Written Answers Nos. 490-509
490. Deputy Denise Mitchell asked the Minister for Children, Equality, Disability, Integration and Youth what funding is available for an organisation (details supplied) through his Department or the organisation's respective local authority. [41356/23]
View answerSome €69 million has been allocated over the period 2023-2025 to the early learning and childcare sector under the revised National Development Plan (NDP). This will enable significant capital investment in early learning and childcare across three pillars:
1. Building Blocks - Improvement Grant;
2. Building Blocks - Capacity Grant; and
3. Building Blocks - Innovation Grant.
The Building Blocks - Improvement Grant is now closed. Under this Pillar, €9 million was allocated earlier this year in grants ranging from €35,000 to €75,000 for energy upgrades and retrofit projects, which supported services in need of upgrading, such as kitchen refurbishments, roof repairs and the replacement of flooring.
I am advised that the service did not apply for funding under this scheme. The service did receive funding from my Department under the Early Years Capital Grant Scheme in 2016 and the Fire Safety Capital Grant Scheme in 2021.
Work is currently underway on the design and delivery of Pillars 2 and 3, which have a combined allocation of €20 million in 2024 and €40 million in 2025.
The Building Blocks – Capacity Grant will fund an expansion of existing services in areas of under supply. Funding will also be provided to support the development of new services, where most needed.
The Building Blocks – Innovation Grant will pilot a range of innovative initiatives such as outdoor early learning and childcare services.
491. Deputy Maurice Quinlivan asked the Minister for Children, Equality, Disability, Integration and Youth to provide an update on the case of a child (details supplied) who, having been referred by their GP in October 2021 to attend the St. Gabriel’s early intervention team, Limerick, for assessment, has yet to receive an appointment date; and if he will make a statement on the matter. [41387/23]
View answerAs this refers to service matters, I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
492. Deputy Eoin Ó Broin asked the Minister for Children, Equality, Disability, Integration and Youth the number of adults and children seeking international protection, not including those with status or leave to remain, with a breakdown by local authority area and by household size, one- and two-adult households with no children, households with one child, two children, three children, and with more than three children. [41402/23]
View answerI thank the Deputy for his question. Please see below table detailing a break-down of the family units seeking international protection, by local authority area and by household size, excluding those with leave to remain.
I trust this information clarifies the matter.
|
Local Authority |
Sum of Units of 1 Parent 1 child |
Sum of Units of 1 Parent 2 children |
Sum of Units of 1 Parent 4 children |
Sum of Units of 1 Parent 3 children |
Sum of Units of Other |
Sum of Units of Couple 4 Children |
Sum of Unts of Couple 6 Children |
Sum of Units of Couple 1 Child |
Sum of Units of Couple 5 Children |
Sum of Units of Couples, no children |
Sum of Units of Couple 2 Children |
Sum of Units of Couple 3 Children |
Sum of Units of 1 Parent 5 children |
|
Carlow County Council |
1 |
0 |
0 |
0 |
0 |
0 |
0 |
2 |
0 |
0 |
1 |
3 |
0 |
|
Cavan County |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
