Written Answers Nos. 1160-1176
1160. Deputy Louise O'Reilly asked the Minister for Health the number of people with lung injuries and all other injuries arising from e-cigarettes treated by the health service in 2022 and to date in 2023; the location of this treatment that is, primary or secondary care; and if he will make a statement on the matter. [27534/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.
1161. Deputy Róisín Shortall asked the Minister for Health if his attention has been brought to a campaign (details supplied); the steps being taken to improve access to male infertility services and address stigma surrounding the condition; and if he will make a statement on the matter. [27561/23]
View answerI thank the Deputy for drawing my attention to this campaign.
As the Deputy will be aware, a commitment to “introduce a publicly funded model of care for fertility treatment” is included in the Programme for Government. The Model of Care for Fertility was developed by the Department of Health in conjunction with the HSE’s National Women & Infants Health Programme (NWIHP) in order to ensure that fertility-related issues are addressed through the public health system at the lowest level of clinical intervention necessary. This Model of Care comprises three stages, starting in primary care (i.e., GPs) and extending into secondary care (i.e., Regional Fertility Hubs) and then, where necessary, tertiary care (i.e., IVF (in-vitro fertilisation), ICSI (intra-cytoplasmic sperm injection) and other advanced assisted human reproduction (AHR) treatments), with patients being referred onwards through structured pathways.
Phase One of the roll-out of the Model of Care has involved the establishment, at secondary care level, of Regional Fertility Hubs within maternity networks, in order to facilitate the management of a significant proportion of patients presenting with fertility-related issues at this level of intervention. Patients are referred by their GPs to their local Regional Fertility Hub, which provides a range of treatments and interventions for both males and females, including: relevant blood tests, semen analysis, assessment of tubal patency, hysteroscopy, laparoscopy, fertility-related surgeries, ovulation induction and follicle tracking.
There are currently five out of six Regional Fertility Hubs in service and the completion of Phase One of the roll-out of the Model of Care, envisaged for later this year, will result in fully operational Regional Fertility Hubs at six locations across the country. Phase Two of the roll-out of the Model of Care will see the introduction of tertiary fertility services, including IVF, provided through the public health system. In this regard, funding was secured in Budget 2023 to support access to advanced AHR treatments, including, crucially, to allow the commencement of Phase Two of the roll-out of the Model of Care.
This investment will facilitate the first steps to be taken towards the provision of a complete publicly-provided fertility service, which is the ultimate objective of Government. In particular, it will allow the historic development of the first National Advanced AHR Centre, delivering IVF and ICSI through a wholly public clinic and is scheduled to open in 2024. Subject to the provision of additional funding in future, it is envisaged that additional National Advanced AHR Centres will be developed and become operational on a phased basis elsewhere in the country.
The 2023 allocation is also being utilised to support the Regional Fertility Hubs in order to expand the scope of services by introducing the provision of IUI (intrauterine insemination), which can, for certain cohorts of patients, be a potentially effective, yet less complex and less intrusive, type of AHR treatment.
Separately, as an interim measure, I have instructed that some funding be made available to support access to advanced AHR treatment via private providers from September 2023.
My officials, in conjunction with NWIHP, are continuing to actively prepare for the operationalisation of both the publicly- and privately- provided service, including finalising access criteria and determining how the interim funding for private treatments will be provided to individual eligible patients. The design and scope of this final phase of the Model of Care for Fertility have not yet been finalised, but I am hopeful to be in a position to provide more specific details shortly.
In terms of GPs making referrals to the six Regional Fertility Hubs – which will in turn be clinically responsible for making onward referrals for AHR treatment as clinically indicated – GPs can make such referrals in relation to couples who may be struggling to conceive for a defined period of time and/or individuals who have a medical condition/history which is known to adversely impact fertility. Males with Klinefelter Syndrome who are struggling to conceive with their partner may therefore have access to Regional Fertility Hub services under either of these criteria depending on their knowledge or otherwise of their genetic condition at the point that they are trying to conceive with their partner.
My Department and the Government is fully committed, through the full implementation of the Model of Care for Fertility, to ensuring that patients always receive care at the appropriate level of clinical intervention and then those requiring, and eligible for, advanced AHR treatment such as IVF will be able to access same through the public health system. The underlying aim of the policy to provide a model of funding for AHR, within the broader new AHR regulatory framework, is to improve accessibility to AHR treatments, while at the same time embedding safe and appropriate clinical practice and ensuring the cost-effective use of public resources.
1162. Deputy Jim O'Callaghan asked the Minister for Health if the offers of bursaries made to new incoming psychology students who will work in counselling that can be made retrospectively to current second and third year psychology students; and if he will make a statement on the matter. [27564/23]
View answerAs you will be aware, €750,000 has been provided in Budget 2023 to support counselling psychology training places. This funding demonstrates the Government’s commitment to strengthen access to psychology training.
I am focused on supporting counselling psychology students in an equitable way and that delivers value for money. The structure of this funding is still being finalised by officials in the Department, however there will be no allocation retrospectively. The approach will be based on best practice and knowledge gained from other health and social care funded training models.
