Peter Burke
Question:578. Deputy Peter Burke asked the Minister for Health if he will consider the costs of Platelet Rich Plasma (PRP) injections to be covered by the HSE (details supplied). [32160/23]
View answerHealth Services
Questions (578)
Written answers
The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013. I, as the Minister for Health, have no role in these decisions.
The HSE have advised that Platelet rich plasma (PRP) injections, or any other blood products, are not covered under the community drug schemes.
Departmental Funding
Questions (579)
Mark Ward
Question:579. Deputy Mark Ward asked the Minister for Health for a breakdown of funding for wages for trainees in the counselling psychology postgraduate degree at Trinity College Dublin; where this funding has been allocated from; if the €750,000 funding for trainee counselling psychologists has been allocated; if so, where it has been allocated; and if he will make a statement on the matter. [32161/23]
View answerWritten answers
As the Deputy 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. 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 for academic year 2023-2024.
In relation to the funding for wages for trainees, I have referred the question to the HSE for direct reply to the Deputy.
Hospital Staff
Questions (580)
Claire Kerrane
Question:580. Deputy Claire Kerrane asked the Minister for Health the number of speech therapists in Sligo University Hospital; the number of current vacancies, if any; the length of time each vacancy has existed; the plans to provide a full complement of therapists; and if he will make a statement on the matter. [32186/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
Hospital Facilities
Questions (581)
Claire Kerrane
Question:581. Deputy Claire Kerrane asked the Minister for Health the status of the new rehabilitation unit at Roscommon University Hospital; and if he will make a statement on the matter. [32187/23]
View answerWritten answers
As 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.
Hospital Staff
Questions (582)
Claire Kerrane
Question:582. Deputy Claire Kerrane asked the Minister for Health if he will provide, in tabular form, the number of speech therapists employed in Roscommon University Hospital; the number of current vacancies, if any; and if he will make a statement on the matter. [32188/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
Nursing Homes
Questions (583)
Steven Matthews
Question:583. Deputy Steven Matthews asked the Minister for Health the position regarding any discussions being held with representatives of the private nursing home sector regarding concerns related to the fair deal scheme; and if he will make a statement on the matter. [32193/23]
View answerWritten answers
Both I and officials from the Department have had, and continue to have, engagement with Nursing Homes Ireland (NHI).
As a key stakeholder, it is important to maintain constructive dialogue with this representative body as we continue to discuss matters relevant to the operation and funding of nursing homes and ongoing matters relating to the operation of, and proposed changes to, the Nursing Homes Support Scheme. Most recently officials met with NHI to review the publication of the PWC report Challenges for Nursing Homes in the Provision of Older Persons Care which was commissioned by NHI.
The Department of Health has also met with The Alliance, a newly formed support network for smaller, family-run nursing homes, and will continue to engage with them.
In addition, the Department has been engaging with individual nursing homes on a continuous and consistent basis and nursing home groups in attempting to address some of the issues they are raising in relation to funding and increased inflationary costs.
I firmly believe that good communication must be at the heart of everything we do in the health service. I also believe that it is important that the HSE is made aware of all matters raised about its service, including all matters related to the operation and administration of the Nursing Home Support Scheme, as under the Health Act 2004, the day-to-day operational responsibility for the management and delivery of health services is a matter for the HSE. In this regard the Department of Health engages with the HSE in a consistent, timely manner on all issues in respect of administrative, operational and policy-related decisions to ensure that Fair Deal functions optimally, as intended.
Furthermore, the Department of Health continues to engage with the National Treatment Purchase Fund (NTPF) to examine ways in which funding can be used to provide support to nursing homes. In addition, the NTPF will shortly be seeking up-to-date financial & operational information from nursing homes to inform further analysis and considerations of measures to support the sector. The NTPF have informed the Department that they have engaged with NHI on this matter. The Department of Health and I have regular interaction with the NTPF. I recently met with the NTPF to discuss ways to support the sector, where necessary and appropriate, to complement the normal process of negotiating rate increases when contracts are renewed.