5 |
0 |
2 |
4 |
0 |
0 |
|
Clare County |
5 |
5 |
0 |
3 |
3 |
0 |
0 |
3 |
0 |
6 |
8 |
6 |
0 |
|
Cork City |
0 |
2 |
0 |
1 |
1 |
2 |
0 |
7 |
0 |
1 |
4 |
6 |
2 |
|
Cork County |
23 |
22 |
6 |
12 |
2 |
4 |
1 |
18 |
1 |
4 |
21 |
7 |
1 |
|
Donegal County |
29 |
34 |
8 |
17 |
4 |
9 |
0 |
32 |
5 |
8 |
39 |
22 |
1 |
|
Donegal County Council |
5 |
5 |
0 |
1 |
0 |
0 |
0 |
1 |
0 |
0 |
6 |
4 |
0 |
|
Dublin City |
52 |
18 |
1 |
3 |
13 |
1 |
0 |
53 |
0 |
72 |
20 |
12 |
0 |
|
Dublin City Council |
2 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
Dublin City Council |
0 |
7 |
1 |
0 |
0 |
1 |
0 |
5 |
0 |
0 |
2 |
0 |
0 |
|
Dun Laoghaire Rathdown |
7 |
0 |
0 |
4 |
6 |
1 |
0 |
4 |
0 |
2 |
6 |
3 |
0 |
|
Dun Laoghaire Rathdown |
0 |
3 |
0 |
0 |
0 |
0 |
0 |
3 |
0 |
0 |
0 |
0 |
0 |
|
Fingal County |
59 |
24 |
1 |
9 |
10 |
3 |
0 |
46 |
0 |
107 |
31 |
4 |
0 |
|
Galway City Council |
4 |
7 |
0 |
4 |
0 |
0 |
0 |
9 |
0 |
5 |
9 |
4 |
1 |
|
Galway County Council |
1 |
0 |
0 |
0 |
0 |
2 |
0 |
0 |
1 |
0 |
2 |
5 |
0 |
|
Kerry County |
5 |
3 |
0 |
0 |
3 |
1 |
0 |
3 |
0 |
14 |
3 |
0 |
0 |
|
Kerry County Council |
1 |
8 |
0 |
1 |
0 |
1 |
0 |
4 |
0 |
2 |
5 |
1 |
0 |
|
Kildare County |
3 |
1 |
5 |
2 |
1 |
1 |
0 |
2 |
0 |
1 |
6 |
7 |
0 |
|
Kilkenny County |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
Laois County |
33 |
17 |
1 |
0 |
1 |
4 |
0 |
13 |
1 |
1 |
10 |
6 |
1 |
|
Leitrim County |
0 |
0 |
0 |
0 |
3 |
4 |
0 |
3 |
0 |
0 |
0 |
6 |
0 |
|
Limerick City & County |
4 |
6 |
1 |
4 |
0 |
0 |
0 |
8 |
1 |
3 |
8 |
5 |
0 |
|
Longford County |
4 |
3 |
1 |
1 |
0 |
1 |
0 |
0 |
0 |
6 |
1 |
0 |
0 |
|
Louth County |
2 |
3 |
2 |
6 |
0 |
3 |
0 |
3 |
0 |
3 |
8 |
4 |
0 |
|
Louth County Council |
0 |
3 |
0 |
0 |
0 |
0 |
0 |
1 |
0 |
0 |
0 |
0 |
0 |
|
Mayo County |
33 |
43 |
9 |
22 |
4 |
14 |
0 |
31 |
7 |
56 |
50 |
37 |
10 |
|
Meath County |
6 |
10 |
1 |
4 |
6 |
4 |
0 |
6 |
0 |
4 |
4 |
13 |
0 |
|
Monaghan County |
7 |
10 |
0 |
6 |
0 |
0 |
0 |
15 |
0 |
7 |
19 |
11 |
0 |
|
Offaly County |
3 |
2 |
1 |
1 |
0 |
1 |
0 |
1 |
0 |
0 |
0 |
1 |
0 |
|
Roscommon County |
6 |
5 |
0 |
1 |
0 |
3 |
0 |
10 |
0 |
3 |
9 |
2 |
0 |
|
Sligo County |
14 |
16 |
2 |
4 |
1 |
2 |
0 |
2 |
0 |
4 |
3 |
4 |
0 |
|
South Dublin County |
41 |
33 |
1 |
7 |
8 |
2 |
0 |
58 |
1 |
85 |
23 |
3 |
3 |
|
Tipperary County |
3 |
1 |
1 |
5 |
0 |
2 |
1 |
1 |
0 |
5 |
0 |
5 |
2 |
|
Waterford City and County |
28 |
5 |
0 |
1 |
2 |
2 |
0 |
13 |
0 |
5 |
9 |
2 |
1 |
|
Westmeath County |
15 |
3 |
0 |
1 |
9 |
1 |
1 |
10 |
0 |
3 |
12 |
4 |
1 |
|
Wexford County |
4 |
8 |
5 |
2 |
4 |
4 |
1 |
14 |
1 |
7 |
12 |
14 |
0 |
|
Wicklow County |
31 |
17 |
4 |
10 |
8 |
4 |
0 |
20 |
2 |
11 |
28 |
14 |
1 |
|
Grand Total |
431 |
324 |
51 |
132 |
89 |
77 |
4 |
406 |
20 |
427 |
363 |
215 |
24 |
494. Deputy Cian O'Callaghan asked the Minister for Children, Equality, Disability, Integration and Youth if he is aware of the numbers of naíonraí being forced to close due to increasing costs and lack of supports; what support his Department offers specifically for naíonraí that are struggling to stay open; what his Department will do to reduce the numbers of naíonraí closing; and if he will make a statement on the matter. [41442/23]
View answerFunding provided by my Department for early learning and care (ELC) and school-age childcare (SAC) services is the same for both Irish-medium and English-medium services. My colleague the Minister for Tourism, Culture, Arts, Gaeltacht, Sport and Media provides additional supports for naíonraí in the Gaeltacht through her Department and its agencies.
