David Cullinane
Question:741. Deputy David Cullinane asked the Minister for Health the status of each recommendation of the nursing home expert panel review, in tabular form. [33761/23]
View answerCare Services
Questions (741)
Written answers
As the Deputy is aware, the Fourth Progress Report on the Implementation of the COVID-19 Nursing Homes Expert Panel Recommendations was published in June 2022. The report highlighted the important progress that had already taken place across a number of areas and set out the structures and processes that have been established to ensure continued implementation. It also highlighted that the majority of short- and medium-term recommendations which were aimed at safeguarding people living in nursing homes against the COVID-19 virus had already been implemented and mainstreamed into normal operations.
Since then, significant progress has also been made on progressing medium- and longer-term reform recommendations in the following areas:
• The Patient Advocacy Services was extended to private nursing homes from 1st November 2022.
• Revised Regulations were signed in December 2022 to enhance and streamline complaints processes. These came into effect on the 1st March 2023.
• The results of the first Nursing Homes Care Experience survey were published in November 2022.
• Work is advancing on the development of a Safe Staffing & Skillmix Framework for the sector.
• New palliative and end-of-life programme for nursing homes was launched in 2022.
• General Scheme of a Bill was published in October 2022 to give the regulator (HIQA) further powers, including in relation to enforcement and data collection.
• New dedicated IPC and Safeguarding Specialist Capacities for nursing homes have been established across the 9 CHOs and recruitment is ongoing.
• Recruitment has also commenced for Community Support Teams with 44% of recruitment completed for phase 1 implementation.
• Over 100 places funded on postgraduate gerontological nursing training courses for the academic year 2022/2023.
• The Patient Safety Bill has been signed into law in May 2023 providing the Chief Inspector in HIQA with investigation powers for serious incidents in nursing homes.
While it is accepted that this broad programme of wide-ranging and complex reform will take time to implement, the Government is committed to the implementation of the Expert Panel recommendations. Funding has been put in place in 2023 for the continued implementation and mainstreaming of a range of Expert Panel recommendations, including the establishment of permanent Community Support Teams, the piloting of Clinical Governance Oversight committees and the development of a Safe Staffing Framework for the sector.
In addition, the Programme for Government (2020) commits to the establishment of a Commission on Care that will assess how we care for older people and examine alternatives to meet the diverse needs of our older citizens, learning the lessons from COVID-19. The Department of Health has responsibility for fulfilling this commitment. The scoping of, and planning for, the commission is being advanced as a priority in 2023.
Please find attached the status of the NHEP recommendations in tabular form as requested.
|
Summary Table |
|||
|
Recommendations |
86 |
% |
|
|
Complete |
55 |
64% |
|
|
Work in Progress |
26 |
30% |
|
|
Commission on care |
5 |
6% |
Health Services
Questions (742)
Pádraig O'Sullivan
Question:742. Deputy Pádraig O'Sullivan asked the Minister for Health when a person (details supplied) will receive payment under the Cross-Border Directive scheme; and if he will make a statement on the matter. [33770/23]
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 Services
Questions (743)
Catherine Murphy
Question:743. Deputy Catherine Murphy asked the Minister for Health the number of persons that have attended the specialist menopause clinic at the National Maternity Hospital in 2022 and to-date in 2023, and the backlog for same, in tabular form. [33781/23]
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 Equipment
Questions (744)
Catherine Murphy
Question:744. Deputy Catherine Murphy asked the Minister for Health the number of optical coherence tomography machines currently in use in the ophthalmology department of St. Vincent's University Hospital. [33782/23]
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 Services
Questions (745)
Catherine Murphy
Question:745. Deputy Catherine Murphy asked the Minister for Health the number of selective dorsal rhizotomy surgeries carried out in public hospitals here in 2021, 2022 and to-date in 2023, in tabular form; and the public hospitals in which this surgery is carried out. [33783/23]
View answerWritten answers
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.