As a result of this meeting nursing homes which had a scheduled renegotiation of their Deed of Agreement this year with the NTPF have seen a significant uplift. In addition, other options to support nursing homes are also being explored at the moment, such as to help with the often costly nature of compliance for nursing homes under necessary HIQA regulations. The Department of Health published a review of the NTPF pricing system in June 2021 and continues to work on bringing forward the recommendations that emerged from this review. Officials from the Department of Health and the NTPF meet regularly to report on progress of the four recommendations and a steering group has been established to oversee delivery of those recommendations. There will be opportunities for NHI to engage formally with this steering group.It is important that lines of communication are maintained with all relevant stakeholders to ensure that nursing home care continues to be provided to older people that is accessible and affordable for everyone, and that people are cared for in the most appropriate settings whilst simultaneously maintaining comfort levels and standards of care.
Dental Services
Questions (584)
Bernard Durkan
Question:584. Deputy Bernard J. Durkan asked the Minister for Health how contact can be made with the school dental service by the parents of a child (details supplied); and if he will make a statement on the matter. [32208/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Health Services
Questions (585, 586)
Mark Ward
Question:585. Deputy Mark Ward asked the Minister for Health the funding that has been given to the Hereditary Cancer Model of Care in 2023; the expected funding for each year of implementation; and if he will make a statement on the matter. [32211/23]
View answerMark Ward
Question:586. Deputy Mark Ward asked the Minister for Health if multi-annual funding will be provided for the Hereditary Cancer Model of Care; what funding will be given; and if he will make a statement on the matter. [32213/23]
View answerWritten answers
I propose to take Questions Nos. 585 and 586 together.
This Government’s commitment to the implementation of the National Cancer Strategy is evidenced by significant investment in recent years. New development funding of €20 million was allocated to cancer services in 2021 and a further €20 million was allocated in 2022. This funding has supported investment in cancer services, including:
• Recruitment of staff to cancer genetics services.
• Development of GP referral guidelines for breast family history.
• Completion of a needs assessment for those with a BRCA gene alteration.
• Development of online training for health care professionals delivering mainstreamed BRCA testing, i.e. genetic testing embedded in oncology services.
• Recommendations on universal tumour testing in certain types of cancer for possible Lynch Syndrome, an inherited condition which causes people to have a higher risk of developing certain colorectal cancers.
The HSE's National Cancer Control Programme (NCCP) launched its Hereditary Cancer Model of Care in June 2023.
Funding for current expenditure, including cancer services, is allocated on an annual (single-year) basis through the Estimates process with future levels of funding considered as part of the national estimates and budgetary process. Decisions on the funding of cancer services are being made in the context of the Estimates process for 2024.
There is no multi-annual funding for current expenditure. However, I am aware that there has been a discussion paper published by the Department of Public Expenditure that highlights the benefits of introducing multi-annual funding and discusses the possible future introduction of it for the Garda Síochána vote.
I acknowledge that there are potential benefits of introducing multi-annual funding to improve planning over a multi-annual horizon on a more structured/sustainable timeframe than a single year. However, there currently exist a range of legislative barriers to the introduction of such a funding mechanism for current expenditure on health services.
The position is different in relation to capital expenditure where the National Development Plan sets out the longer-term investment plan over multiple years.
Question No. 586 answered with Question No. 585.
Ambulance Service
Questions (587)
Gary Gannon
Question:587. Deputy Gary Gannon asked the Minister for Health the efforts being made to retain paramedics in the National Ambulance Service. [32219/23]
View answerWritten answers
In line with delivery of the Programme for Government I am committed to providing for both the strategic reform of the National Ambulance Service (NAS) and frontline staff capacity increases in the NAS. In this regard the Deputy may wish to be aware that total NAS staffing as at April 2023 was 2,167 WTEs. This represents a staffing increase of over 28% since December 2015.