With regards to funding the sector as a whole, this Government has in 2023, for the first time, allocated more than €1 billion to early learning and childcare – a clear demonstration from Government of the value of the sector. Over the past eight budgets, investment in early learning and childcare has risen from €260 million in 2015 to € 1.025 billion in 2023, reaching the First 5 investment target 5 years ahead of time. This unprecedented investment speaks to the commitment of Government in prioritising early learning and childcare services.
In September 2022, Together for Better, the new funding model for early learning and childcare was launched, bringing together the ECCE programme, including the Access and Inclusion Model (AIM), the NCS and Core Funding, with a fourth programme, the Equal Participation Model in development.
For year 1 of the new Core Funding scheme, €259m was made available. For year 2 of this scheme, €287m is being made available. The additional €28 million – equivalent to 11% increase - is being allocated as follows:
• €8.47m for a 3% growth in capacity.
• €6.11m for non-staff overheads.
• €2.2m for administrative staff time.
• €4m for graduate premiums
• €7.22m for new targeted measures aimed at improving the sustainability of sessional services.
Core Funding has achieved very significant success in terms of the high levels of participation, with 95% participation in year 1, and 90% participation to date in year 2. It also supported the agreement of Employment Regulation Orders leading to wage increases for over 70% of staff.
Fee management was introduced with the substantial investment through Core Funding. This ensures that parents’ costs do not increase and that the increased National Childcare Scheme subsidies are fully felt by parents. It followed the recommendations of the Expert Group, approved by Government, to first limit increases in fee rates. This effectively freezes services fees at those they set in September 2021 to ensure that the introduction of Fee Management to the sector is done in a sustainable and considered manner. Services that are experiencing difficulty and who would like support are encouraged to contact their City/County Childcare Committee (CCC) to access case management supports.
For Budget 2024, I want to build on the success of Together for Better, with the ECCE programme (including AIM), the NCS and Core Funding working well to achieve affordability, quality, inclusion and sustainability achieving significant benefits for services, staff, parents, children and society overall.
There is much value in supporting the provision of services in the Irish language to children at an early age. Early learning and childcare services play an important role here, in particular in promoting Irish as a living language.
My Department is working closely with the Department of Tourism, Culture, Arts, Gaeltacht, Sport and Media and the Department of Education to implement a comprehensive set of actions that were agreed as part of the 5 Year Action Plan for the Irish Language 2018-2022. These actions are designed to affirm the importance that ELC settings have in encouraging the development and revitalisation of the Irish language. The aim of these actions is to build on the existing measures, supports and partnerships in place in the area of Irish-medium early learning and childcare, and to further improve these supports and services.
Inter-Departmental coordination in relation to supports for Irish-medium provision of ELC, both inside and outside the Gaeltacht, takes place through the National Early Years Oversight Group (established as part of the 5-Year Irish Language Action Plan), which is chaired and coordinated by officials in my Department.
In line with the commitments in the 5 Year Action Plan, the development of a Comprehensive Plan to further the development of Irish language provision in the ELC and SAC sector has commenced. To support the development of a Comprehensive Plan it was necessary to survey Irish-medium ELC/SAC settings including childminders to obtain a baseline of the current level of Irish-medium provision in the sector. A survey of providers was therefore undertaken, and the opportunity was also used to survey providers on the supports, services and resources they believe would be most useful to support Irish-medium provision. A report on this survey is being finalised and will be published shortly. The report will complement other research and consultation processes planned for later this year, to support the work of an Advisory Group which is being established to oversee the drafting of the Comprehensive Plan. It will provide a baseline for the analysis of future trends in Irish-medium provision.