Health Services Staff
Questions (746)
Catherine Murphy
Question:746. Deputy Catherine Murphy asked the Minister for Health the number of WTE mental health midwives; the training they receive; and the role of mental health midwives within the perinatal mental health integrated care pathway. [33784/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
Health Services
Questions (747)
Neasa Hourigan
Question:747. Deputy Neasa Hourigan asked the Minister for Health if he will outline how each individual CHO funds interpreting services in general practices; if he plans to improve access to interpreters in general practice by establishing a central service for use across all CHOs; and if he will make a statement on the matter. [33798/23]
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 Service Executive
Questions (748)
Jim O'Callaghan
Question:748. Deputy Jim O'Callaghan asked the Minister for Health when the report (details supplied) will be completed by the HSE; and if he will make a statement on the matter. [33800/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
Departmental Funding
Questions (749)
Fergus O'Dowd
Question:749. Deputy Fergus O'Dowd asked the Minister for Health to outline the total funding provided by the HSE/his Department to all older persons’ support groups/organisations/advocacy services in 2022 and planned for 2023, in tabular form, by name, location, budget and number of staff employed; and if he will make a statement on the matter. [33801/23]
View answerWritten answers
The Patient Advocacy Service (PAS) provides support to people of all ages, including older persons, who wish to make a complaint about the care they have received in Public Acute Hospitals or Nursing Homes. PAS also supports people in the aftermath of patient safety incidents. PAS is a National Service with a National Phone line which is available from 10 a.m. to 4 p.m. Monday to Friday.
|
Year |
Year |
|
|
2022 |
2023 |
|
|
Location |
PAS had a Head Office in Dublin and an office hub in Galway |
PAS had a Head Office in Dublin and office hubs in Galway and Cork |
|
Staff Employed |
18 |
24 |
|
Expenditure |
€1,1291,811 |
€772,788* |
|
Budget |
€3,350,834 |
*This is the expenditure to date in 2023 (as at 30/06/2023). PAS has informed the Department that the underspend on the projected budget YTD is in relation to a) salaries and associated costs, due to phased recruitment as resources required (recruitment ongoing) and b) rent, due to impact of blended working model and requirement for office space.
A component of the Deputy’s question is an operational matter for the HSE. I have therefore asked the HSE to respond to the deputy directly, as soon as possible.
Nursing Homes
Questions (750)
Michael McNamara
Question:750. Deputy Michael McNamara asked the Minister for Health if he or his Department will address serious concerns with the ongoing crisis in the funding of nursing homes under the fair deal scheme, given that a number of nursing homes (details supplied) in County Clare have been dealing with severe sustained financial pressures in the provision of care for residents; and if he will make a statement on the matter. [33808/23]
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 Homes 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 Nursing Homes Support Scheme 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 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 €77 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 was 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 Homes Support Scheme Act 2009.
Nursing Homes
Questions (751)
Fergus O'Dowd
Question:751. Deputy Fergus O'Dowd asked the Minister for Health the responses he is planning to make to the report into the death of a person (details supplied) a former resident of a nursing home who died in 2020; if he will ensure the extension of HSE safeguarding and protection teams and clinical governance systems across all private nursing homes; and if he will make a statement on the matter. [33809/23]
View answerWritten answers
My officials are engaging with the relevant parties on the progression and implementation of the recommendations contained in the report in question, so that the learning from this tragic death can inform improvement in relation to the quality and safety of service provision.
Significant changes and improvements have been made in recent years arising from learnings during the pandemic. The Nursing Home Expert Panel Report published in August 2020, identified the need for a Clinical Governance Oversight Committee to be established in all nursing homes and the HSE is identified as the lead agency for this recommendation. The HSE established a Clinical Governance Working Group to consider issues relating to clinical governance in nursing homes and to support the development and piloting of a model of clinical governance committees. Funding was provided to the HSE, and work is underway to design a pilot which will be implemented later this year.
The Government has provided a comprehensive suite of measures for nursing homes which is cognisant of the health and well-being requirements of people living in long-term residential care. Such measures include:
• The Patient Advocacy Service was extended to private nursing homes from 1st November 2022.
• Revised Regulations were signed in December 2022 to enhance and streamline complaints processes which came into effect on the 1st of March 2023.
• A new dedicated Infection Prevention and Control resource and Safeguarding Specialist Capacities for nursing homes have been established across the 9 Community Healthcare Organisations.
• Recruitment has also commenced for Community Support Teams with 44% of recruitment completed for phase 1 implementation.