The NAS continues to actively recruit with a successful student paramedic campaign in 2022 resulting in 188 students enrolled onto the BSc course delivered by the NAS college in conjunction with UCC. A total of 128 Student Paramedics are due to commence training in the NAS College in September and 161 Student Paramedics are expected to graduate in 2023 pending successful completion of their education. Furthermore, rolling recruitment campaigns for Qualified Paramedics, Student Paramedics and Intermediate Care Operatives launched in January 2023.
To further support staff retention, the NAS has developed the NAS HR People Plan 2022 – 2025 to enhance employee experience and support their retention within the organisation while meeting expectations of health policy in Ireland.
I have asked the Health Service Executive to respond to the Deputy directly with any further pertinent information it may have on the matter.
Family Reunification
Questions (588, 623)
Holly Cairns
Question:588. Deputy Holly Cairns asked the Minister for Health to outline his engagement with the Minister for Justice concerning reform of the family reunification process of Non-EEA healthcare assistants. [32230/23]
View answerClaire Kerrane
Question:623. Deputy Claire Kerrane asked the Minister for Health what engagement his Department had with the Department for Justice on visa criteria for non-EEA healthcare assistants particularly with regard to family reunification processes and eligibility criteria; and if he will make a statement on the matter. [32388/23]
View answerWritten answers
I propose to take Questions Nos. 588 and 623 together.
Department of Health officials engage on an ongoing basis with Department of Enterprise, Trade and Employment and The Department of Justice regarding work permits and visas for healthcare workers.
Access to the General Employment Permit for non-EEA nationals wishing to take up employment in the role of health care assistant was announced in June 2021 to address skills and labour shortages in the healthcare and nursing home sector. The framework agreed following constructive engagement with the Department of Health provided a salary of at least €27,000 for the role and the requirement for the permit holder to attain a relevant qualification at least QQI Level 5 after 2 years employment in the State.
Remuneration for employment permit purposes is a labour market policy instrument in which setting minimum remuneration thresholds is a delicate balancing act. Economic migration seeks to serve the skills needs of the economy without impacting the wider labour market. Therefore, being cognisant that there are a range of remuneration levels in the sector (€24,000 - €32,000) and recognising the need to be able to recruit staff while ensuring that there is no disruption to the domestic labour market, a minimum annual remuneration threshold of €27,000 has been set for this occupation.
The conditions governing the eligibility requirements for family reunification and the granting of Stamp 1G visas for spouses and/or dependents of employment permit holders are a matter for the Minister for Justice. The Department of Justice policy requires that the sponsor demonstrate their capacity to provide for their family member(s) if they are to be granted a permission to come to Ireland. The policy sets out the rationale for applying resource requirements as part of the overall assessment of whether to approve an application for family reunification and the conditions attaching to permissions issued to family members. The Policy, which was last amended in 2016, is currently under review. Information regarding financial resources for family reunification is outlined in the policy document available at the following link; www.irishimmigration.ie/wp-content/uploads/2021/04/Policy-document-on-Non-EEA-family-reunification.pdf.
Mental Health Services
Questions (589)
Holly Cairns
Question:589. Deputy Holly Cairns asked the Minister for Health to provide his response to a campaign concerning Child and Adolescent Mental Health Services (details supplied). [32231/23]
View answerWritten answers
The Government remains committed to the development of all aspects of mental health services nationally, including those for children and young people. The total allocation for mental health services in 2023 is a record at over €1.2 billion. Around €137 million is provided to Child and Adolescent Mental Health Services (CAMHS) annually. In addition, over €80 million was provided to community-based mental health organisations last year, with a significant proportion of this dedicated to supporting child and young people.