It is intended that the Plan will be published in 2024.
495. Deputy Colm Burke asked the Minister for Children, Equality, Disability, Integration and Youth if consideration would be given to classifying long-Covid as a disability, in view that long-Covid is characterised by extreme exhaustion after minimal exertion, cardiovascular issues including MI, myocarditis/pericarditis, clots, arrhythmias, and neurological issues such as cognitive impairment, stroke, and ultimately that there is no treatment for the condition; and if he will make a statement on the matter. [41455/23]
View answerThere are a number of definitions of disability contained in legislation, e.g. Disability Act 2005, the Employment Equality Acts 1998 and 2004, the Education for Persons with Special Education Needs Acts and Equal Status Acts, which are used for particular purposes, e.g. the Census and qualifying criteria for the Department of Social Protection income supports such as the Domiciliary Care Allowance, Disability Allowance etc. These definitions define disability in terms of an individual's functional ability in their environment, rather than a medical diagnosis or condition. In the context of the provision of specialist disability services, my Department does not classify specific medical illnesses or conditions as a disability.
My officials have clarified with the Deputy that the query relates to people who are unable to continue employment following long-COVID. The Department of Social Protection has a number of schemes under its remit that may be of assistance in this regard.
496. Deputy Thomas Pringle asked the Minister for Children, Equality, Disability, Integration and Youth when an assessment of need will take place for a child (details supplied) who is showing signs of special needs; and if he will make a statement on the matter. [41457/23]
View answerAs this refers to service matters, I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
498. Deputy Duncan Smith asked the Minister for Children, Equality, Disability, Integration and Youth to account for the reason that no community neurorehabilitation team is in place in CH09; to set out his plans to establish one; and if he will make a statement on the matter. [41494/23]
View answerAs this refers to service matters, I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
499. Deputy Catherine Connolly asked the Minister for Children, Equality, Disability, Integration and Youth the number of Bills prepared by his Department in the 33rd Dáil to date; the number and title of those Bills that included a Regulatory Impact Assessment; the title of the RIAs published by his Department; and if he will make a statement on the matter. [41584/23]
View answerMy Department is currently collating the information requested and a reply will issue directly to the Deputy as soon as possible.
500. Deputy Joe Flaherty asked the Minister for Children, Equality, Disability, Integration and Youth for an update on the request from a person (details supplied) to have their two children included in the ECCE scheme this year. [41603/23]
View answerThank you Deputy for your correspondence regarding the Early Childhood Care and Education (ECCE) Programme. The ECCE programme is available to all children within the eligible age range. A child must have reached 2 years and 8 months of age on or prior to 31 August of the relevant programme year to be eligible for the 1st September start date. There is no underage exception for ECCE enrolment.
I accept that the use of age limits in a scheme such as ECCE creates a situation whereby a child can fall just outside the age range, however, my Department have to place an age cut-off at some point, and in the interests of fairness and consistency there can be no discretion in this regard. I have appointed Stranmillis University College, Belfast, to undertake an independent review of the ECCE Programme. The review will assess whether the ECCE Programme is meeting its core objectives and will identify any changes or improvements that can be made to the Programme, based on international evidence and experience to date. The final report is expected to be completed by the end of 2023. I will then consider the review fully and consider any policy changes that may need to be made to the Programme.
501. Deputy Ivana Bacik asked the Minister for Children, Equality, Disability, Integration and Youth the number of reports made of early years facilities in breach of the Core Funding Agreement for failing to pass on the benefit to employees; and the number of reports made of early years facilities in breach of the Core Funding Agreement for failing to comply with requirements on fees charged to parents. [41613/23]
View answerCore Funding is a payment to Partner Services designed to support quality, sustainability, and enhanced public management, with associated conditions in relation to fee control and cost transparency, incorporating funding for administration and to support improved pay and working conditions of staff and to support the employment of graduate staff.
The State is not the employer within the early learning and childcare sector and therefore does not set the pay and conditions for employees in early learning and childcare services. As such, the terms and conditions of Core Funding do not contain any rules on staff pay and conditions.