Further detailed discussions are required between the Department and HSE to progress this. I hope to be in a position to announce the details shortly.
1163. Deputy Jim O'Callaghan asked the Minister for Health the on-street outreach work that is being conducted in Dublin 1,3,7 and 9 to engage with people who are abusing substances in public places; the level of resources available for this type of work; what has been conducted in the past 12 months; the plan for 2023; and if he will make a statement on the matter. [27569/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1164. Deputy Richard Bruton asked the Minister for Health if he will outline the planned developments in the DTSS; and whether discussions are under way with the profession to extend these services. [27575/23]
View answerThe Dental Treatment Services Scheme (DTSS) provides dental care, free of charge, to medical card holders aged 16 and over. In May 2022, the Scheme was extended to include Scale and Polish for all medical card patients along with an expansion of the oral examination to include provision of preventative advice, using €10 million awarded in Budget 2022. In addition, the fees paid to contractors were increased by 40-60% across most treatment items. Both the numbers of patients and treatments have been increasing since the measures were introduced in May 2022.
The Government recognises that substantive reform of the DTSS is required, as set out in the National Oral Health Policy, Smile agus Sláinte. My Department is working closely with the HSE to ensure the establishment of focused structures to drive implementation of the Policy. These implementation structures will include new clinical leadership and reform leadership posts in the HSE for which resources will be provided. In that context, the design and establishment of the necessary leadership and implementation structures is a key objective in the HSE’s National Service Plan for 2023.
In addition, arrangements for an implementation oversight group are currently being finalised. This group will be accountable to the Minister for Health and will facilitate central oversight of the policy implementation work of all relevant actors. The group will engage with stakeholders, including the dental profession, in line with their respective roles and responsibilities.
1165. Deputy Cian O'Callaghan asked the Minister for Health if the condition fibromyalgia, will be recognised on the long-term illness scheme; what supports will be introduced to assist people with fibromyalgia; and if he will make a statement on the matter. [27592/23]
View answerFibromyalgia is a condition characterized by severe pain, fatigue and stiffness, among many other symptoms. Fibromyalgia can be a difficult condition to diagnose because there is no specific test, and the symptoms can be similar to those of other conditions. Treatment often requires interventions from various medical specialists for management of symptoms as they arise.
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.
While there are no current plans to extend the list of illnesses covered, 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 inpatient 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 this and will facilitate further and 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 includes an expansion of GP care without charges to people earning no more than the median household income, the extension of the free contraception scheme, and the abolition of all public inpatient hospital charges from 17 April 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.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%.
1166. Deputy Paul Murphy asked the Minister for Health if he is aware that adolescent mental health services that parents are being told that there is no funding available for a public bed in a private in-patient adolescent unit; if he will advise why this is the current situation; if funding can be made available; and if so, when. [27604/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1167. Deputy Paul Murphy asked the Minister for Health in relation to support for those with long-Covid, if he agrees that the SLWP scheme needs to be extended; and if he will ensure that this view is expressed at the talks with healthcare union representatives and his Department at the WRC to discuss the future of the scheme. [27614/23]
View answerI am acutely aware that the temporary Scheme, specific to the public health service that provides Paid Leave for Public Health Service Employees unfit for work post Covid infection is due to conclude at the end of this month and I am committed to providing support.
Sanction has been sought from the Department of Public Expenditure, NDP Delivery and Reform to extend the existing Scheme and their response is awaited. Staff representative bodies have been advised of the request to extend the temporary Scheme.
At present, those who remain unwell beyond the 30th June may utilise the provisions of the Public Service Sick Leave Scheme.
1168. Deputy Niall Collins asked the Minister for Health the total number of home support hours provided; the total number of home support workers covering an area (details supplied); if there are issues with recruitment and staff or funding in the area; and if he will make a statement on the matter. [27615/23]
View answerAs these are operational matters, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1169. Deputy Fergus O'Dowd asked the Minister for Health if he is aware of the potential negative impact of technology and social media on users' mental well-being; if he can detail if current mental health services including CAMHS assess this area or provide education to mitigate the risks; if he can detail whether core mental health professionals from all disciplines of the multidisciplinary teams receive training in this area.; and if he will make a statement on the matter. [27618/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1170. Deputy Kathleen Funchion asked the Minister for Health the number of vacant consultant posts by speciality and registrar posts by speciality currently at St. Luke's General Hospital, Kilkenny; and when each of these vacancies will be filled, in tabular form. [27623/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1171. Deputy Alan Kelly asked the Minister for Health if a price has been agreed for the purchase of the Mount Carmel nursing home and site in Roscrea that has been referenced in the HSE's 2023 capital plan; and if he will provide, in tabular form all dates and all attendees of all meetings between the HSE and the owners of the site to date. [27631/23]
View answerGiven the level of detail sought, I have asked the HSE to respond to you directly in relation to this matter.
