Written Answers Nos. 270-295
270. Deputy Michael Healy-Rae asked the Minister for Health to review a decision that has been made on an application for the freestyle libre device (details supplied); and if he will make a statement on the matter. [40851/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
271. Deputy Carol Nolan asked the Minister for Health to clarify the reason that certain cohorts of healthcare workers are denied access to the Covid pandemic payment (details supplied); and if he will make a statement on the matter. [40884/23]
View answerAs 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.
272. Deputy Eoin Ó Broin asked the Minister for Health if policy relating to instances where a person in possession of a medical card can be assigned a GP by the HSE Primary Care Reimbursement Services following three GP refusals, has been changed; if so, the reason for the change; if another policy has replaced it; and if he will make a statement on the matter. [40891/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
273. Deputy Maurice Quinlivan asked the Minister for Health when the trial 24/7 mental health de-escalation unit (community access support team) in Limerick will be launched; and if he will make a statement on the matter. [40899/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
274. Deputy Maurice Quinlivan asked the Minister for Health what immediate steps he is taking to address the ongoing overcrowding and capacity issues at University Hospital Limerick; and if he will make a statement on the matter. [40900/23]
View answerI have previously met with the HSE, University of Limerick Hospital Group (ULHG) management, and elected Oireachtas members from the Midwest to discuss the ED situation in University Hospital Limerick (UHL) and future developments in ULHG.
Urgent and Emergency Care pressures are no longer just experienced during winter periods. Prolonged levels of high presentations and congestion now occur throughout the year. While significant investment has been driven through Winter Planning and National Service Plans over the past three years, a new approach to Urgent and Emergency Care (UEC) planning is now required in response the changing demands.
This approach is twofold:
• The delivery of an Urgent and Emergency Care Operational Plan for 2023, which was signed off by Government at the end of July; and
• The delivery of a 3-year multi-annual UEC Strategy, which is expected to be submitted to Government in the Autumn.
The UEC Operational Plan 2023 focuses on improving four key performance indicators. There are specific targets to:
• reduce ED waiting times for older patients;
• reduce the number of patients with Delayed Transfers of Care;
• reduce the numbers of patients waiting on trolleys; and
• reduce average inpatient lengths of stay.
Surge periods of exceptionally high ED activity are anticipated for the remainder of 2023. The Plan contains surge measures, which were informed by the After-Action Review of the Winter Plan 2022/23. These surge measures will be triggered based on a composite risk assessment. Contingency measures for surge periods of exceptionally high urgent and emergency care activity in 2023 have potential additional expenditure in order of €5.7 million.
The UEC Operational Plan 2023 will lead into year one of the multi-annual UEC Strategy and will align with the governance structure of the overarching multi-annual UEC Strategy.
There are currently 867 inpatient beds across ULHG, which includes 530 beds in UHL. 150 additional beds have been opened in the ULHG since 1 January 2020; 98 of these beds in UHL. There has been significant investment in infrastructure, including work on the new 96-bed inpatient block project at UHL, which commenced in October 2022. The project represents a total capital investment of just over €90 million. It will deliver an acute inpatient ward block that will go some way toward addressing capacity issues in the region. The next phase of additional works on a second 96-bed inpatient block will commence following pending planning permission approval. These are in addition to a new 60-bed modular ward block opened in 2021. This follows the completion of two separate rapid-build projects, constructed in response to the Covid-19 emergency, which provided an additional 38 inpatient beds. There has been significant recent recruitment into UHL Emergency Department, of both doctors and nurses. This has already facilitated additional rostering for consultants in emergency medicine. It is ensuring improvements in safe staffing levels in the Emergency Department. Recruitment is ongoing.ULHG also remains committed to investing in their Model 2 hospitals to enhance non-acute patient care, and reduce presentations at the UHL Emergency Department.