However, the Joint Labour Committee has established a formal mechanism by which employer and employee representatives can negotiate pay rates in this sector.
Last September, the first Employment Regulation Orders (EROs) for Early Years Services came into effect, providing minimum hourly rates of pay for different roles, including higher minimum rates for those in leadership roles and those with graduate qualifications, thus establishing a wage structure for staff.
This historic achievement is supported by Core Funding, which supports the ability of service providers to meet the additional costs resulting from the EROs, while also providing for a freeze on parental fees, and assisting services with financial sustainability. It is nevertheless entirely separate to Core Funding, and any potential breach of an Employment Regulation Order may be referred to the Workplace Relations Commission for appropriate action.
As a condition of receiving Core Funding, Partner Services must uphold their contractual obligations regarding their fees charged to parents/guardians as laid out in the Core Funding Partner Service Funding Agreement. This includes agreement not to increase the fee for any Service Type which was extant on September 30th 2021 or introduce an extra charge for any component of an unchanged Service Type. An increased charge of any kind for an existing and unchanged Service Type will be in breach of Core Funding rules. This also includes circumstances by which a change of fee policy would result in increased charges to parents, for example, a service that offered a multiple child deduction cannot remove it.
The Core Funding fee management system aims to ensure that affordability measures are passed on to parents/guardians. Where a parent/guardian identifies a case of a potential breach of Core Funding fee rules, they can contact their local CCC and seek to have this examined and a conclusion reached through the Core Funding Fee Review process. Contact details for the CCCs can be found at myccc.ie/ Currently, there are four fee review cases which have found to be in breach of the fee management rules. There are a number of other cases currently being assessed, but I cannot comment on these until the cases are concluded.
502. Deputy Ivana Bacik asked the Minister for Children, Equality, Disability, Integration and Youth if he will make a statement on the practice of childcare operators who are signed up to core funding charging parents administrative costs and for purchase and use of equipment at early years facilities. [41614/23]
View answerTogether for Better, the new funding model, is about getting the most out of the three Early Learning and Childcare programmes, ECCE including AIM, NCS and Core Funding, working together and ensuring stability and sustainability in the sector. Together for Better is already delivering substantial benefits for children, parents, staff and providers and I am very proud of the significant achievements in its first year of operation. Investment in early learning and childcare is at unprecedented levels with public funding for the first time reaching more than €1 billion in 2023 for early learning and childcare – a clear demonstration from Government of the value of the sector.
For year 1 of the new Core Funding scheme, €259m was made available. For year 2 of this scheme, €287m is being made available. The additional €28 million – equivalent to 11% increase - is being allocated as follows:
• €8.47m for a 3% growth in capacity.
• €6.11m for non-staff overheads.
• €2.2m for administrative staff time.
• €4m for graduate premiums
• €7.22m for new targeted measures aimed at improving the sustainability of sessional services.
Core Funding allows for substantial increases in the total cost base for the sector, related both to pay and non-pay costs, without additional costs being passed on to parents.
Core Funding is a payment to Partner Services designed to support quality, sustainability, and enhanced public management, with associated conditions in relation to fee control and cost transparency, incorporating funding for administration and to support the employment of graduate staff.
As a condition of receiving Core Funding, Partner Services must uphold their contractual obligations regarding their fees charged to parents/guardians as laid out in the Core Funding Partner Service Funding Agreement. This includes agreement not to increase the fee for any Service Type which was extant on September 30th 2021 or introduce an extra charge for any component of an unchanged Service Type. An increased charge of any kind for an existing and unchanged Service Type will be in breach of Core Funding rules.
One of the key features of Core Funding is the introduction of a system of fee management, to ensure that affordability measures are passed on to parents/guardians. To achieve this, Core Funding introduced a fee freeze for the September 2022 - August 2023 programme year.
The Core Funding fee management system aims to ensure that affordability measures are passed on to parents/guardians. Where a parent or guardian identifies a case of a potential breach of Core Funding fee rules, they may seek to have this examined and a conclusion reached through the Core Funding Fee Review process.
As outlined in the Together for Better - Guidelines on Fee Management Documents, additional services Partner Services can continue to offer services in addition to early learning and childcare are subject to the following conditions;
• Partner Services cannot introduce or extract an extra charge for any Additional Service (such as meals) which was included in the fees on 30 September 2021.
