Written Answers Nos. 1110-1126
1110. Deputy Kathleen Funchion asked the Minister for Health if he will provide an update in regard to tender 2018 for a service (details supplied); if he will ensure the process is transparent; if he will provide an update on when tender 2023 will be concluded; and if he will make a statement on the matter. [27101/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1111. Deputy Aengus Ó Snodaigh asked the Minister for Health if psychological or other such assessments for children paid for privately by parents, rather than waiting years on HSE assessments, are accepted by the CAMHS service; and if he will make a statement on the matter. [27115/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1112. Deputy David Stanton asked the Minister for Health the progress made to date in the establishment of the integrated care of chronic disease management hub based in north Cork; the location of the hub; the number of staff working in the hub and their respective roles, in tabular form; the number of patients treated at the hub to date in 2023; and if he will make a statement on the matter. [27122/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1113. Deputy Mairéad Farrell asked the Minister for Health if he will provide an update on the plan to regulate the psychology profession under CORU; and if he will make a statement on the matter. [27124/23]
View answerAs the Deputy will be aware, CORU is Ireland’s multi-profession health and social care regulator. CORU’s role is to protect the public by regulating the health and social care professions designated under the Health and Social Care Professionals Act 2005 (as amended), including setting the standards that health and social care professionals must meet to be eligible for registration and maintaining registers of persons who meet those standards.
Seventeen health and social care professions are designated for regulation by CORU. There are currently registers open for eleven professions and CORU is continuing the substantial work required to open the registers for the remaining designated professions of Social Care Workers; Psychologists; Counsellors and Psychotherapists; Clinical Biochemists; and Orthoptists.
The Psychologists Registration Board (PSRB) was established in 2017. The work of the PSRB includes consideration of the titles to be protected, the minimum qualifications to be required of existing practitioners, the qualifications that will be required for future graduates, and drafting the Standards of Proficiency and Criteria for Education and Training Programmes.
Regulating a new profession is a complex and lengthy process, requiring careful consideration and preparatory work to ensure that it is effective in protecting the public. Psychology has been a uniquely challenging profession to regulate due to the diversity of its specialisms (for example clinical psychology, counselling psychology, occupational and work psychology, sports and performance psychology) and the fact that there is no common education pathway or standards for entry to the profession.
In 2020 a public consultation on the draft Standards of Proficiency and Criteria for Education and Training Programmes developed for the profession revealed significant issues and a lack of consensus on how to proceed with regulation. Key areas of disagreement among the profession are around the minimum level of qualification required for entry to the profession, the number of placement hours, and the appropriateness of practice placement settings.
Having reached an impasse, CORU wrote to me on behalf of the PSRB in September 2021 seeking guidance on how to proceed. Having considered the matter with due regard to the complexity of this profession, its diverse specialisms (including non-health and social care specialisms), the lack of consensus among the profession on how to proceed, and risks to the public of delays in opening a register, I wrote to CORU in August 2022 requesting that the PSRB consider a dual-stream and phased approach to regulating the profession. This approach will allow the PSRB to prioritise regulating the psychology specialisms which present the greatest risk to public safety, while simultaneously continuing to work towards the long-term objective of protecting the title of ‘psychologist’.
CORU wrote to wrote to me on 3 March 2023 with the PSRB’s recommendations on which specialisms should be prioritised for regulation, using an evidence and risk-based methodology. I have accepted the PSRB’s recommendations to prioritise regulation of clinical, counselling, and educational psychology. On 24 April 2023 I wrote to CORU requesting the PSRB to proceed to immediately regulate these three specialisms, while progressing work to protect the title of psychologist in parallel.
CORU, the PSRB, and my Department are fully committed to delivering regulation of this very important profession through protection of the title of ‘psychologist’.
1114. Deputy Alan Kelly asked the Minister for Health the estimated number of long-stay elderly care beds there will be in Roscrea town following the proposed purchase of a nursing home (details supplied) in the town this year, as proposed in the 2023 HSE capital plan. [27169/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1115. Deputy John Lahart asked the Minister for Health if he will outline the situation with regard to the HSE job evaluation team scheme as it relates to the Haddington Road Agreement of May 2013 where an undertaking was given to assess and where feasible, upgrade a position if it was held by a person for a period in excess of 24 months; and if he will make a statement on the matter. [27181/23]
View answerAs this relates to implementation of the scheme, I have asked the Health Service Executive to respond to the Deputy directly.