275. Deputy Paul Murphy asked the Minister for Health his views on the allegations in a media report in relation to spinal surgeries at Temple Street Children's Hospital (details supplied); and if he will make a statement on the matter. [40901/23]
View answerMy Department was notified of this issued on the 4th August 2023, while the surgeries where these springs were used, according to the information currently available, happened in 2020 and 2022. An external investigation is under way into the use of these springs, as well as a clinical review of the three patients, two of whom have since had the springs removed. This investigation needs to establish all the facts, in the end-to-end process, about how these springs came to be procured and ultimately used in surgeries.
The HPRA has issued clear statements about the regulatory processes for medical devices that are in place to protect patients and about the processes available for the exceptional circumstances where a non-CE device is being considered. The HPRA has confirmed that it has not had any applications to the processes for exceptional circumstances for approval for the use of non-medical grade products, which are sold or supplied not intended for medical use, for clinical use in surgery.
This is a very serious matter and while there is some information circulating, we must await the outcome of the investigation before we can draw conclusions. We need the full facts established. I have asked for this investigation to be completed as quickly as possible, there is also a clear need to ensure that there is a robust governance in place for it and I have also asked my officials and the HSE to reflect on this and advise me how this can best be achieved.
276. Deputy Paul Murphy asked the Minister for Health if he will publish the internal and external reviews into spinal surgeries at Temple Street Children's Hospital; and if he will make a statement on the matter. [40902/23]
View answerAs this is an operational matter for the Health Service Executive, the HSE has been asked to reply directly to the Deputy.
277. Deputy Bernard J. Durkan asked the Minister for Health if and when medical card eligibility income thresholds might be upgraded; and if he will make a statement on the matter. [40915/23]
View answerEligibility for a Medical Card is primarily based on a financial assessment which is conducted by the HSE in accordance with the Health Act 1970 (as amended). The HSE assesses each medical card application on a qualifying financial threshold. This is the amount of money that an individual can earn a week and still qualify for a card. It is specific to the individual’s own financial circumstances.
Persons aged 69 and under are assessed under the general means tested medical card thresholds which are based on an applicant’s household income after tax and the deduction of PRSI and the Universal Social Charge. Certain expenses are also taken into account. Persons aged 70 or older are assessed under the over 70s medical card income thresholds which are based on gross income. It should be noted that in November 2020, the weekly gross medical card income thresholds for those aged 70 and over were increased to €550 per week for a single person and €1,050 for a couple. This increase ensures that a greater proportion of those aged 70 and over now qualify for a medical card. Furthermore, the Deputy may be aware that, since 2015, every individual aged 70 and over has automatic eligibility for a GP visit card.
As provided for in Budget 2023, eligibility for GP visit cards will be extended to people who earn up to the median household income and to all children aged 6 & 7. Approximately 500,000 additional persons, who otherwise would have attended their GP on a private basis, are expected to become eligible for free GP care under this expansion. The extension of GP visit cards to children aged 6 & 7 commenced on 11 August. The extension of cards to those who earn the median household income or less commenced on 11 September and will be completed in two phases with the second phase commencing on 13 November.
279. Deputy Bernard J. Durkan asked the Minister for Health the degree to which provision is being made for patients in need of scoliosis treatment in the current year; and if he will make a statement on the matter. [40917/23]
View answer280. Deputy Bernard J. Durkan asked the Minister for Health the proposals to reduce waiting lists for patients expecting scoliosis treatment in the shorter term; and if he will make a statement on the matter. [40918/23]
View answerI propose to take Questions Nos. 279 and 280 together.
I sincerely regret that children can experience a long waiting time for scoliosis treatment, and I remain conscious of the burden that this places on them and their families.
Scoliosis and Spina Bifida have been identified as priority areas in both the 2022 and 2023 Waiting List Action Plans.
Last year some €19 million of current and capital funding was committed to tackle these waiting lists. In 2022, 509 scoliosis procedures were carried out, compared to 380 for the same period in 2019 (the most recent comparable year given the COVID-19 pandemic). This represents a 34% increase and an increase of 47% compared to 2021.
Despite undertaking a substantial number of spinal procedures in 2022, corresponding reductions in the waiting list were offset by significant increases in demand and referrals compared to previous years, with a 30% increase in additions to the spinal surgery list compared to 2021.
