Mick Barry
Question:51. Deputy Mick Barry asked the Minister for Health to what extent hospital wards are mixed gender due to over-capacity in the health service; and if he will make a statement on the matter. [31340/23]
View answerHospital Overcrowding
Departmental Policies
Questions (52)
Robert Troy
Question:52. Deputy Robert Troy asked the Minister for Health the digital reforms he has undertaken, and those he intends to undertake; and his views on whether a greater use of digital health will improve patient outcomes, improve efficiencies and be a solution to escalating costs. [40600/23]
View answerWritten answers
Digital Health is essential to support planning for the populations’ health needs, in building integrated care models, in delivering universal health and social care services (services) and in ensuring safety, quality and sustainability in patient care.
Digital Health developments to date
Our services have experienced positive digital developments over the past decade. The COVID-19 pandemic accelerated the adoption of digital health globally and nationally. Patient and clinical demand for the adoption of digital health accelerated in response to Covid-19 resulting in a sustained increase in the use of telemedicine, remote care programmes and the issuing of electronic prescriptions (emergency legislation). Our Covid-19 response delivered the efficient implementation of test and trace initiatives and a robust and effective vaccination programme. A data driven approach was taken to managing the response to Covid-19 allowing for the monitoring of infection rates and tracking the effectiveness of vaccination efforts.
The cyberattack on the Health Service Executives (HSE’s) health information systems, highlighted the vital role that digital health plays in the delivery, management and planning of health and social care services. It demonstrated the risks associated with managing IT systems and identified areas that need to be strengthened and developed with a particular focus on governance, training, data and information security and systems enabling both health care professions and patients access to patient data held in digital format. Building on investment to-date, Ireland is now further investing heavily in foundational infrastructure to strengthen its cyber resilience.
There are various digital health initiatives that have been deployed and are delivering benefits for both patients and the workforce. Enterprise level EHR deployments in St James hospital, the national rehabilitation hospital, and the national forensics hospital, across maternity, and paediatric settings, and other clinical and operations systems are in place.
The New Children’s Hospital hospital-wide electronic health record is underway with a contract now in place and staff being recruited to support its roll-out. When complete, this will be the most extensive EHR deployment in Ireland to date. The New Children’s Hospital has been designed as a digital hospital and requires a functional electronic health record as a core element of its operations.
Future Reform and Benefits
Development of a new Digital Health and Social Care Strategic Framework (2023-2030) is nearing completion and will align with Government’s “Harnessing Digital” and sets the roadmap for digital health in Ireland for the next decade. Concurrently, the HSE are developing the corresponding Implementation Plan that will detail out the specifics and sequencing of the roadmap and confirm the necessary support required to realise this intent.
The Strategic framework will support reform of our services through streamlined processes, modernisation of patient facing health services and provides patients and staff with access to digital health records improving health outcomes for all. The framework puts a greater focus on empowering patients to take greater control of their own health and wellbeing, giving them secure access to their own health information. It enables staff to do their jobs by providing them with digital skills and toolsets in a modern digital environment. The strategic framework supports investment in core clinical and operational systems that are joined up, promotes innovation, and ensures that digital is built on a robust and secure infrastructure.
A key underlying enabler of this Strategic Framework is the new Health Information Bill. The Bill is about helping to deliver better patient-centred integrated care; improving performance and innovation; and supporting digital and data initiatives in healthcare. The Bill includes provisions on the Digital Patient Record programme encompassing both Summary Care Records and Shared Care Records. The Bill will also include provisions that support the deployment of electronic health records on a nationwide basis. They are included in the Bill because the government views them as an essential and critical element of the digital transformation of healthcare. The Department of Health is now working closely with the HSE, given the emergence of the Health Regions, to develop a procurement approach, a phased deployment plan and a hosting model, suitable for the deployment of EHRs.
Access to modern digitally enabled services can lead to better patient experience, and improved health outcomes. Up-to-date information about our care is critical to ensuring we can:
• Stop asking the people to repeat their information unnecessarily by having it available at the right time.
• Help people make better informed decisions about their care with their health care provider.
• Avoid the need for repeat tests that have been carried out elsewhere but where clinicians don’t have access to that information.
• Develop new insights by being able to better analyse data and information.
• Better manage patients with chronic conditions and keep people well and offer more treatments closer to home, by offering telehealth services and joined up data.
Hospital Waiting Lists
Questions (53)
Joan Collins
Question:53. Deputy Joan Collins asked the Minister for Health the reason that a person (details supplied) has been waiting so long for their operation. [40651/23]
View answerWritten answers
I fully acknowledge the distress and inconvenience for patients and their families when elective procedures are cancelled, particularly for clinically urgent procedures. While every effort is made to avoid cancellation or postponement of planned procedures, the HSE has advised that planned procedures and operations can be postponed or cancelled for a variety of reasons including capacity issues due to increased scheduled and unscheduled care demand.
Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.
Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
General Practitioner Services
Questions (54)
Cathal Crowe
Question:54. Deputy Cathal Crowe asked the Minister for Health if he will provide an update on actions being taken by his Department to ensure that the services of a general practice medical doctor remain in Newmarket-on-Fergus, County Clare; and if he will make a statement on the matter. [40621/23]
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.
Addiction Treatment Services
Questions (55)
Brendan Smith
Question:55. Deputy Brendan Smith asked the Minister for Health if it is proposed to increase the level of funding for the North-East Drug Task Force, in view of the increased demand for services; and if he will make a statement on the matter. [40708/23]
View answerWritten answers
I am very aware of the key role that all Drug and Alcohol Task Forces play under the national drug strategy in coordinating interagency action and supporting evidence-informed approaches to addressing substance use in local communities.
The Network of 24 Drug and Alcohol Task Forces receive in the region of €29 million in annual funding from the Department and the HSE of which the North East Task Force receives €937,813.
In August I announced recurring annual funding of €3.5 million to maintain existing level of drugs and inclusion health services provided by community and voluntary organisations.
Funding is aimed at assisting community and voluntary organisations in maintaining existing level of service for drugs and inclusion health. The funding recognises the important role of community and voluntary groups in providing drugs and inclusion health services, and acknowledges the increased costs of providing these essential services. The funding will be distributed by community healthcare organisations (CHOs), in line with guidance issued by the Department of Health.
The funding also complements the once-off inflation fund, which provided €3.9 million to drugs and inclusion health services in 2023.
www.gov.ie/en/press-release/5d2c8-minister-naughton-announces-additional-annual-funding-of-3-5-million-for-drugs-and-inclusion-health-services/#
As discussions on the estimates for 2024 are ongoing in the lead up to the Budget it would not be appropriate for me to comment on or prejudge the outcome of this process.
Mental Health Services
Questions (56)
Mark Ward
Question:56. Deputy Mark Ward asked the Minister for Health if the Government has any plans to regulate CAMHS under the Mental Health Act 2001 to give the Mental Health Commission statutory oversight of CAMHS; and if he will make a statement on the matter. [40730/23]
View answerWritten answers
Under the Mental Health Act 2001, the Mental Health Commission (MHC) is required to register, inspect and regulate all approved centres, including CAMHS approved centres across the country, with inspections taking place at least once a year.
The Government values the independent role of the MHC, which is to promote high standards and good practice in mental health services. I acknowledge that mental health services must evolve to ensure they are in line with international best practice and regulatory requirements. It has been the Government's long standing position that all mental health services in the community would be regulated under the new Mental Health Bill, including all CAMH services.
The Department has consulted closely with the MHC over the past number of years on the new Mental Health Bill which is currently being drafted. A key element of that Bill, agreed with the MHC, will be the expansion of the Commission’s regulatory remit to include community residences and services, including CAMH services. Secondary legislation may only be made to expand upon that which is already present in primary legislation, and there are no provisions in the existing Mental Health Act for the making of Regulations in community residences or services, as Section 66 of the 2001 Act explicitly refers only to approved centres.
Drafting of the Mental Health Bill is currently being progressed by the Office of Parliamentary Counsel, generally in line with the published General Scheme. The Bill received priority drafting in the spring and summer legislative sessions this year and officials in my Department and the Office of Parliamentary Counsel are working intensively to prepare this lengthy, complex Bill. The publication of the Mental Health Bill is a priority for me and for the Government and I look forward to introducing the Bill to the Oireachtas as soon as possible, once published. Following publication of the Bill, the regulation of community residents and services, including CAMHS, will be introduced on a phased basis.
The new Bill will overhaul our mental health legislation making it more person-centred and human rights focused and help to put in place a more robust framework in which mental health services can be delivered.
Hospital Staff
Questions (57)
Robert Troy
Question:57. Deputy Robert Troy asked the Minister for Health when the management of the MRH Mullingar can expect approval to recruit the necessary staff for the new MRI scanner which has recently been commissioned. [40599/23]
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.
Primary Care Centres
Questions (58)
Duncan Smith
Question:58. Deputy Duncan Smith asked the Minister for Health for an update on the provision of a much-needed primary care centre for Swords in north County Dublin; and if he will make a statement on the matter. [40551/23]
View answerWritten answers
As the Health Service Executive (HSE) holds responsibility for the provision, along with the maintenance and operation of Primary Care Centres, I have asked the HSE to reply to the deputy as soon as possible.
Mental Health Services
Questions (59)
Violet-Anne Wynne
Question:59. Deputy Violet-Anne Wynne asked the Minister for Health his views on expanding Jigsaw services on the ground into County Clare; and if he will make a statement on the matter. [40656/23]
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.