1116. Deputy Michael Lowry asked the Minister for Health when a clinical care programme will be implemented to meet the requirements of patients with lung fibrosis; the resources that will be allocated to its implementation and delivery; and if he will make a statement on the matter. [27184/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1117. Deputy Róisín Shortall asked the Minister for Health if he will respond to matters raised in correspondence (details supplied); the status of the review of this policy; and if he will make a statement on the matter. [27191/23]
View answerThe Government takes the closure of nursing homes very seriously. Ensuring that the welfare and safety of residents is secured when nursing homes close is of the utmost importance. It is essential that when nursing homes are intending to close or cease participating in the Nursing Home Support Scheme, that residents and their families must be consulted with, and given appropriate notice so that new homes can be found and residents can move in a safe, planned way.
There is a legal requirement that providers must give at least six months’ notice to the Health Information and Quality Authority (HIQA) if they intend to close. This provides residents, families and public health authorities appropriate time to respond effectively.
It became apparent in late August last year that a small number of active nursing homes had chosen, or were seriously considering, to convert into accommodation centres for beneficiaries of temporary protection. Other active nursing homes were known to be in official negotiations or to be considering this approach.
Given the challenges currently being faced in the nursing home sector and noticing a small trend emerging, Minister Donnelly and I agreed with the Minister for Children, Equality, Disability, Integration and Youth, Roderic O’Gorman TD, to change the procurement guidelines around accommodation for persons under temporary protection in order to remove from consideration active nursing homes that were still registered operators with HIQA on or after the date of 1 September 2022.
The intention behind this position has been to avoid unintentionally incentivising active nursing homes to leave the market. Former nursing homes that had already ceased operation and were deregistered prior to this date remained unaffected if they wished to enter into contracts as accommodation providers.
Following review of the policy at the end of April, the decision has been made to adopt a more flexible approach and to allow the conversion of nursing homes into accommodation centres for international protection applicants and/or beneficiaries of temporary protections after 18 months following deregistration from the Health Information and Quality Agency Chief Inspector’s register.
This allows for an appropriate closure process for residents and staff of nursing homes, while preventing facilities from being empty indefinitely where they might provide a source of accommodation for international protection applicants and/or beneficiaries of temporary protection.
The Government continues to prioritise the best interests of nursing home residents to ensure that their welfare, care and well-being is ensured whilst simultaneously ensuring that nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.
1118. Deputy Louise O'Reilly asked the Minister for Health if he is aware of the situation whereby nursing home residents in private nursing homes who are medical card holders were wrongly charged for nursing home care; the steps that the family of a deceased nursing home resident who died in 2002 can take to establish if their parent and family members were wrongly charged for this care; if he can provide details of the steps to take in the event that their parent was wrongly charged; and if he will make a statement on the matter. [27193/23]
View answerUp until 2004, people who were provided with publicly-funded long-stay care in public facilities and in publicly contracted beds paid a contribution towards the cost of their maintenance through a charge raised under Regulations made in 1954 and 1976.
It was accepted in 2004 that there was a flawed legal basis for raising charges on those with full eligibility in publicly funded care. This was regularised by the introduction of legislation in 2005 to provide for charges in publicly funded care and the establishment of a statutory repayment scheme, under the Health (Repayment Scheme) Act 2006, to repay specified pre-2005 charges for in-patient services imposed on certain persons with full medical card eligibility in public long stay facilities, including public nursing homes.
The scope of the Scheme was well publicised at the time and was limited to those who had full eligibility under the 1970 Act and who had paid charges to the State as a contribution towards their publicly-funded care. The Scheme closed to new applications on 31 December 2007 in accordance with the provisions of the Act. The HSE processed almost 35,500 claims under the Scheme and issued repayments of approximately €453 million to over 20,300 claimants.
It is a matter of public record that legal cases have been taken against the State seeking the repayment of private nursing homes fees in cases where people had full eligibility under the 1970 Act. Fees paid to private nursing homes were not statutory charges levied under Regulation and were therefore not deemed recoverable charges under the Health Repayment Scheme. This was well publicised and debated at the time. Legal cases have been managed by the Department on a case-by-case basis in close consultation with the Office of the Attorney General. The consistent position has been that it was not the policy intent of Government at that time for public monies to be used in this way, and that eligibility under the 1970 Act was and continues to be subject to the availability of resources.