• Training and development opportunities continue for staff working in nursing homes with a new palliative and end-of-life programme for nursing homes launched in 2022 and over 100 places funded on postgraduate gerontological nursing training courses for the academic year 2022/2023.
• More broadly, a General Scheme of a Bill was published in October 2022 to give the regulator (HIQA) further powers, including in relation to enforcement and data collection. Furthermore, the Patient Safety Act has been signed into law in May 2023 providing the Chief Inspector in HIQA with investigation powers for serious incidents in nursing homes.
In addition, the Department of Health is at a very advanced stage in its development of an overarching policy on adult safeguarding in the health and social care sector, which is intended to cover all public, voluntary and private settings. It is planned to commence a public consultation on a draft policy in September.
Health Services Staff
Questions (752)
Fergus O'Dowd
Question:752. Deputy Fergus O'Dowd asked the Minister for Health the number of staff currently allocated to working on Older Persons issues in his Department; the number of people working at national level in Older Person Services in the HSE; and if he will make a statement on the matter. [33810/23]
View answerWritten answers
The Social Care, Mental Health, Drugs Policy and Unscheduled Care Policy Division spans issues relating to older people, palliative care, dementia and carers, mental health services, people who use drugs, inclusion health and access to urgent and emergency care. The divisional remit is to develop policy and underlying legislation as required, to ensure the provision of high quality health and social care services to support and enable all service users to maximise their full potential, supporting people to live and age well in their communities through the provision of locally accessible community services aligned with Sláintecare policy.
There are 50 staff within the Division working within Older Persons Policy Development, Older Persons Strategy, Older Persons Oversight and Planning and Home Support Reform units across the grades of Clerical Officer to Principal Officer. Further details about these units are available at www.gov.ie/health.
The Deputy should also note that the work assigned to these four units is not confined to issues relating exclusively to older people and that the work of many other units within the Department address the needs of older people as part of their wider remit.
Nursing Homes
Questions (753)
Fergus O'Dowd
Question:753. Deputy Fergus O'Dowd asked the Minister for Health if he will request HIQA and the decision support service to jointly develop a code of practice to protect the rights and interests of people entering nursing homes whose capacity to review, understand and make an informed decision to sign a contract for care is at issue; and if he will make a statement on the matter. [33811/23]
View answerWritten answers
Overall policy on assisted decision-making is vested in the Minister for Children, Equality, Disability, Integration and Youth and decisions in relation to the preparation of codes of practice under the Assisted Decision-Making (Capacity) Act 2015 ("the 2015 Act") are a matter in the first instance for the Director of the Decision Support Service (DSS) under section 103 of the Act.
I have been advised by the Department of Children, Equality, Disability, Integration and Youth, in relation to the matters raised in the Deputy’s question, that:
• The 2015 Act, as amended by the Assisted Decision-Making (Capacity) (Amendment) Act 2022, provides a role for the Director of the Decision Support Service to prepare and publish Codes of Practice to support the operation of the Act.
• As part of the commencement of the 2015 Act in April 2023, the Director published a number of individual codes, which are available on the Decision Support Service's website. These codes are considered sufficient for the operation of the Act and cover a range of different areas aimed at ensuring the maximum protection of vulnerable persons relying on the Act’s provisions.
• These published codes cover a range of different areas and provide advice and guidance to decision supporters and professionals interacting with relevant persons under the legislation. This includes all tiers of decision supporters, who hold a statutory role in supporting to a person who may be lacking capacity to make certain decisions, including those who may need support when entering nursing homes. There is also a code for healthcare professionals, where they are interacting with a relevant person, which would include in a nursing home setting.
• Section 8 of the 2015 Act also provides guiding principles to be followed under the Act, which interveners under the Act must abide by. These principles ensure that the will and preference of the relevant person is adhered to, and that presumption of capacity is respected unless shown otherwise in accordance with the Act.
The Assisted Decision-Making (Capacity) (Amendment) Act 2022 also makes changes to the Nursing Homes Support Scheme Act 2009, and a decision-making representative must now be appointed where a care representative previously acted. This is to ensure further safeguards are provided to support persons entering nursing homes.