• Any new Additional Services can be charged for, with fees set at the provider’s discretion, but they must be genuinely optional for the parent (e.g. if a service begins offering meals where it had not before, it may charge for these but must allow parents/guardians to supply a packed meal instead).
• If an additional service charge is introduced to fund a tour or outing, for example, a parent must be able to refuse this offer on the basis that they will still receive the early learning and childcare they would be entitled to if the tour or outing had not taken place.
• Additional Services cannot be added to ECCE-only Service Type, these can only offer Optional Extras as defined in the DCEDIY Childcare Funding Programmes Optional Extras Guide.
I would encourage Parents/Guardians experiencing difficulty in relation to understanding the fees charged by their Partner Service to contact their local City/County Childcare Committee (CCC) for assistance. Contact details for CCCs may be found on www.myccc.ie .
503. Deputy Ivana Bacik asked the Minister for Children, Equality, Disability, Integration and Youth if it is anticipated that the Pregnancy Loss in Workplaces project will report in 2023; and if he will make a statement on the matter. [41616/23]
View answerI recognise the enormous impact that pregnancy loss has on expectant parents, and I wish to extend my sympathies to all parents who have suffered such a loss.
Work to examine the needs of bereaved working parents coping with pregnancy loss is being advanced at present. My Department has commissioned a qualitative research study to examine the workplace experiences of parents coping with pregnancy loss. The study examines whether policy interventions are required at a national level to better to support these bereaved parents in the workplace.
The study focuses on people who experience pregnancy loss prior to 24 weeks’ gestation, as people who have a pregnancy loss after 24 weeks’ gestation can avail of full maternity leave and paternity leave entitlements.
The study has now largely concluded, and a report is being finalised which will be published shortly. The recommendations that arise from this study will help to inform Government policy, including the development of legislation to address the issue of miscarriage leave if required.
504. Deputy Michael Lowry asked the Minister for Children, Equality, Disability, Integration and Youth if his Department has conducted a review of the funding streams for family resource centres; whether he is committed to allocating additional funding in Budget 2024 to family resource centres, considering the profoundly positive impact that increased funding would have on the valuable work these centres provide in supporting families and local communities; and if he will make a statement on the matter. [41645/23]
View answerAs the Deputy will be aware, the Child and Family Agency, Tusla administers the Family Resource Centre programme, funding 121 Family Resource Centres (FRCs). Where possible I make it a point to engage with Family Resource Centres, they play a pivotal role for so many communities across the country providing a comprehensive range of services tailored to individual community needs. Their commitment to the people who use their services is exemplary and they also support those newly arrived to the country.
My Department allocates core funding for the FRC Programme through Tusla, which amounts to some €18m. Tusla has advised my Department that the current level of funding is to sustain existing services operating in the FRC Programme.
I am aware that Family Resource Centres are providing significant levels of assistance on the ground in communities who are welcoming Ukrainian people and I have provided specific funding to allow Tusla to continue to support Family Resource Centres in those efforts.
I should inform the Deputy that the funding from my Department represents only a portion of the total funding available to Family Resource Centres nationally. Family Resource Centres draw on various sources of funding provided by other Government Departments and agencies.
Tusla Area Managers consider proposals in the context of the commissioning priorities in the local area. Tusla aims to utilise the resources available in the most equitable, proportionate and sustainable way to improve outcomes for children and families.
Any potential changes in funding are considered as part of the annual Budgetary process. As this process is ongoing, I cannot comment on the funding for FRCs under Budget 2024 at this time.
505. Deputy Pa Daly asked the Minister for Health what solution will be in place for new patients seeking a GP to apply for a medical card and to sign social welfare forms, given that the HSE has indicated that it will now not assign a GP after a patient receives three or more refusals from GPs; and if he will make a statement on the matter. [40967/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
506. Deputy Emer Higgins asked the Minister for Health to provide details on the progress that has been made by his Department since the formation of the Government to develop and fully efficient and modern eHealth and ICT infrastructure. [40969/23]
View answerThe ICT environment supporting the provision of health services to the public in Ireland is the largest of its kind in the State, providing 24/7 services to over 70,000 end users across 2,000 interwoven systems and applications.
