Thomas Gould
Question:649. Deputy Thomas Gould asked the Minister for Health if he will provide update on the last meeting of the SIG under the National Drugs Strategy chaired by his Department. [34091/23]
View answerHealth Strategies
Questions (649)
Written answers
The Strategic Implementation Groups (SIGs) were established in 2022 to support the implementation of the 6 new strategic priorities that arose from the midterm review of the National Drugs Strategy. These groups sit under the National Oversight Committee.The strategic priorities strengthen the health-led approach, reflect commitments in the Programme for Government and align with the EU drugs strategy and action plan 2021-2025.Membership of the Groups is comprised of representatives from government departments and agencies, drug and alcohol taskforces and civil society.
Independent leadership has been provided to ensure the accountability of all stakeholders. These independent chairs have been assigned to bring impartiality, insight and experience in addressing the challenges of drug and alcohol use.
The SIGs have been tasked with developing strategic actions, which were published on the 29th of June, and with providing oversight on the implementation of these actions.
The chairs of Strategic Implementation Groups report to the National Oversight Committee (NOC) on the progress of their work. The NOC usually meets on a quarterly basis.
The minutes from meetings of the National Oversight Committee are available here:
www.gov.ie/en/publication/39e48-national-oversight-committee/#minutes-of-the-meetings-of-the-national-oversight-committee.
Mortality Rates
Questions (650)
Peadar Tóibín
Question:650. Deputy Peadar Tóibín asked the Minister for Health the reason the excess mortality rate in Ireland has been spiking so high in recent months; the reason there were 25.4% more deaths in Ireland in December 2022 than the average for the same month from 2016 to 2019; the reason that the excess mortality rate in Ireland has been higher than the EU average for the past 12 months apart from July 2022; and if there is a formal investigation being carried out by any State organisation into the reasons for these excess deaths. [33438/23]
View answerWritten answers
The Department of Health does not produce estimates of excess mortality. However, the Department works closely with the Health Protection Surveillance Centre (HPSC) and other stakeholders to monitor estimates of excess mortality. Excess mortality refers to the number of deaths from all causes during a period of time above and beyond what we would have normally expected to see.
A number of different methodologies have been developed by organisations and academics internationally to try to estimate levels of excess mortality. It is important to note that estimation methods vary, for example in the years used to estimate a baseline, in how they estimate the level of expected deaths, the data source used for ‘actual’ deaths and whether statistical significance tests are applied before reporting deaths as excess. There is therefore no single source of data on estimated excess mortality.
Internationally work is currently underway to improve methods to estimate excess mortality including moving the baseline years used to calculate expected deaths forward from pre-pandemic years. The gap between the current period and the baseline period is relatively wide and growing. The gap is greater than would have been normal practice previously, which impacts on comparability between the current period and the period used to estimate ‘expected’ deaths.
In addition, most estimation methods, including Eurostat and EuroMOMO, do not currently take account of demographic changes such as population change or ageing which may have occurred since the baseline period and which can have a large impact on mortality. EuroMOMO has received four-year funding to further develop their model, including the incorporation of demographic change.
The recent Census 2022 summary results released by the CSO have shown that the number of persons in Ireland aged 65 years and over increased by 22% between 2016 and 2022. Within this category, the highest increases were among those aged 75-84 years (28%) and 85 years and over (25%). Over the same period, the total population only increased by 8.1% with declines in some younger age groups e.g. 25-39 years and those aged under 10 years.
The 22% increase in the population aged 65 years and older in Ireland between 2016 and 2022, was more than double the 10% increase which occurred for the EU27 over the same period. For the 75-84 years age category the difference was greater, with a 3% increase across the EU27 compared with a 28% increase in Ireland.
As persons in older age groups account for the majority of deaths (in 2019 82% of all deaths which occurred in Ireland were among persons aged 65 years and over), the substantial increase in the number of persons in these age groups within the population would be expected to increase the absolute number of deaths occurring in Ireland, compared with the number which occurred in 2016-2019. Compared with the most recent year included in the baseline (2019) the number of persons aged 65 years and over in Ireland was 12% higher in 2022 and for 75-84 years, it was 17% higher (based on CSO estimated 2019 population).
The Health Protection Surveillance Centre (HPSC) has monitored excess mortality in Ireland since 2009, using registered deaths data reported to HPSC on a daily basis from the General Register Office (GRO). HPSC participates in EuroMOMO for Ireland, a European mortality monitoring activity, aiming to detect and measure excess deaths related to seasonal influenza, pandemics and other public health threats. EuroMOMO publish a weekly update of estimates of excess mortality for all participating European countries www.euromomo.eu/graphs-and-maps.