Departmental Expenditure
Questions (60)
Richard Bruton
Question:60. Deputy Richard Bruton asked the Minister for Health what the key drivers of the reported overruns in health expenditure are; whether there are improvements that can be made in spending management; and if he will make a statement on the matter. [40276/23]
View answerWritten answers
The Health system has experienced significant pressures in 2023, which in turn are having an impact on the overall expenditure position of the HSE.
Key drivers
• In 2022 our actual population had reached 5.14 million which is ahead of the population projection that the 2018 Health Service capacity review that Ireland would reach by 2026. The fastest growing population segments within this rapidly growing population are those for older people who typically have much higher requirement to access health services. These demand pressures have led to additional activity in the Health system in 2023, which is presenting mainly within the Acute Hospital system
• inflationary pressures in 2023 have impacted on a range of clinical and non-clinical inputs within non-pay expenditure, such as electricity and fuel, drugs costs, transport costs, food costs, cleaning costs, etc.
• These pressures highlight the need for ongoing structural reform of our Health system, which is a high priority for the Minister and the Government. A range of expenditure management initiatives are jointly underway between the HSE and the Department to manage the overall position and to implement savings and efficiency programmes which will mitigate risks to the Exchequer. There is a clear agreement between the HSE and the Department that our joint efforts to control costs will not impact on patient access to service or waiting times.
Primary Care Centres
Questions (61)
Alan Dillon
Question:61. Deputy Alan Dillon asked the Minister for Health how many primary care centres had construction halted due to increased construction costs; and if he will make a statement on the matter. [40745/23]
View answerWritten answers
As the Health Service Executive (HSE) holds responsibility for the provision, along with the maintenance and operation of Primary Care Centres, I have asked the HSE to reply to the deputy as soon as possible.
Health Services Staff
Questions (62)
Thomas Pringle
Question:62. Deputy Thomas Pringle asked the Minister for Health if he will contact the Cuban Ambassador to request that Cuba assist with the provision of Cuban doctors and medical staff from to help with the staffing crisis in our health services; and if he will make a statement on the matter. [39627/23]
View answerWritten answers
There is a recognised need for substantial increases in the medical workforce. While we take the necessary steps to build domestic supply, in the interim, we must continue to recruit internationally.
The Medical Council is the statutory agency responsible for registration and regulation of doctors in Ireland. To protect patients, we must ensure all doctors registered to practise medicine in Ireland meet requirements to practise, as set out in legislation.
The Medical Council pathways for registration are not based on doctors’ nationality but on their qualifications and training. Doctors who qualified in other jurisdictions and are not entitled to automatic recognition by the Medical Council, are required to pass, or be exempt from, the Medical Council’s pre-registration examinations (PRES).
Any obligation to sit PRES exams depends on each individual doctor's training and potentially any time spent practising in the EEA. It is not possible to outline a definitive position on requirements for individuals without assessment by the Medical Council.
The HSE welcomes applications from all eligible applicants who meet registration criteria and is actively exploring all potential markets to increase the medical workforce, including collaboration with the Irish Medical Council to identify potential regions for recruitment of doctors who meet registration standards.
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. In addition, 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 Ireland up to 250 more non-EU GPs by the end of 2024.
Primary Medical Certificates
Questions (63)
Seán Sherlock
Question:63. Deputy Sean Sherlock asked the Minister for Health the number of applicants notified to his Department in the years 2020, 2021, 2022 and to date in 2023 for a primary medical certificate; and if he believes the system is fit for purpose as constituted. [32068/23]
View answerWritten answers
The Health Service Executive (HSE) have confirmed that the number of applicants for a Primary Medical Certificate was 2,803 in 2020, 3,273 in 2021 and 3,621 in 2022. While the number of applicants for 2023 is not immediately available, I have requested that the HSE forward on these details to the Deputy as soon as possible.As the Deputy may be aware, responsibility for the Disabled Drivers and Disabled Passengers (Tax Concessions) Scheme, operated by the Revenue Commissioners, falls under the remit of the Minister for Finance. To qualify for the scheme, an applicant must hold a Primary Medical Certificate. To qualify for a Primary Medical Certificate, an applicant must be permanently and severely disabled within the terms of the Disabled Drivers and Disabled Passengers (Tax Concessions) Regulations 1994. The extent of the involvement of health personnel in the scheme relates to making a professional clinical determination as to whether an individual applicant satisfies the medical criteria set out in the Department of Finance regulations. This determination is undertaken by Senior Medical Officers for the relevant local Health Service Executive (HSE) Community Health Organisation, on behalf of the Revenue Commissioners. These HSE personnel have no role in setting or amending the criteria.A successful applicant is provided with a Primary Medical Certificate. An unsuccessful applicant can appeal the HSE's Senior Medical Officer's decision to the Disabled Drivers Medical Board of Appeal, which is under the auspices of the Minister for Finance. As Minister for Health, my role under the legislation is to nominate to the Minister for Finance members of the Disabled Drivers Medical Board of Appeals (DDMBA).However, the Department of Finance has advised that the final report of the National Disability Inclusion Strategy Transport Working Group's review of mobility and transport supports including the Disabled Drivers and Disabled Passengers Scheme (DDS), endorsed proposals for a modern, fit-for-purpose vehicle adaptation scheme in line with international best practice that would replace the DDS, as it is no longer fit-for-purpose on any and all aspects.The Department of Finance has confirmed that officials from relevant Departments and agencies are meeting to discuss the issues arising from the NDIS report and to map a way forward.