Upon the raising of issues earlier this year about how the State had approached legal challenges taken against it in relation to pre-2005 legacy nursing home charges, the Government moved quickly to establish the facts surrounding these issues, which go back many decades, by requesting the Attorney General to prepare a Report on the litigation management strategy. This comprehensive Report was published on 7 February 2023.
The Government agreed that I and the Minister for Social Protection would consider the Report further and revert to the Government on any further steps required. This consideration is ongoing.
1119. Deputy Denis Naughten asked the Minister for Health when a person (details supplied) will receive approval for an item; the reason for the delay; the number of such applications awaiting approval in Roscommon; and if he will make a statement on the matter. [27194/23]
View answerAs the Health Service Executive (HSE) have responsibility for the provision of aids and appliances, under the Community Funded Schemes, I have asked HSE to respond to the Deputy directly as soon as possible.
1120. Deputy Michael McNamara asked the Minister for Health the reason for the delay in issuing non-payment-of-pay increases to retired HSE staff (details supplied); and if he will make a statement on the matter. [27200/23]
View answerAs this is an administrative matter for the Health Service Executive, the HSE has been asked to respond directly to the Deputy.
1121. Deputy Holly Cairns asked the Minister for Health his views on providing funding to address the rising cost of baby formula; and if he will make a statement on the matter. [27206/23]
View answerArticle 10 of Commission Delegated Regulation (EU) 2016/127 sets out the requirements for promotional and commercial practices for infant formula. This does not make provision for free or low-priced products, samples or any other promotional gifts, to promote the use of infant formula. These measures are designed so that the marketing and distribution of infant formula does not interfere with the protection and promotion of breastfeeding.
Encouraging mothers to breastfeed is a priority for the Department of Health. National health policy, including the Healthy Ireland Framework, the National Maternity Strategy, the Obesity Policy and Action Plan, and the National Cancer Strategy, emphasises the importance of supporting mothers who breastfeed, as well as taking action to increase breastfeeding rates in Ireland.
The HSE Breastfeeding in a Healthy Ireland Action Plan is the framework for progressing supports for breastfeeding in Ireland and compliance with the EU and WHO code is a key action to reduce promotion of infant formula. Additional funding of €1.58m was announced by Stephen Donnelly in May 2021, to fund 24 additional HSE Lactation Consultants thereby providing support to every maternity unit in the country.
It is important that children get the best possible start in life, and this is something all Government partners have prioritised in the Programme for Government. Ireland has a culture of bottle feeding; in order to improve child and maternal health, as well as achieve reductions in childhood obesity and chronic diseases, it is necessary to improve breastfeeding rates. Breastfeeding also has the benefit of avoiding, either totally or in part, the costs associated with the use of breast milk substitutes.
The Department of Health is working with other Departments to offer a range of supports to vulnerable families. As part of our work on obesity, food and nutrition, this Department is represented on a Food Poverty group which is led by the Department of Social Protection. The free school meal initiative will support up to 230,000 children attending DEIS schools in September of this year.
To date, the Government has introduced measures to the value of €12 billion to help ease the burden of inflation being experienced by consumers and businesses. Household transfers, including electricity credits, account for around half of the overall fiscal response, with tax measures accounting for one-third and the remainder is composed of business and other expenditure supports.
1122. Deputy Sorca Clarke asked the Minister for Health when the drug, Ozempic, used to treat obesity as a consequence of polycystic ovary syndrome (PCOS) will be available to medical card holders; and if he will make a statement on the matter. [27210/23]
View answerThe Health Service Executive (HSE) has statutory responsibility for pricing and reimbursement decisions under the community schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. Therefore, this matter has been referred to the HSE for attention and direct reply to the Deputy.
1123. Deputy Michael Healy-Rae asked the Minister for Health if he will provide an update on a waiting list for ophthalmology services (details supplied); and if he will make a statement on the matter. [27217/23]
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.
1124. Deputy Richard Bruton asked the Minister for Health if he is aware of the desire of athletic therapists to obtain recognition for their profession; and how such a process can be initiated. [27223/23]
View answerA number of representative bodies for unregulated professions, including the body representing athletic therapists. have approached the Department seeking to be regulated It is important in this context to point out the issues to be considered regarding the proportionate degree of regulatory force required to protect the public are complex.
In light of this, and in line with ongoing work in the Department of Health, the Health Research Board was requested to carry out research on behalf of the Department to assist in policy development in this area. The report, “National Approaches to Regulating Health and Social Care Professions”, examines the approaches to the regulation of health and social care professionals internationally and is publicly available on the Department’s website (www.gov.ie/en/publication/ea62b-national-approaches-to-regulating-health-and-social-care-professions/).