1172. Deputy Alan Kelly asked the Minister for Health if it is appropriate for the HSE to say in its capital plan that it intends to purchase a specific site and business without any due diligence undertaken and no discussions having even begun on the price of the acquisition. [27632/23]
View answerThis Government is committed to transforming how we deliver healthcare in Ireland. The aim is to deliver universal healthcare, so that everyone has access to affordable, high-quality, sustainable care when they need it. Capital investment is essential to enable the achievement of this objective.
Capital Plan 2023 provides for the finalisation of plans for future provision of continuing care capacity to meet the needs of those living in Roscrea and its environs. The purchase of Mount Carmel is presented in this context, and that the purchase is to be “[…] funded and completed in 2023 subject to due diligence[…]”.
The HSE comply with public financial procedures, Public Spending Code and their internal due diligence processes and protocols when investing public funds. Requirements of these procedures and application of the due diligence processes will apply in respect of the planned purchase of Mount Carmel.
1173. Deputy Alan Kelly asked the Minister for Health how many private nursing homes the HSE is in negotiations to purchase currently and where. [27633/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1174. Deputy Holly Cairns asked the Minister for Health the percentage of social media videos posted on each of his Departmental social media accounts, or the social media accounts of public bodies and agencies that operate under his remit, that included closed captioning/subtitling between 1 May 2022 and 30 April 2023, inclusive; and the percentage of same that feature translations into Irish or another language; and if he will make a statement on the matter. [27658/23]
View answerThe Department of Health operates social media accounts under the names "Department of Health/An Roinn Sláinte", "Healthy Ireland" "National Patient Safety Office (NPSO)" and "Sláintecare" brandings.
Between the dates of 01 May 2022 and 30 April 2023 -
90% of the videos posted on the Department of Health/Roinn Sláinte channels included closed captioning, and 3% were translated into another language.
On Healthy Ireland channels, 52% of the videos posted included closed captioning, and 3% were translated into another language.
The NPSO and Sláintecare channels did not post any videos over the specified time period.
My Department is committed to ensuring important messages are accessible and use the National Disability Authority Communication Toolkit for Public Service as a guide on best practice. The Department of Health also remains committed to meeting all its obligations under the Official Languages Act and to providing timely and meaningful information and guidance through Irish.
Links shared by the Department of Health on social media direct to the Department's website, gov.ie/health, which is consistently managed to ensure a high level of content available in both English and Irish.
In addition, I am referring the Deputy's question to the HSE to allow for a response regarding HSE social media accounts.
1175. Deputy Holly Cairns asked the Minister for Health if his Department, and public bodies and agencies under his remit, have an anti-racism policy which can be accessed by the public; and if he will make a statement on the matter. [27676/23]
View answerWhile we do not have a specific internal anti-racism policy, all staff in my Department are bound by the Civil Service Code of Standards and Behaviours and by the Civil Service Dignity at Work policy and we are committed to protecting dignity and respect. These policies are regularly communicated and readily accessible by staff on our Intranet.
In terms of services to the public, I have asked the HSE to respond to the Deputy directly on this matter. In respect of the Non Commercial State Agencies under the aegis of the Department, responses will be sought, collated and returned to the Deputy by way of separate cover.
1176. Deputy Ged Nash asked the Minister for Health when semaglutide will be available to diabetic patients as there currently is a shortage of this vital medication for many patients; and if he will make a statement on the matter. [27686/23]
View answerOzempic (Semaglutide) is licensed by the Health Products Regulatory Authority (HPRA) in Ireland and indicated as an adjunct to diet and exercise to improve glycaemic control in adults with type 2 diabetes mellitus. Novo Nordisk markets Ozempic in Ireland.
To date, there have been particular challenges in the supply of Ozempic to all markets, including to the Irish market. Novo Nordisk anticipates that intermittent supply will continue throughout 2023. These supply issues are not unique to Ireland, increases in demand for these medications and supply constraints have been observed in the UK, throughout the EU and across the world in recent months. Shortages of Ozempic are linked to the increased demand which has been attributed to the off-label use of the product to treat obesity.
Novo Nordisk has implemented monthly allocation to pharmacies to help ensure continuity of supply and equitable distribution of Ozempic stock to Irish patients. The company has issued advisory letters to healthcare professionals to ensure they are aware of these supply issues and how to manage them. In one such recent communication to healthcare professionals, the company stated that Ozempic is only indicated for treating adults with insufficiently controlled type 2 diabetes mellitus as an adjunct to diet and exercise. Any other use, including for weight management, represents off-label use and currently places the availability of Ozempic for the indicated population at risk. Reimbursement support from the HSE is available for the licensed indication and approved dosage only.
The Department of Health, along with relevant experts from the HSE, HPRA, Pharmaceutical Society of Ireland and the Medical Council are continuing to work together during times of limited supply to mitigate the impact of the shortages on patients. Those patients that have been prescribed Ozempic by their doctor and are struggling to source it, are encouraged to speak to their doctor and to the pharmacies in their area as early as possible, in order to seek support in accessing appropriate treatment for their medical condition.
