Written Answers Nos. 182-200
182. Deputy Catherine Murphy asked the Minister for Health the number of WTE clinical nurse specialists in behaviours of concern working in each CHO area in 2021, 2022 and to date in 2023, in tabular form. [29923/23]
View answerAs this is an operational matter for the Health Service Executive, the HSE has been asked to reply directly to the Deputy.
183. Deputy Catherine Murphy asked the Minister for Health the number of WTE vacant consultant posts, by speciality, currently at St. Vincent's University Hospital; and when each of these vacancies will be filled, in tabular form. [29924/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
184. Deputy Ged Nash asked the Minister for Health if he is aware of capacity issues in GP surgeries in the Drogheda area and that some practices are not in a position to take on new patients; his plans to address the situation; and if he will make a statement on the matter. [29941/23]
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. As of the start of the month, there is one GMS vacancy in Drogheda. A locum GP is in place to ensure continuity of the service whilst the recruitment process is on-going.
The Government is aware of the workforce issues currently facing general practice, including the limited access to GP services in certain areas, and is working to ensure that general practice is sustainable in all areas into the future.
Under the 2019 GP Agreement 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. In addition, the enhanced supports package for rural GP practices was increased by 10%.
These measures will make general practice in Ireland a more attractive career choice and will see an increase in the number of GPs working in the State, improving access to GP services for patients throughout the country.
The number of doctors entering GP training has been increased in recent years, rising from 193 in 2019 to 258 in 2022, with 285 new entrants places made available for this year and 350 places now planned for next year. Furthermore, the joint HSE and ICGP programme to bring 100 non-EU GPs to Ireland in 2023 will help to quickly improve access to GP services, particularly in areas with limited access. This will increase to 250 placements by the end of 2024.
The strategic review of GP services is to commence shortly and will 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.
185. Deputy Kathleen Funchion asked the Minister for Health to provide an update on the steering group on the dedicated child health workforce, as committed to in First 5; and if he will make a statement on the matter. [29945/23]
View answerFirst 5 is Ireland’s first ever cross-departmental strategy to support babies, young children and their families. The ambitious ten-year plan will deliver a broader range of options for parents to balance working and caring and a new model of parenting support.
In line with the principles set out in Sláintecare, and the First 5 Whole of Government Strategy for Babies, Young Children and Their Families 2019- 2028, the Department of Health is tasked with progressing Strategic Action 3A - to develop a dedicated child health workforce model with a population-based approach and focused on areas of high population density and disadvantage, recognising that this will require additional resources. This work was overtaken by other more immediate priorities with the onset of the pandemic.
This Department is now focusing on progressing this matter, including the development of a pilot model of practice for child health and wellbeing workforce. This requires the re-establishment of the relevant working group which will be tasked with, among other things, the scoping out of the most appropriate approach to developing a model, informed by international best practice and outcomes and the implications for the Irish context.
Separately, the Department is identifying an appropriate model for community nursing and midwifery in Ireland and aligning this model with the framework for Safe Nurse Staffing and Skill Mix in Community Care settings. This work will be helpful in developing a dedicated child health workforce model.
A detailed implementation report was published in 2019. Multiple divisions of the Department of Health, as well as partners including the HSE and Tusla, are involved in the implementation of the health-related elements of the plan.
Implementation of the 2019 actions of the First Five Years Strategy is underway across the following areas in the HSE that are responsible for implementing the actions from the First Five Years Strategy: 1) National Healthy Childhood Programme, 2) The Healthy Eating and Active Living Programme, 3) The Mental Health Division, 4) The National Women and Infants Programme, 5) National Immunisation Office, 6) Community Operations, 7) The Nurture Programme and 8) Strategic Planning and Transformation”. Some examples of the significant number of service delivery areas with a focus on children, either in whole or in part are outlined below.
The 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 on the campuses of Tallaght and Connolly 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. NCH will be Ireland’s first digital public hospital, providing 39 clinical specialties, and act as the hub for acute paediatric care and services nationally.
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.
Building on the significant investment of €7.3m to continue implementation of the National Maternity Strategy (2016-2026) in 2021, funding of €8.7m was allocated under Budget 2022.