Despite significant increases in funding since the formation of this Government in terms of ICT capital, revenue and staffing, there is still much to be done to catch up with other EU member states in relation to digital health capacity and capabilities.
Our health services have experienced positive digital developments during the lifetime of this Government. 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 the response to Covid-19 resulting in a sustained increase in the use of telemedicine, remote care programmes and the electronic transfer of prescriptions, that necessitated changes to legislation. Our Covid-19 response required the digitisation of test and trace services to maintain social distancing and speed up the process from sampling to notification and reporting.
Overall, 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. This was all enabled through digitisation of health services and functions.
However, the ransomware attack on the Health Service Executives (HSE’s) health information systems in May 2021, also highlighted the real risks to health systems based on the criminal activities of those involved in cyberattacks.
Since the attack in 2021, this government has provided additional funding in terms of capital, revenue and staffing on a sustained basis, to act on the recommendations of the independent post incident report and build the additional resilience for these critical systems that underpin delivery of our health services today.
More broadly, we continue to invest in various digital health initiatives that have been deployed and are delivering benefits for both patients and the workforce. Significantly, enterprise level Electronic Health Record (EHR) systems have been deployed at St James hospital, the national rehabilitation hospital, and the national forensics hospital, and across several maternity sites. Following a decision by Government, the EHR for Children Hospital Ireland has been procured.
The New Children’s Hospital hospital-wide EHR 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.
The development of a new Digital Health & Social Care Strategic Framework (2023-2030) is currently underway. This will align with Government’s “Harnessing Digital” and EU ambitions under the EU Digital Decade to provide patients with access to digital health records by 2030. The new Strategic Framework sets the roadmap for digital health in Ireland for the next decade providing a clear roadmap for investment in digital health and delivery of electronic health record systems. In tandem, the HSE are developing an underlying Implementation Plan that will detail the specifics and sequencing of the roadmap and confirm the necessary support required to realise the intent of the framework and the plan.
The key goal of the framework and implementation plan is to support reform of the health service through streamlined processes, modernisation of services and by providing patients and healthcare professionals with access to digital health records. This will empower patients and enable healthcare professionals to treat patients more safely by providing them with access to better information. It will also result in Ireland being better positioned to meet EU expectations and obligations under the European Health Data Space directive and EU Digital Decade.
A key underlying enabler of the new Digital Strategic Framework will be the new Health Information Bill. The purpose of the Health Information Bill is to provide a clear, certain and consistent legislative framework to transform the health information system into one that is fit for purpose and best serves the individual patient, healthcare practitioners and society as a whole. With that in mind, the Bill is focussed on delivering patient-centred integrated care; improving performance and innovation in the health service; and supporting digital and data initiatives in healthcare.
507. Deputy Emer Higgins asked the Minister for Health to provide details on the progress that has been made by his Department since the formation of the Government to promote women's health. [40970/23]
View answerProgressing women’s health is a priority for myself and for this Government. We made a strong commitment to Promoting Women’s Health in the Programme for Government 2020 and are fully committed to the continued development and improvement of women’s health services and to working with women and girls to improve their health and experiences of healthcare across the whole life cycle.
Underscoring our commitment to women’s health was the establishment of a Women’s Health Taskforce in September 2019 to improve both health outcomes and experiences of healthcare for women and girls. The Women’s Health Taskforce continues to work with the National Women’s Council of Ireland and the European Institute of Women’s Health to prioritise different issues each year with the aim of improving women’s health outcomes and experiences. Critical to this work is the process of listening to women - the Taskforce has so far listened to, engaged with and worked with thousands of women and hundreds of organisations representing women and girls across the country and commits to continued listening.
The Women’s Health Action Plan 2022-23 was published on 8 March 2022, marking International Women’s Day. The Action Plan identifies key actions to improve health outcomes and experiences for women in Ireland. It provides the foundation to address women’s whole health and help ensure that action on women’s health looks beyond reproductive health to make a real difference to women’s lives.
Prioritisation of women’s health is further supported through the significant investment contained within Budget 2022 and 2023, which allocated €31m and €69.2m respectively in funding for new developments in Women's Health. This includes:
2022:
• €8.66 million additional funding for the National Maternity Strategy.