This Government continues to invest significant funding to help clinicians reduce the amount of time children are waiting for important hospital appointments and procedures, with scoliosis and spina bifida again included as a priority area for funding under the 2023 Waiting List Action Plan. Under this plan over 290 spinal procedures have been completed by the end of August this year.
Recognising the significant increase in demand, I have requested that the HSE explore all options to increase capacity for this vital service, including outsourcing care both at home and abroad.
281. Deputy Bernard J. Durkan asked the Minister for Health what steps have been taken to ensure that patients seeking treatment for cataracts can expect to have their needs met in the shortest possible timeframe; and if he will make a statement on the matter. [40919/23]
View answerIt is recognised that waiting times for many scheduled appointments and procedures were too long before and have been made worse by the Covid-19 pandemic.
The Department of Health continues to work with the HSE and the National Treatment Purchase Fund (NTPF) to identify ways to improve access to care.
On the 7th of March, I published the 2023 Waiting List Action Plan, which is the latest stage of a new multi-annual approach to sustainably reduce and reform hospital waiting lists.
The 2023 plan builds on the foundational work done through the short-term Waiting List Action Plan between September and December 2021, and the Waiting List Action Plan for 2022, both of which reversed the annual trend of rising waiting lists.
The 2023 Plan sets out the priorities to continue to address waiting lists this year. The 30 actions in the Plan, which are governed by the Waiting List Task Force, focus on delivering capacity and reforming scheduled care.
For 2023, funding totalling €443 million is being allocated to tackle Waiting Lists with €363 million of this being allocated to the 2023 Waiting List Action Plan, to implement longer term reforms and provide additional public and private activity to clear backlogs exacerbated during the pandemic.
The €363 million is targeted at reducing hospital waiting lists by 10% in 2023 as well as continuing to significantly reduce waiting times in line with Sláintecare recommendations. The remaining €80 million of the €443 million is being targeted at various measures to alleviate community/primary care waiting lists.
With this ambitious 2023 Waiting List Action Plan, the Department of Health, the HSE and the NTPF are taking the next steps in the multi-annual approach towards achieving the vision of a world-class public healthcare system in which everyone has timely and transparent access to high-quality scheduled care, where and when they need it, in line with Sláintecare reforms.
The NTPF has advised my Department, that they have approved 3 insourcing cataracts initiatives for funding so far in 2023, which will facilitate treatment for 2,900 patients on cataracts waiting lists. The NTPF has also approved 4 outpatient ophthalmology initiatives for funding so far in 2023, which will facilitate treatment for 8,600 patients on ophthalmology waiting lists.
284. Deputy Bernard J. Durkan asked the Minister for Health the extent to which adequate provision is being made to replace the number of GPs retiring/resigning; and if he will make a statement on the matter. [40922/23]
View answerThe Government is aware of the workforce issues currently facing general practice 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%.
The recent GP Agreement 2023 announced in July, which provides for the expansions of GP care without charges to those who earn up to the median household income and to children aged 6 & 7, includes additional capacity supports to enable the expansion and retention of staffing within general practice. It includes additional supports for GP Out of Hours services also.
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, with 287 new entrants for this year and 350 places for new entrants now planned for next year. Annual intake to the GP training scheme has been increased by over 80% since 2015. Adjusting for certain variables such as graduate attrition, it is estimated from 2023 to 2027 that between 1.5 and 3.1 GP graduates will on-board relative to each retiring GP.
Furthermore, the joint HSE and ICGP programme underway to bring up to 100 non-EU GPs to Ireland in 2023 will help to quickly improve access to GP services, particularly in areas with limited access. It is planned to bring to Ireland up to 250 more non-EU GPs by the end of 2024.
Lastly, my Department and the HSE have commenced a Strategic Review of General Practice. The review, with input from key stakeholders, will examine the broad range of issues affecting general practice, including issues related to GP capacity, and will set out the measures necessary to deliver a more sustainable general practice into the future.