Evidence shows that only 2% of children and young people need the support of the specialist CAMHS multidisciplinary teams. Access is on basis of prioritised clinical assessment and all referrals to CAMHS are assessed by a multidisciplinary team. Urgent cases are prioritised. CAMHS waiting lists can fluctuate over time, due to a variety of operational pressures, including capacities in other parts of the system where young people may not receive early intervention and thus their needs escalate necessitating referrals to CAMHS. Between 2020 and 2021, referral rates into CAMHS increased by 33%, while the number of new cases seen increased by 21% in that same period.
All aspects of CAMHS are being developed under the HSE Service Plan 2023, including a new post of Youth Mental Health Lead at Assistant National Director level, and a new Clinical Lead for Youth Mental Health. Recruitment is underway. A key objective is to improve access and address CAMHS waiting lists, in light of increasing demand and case complexity. This includes various measures such as better links with Primary Care or Disability Services, and greater use of e-mental health responses. In collaboration with local CAMHS services, a waiting list initiative is underway in six CHO areas, specifically targeting areas where children and young people have waited longer than nine months.
I await the outcomes of all audits underway on CAMHS nationally, including the final report of the independent review currently underway by the Mental Health Commission on CAMHS. These audits will help inform any next steps necessary to improve CAMHS. In addition, I recently completed a series of high-level roundtables bringing together the Department of Health, HSE, and other key stakeholders in youth mental health to drive improvement in CAMHS with a focus on executive leadership, clinical expertise and service provision.
The national waiting list initiative in Primary Care Child Psychology Services saw 3,507 children or young people removed from this wait list by the end of December 2022. This initiative is continuing in 2023.
I am aware of the recent campaign referred to by the Deputy. I will certainly bear this in mind, along with the HSE, in the context of progressing several on-going or planned initiatives to improve CAMHS over this year and beyond.
National Treatment Purchase Fund
Questions (590)
Michael Ring
Question:590. Deputy Michael Ring asked the Minister for Health if he will consider increasing the NTPF funding to private nursing homes in view of the rising cost of inflation; and if he will make a statement on the matter. [32236/23]
View answerWritten answers
Fair 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.Overall, €1.4 billion of the total Health Budget was allocated last year to support over 22,700 people under Fair Deal. This will increase to nearly €1.5 billion for 2023, and I am cognisant that the budget has to support all residents under the Nursing Home Support Scheme (NHSS) for the full calendar year.The long-established statutory mechanism through which private and voluntary nursing homes are funded was established by the Oireachtas under the Nursing Homes Support Scheme Act 2009. This legislation outlines the process for private and voluntary providers to negotiate the prices for their services with the designated State agency, the National Treatment Purchase Fund (NTPF).Maximum prices for individual nursing homes are agreed with the NTPF following these negotiations and are 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. Under the NHSS Act 2009 the NTPF has statutory independence, and there is no role for Ministers or the Department of Health in negotiations with individual nursing homes. I cannot comment on individual NTPF negotiations and it must be appreciated that this is a matter for each individual nursing home and the NTPF. Nevertheless, it is important that lines of communication are at all times maintained during the negotiation process.Overall, approximately 425 private nursing homes negotiate with the National Treatment Purchase Fund (NTPF). The Department of Health and I have regular interaction with the NTPF and met them recently to discuss ways to support the sector, where necessary and appropriate, to complement the normal process of negotiating rate increases when contracts are renewed. Budget 2023 saw an over €40 million in additional funding for the Nursing Home Support Scheme (NHSS) which will provide for an uplift in the maximum prices chargeable by private and voluntary nursing homes, as negotiated. Anyone who has had a scheduled renegotiation of their Deed of Agreement this year with the NTPF has seen a significant uplift. In addition, other options to support nursing homes are also being explored, such as to help with the often costly nature of compliance for nursing homes under necessary HIQA regulations.I am conscious of private and voluntary nursing homes that are not scheduled to renegotiate their Deed of Agreement in 2023 and other options are being considered. One of the options under consideration is for nursing home providers to agree to a shorter contract duration with the NTPF.The Government is conscious of the financial challenges faced by the nursing home sector, especially smaller and voluntary nursing homes that may not have access to the same economies of scale as larger homes or groups. The Government has provided substantial support to the private and voluntary nursing home sector over the course of the pandemic. Over €150m of financial support has been provided to private and voluntary nursing homes through the COVID-19 Temporary Assistance Payment Scheme (TAPS) and the provision of free PPE and oxygen to private nursing homes continues, costing approximately €75 million to date.A new €10 million scheme (TIPS) was established last year to support private and voluntary nursing homes with increases in energy costs, covering 75% of year-on-year cost increases up to a monthly cap of €5,250 per nursing home. Following a recent review this scheme has been extended for a second time to the end of June 2023.The only mechanism for funding from the public purse for nursing home residents is Fair Deal and it is really important that private and voluntary providers continue to engage in the process as set out in the Nursing Home Support Scheme Act 2009.