My officials are in the process of drawing from this report and other relevant sources to develop a framework to guide policy on the regulation of health and social care professionals into the future. This framework will also be informed by an evidence and risk-based approach to regulation in line with requirements set out in the EU Proportionality Test Directive, which was transposed into Irish law on 19 August 2022 (S.I. No. 413/2022). Further information on the Proportionality Test Directive can be found here: single-market-economy.ec.europa.eu/news/services-directive-handbookproportionality-test-directive-guidance-2022-12-22_en
It should be noted that there are no plans in place to progress regulation of individual professions until appropriate risk-assessment and evaluation tools are in place in compliance with best practice, international evidence, and the Proportionality Test Directive.
Statutory regulation forms a part of a system of assurance that the Department utilises to mitigate risk posed to the public by the practise of health and social care professions. The public health service employs a mix of regulated and non-regulated professions. Whether a profession is regulated or not is not a determining factor to employment. For example, among the health and social care professions, audiologists, clinical engineers, clinical measurement physiologists, medical physicists, play therapists and play specialists, and perfusionists (amongst others) are some of the non-regulated groups which are currently employed by the HSE.
As demands on the health service evolve, so too will the professions and grades required to deliver services. For a new profession/grade to be established for use by the public health service, the standard way to do this is by way of a strong business case, prepared by the HSE as the employer. The business case is then submitted to the Department for consideration. Professions not employed in the HSE should engage with the HSE and the Department of Health regarding their potential contribution to the provision of care in Ireland.
My officials met with representatives of the professional body for athletic therapy recently to provide an update on the Department’s work on the future policy framework and to reiterate that at present there are no plans to include any further professions in the CORU regulation process.
1125. Deputy Richard Bruton asked the Minister for Health if he is aware that negotiations have broken down between the NTPF and some private nursing homes, thereby jeopardising continuing care for many residents; if there is scope for mediation or adjudication on the issues; and if he will make a statement on the matter. [27224/23]
View answerFair Deal was designed to protect and support vulnerable older people, to ensure equal access to nursing home care based on what they could afford. This gives certainty to people and families. Government funding for Fair Deal is to support vulnerable older people at a time in their lives where full-time care is essential. It should be recognised that this is a very difficult decision for people and their families and often takes place at a time of crisis.
The National Treatment Purchase Fund (NTPF) are the body designated, under section 40 of the Nursing Homes Support Scheme Act 2009, to negotiate with persons carrying on the business of a nursing home, for the purposes of reaching an agreement on the maximum prices to be charged for nursing home care.
Private and most voluntary nursing homes agree the price that they can charge for a Fair Deal resident with the designated State agency, the National Treatment Purchase Fund (NTPF). Maximum prices for individual nursing homes are agreed with the NTPF following negotiations and based on the NTPF’s cost criteria such as costs reasonably incurred by the nursing home, local market prices, historic prices and overall budgetary capacity.
The NTPF has statutory independence, and there is no role for Ministers or the Department of Health in negotiations with individual nursing homes.
Where, notwithstanding the best efforts of both parties, agreement is not reached through negotiation, the Account Manager assigned by the NTPF will advise the nursing home in writing that negotiations have concluded without agreement.
The Account Manager will set out the final offer proposed and will explain the legal implications of the failure to come to an agreement on price. All final offers are reviewed and signed off on by the Director of Finance.
The Account Manager will also inform the nursing home that it is open to it to request a review of the Final Offer, and will set out the procedure to be followed for such a review.
The details of the review process can be accessed on the NTPF website by following this link: www.ntpf.ie/home/nhss.htm
Apart from those engagements reported in the media recently, I am not aware of any negotiations between nursing homes and the NTPF that have failed to reach a conclusion.
I cannot comment on individual NTPF negotiations and it must be appreciated that this is a matter for the each individual nursing home and the NTPF.
Nevertheless, it is imperative that private and voluntary providers continue to engage in the process as set out in the Nursing Homes Support Scheme Act 2009. There is no other mechanism for funding from the public purse for nursing home residents outside the Nursing Home Support Scheme (Fair Deal).
1126. Deputy Richard Bruton asked the Minister for Health if will outline the recent capital investments made in Beaumont Hospital; and the planned investments in the next five years, covering both buildings and additional equipment for diagnostics and treatment. [27228/23]
View answerAs 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.