The latest HPSC excess mortality analysis of all registered deaths in Ireland for the 2022/2023 winter period, using the standardised European EuroMOMO algorithm, has shown:
• Excess all-cause mortality over five consecutive weeks (week 51 2022 – week 3 2023), reaching moderate levels of excess during weeks 51 and 52 2022 and week 2 2023.
• Excess Pneumonia and Influenza mortality over four consecutive weeks (weeks 51 2022 – week 2 2023), reaching moderate levels of excess during week 52 2022. Pneumonia and influenza deaths refer to deaths where pneumonia and/or influenza were listed as one of the causes of death on the death certificate.
These data are provisional due to the time lag with death registration in Ireland. A country-specific adjustment function was applied to correct for the typical lag in registrations of deaths in Ireland (the legal period for death registration in Ireland is three months). Nonetheless, estimates of excess mortality for the most recent weeks are reported with some uncertainty and should be interpreted with caution.
It is important to note that excess mortality has been observed during previous periods when influenza viruses circulated at high levels in Ireland, for example in winter 2017/2018 which has previously been characterised as a severe flu season, and during certain periods of the COVID-19 pandemic (April 2020 and January 2021).
As Ireland experienced a winter of high levels of influenza cases and hospitalisations, it would not be unexpected to see excess mortality. Influenza activity was at very high levels in Ireland during December 2022 and early/mid-January 2023, with a high number of influenza hospitalisations reported (see www.hpsc.ie/a-z/respiratory/influenza/seasonalinfluenza/surveillance/influenzasurveillancereports/20222023season/). Other important factors that may impact excess mortality include the ongoing COVID-19 pandemic, circulation of other respiratory viruses, impacts of cold weather, and an ageing population.
Excess mortality was also observed in other European countries over the course of winter 2022/2023. In Europe, the overall pooled EuroMOMO estimates of all-cause excess mortality in all age groups for the participating European countries have shown elevated mortality in all age groups for late 2022/early 2023. Some European countries also experienced excess mortality during Summer 2022 associated with heatwaves.
Separately, Eurostat publishes monthly estimates of excess mortality for EU (and some non-EU) countries. This data only incudes excess mortality estimates from January 2020 onwards. Eurostat use the following methodology, ‘The excess mortality indicator simply takes the number of people who died from any cause, in a given period, and compares it with a historical baseline from previous years in a period which was not affected by the pandemic. In this case, the baseline consists of the average number of deaths that occurred in each month during the period 2016-2019’. The methodology does not require a statistically significant difference to report excess deaths. As noted above, it also does not take account of factors such as demographic change.
In relation to Ireland, it is important to note that data from 2020 onwards is based on data provided by the CSO based on a web-scraped series from rip.ie. The comparison baseline (2016-2019) is built using official data on registered deaths. Caution is required in interpreting this indicator.
The latest data published by Eurostat (published 9 June 2023 ec.europa.eu/eurostat/statistics-explained/index.php?title=Excess_mortality_-_statistics), refers to deaths in April 2023. Based on the Eurostat methodology, it is estimated that Ireland experienced 12.2% additional deaths in April.
The Central Statistics Office (CSO) publishes official statistics on mortality in Ireland and publishes quarterly and yearly statistics on registered deaths through their Vital Statistics publications. The latest published data is for deaths registered in Quarter 4 2022 and data is provisional. Data for deaths registered in Quarter 1 2023 will be published in September. This will include data on cause of death and allow more detailed analysis of mortality trends over the winter 2022/2023 period.
The Department of Health is actively monitoring and reviewing all available data on mortality as it becomes available and supports the clear national commitment to learn from the COVID-19 pandemic, in particular with a view to ensuring the State’s preparedness for future public health threats.
Departmental Funding
Questions (651)
Seán Sherlock
Question:651. Deputy Sean Sherlock asked the Minister for Health what funding has been allocated to the ICGP to provide training and certification to health care professionals on long-acting reversible contraception insertion in 2022 and 2023; the number of health care professionals who have availed of training and certification in the same time period; the resultant increase in capacity of LARC-trained health care professionals; and if he will make a statement on the matter. [33451/23]
View answerWritten answers
The free contraception scheme, currently open to women aged 17 -26 who are ordinarily resident in Ireland, was launched on 14th September, 2022, and expanded to include 26 year-olds on January 1st, 2023. The scheme is due to be further expanded to women aged 30 and under by September 1st, 2023.
For eligible women, the free contraception scheme provides for the full cost of consultations, prescriptions, fittings, removals and check-ups related to the wide range of contraception also available to GMS card holders on the Re-Imbursement List.