Primary Care Centres
Questions (64)
James O'Connor
Question:64. Deputy James O'Connor asked the Minister for Health the position regarding the provision of a primary care centre in Youghal, County Cork; and if he will make a statement on the matter. [40617/23]
View answerWritten answers
As the Health Service Executive (HSE) holds responsibility for the provision, along with the maintenance and operation of Primary Care Centres, I have asked the HSE to reply to the deputy as soon as possible.
Hospital Waiting Lists
Questions (65)
Pádraig O'Sullivan
Question:65. Deputy Pádraig O'Sullivan asked the Minister for Health the average waiting times for children with scoliosis; the number waiting 0 to 4, 4 to 12, and over 12 months, by hospital, in tabular form; and if he will make a statement on the matter. [40477/23]
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.
Health and Safety
Questions (66)
Duncan Smith
Question:66. Deputy Duncan Smith asked the Minister for Health if he is aware of an organisation (details supplied); if so, his views on the organisation’s role in assisting recovery through exercise; if he can commit to ensuring support for current classes in line with other support partners; and if he will make a statement on the matter. [40548/23]
View answerWritten answers
The promotion of physical activity is a priority item under the Healthy Ireland Framework, as evidenced by the publication of the National Physical Activity Plan (NPAP) in 2016.
Substantial progress has been made in the implementation of the 60 actions set out in the NPAP, led by the Departments of Health and Tourism, Culture, Arts, Gaeltacht, Sport and Media, through a cross-sectoral Implementation Group that includes a range of other Government Departments and agencies. Drafting of a successor strategy to the NPAP is currently underway which will set out the priorities in this area for the coming years.
One in three Irish adults are living with chronic disease. A range of organisations provide community-based exercise classes for chronic disease populations. These include patient support organisations, not-for-profit organisations such as ExWell Medical, and the publicly funded network of Local Sports Partnerships across Ireland. The HSE works in partnership with many of these to ensure access to exercise provision for adults living with chronic disease.
In a number of areas, the HSE has established formal working and funding relationships with ExWell Ltd. to provide access for patients to their exercise programmes.
The HSE are currently in the process of designing and implementing a Physical Activity Pathways in Healthcare model (PAPH), which will provide a structured physical activity programme for people with chronic disease or long-term health conditions, who do not require clinically led exercise programmes, with a focus on building their skills and confidence to engage with and maintain recreational sport participation independently.
Any future engagement with ExWell Medical will be considered in the context of the development and implementation of the PAPH model.
Health and Safety
Questions (67)
Colm Burke
Question:67. Deputy Colm Burke asked the Minister for Health if there are plans in place to further restrict the sale of single-use vapes in the country, especially those aimed at children; and if he will make a statement on the matter. [40618/23]
View answerWritten answers
The Public Health (Tobacco Products and Nicotine Inhaling Products) Bill will introduce a suite of measures which aim to reduce the appeal and availability of nicotine inhaling products such as electronic cigarettes to young people. In particular the Bill will prohibit the sale of these products to children and introduce a requirement for a licence for their sale.
In addition to legislation, there are a number of initiatives and campaigns at local and national level that tackle the issue of youth vaping. The HSE has recently worked with the Department of Education to develop Junior Cycle SPHE modules on substance misuse, including e-cigarettes. The module for Second Year students focuses on raising awareness of the impact of ’roll your own’ cigarettes, vaping and e-cigarettes, and exploring the marketing techniques employed by tobacco companies.
In addition, local initiatives that promote smoke free environments such as Not Around Us have sought to further reduce the areas where smoking and vaping are present in daily life, furthering the denormalisation of these products.
It should also be noted that my colleague Ossian Smyth, Minister of State in the Department of Environment, Climate and Communications has recently run a public consultation on disposable vaping devices to examine what action should be taken, from an environmental perspective, as disposable vaping devices present several environmental challenges. The options being considered include introducing legislation to ban the manufacture, sale, distribution, or free offer of disposable vaping devices. I await the results of this consultation with interest.
Question No. 68 taken with No. 14.
Questions Nos. 69 to 76, inclusive, answered orally.