where they are making a decision about their treatment and during the admission and discharge processes. Priority drafting of the final text of the new Mental Health Bill was secured for the in the spring and summer legislative session and officials in my Department are continuing to work with drafters to progress the Bill.