285. Deputy Bernard J. Durkan asked the Minister for Health the extent to which adequate mental health provision is being made to ensure the availability of an adequate number of residential places to meet the current and ongoing requirements; and if he will make a statement on the matter. [40923/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
286. Deputy Bernard J. Durkan asked the Minister for Health the current position in regard to the upgrading of Naas Hospital, with particular reference to the intention to meet oncology and endoscopy as well as other requirements in the near future; and if he will make a statement on the matter. [40924/23]
View answerAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
287. Deputy Bernard J. Durkan asked the Minister for Health if the full extent of treatment will continue to be made available in the case of a person (details supplied); and if he will make a statement on the matter. [40948/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
288. Deputy Danny Healy-Rae asked the Minister for Further and Higher Education, Research, Innovation and Science if he will make a change to the SUSI guidelines that presently penalises students who continue to work part-time outside of holidays, putting them over the threshold for the SUSI grant. [40914/23]
View answerI recognise that third level education can be a significant cost for families and students.
The main financial support available to students is the Student Grant Scheme. The means-tested Scheme is administered by SUSI on behalf of my Department.
Under the Scheme, "holiday earnings", that is income that a student has earned outside of term time in the previous tax year, can be deducted from the total income assessed, up to a maximum level.
Previously the maximum level that could be deducted was €4,500. However, as part of Budget 2023 I secured agreement for a significant increase on this amount. For the 2023/24 academic year, the level has increased to €6,552 which will allow students to work longer hours outside of term time without their student grant eligibility being affected.
It is important to say that the rationale for the policy approach of focusing on earnings outside of term time is to mitigate against students working so much during their third level education that it negatively impacts on their ability to fully participate in their course. This issue was highlighted most recently by the independent review of the Student Grant Scheme, which outlined that while there are many benefits to students engaging in some forms of employment, it is also important to recognise that working excessive hours can negatively impact a student's education experience and may result in them dropping out.
My Department has recently published an annual options paper on the cost of higher education which has explored the option of removing the provision which limits the deduction of holiday earnings outside of term time.
I will have regard to all of the options set out in the Options paper when deciding how best to prioritise proposals in the context of the estimates process.
289. Deputy Marian Harkin asked the Minister for Further and Higher Education, Research, Innovation and Science further to Parliamentary Question No. 108 of 19 May 2022, to provide an update on the long-outstanding issue of regularising the terms and conditions of adult education tutors employed by Education and Training Boards. [40912/23]
View answerThere are over 2,800 tutors employed across the 16 ETBs who are involved in delivering key programmes to learners within the Further Education and Training sector.
A range of industrial relations issues regarding adult education tutors have been under discussion for a number of years and progress has been made in resolving key issues, including the introduction of a consistent formula for awarding Contracts of Indefinite Duration in 2017 and the provision of access to leave schemes, paid leave and access to the appropriate public sector pension scheme in 2019. The claim to align tutors to a pay scale of an existing ETB grade remained unresolved.
Following discussions between the Department of Further and Higher Education, Research, Innovation and Science, the Department of Education, which retains regulatory responsibility for the ETB sector, and the Department of Public Expenditure, National Development Plan Delivery and Reform, a proposal in response to the recommendation of the Labour Court regarding Adult Education Tutors was agreed.
The proposal is to establish a grade of Adult Educator with a standardised pay scale aligned with the Youthreach Resource Person Scale. This grade will apply to tutors employed in ETBs to deliver FET programmes.
The provision of a pay scale will allow for incremental progression and a career path for Tutors in the further education and training sector.
A formal offer has been issued to the relevant Unions and both sides are now engaging on the operational aspects of the offer.
290. Deputy Verona Murphy asked the Minister for Further and Higher Education, Research, Innovation and Science what additional capacity within the further and higher education system he is planning to address the chronic shortage of healthcare professionals across all sectors of healthcare in Ireland; and if he will make a statement on the matter. [40795/23]
View answerMy Department and the Department of Health have made significant progress in providing additional places on healthcare programmes. This year, 460 additional places were created in healthcare programmes, including key therapeutic disciplines. This represents meaningful additionality within existing infrastructure in the Higher Education sector.