Funding has been provided, through the HSE, to the ICGP under the scheme to provide additional training and education to GPs regarding the fitting, removal and management of long-acting reversible contraceptives (LARCs).
In September 2022, ICGP received €78,110 for the development of LARC training and education over a two-year period. In 2023, ICGP will receive €211,263 for completion of Year 1 development and delivery of the training programme and to commence Year 2.
ICGP advise that they have been delivering and continue to develop a high quality LARC training scheme that is accessible to GPs and GP trainees alike. Engagement with stakeholders has been critical to ensure success. ICGP has developed a checklist to support LARC tutors and is adapting the programme to incorporate Entrustable Professional Activities (EPA) tools to determine if GPs meet the requirements for certification at the end of their training and can demonstrate that they have achieved standards which have also been set, ensuring standardisation.
LARC training is complex and requires various levels of education from understanding the evidence base to competency in inserting LARC. As part of the overall plan, ICGP has undertaken research through the Research Hub for General Practice to examine areas where there is a lack of LARC inserters. The funding allocated to ICGP includes grants for training in these areas of greatest need. This work is is ongoing. It is anticipated that there will be an increase in the number of LARC inserters as a result of the funding by 2024. ICGP anticipates that 55 GPs located in geographic locations with the greatest lack of LARC Inserters will be identified and trained each year.
ICGP is also working to increase the availability of LARC tutors by providing an online on demand course for training, while also developing an easily accessible directory of LARC tutors, with appropriate permissions in place as a critical element of this process.
Two modules on contraception theory are provided as part of the course, these can be accessed throughout the year and can be taken at a GP’s own pace. Each GP training scheme now also runs the contraception theory course. A contraception theory resource pack is disseminated to each GP training scheme to support in person training, which is delivered to all GP trainees. This means that each GP Trainee is provided with comprehensive education on contraception, regardless of a decision to complete the certificate course.
In terms of course completions to date, 37 LARC Certificates were issued in 2022 and 26 certificates have been issued in 2023 so far.
In addition to education and training, the ICGP has also developed Patient Information Leaflets, consent forms and protocols for insertion, to standardise practice. The ICGP have also hosted a number of webinars and conferences, either focussed on contraception, with 1147 GPs and Practice Nurses attending a webinar in October 2022. The ICGP delivers a separate blended, modular course in Community Gynaecology, of which the first module is on Contraception.
Departmental Schemes
Questions (652)
Seán Sherlock
Question:652. Deputy Sean Sherlock asked the Minister for Health the type of data being compiled to inform further development of the free contraception service; and if he will make a statement on the matter. [33452/23]
View answerWritten answers
The free contraception scheme, currently open to women aged 17 -26 who are ordinarily resident in Ireland, was launched on 14th September, 2022, and expanded to include 26 year-olds on January 1st, 2023. The scheme is due to be expanded to women aged 27-30 on September 1st, 2023.
For eligible women, the free contraception scheme provides for:
• The cost of consultations with GPs, family planning clinics and other relevant medical professionals to discuss contraceptive options with eligible patients and to provide prescriptions for these;
• The cost of prescription contraception, dispensed at local pharmacy of choice;
• The cost of fitting and/or removal of various types of long-acting reversible contraception (LARC) plus any necessary checks, by medical professionals certified to fit/remove LARCs (e.g. intrauterine devices (IUD), systems (IUS), coils and implants);
• The cost of providing the wide range of contraceptive options currently available to GMS (medical) card holders, which will also be available through this scheme, including contraceptive injections, implants, IUS and IUDs, the contraceptive patch and ring, and various forms of oral contraceptive pill, including emergency contraception.
• Women who have had coils, IUDs, IUSs or implants inserted under the scheme will remain eligible for the subsequent checks and free removal of any devices that were inserted before their 27th birthday, in order to ensure continuity of care.
As with similar State schemes, reimbursements to GPs, family planning clinics, pharmacists and other contracted providers are managed by the HSE Primary Care Re-imbursement Service (PCRS). As the scheme has not yet been in place for a full calendar year, it is not yet possible to provide detailed statistics on annual usage, however, PCRS annual reports are published by PCRS on their website www.sspcrs.ie/portal/annual-reporting/ . The contraception scheme will be included in these in due course (the 2022 Report has not yet been published).
As reported in the Budget announcements, a full year amount of approximately €32m, taking into account scheduled expansions, has been allocated for 2023. The HSE advise that, as of June 2023, there are 2,351 GPs providing the service under the Scheme and also 1,892 pharmacies participating in the scheme.