The funding allocated in 2021 provided for an additional 96.5 Whole Time Equivalent staff (WTE) and allowed for further development of community midwifery as well as specialist services. It has enabled the expansion of breastfeeding supports and strengthened training and education supports for staff.
The funding allocated in 2022 is providing for the recruitment of an additional 87.8 WTEs into maternity services across the country, including consultants, midwives/nurses, Allied Health professionals, healthcare assistants and administrative staff. These posts are supporting the realisation of the Strategy’s vision of a new model of integrated, team-based care that provides increased choice to women, as well as improving outcomes and experiences for women and babies accessing maternity services.
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.
In May 2021, the Minister for Health announced additional annual funding to the HSE of €1.58 million to fund 24 additional lactation consultants thereby providing support to every maternity unit in the country.
There are currently 55.1 dedicated lactation posts employed in the HSE, with 35.5 wte working in maternity services and 19.6 wte in primary care. 30.5 of the 34.5 of the new lactation posts approved by the DOH and the HSE’s National Women and Infants Health Programme have been appointed, with a further 1 wte starting in August. 1.5 wte are awaiting commencement dates and supplementary campaigns are in progress for the remaining 1.5 wte.
The HSE is actively engaged in enhancing lactation supports through both these dedicated infant feeding positions and the implementation of training for all practitioners who provide advice and support in infant feeding as part of their wider service roles.
Healthy Ireland, which comprises both the Health and Wellbeing Programme in this Department, and the Health and Wellbeing Division in the HSE, also provides significant supports for child health and wellbeing.
The HSE Education Team works with the Professional Development Service for Teachers in terms of supports and resources for schools and various wellbeing curricula.
The Sláintecare Healthy Communities Programme, which has been rolled out to 19 of the communities of most need around the country, includes many supports for families and children, including parenting supports and Healthy Food Made Easy courses.
The Department of Education’s Active School Flag programme, co-funded by Healthy Ireland, supports pupils in more schools to be more active, more often. Over 2,100 primary schools have engaged with the programme since inception and a pilot programme for post-primary schools is also in progress. Healthy Ireland also co-funds Sport Ireland’s Children’s Sport Participation and Physical Activity Study, and the Daily Mile in schools, which is managed by Athletics Ireland.
Finally, the Deputy will be aware that my colleague the Minister for Children, Equality, Disability, Integration and Youth has responsibility for reporting on the wider implementation of the Strategy. Earlier this month, Minister O'Gorman published the First 5 Annual Implementation Reports for 2020 and for 2021/22. These reports highlight how the interim target for paid parents' leave, of 7 weeks per parent by 2021, has been achieved, how the interim target of a 30% graduate early learning and childcare workforce by 2021 has been exceeded, and how the investment target for early learning and childcare, of €970 million by 2028, has been exceeded 5 years ahead of schedule.
The progress outlined in these reports over the period 2020-2022 gives a valuable insight into the broader achievement of the First 5 commitments to date.
186. Deputy Robert Troy asked the Minister for Health if he will expedite an appointment for a person (details supplied). [29947/23]
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.
187. Deputy Richard Bruton asked the Minister for Health if he will outline the progress being made on a 2023 tender for home care services and on the development of a statutory scheme for home care, which would bring equity and consistency into access; if he is aware of the frustration of some existing care providers at the continuous extension of the 2018 tender; and if he will make a statement on the matter. [29951/23]
View answerThe Programme for Government commits to ‘Introduce a statutory scheme to support people to live in their own homes, which will provide equitable access to high-quality, regulated home care’. Work is ongoing within the Department across four broad areas to progress this commitment: (i) Regulation of home-support providers; (ii) the examination of future funding options for home-support services; (iii) working with the HSE to develop a reformed model of service delivery for home support (iv) Implementation of the recommendations of the Strategic Workforce Advisory Group.
The Government gave its approval in April 2021 to start drafting legislation to establish a licensing framework for providers who operate in the home care sector. It is intended to bring this legislation through the Houses of the Oireachtas at the earliest opportunity. This will ensure that all users are provided with high quality home care.