Nursing Homes
Questions (591, 686)
Michael Ring
Question:591. Deputy Michael Ring asked the Minister for Health if he will review the situation for private nursing homes with regard to the services that are provided to patients in public nursing homes but are not provided to patients in private nursing homes (details supplied); and if he will make a statement on the matter. [32237/23]
View answerMichael Ring
Question:686. Deputy Michael Ring asked the Minister for Health when funding will be provided for much-needed equipment for a resident (details supplied) in a nursing home in County Mayo in view of this person’s condition and the fact that residents in public nursing homes are provided with this funding for equipment if it is required; and if he will make a statement on the matter. [32716/23]
View answerWritten answers
I propose to take Questions Nos. 591 and 686 together.
As the Health Service Executive (HSE) have responsibility for the provision of aids and appliances under the Community Funded Schemes, I have asked the HSE to respond to the Deputy directly, as soon as possible.
Departmental Bodies
Questions (592)
Emer Higgins
Question:592. Deputy Emer Higgins asked the Minister for Health if he will seek an update on the status of a report (details supplied) which was granted funding by the Health Research Board; and if he will make a statement on the matter. [32240/23]
View answerWritten answers
In July 2017, the Health Research Board (HRB) was contacted by the Medical Council with a request for assistance in utilising funds from a bequest (€567,106.70) to support research into Parkinson’s Disease. The HRB Board agreed to provide additional co-funding to bring the overall funding for an open call to €750,000 and this issued in September 2017.
The overarching aim of the Patrick Quinn Awards for Parkinson’s Research scheme was to support high-quality applied research projects where academic researchers, knowledge users, and PPI contributors come together to focus on themes/questions developed in consultation with people affected by Parkinson’s. The focus of these health research projects was to improve health outcomes, as well as deliver benefits and improvements to the lives of people with Parkinson’s, their families, and carers in Ireland.
Following a competitive application and peer review process, the HRB co-funded two awards. The first is the project referenced in this question, full details of which can be found below. The second, which is entitled, “Examining the interplay of the immune system with brain cells in Parkinson’s disease”, led by Professor Maeve Caldwell in TCD, has a completion date of January 2024. As these projects were supported through a bequest and one is still underway, there are currently no plans to update these studies.
Reference PQA-2019-002
Title Mapping Parkinson’s Disease needs and services in Ireland to inform service planning
Lead Applicant Researcher Dr Suzanne Timmons, Centre for Gerontology and Rehabilitation, University College Cork
Lead Applicant Knowledge User Professor Orla Hardiman
Lead Applicant PPI Contributor Ms Paula Gilmore
Other Co-Applicants
• Professor Tim Lynch
• Dr Geraldine Foley
• Dr Siobhan Fox
• Professor Kathleen Bennett
• Dr Diarmuid O'Shea
• Mr Patrick Browne
• Dr Eilis O'Reilly
• Mr Tony Wilkinson
Host Institution University College Cork
Project Abstract: Although the National Clinical Programme (NCP) for Neurology’s Model of Care included a pathway for Parkinson’s Disease (PD), and the number of people with Parkinson's (PwP’s) is increasing significantly annually (it will double globally from 2015 to 2040), services for PwP’s have not had any significant healthcare investment in recent years. Anecdotally, Irish PD services fall well below internationally recommended standards for staffing resources. This not only affects the quality of life of PwP’s, it also leads to avoidable hospital admissions, with high associated costs and morbidity. The Parkinson’s Association of Ireland has lobbied to improve PD services in Ireland. However, there is no reliable estimate of the current prevalence of PD in Ireland, and of either the services available to PwP’s or the quality/user-appraisal of these services.