The Minster expects to shorty receive more detailed data about the usage of the contraception scheme, including the number of unique individuals accessing the scheme, a breakdown by age and what types of contraception are accessed, in addition to high level monthly budgetary reporting that is already provided.
With regard to contraception for men and their partners, the HSE Sexual Health and Crisis Pregnancy Programme manages the National Condom Distribution Scheme (NCDS). The NCDS supplies free condoms on order to the national network of free STI clinics, through participating NGOs, 3rd level campuses and with orders from the new home STI testing scheme. The NCDS annual report for 2022 is available at the following link: www.sexualwellbeing.ie/for-professionals/national-condom-distribution-service/national-condom-distribution-overview/national-condom-distribution-service_annual-report_2023_final.pdf.
Health Services
Questions (653, 703)
Denis Naughten
Question:653. Deputy Denis Naughten asked the Minister for Health if he will outline the planned revision of the model of care for long-Covid following the publication of the report by HIQA; when the model of care was last reviewed; and if he will make a statement on the matter. [33461/23]
View answer
Paul Murphy
Question:703. Deputy Paul Murphy asked the Minister for Health if, given the issues with long-Covid diagnosis and the lack of services and supports made available to those who are diagnosed, he can advise what mental health services are in place to support patients who have had to battle for their illness to be recognised; if he can describe the services for adult patients, children suffering with long-Covid and their families; and if he will make a statement on the matter. [33608/23]
View answerWritten answers
I propose to take Questions Nos. 653 and 703 together.
As the matter raised is a service delivery matter, I have asked the Health Service Executive to respond to the Deputies directly as soon as possible.
Covid-19 Pandemic
Questions (654, 696)
Denis Naughten
Question:654. Deputy Denis Naughten asked the Minister for Health further to Parliamentary Question No. 289 of 15 June 2023, if he will provide the spend out-turn for the first six months of 2023 and the corresponding activity data and numbers awaiting appointment at the end of June 2023; and if he will make a statement on the matter. [33462/23]
View answerPaul Murphy
Question:696. Deputy Paul Murphy asked the Minister for Health for details in relation to how many people are currently waiting to be seen by a long-Covid clinic, with a breakdown per clinic. [33601/23]
View answerWritten answers
I propose to take Questions Nos. 654 and 696 together.
As the matter raised is a service delivery matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
Health Services Staff
Questions (655)
Colm Burke
Question:655. Deputy Colm Burke asked the Minister for Health to confirm how €750,000 provided in Budget 2023 to support counselling psychology training places has been allocated; and if he will make a statement on the matter. [33466/23]
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.
Health Services Staff
Questions (656)
Colm Burke
Question:656. Deputy Colm Burke asked the Minister for Health to confirm that education and additional financial support will be made available to those undertaking counselling psychology courses; and if he will make a statement on the matter. [33467/23]
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.
Health Services Staff
Questions (657)
Colm Burke
Question:657. Deputy Colm Burke asked the Minister for Health to confirm that financial supports such as the ones given to first-year students in the educational psychology doctorate programme (details supplied) will be made available to those in counselling psychology courses; and if he will make a statement on the matter. [33468/23]
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.
Hospital Facilities
Questions (658)
Pádraig Mac Lochlainn
Question:658. Deputy Pádraig Mac Lochlainn asked the Minister for Health his views on whether it is acceptable that ten years since the major flood at Letterkenny University Hospital, the onsite outpatient clinic has not been reinstated at the hospital; and if he will ensure that this important clinic is reinstated as soon as possible. [33470/23]
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.
Covid-19 Pandemic
Questions (659)
Kathleen Funchion
Question:659. Deputy Kathleen Funchion asked the Minister for Health when a person (details supplied) will receive the €1,000 pandemic payment; and if he will make a statement on the matter. [33478/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
I would also like to remind the Deputy that it is against Department policy to comment on individual cases.
Covid-19 Pandemic
Questions (660)
Bríd Smith
Question:660. Deputy Bríd Smith asked the Minister for Health if a person (details supplied) has been approved for the €1,000 pandemic payment; when they will receive same; and if he will make a statement on the matter. [33481/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
I would also like to remind the Deputy that it is against Department policy to comment on individual cases.
Departmental Data
Questions (661)
Paul Murphy
Question:661. Deputy Paul Murphy asked the Minister for Health the number of concerns HIQA has received relating to a facility (details supplied) for the years 2020-2023, with a breakdown into specific themes of concern type; and if any of these concerns have been forwarded to An Garda Síochána or to the safeguarding and protection teams. [33482/23]
View answerWritten answers
The Health Information and Quality Authority (HIQA) was established under the Health Act 2007, as amended, to promote safety and quality in the provision of health and personal social services for the benefit of the health and welfare of the public. HIQA’s regulatory role is to regulate designated centres for older people, people with a disability and special care units. HIQA also regulates medical ionising radiation exposure and monitors standards in acute and community hospitals and some children’s social care services.