In order to help in drafting the legislation and regulations a 6-week public consultation was completed in August 2022 and the analysis of the results by the IPH was published on 20th January 2023. See:
www.gov.ie/en/publication/56ab1-draft-regulations-for-providers-of-home-support-services-an-overview-of-the-findings-of-the-department-of-healths-public-consultation/
The department has also been in consultation with HIQA, the HSE, legal counsel, and representative groups to help improve the regulations further. They are now at an advanced stage.
How home support will be funded in the future will be an essential factor of the new Statutory Scheme. With this in mind the Department is researching different funding models. An internal consultation within the Department has been underway on a range of potential funding options. The Economic and Social Research Institute (ESRI) also undertook a programme of work on behalf of the Department on the potential demand and cost of home support which culminated in two reports published in 2021 and 2022:
www.esri.ie/publications/demand-for-the-statutory-home-care-scheme
www.esri.ie/publications/home-support-services-in-ireland-exchequer-and-distributional-impacts-of-funding
A rapid response from the European Observatory on Health Systems was commissioned and published in March of this year. It is titled: “Improving Home Care Sustainability in Ireland. Are user charges a promising option?”
eurohealthobservatory.who.int/publications/i/improving-home-care-sustainability-in-ireland-are-user-charges-a-promising-option
This research will form an important part of the evidence base for the development of a sustainable funding model for home care services.
In 2022 a Pilot for testing of a reformed model of service for the delivery for homecare became fully operational in 4 Community Healthcare Organisations (CHOs). Evaluation of the Pilot has been completed and a final report is expected in the coming months.
The national rollout of interRAI as the new standard assessment tool for care-needs in the community is underway and the recruitment process for 128 interRAI Care Needs Facilitators has commenced.
The HSE is in the process of recruiting key posts to enable the establishment of a National Home Support Office. Funding is provided for 15 full time jobs, including 9 home support manager/coordinator posts. The Head of Service of the new National Home support Office has been appointed in November 2022, with the remaining posts to be filled as soon as possible.
To examine and address the significant workforce challenges in the homecare and nursing home sectors in Ireland, Minister Butler established a cross-departmental Strategic Workforce Advisory Group in March 2022. The group was charged with identifying strategic workforce challenges in publicly and privately provided front-line carer roles in home support and nursing homes and with developing recommendations. Their report was published in October 2022 with 16 recommendations. Minister Butler has strongly endorsed the Advisory Group’s recommendations.
They are being progressed through a dedicated implementation group. A detailed implementation plan will be published in the coming months. The implementation group will meet quarterly, and the Department of Health will publish progress reports against this plan after these meetings take place. Recommendation number 9 has been implemented. The statutory instrument authorising the issuance of 1,000 employment permits for homecare workers was signed on 16 December 2022.
A link to the report is below.
www.gov.ie/en/publication/492bc-report-of-the-strategic-workforce-advisory-group-on-home-carers-and-nursing-home-health-care-assistants/
Your query on a 2023 tender for homecare services is an operational matter and has therefore been referred to the HSE for direct reply to yourself.
188. Deputy David Cullinane asked the Minister for Health if he will provide an update on the regulation of athletic therapists with CORU; and if he will make a statement on the matter. [29954/23]
View answerAs the Deputy might be aware, a number of representative bodies for unregulated professions have approached the Department seeking to be regulated. The issues to be considered regarding the proportionate degree of regulatory force required to protect the public are complex. In light of the various issues to be considered, 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 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.
Finally, I will be preparing a report on progress made in developing a framework to guide future decision-making on the regulation of health and social care professions, which will be laid before each House of the Oireachtas within six months of commencement of the Regulated Professions (Health and Social Care) Act 2023.