This research project aims to support national and local PD service planning by three linked work packages. The first maps the prevalence of PD and service availability for PwP’s, across each of the nine Community Healthcare Organisation regions in Ireland, to highlight mismatches between population needs and service provision. The second develops quality indicators for Irish PD services and assesses existing services against these indicators, to demonstrate where extra resources (e.g. education/training, staff numbers or mix, etc) are needed to provide a quality service. The final work package explores the experience of PwP’s with respect to services they receive, and their priorities for service provision. The applicant team involves key stakeholders in the Health Service Executive (HSE), advocacy/support groups, and service users and providers.
Together, this data will support the Department of Health/HSE to plan future PD services in Ireland, on a region-by-region basis. It will support local PD services to improve the quality of their service and will support ongoing advocacy for health care that meets the needs of PwP’s in Ireland.
Timeline
The Project started at end 2019 and originally had a duration of 24 months. With Covid-related delays, the project concluded in Q3 2022. All fieldwork was completed at grant end date and work was underway to compile the results of the audit and to finalise the national reports and related infographics.
Outputs and knowledge translation
This is the link to the project webpage, where non-confidential outputs are housed, under easy-to-follow headings: www.ucc.ie/en/pdrc/currentresearch/. This includes:
Work Package 1: Population needs and service availability
• PD prevalence summary report www.ucc.ie/en/media/academic/anatomy/pdrc/PDPrevalenceSummary30.06.23.pdf.
• PD service mapping (correct as per 2022) www.ucc.ie/en/media/academic/anatomy/pdrc/MappingofSpecialistPDservices(N=14).pdf.
Work Package 2: Quality of services
• Agreed PD service quality indicators www.ucc.ie/en/media/academic/anatomy/pdrc/QIs_SupportingGuidelinesEvidence30.06.23.xlsx.
• Agreed national PD service audit tool www.ucc.ie/en/media/academic/anatomy/pdrc/MapPDAuditTool30.06.23.pdf
Work Package 3: User Experience
• National survey of 1400 people living with PD- paper www.ucc.ie/en/media/academic/anatomy/pdrc/PDSurveyManuscriptACCEPTED-INPRINT30.06.23.pdf .
Note:
• The audit report based on using this tool in 10/14 clinics nationally in 2022/2023 is not yet signed off by the National Clinical Programme of Neurology (knowledge user) but will be made publicly available once finalised.
• The national report is not yet finalised.
Pathway to impact:
• Two policy briefs based on combined survey/interview data were presented by the Parkinson's Association of Ireland (PAI) the Neurological Alliance of Ireland (NAI) at a meeting with my Department and other Government Ministers in June/July 2022.
www.ucc.ie/en/media/academic/anatomy/pdrc/MapPDPDNurseSpecialistpolicybrief26.06.22.pdf.
www.ucc.ie/en/media/academic/anatomy/pdrc/MapPDHSCPpolicybrief22.06.22.pdf.
• A report was prepared for the Oireachtas Committee in May 2023. This report was used by the NAI to expedite implementation of community neuro-rehab teams. www.ucc.ie/en/media/academic/anatomy/pdrc/Oireachtasmeetingreport03.05.23.pdf.
• Results of the project were disseminated to all PAI members in their July 2022 newsletter.
www.ucc.ie/en/media/academic/anatomy/pdrc/PAINewsletter-Summer-2022.pdf.