This follows on from the work of the working group my Department established last year to identify and address barriers to expansion in the health and social care professions. This working group has included representatives from the Department of Health, the HSE, CORU, and the higher education sector. This group looked at both incremental expansion from September 2023, and enabling more substantial expansion in the medium term.
The HEA recently conducted an expression of interest process for Higher Education Institutions interested in building capacity in Medicine, Nursing, Pharmacy, Dentistry and Veterinary Medicine. Significant options for expansion were identified, and these options are being considered in the context of the Estimates process and National Development Plan capital ceilings. A further process will consider options to build capacity in priority therapy disciplines.
Following engagement between Queens University and Ulster University, my Department and the Departments of Health, both North and South, 200 places in nursing are available to students from this jurisdiction from this September. A further fifty places are available in therapy disciplines in Ulster University from September 2023, with 20 places each in occupational therapy and physiotherapy, and 10 places in speech and language therapy.
There are also a number of healthcare-related courses provided in the further education sector in the areas of occupational therapy assistant, physiotherapy assistant, psychology and dietetics. I recently announced the roll-out of PLC courses to train speech and language therapist assistants. These PLC courses will be running in five Education and Training Boards from this month, with an estimated 120 students expected on these programmes.
291. Deputy Fergus O'Dowd asked the Minister for Further and Higher Education, Research, Innovation and Science if any chief executive of a State/semi-State body or other public body under the aegis of his Department received any benefit from taxable benefits being paid on their behalf by the body/organisation for each of the years 2019 to date; if so, the amount and details, in tabular form; and if he will make a statement on the matter. [40761/23]
View answerNo chief executive of any State/semi-State body or other public body under the aegis of my Department received any benefit from taxable benefits being paid on their behalf by the body/organisation for each of the years from the formation of my Department to date.
292. Deputy Robert Troy asked the Minister for Further and Higher Education, Research, Innovation and Science what discussions he has had with the Department of Further and Higher Education, Research, Innovation and Science and the Higher Education Authority with regard to allowing technological universities to borrow for the provision of student accommodation. [30960/23]
View answerIn November 2022, the Government confirmed approval for a new policy led by my Department, to provide State assistance to stimulate the development of new and additional student accommodation for public higher education institutions. This landmark policy response will, for the first time, see the State providing financial support in the construction of student accommodation, and underpins the policy commitments set out in Housing for All.
Investment of €1m in 2023/2024 was also announced to support the Technological Universities in conducting activation feasibility assessments to ascertain student accommodation needs in campus locations. This will include data led projections of student numbers and engagement with local authorities to examine potential vacant stock.
Department officials and I have had continuous engagement with the sector in relation to the feasibility study. On the 22nd of June I announced the commencement of phase one of this study as part of the Governments’ commitment to support TUs in the development of student accommodation strategies.
The Housing Finance Agency Act 1981, as amended, facilitates lending by the HFA to institutions of higher education, including TUs. My Department and I are working with relevant Government Departments and Agencies to explore the development of a specific borrowing framework for the Technological University (TU) sector. The options arising from the TU feasibility study will inform this ongoing engagement. It is anticipated that any borrowing framework would in the first instance prioritise the provision of student accommodation in line with commitments in the Government's Housing for All plan.
293. Deputy Alan Dillon asked the Minister for Further and Higher Education, Research, Innovation and Science for an update on discussions on pay grades for adult education tutors; and if he will make a statement on the matter. [30951/23]
View answerFollowing discussions between the Department of Further and Higher Education, Research, Innovation and Science, the Department of Education, which retains regulatory responsibility for the ETB sector, and the Department of Public Expenditure, National Development Plan Delivery and Reform a proposal in response to the recommendation of the Labour Court regarding Adult Education Tutors was agreed.
The proposal is to establish a grade of Adult Educator with a standardised pay scale aligned with the Youthreach Resource Person Scale. This grade will apply to tutors employed in ETBs to deliver FET programmes, who are currently employed under a variety of terms and conditions.
The provision of a pay scale will allow for incremental progression and a career path for Tutors in the further education and training sector.