189. Deputy David Cullinane asked the Minister for Health the number of whole-term equivalent tracheotomy nurses in paediatric orthopaedics in Cork University Hospital; and the number of tracheotomy nurses available in CUH. [29955/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
190. Deputy David Cullinane asked the Minister for Health the average response time for an ambulance from each base in County Sligo in 2022 and for the first four months of 2023, in tabular form. [29957/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
191. Deputy David Cullinane asked the Minister for Health the number of persons on a home support waiting list for funding and for a carer in CHO 6, in tabular form. [29958/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
192. Deputy David Cullinane asked the Minister for Health the number of persons who presented at the emergency department at Mercy University Hospital in the years 2021, 2022 and to date in 2023, in tabular form. [29959/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
193. Deputy David Cullinane asked the Minister for Health the number of resuscitation suites in the emergency department of Letterkenny University Hospital; and if he will make a statement on the matter. [29960/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
194. Deputy David Cullinane asked the Minister for Health when day care services will resume in west Sligo and at the day care centre in Easkey; if there are plans to resume a five-day service; and if he will make a statement on the matter. [29964/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
195. Deputy David Cullinane asked the Minister for Health the number of WTE respiratory nurses working in Galway University Hospital in the years 2021, 2022 and to date in 2023, in tabular form. [29965/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
196. Deputy David Cullinane asked the Minister for Health the number of WTE speech and language therapists and occupational therapists working out of University Hospital Kerry in 2022 and to date in 2023, in tabular form. [29966/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
197. Deputy David Cullinane asked the Minister for Health the number of WTE consultant ENT surgeons at Tullamore regional hospital in the years 2021, 2022 and to date in 2023, in tabular form. [29967/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
198. Deputy David Cullinane asked the Minister for Health the number of WTE consultant orthopaedic surgeons and orthopaedic registrars working in Roscommon University Hospital in the years 2022 and to date in 2023, in tabular form. [29968/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
199. Deputy David Cullinane asked the Minister for Health if he has explored the possibility of recognising a product (details supplied) as medical treatment under the drugs payment scheme, instead of a food supplement; and if he will make a statement on the matter. [29969/23]
View answerThe Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
Reimbursement for medicines under the community drugs schemes is for licensed indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority (HPRA).
In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact.
The Medical Cannabis Access Programme (MCAP), a 5-year pilot programme, allows medical consultants to prescribe specified cannabis-based products for patients with certain medical conditions who have exhausted all other available medical treatment options. Those conditions are:
• Spasticity associated with multiple sclerosis
• Intractable nausea and vomiting associated with chemotherapy
• Severe, refractory (treatment-resistant) epilepsy
Prospective suppliers of products to the MCAP can apply to the HPRA to have a cannabis product considered for inclusion. The onus is on prospective suppliers to submit applications to the HPRA.
For medical indications not included in the MCAP, doctors may continue to utilise the Ministerial licensing route to prescribe medical cannabis for their patients. In line with the Chief Medical Officer's advice, the granting of a licence for cannabis for medical purposes must be premised on an appropriate application being submitted to the Department of Health, which is endorsed by a consultant who is responsible for the management of the patient and who is prepared to monitor the effects of the treatment over time.
From 1st December 2021, the HSE approved reimbursement of Cannabidiol (Epidyolex®)100 mg/ml oral solution via the High Tech Drug Arrangements for the following indications:
• use as adjunctive therapy of seizures associated with Lennox-Gastaut Syndrome (LGS) in conjunction with Clobazam, for patients 2 years of age and older,
• use as adjunctive therapy of seizures associated with Dravet Syndrome (DS) in conjunction with Clobazam, for patients 2 years of age and older, and
• use as adjunctive therapy of seizures associated with tuberous sclerosis complex (TSC) for patients 2 years of age and older.
Approved prescribers will be required to provide confirmation that Cannabidiol (Epidyolex®) 100 mg/ml oral solution is being prescribed in accordance with the licensed indications and in line with the terms of reimbursement approval given by the HSE.
The HSE Executive Management Team (EMT) have supported reimbursement of Delta-9-tetrahydrocannabinol (THC) / Cannabidiol (CBD) (Sativex®) for the following indications:
• as treatment for symptom improvement in adult patients with moderate to severe spasticity due to multiple sclerosis (MS) who have not responded adequately to other anti-spasticity medication and
• who demonstrate clinically significant improvement in spasticity related symptoms during an initial trial of therapy, subject to a managed access protocol being implemented.
As a condition of reimbursement, an individual patient approval system will be put in place by the HSE, to enable reimbursement for patients who meet the pre-defined criteria of a HSE devised managed access protocol (MAP).
200. Deputy Alan Dillon asked the Minister for Health how many dentists in County Mayo are available under the dental treatment services scheme; to outline the dentists in County Mayo, in tabular form; and if he will make a statement on the matter. [29973/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