HIQA has no statutory remit to manage or respond to individual complaints, this is the
statutory responsibility of the service provider. However, while HIQA does not investigate or
resolve individual complaints it does welcome feedback about centres and services under its remit –
which the Authority refers to as unsolicited information.
HIQA has advised my Department that all unsolicited information (UROI) received is reviewed by an inspector to establish if the information received indicates a risk to the safety, effectiveness, and management of the service, and the day-today care the resident or patient receives.
If HIQA considers that the service provider may not be compliant with the regulations and or national standards, they can respond by:
• asking the service provider to submit additional information on the issue
• requesting a plan from the service provider outlining how the issue will be investigated and addressed
• using the information on inspection
• carrying out an unannounced inspection to assess the quality and safety of the care being provided in the service
In addition, where the information indicates that people may be at immediate risk, HIQA will ensure that relevant authorities such as the Gardaí, the Child and Family Agency (Tusla) or the HSE’s Adult Safeguarding and Protection Team are informed.
HIQA has advised my Department that it received 10 pieces of unsolicited information in relation to the facility referred to in the Deputy’s question.
|
Year |
Number of pieces of unsolicited information |
|
2020 |
2 |
|
2021 |
3 |
|
2022 |
1 |
|
2022 (to 30 June) |
4 |
HIQA has advised that UROI’s can contain more than one theme. From the table above the themes include Safeguarding (8), Rights (8), Quality of care (4), General welfare and development (3), Infection prevention and control measures (2), Protection (1), Visiting (1), Risk management (1). Governance and management (10), Communication (6), Complaints handling (1).
No referrals were required for the information referred to above to An Garda Síochána or the HSE’s Adult Safeguarding and Protection Team.
Departmental Reports
Questions (662)
Paul Murphy
Question:662. Deputy Paul Murphy asked the Minister for Health if he will provide a copy of the audit report that took place into the TAPs funding. [33483/23]
View answerWritten answers
As this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Departmental Data
Questions (663)
Paul Murphy
Question:663. Deputy Paul Murphy asked the Minister for Health the number of concerns that HIQA has received relating to a facility (details supplied) for the years 2020-2023, with a breakdown into specific themes of concern type; and if any of these concerns have been forwarded to An Garda Síochána or to the safeguarding and protection teams. [33484/23]
View answerWritten answers
The Health Information and Quality Authority (HIQA) was established under the Health Act 2007, as amended, to promote safety and quality in the provision of health and personal social services for the benefit of the health and welfare of the public. HIQA’s regulatory role is to regulate designated centres for older people, people with a disability and special care units. HIQA also regulates medical ionising radiation exposure and monitors standards in acute and community hospitals and some children’s social care services.
HIQA has no statutory remit to manage or respond to individual complaints, this is the
statutory responsibility of the service provider. However, while HIQA does not investigate or
resolve individual complaints it does welcome feedback about centres and services under its remit –
which the Authority refers to as unsolicited information (UROI).
HIQA has advised my Department that all UROI's received are reviewed by an inspector to establish if the information received indicates a risk to the safety, effectiveness, and management of the service, and the day-today care the resident or patient receives.
If HIQA considers that the service provider may not be compliant with the regulations and or national standards, they can respond by:
• asking the service provider to submit additional information on the issue
• requesting a plan from the service provider outlining how the issue will be investigated and addressed
• using the information on inspection
• carrying out an unannounced inspection to assess the quality and safety of the care being provided in the service
In addition, where the information indicates that people may be at immediate risk HIQA will ensure that relevant authorities such as the Gardaí, the Child and Family Agency (Tusla) or the Health Service Executive (HSE) Adult Safeguarding and Protection Team are informed.
HIQA has advised my Department that it received 14 pieces of unsolicited information in relation to the facility referred to in the Deputy’s question.
|
Year |
Number of pieces of unsolicited information |
|
2020 |
9 |
|
2021 |
1 |
|
2022 |
2 |
|
2023 (to 30 June) |
2 |
HIQA has further advised that UROI’s can contain more than one theme. From the table above the themes included Safeguarding (8), Rights (6), Infection prevention and control measures (4), Quality of care (2), Protection (2), Premises (2), Management of personal possessions (1), the discharge process (1). Governance and management (8), Complaints handling (3), Communication (2).
No referrals were required for the information referred to above to An Garda Síochána or the HSE’s Adult Safeguarding and Protection Team.