A formal offer has been issued to the relevant Unions and both sides are now engaging on the operational aspects of the offer.
294. Deputy James Lawless asked the Minister for Further and Higher Education, Research, Innovation and Science to examine a matter with a SUSI grant (details supplied); and if he will make a statement on the matter. [40846/23]
View answerAssessment of means under the Student Grant Scheme 2023 is based on gross income from all sources, of the dependent applicant and his/her parents. No deduction is given for outgoings with the exception of pension contributions, legally enforceable maintenance payments and employment related expenses as approved by Revenue.
The decision on eligibility for a student grant is a matter in the first instance for the grant awarding authority, Student Universal Support Ireland (SUSI).
For the 2023/24 academic year, student grant applications will be assessed based on gross income from all sources for the reference period 1st January 2022 to 31st December 2022. Where the business year differs from the reference period, the income shown in the business accounts for a 12 month period which ends between 1st January and 31st December 2022 will be considered.
With regard to the specific application, I have been advised by my officials that the student outlined by the Deputy submitted an application to SUSI on 23rd July 2023. SUSI requested a copy of the student’s Father’s Revenue Indicative Calculation (RIC) for 2022 by letter on 31st July 2023 and, a copy of his RIC for 2021 was received on 25th August 2023. A letter was also submitted from the applicant’s father stating that he will not be filing his tax returns for 2022 until October 2023 and will not receive the Revenue’s Indicative Calculation for 2022 until early 2024.
As SUSI assesses 2023/24 applications on income received in 2022, they were unable to finalise the application until the RIC for 2022 is received. An additional letter was sent to the applicant on 25th August 2023 re-requesting this document. SUSI is currently awaiting this document in order to assess 2022 income, therefore the application is ongoing.
295. Deputy Pádraig Mac Lochlainn asked the Minister for Further and Higher Education, Research, Innovation and Science the reason that the Government does not provide the same financial assistance to students and their families, regardless of where they are studying on the island of Ireland, the Republic of Ireland or Northern Ireland; and if he appreciates how unfair this discrepancy is to students who live in the border counties of the Republic of Ireland. [40881/23]
View answerThe main support available to assist students with the cost of attending higher education is the Student Grant Scheme. Under the Scheme, grant assistance is awarded to eligible students attending an approved full-time course in an approved institution who meet the prescribed conditions of funding, including those relating to nationality, residency, previous academic attainment and means.
The decision on eligibility for a student grant is a matter, in the first instance, for the centralised student grant awarding authority SUSI (Student Universal Support Ireland) to determine.
Students attending approved undergraduate courses in the EU can apply for a maintenance grant provided they meet the terms and conditions of the Student Grant Scheme. In general, an approved undergraduate course in this context is defined as a full-time undergraduate course of not less than two years duration pursued in a university or third level institution, which is maintained or assisted by recurrent grants from public funds in another EU Member State.
Grant funding is only available to eligible students studying postgraduate courses in four approved institutions in Northern Ireland. This provision is consistent with the principles of the Good Friday agreement and is intended to promote greater tolerance and understanding between both jurisdictions. The Scheme also does not extend to PLC courses pursued outside of the State or postgraduate study pursued outside of Ireland.
Also, Student grant legislation was amended in 2020 to retain the status quo, thus allowing funding for eligible students attending an approved undergraduate course in the UK to continue post Brexit.
The student grant scheme does not extend to the payment of tuition fees to institutions outside the State.
Students seeking to pursue their studies in the UK are advised to contact the Student Finance agency in each of the Devolved Administration in the UK, as each jurisdiction may have variations in eligibility criteria. Students may also wish to contact the relevant Higher Education Institution in the UK for advice on the type and range of supports that may be available in any specific college.
Tax relief at the standard rate of tax may be claimed in respect of tuition fees paid for approved courses at approved colleges of higher education including approved undergraduate and postgraduate courses in EU Member States and in non-EU countries. Further information on this tax relief is available from a student's local Tax office or from the Revenue Commissioners website www.revenue.ie