• €9 million to fund access to free contraception for women aged 17-25.
• €5.3 million to grow access to “see and treat” gynaecology clinics; specialist menopause clinics; and specialist endometriosis services.
• €1.34 million to support initial establishment of a perinatal genetics service.
• €0.71m investment in tackling period poverty for the first time.
• €0.54million to establish an expert Obstetric Event Support Team to support services and sites that report severe maternity incidents
• €0.25m additional investment in Sexual Assault Treatment Units.
2023:
• €11.7 million to provide access to publicly funded AHR/IVF treatment.
• Elimination of VAT on HRT and period products.
• Expansion of the Free Contraception Scheme to cover women aged 30 and under.
• €0.9m investment in the development of Women’s Health Hubs, for the holistic provision of women’s healthcare.
Prioritisation of women’s health in our service provision is seen in the completed and ongoing work happening to improve healthcare for women across the country. There have been a number of key developments since the establishment of the Women’s Health Taskforce and the Women’s Health Action Plan 2022-23.
• Contraception : The free contraception scheme for women was launched in September 2022, initially for those aged 17-25. The scheme was expanded on January 1st to include 26-year-old women, and expanded further, from September 1st, 2023, to include women aged 30 and under. Approximately €32m was allocated to support the scheme, including scheduled expansions, in Budget 2023.
• Menopause: 6 Specialist Menopause Clinics to treat complex symptoms of Menopause, all of which are open and operational. A GP Quick Reference Guide on Menopause was launched in October 2022 to support primary care practitioners in treating menopause and referring patients to Specialist Clinics. The National Menopause Awareness Campaign (Radio, Online, Print, TV) was launched in two phases by the Department of Health to raise awareness and “lift the taboo” around menopause. Gov.ie/menopause was launched as a one-stop shop for information about menopause and its symptoms as well as advice on proactive management. VAT was removed from HRT in Budget 2023.
• Fertility: 6 Regional Fertility Hubs have been established to provided tailored, low-level intervention for patients with fertility issues. Investment to support publicly-fund Assisted Human Reproduction has also been allocated and will see the first National AHR Centre established. As an interim measure, funding has been made available to enable eligible patients to access AHR treatment via private providers, a new initiative which is to ‘go live’ week commencing 25th September 2023.
• Gynaecology: A network of 20 “see and treat” ambulatory gynaecology clinics are in development, where an estimated 70% of general gynaecology referrals are suitable for management. 13 Ambulatory Gynae Clinics are currently open and operational, with additional clinics in development. The national network will improve access to services; help to reduce the requirement for multiple gynaecology appointments; help to ensure sustainability of service provision into the future given the significant waiting lists for this specialty; and will help improve clinical outcomes.
• Maternity: Under Budgets 2021 and 2022, €16m in new development funding was allocated to the National Maternity Strategy to ensure the continued implementation of the Strategy and the ongoing roll out of the Strategy’s model of care in line with the Programme for Government. This investment is providing for further development of community midwifery services, expansion of breastfeeding supports, improved access to allied and specialised services and strengthened training and education supports for staff. This investment is also improving the infrastructure of our maternity services by providing additional home-from-home birthing suites and upgrades to theatres and wards.
• Termination of Pregnancy Review: The final Report of Review of the operation of the Health (Regulation of Termination of Pregnancy)Act 2018 was considered by Cabinet on the 25th April 2023. The Report contains a range of recommendations most of which are operational in nature, with some proposing legislative change. Government agreed, that the HSE would establish an implementation group to progress the operational recommendations. Significant progress is being made in respect of various recommendations in the Report. The HSE has advised that a significant number of additional sites will be introducing termination services in the coming months. Legislation providing for safe access zones has been initiated in the Houses and it is our intention to enact it before the end of the year. The proposals around legislative change were referred to the Joint Committee on Health for consideration.
• Safe Access Zones : I secured Cabinet approval to legislate for the designation of safe access zones around healthcare premises to safeguard access to termination of pregnancy services in July 2022 and published the General Scheme of the Health (Termination of Pregnancy Services (Safe Access Zones) in August 2022. Since that time officials have worked with the Office of the Attorney General and other relevant stakeholders to draft the text of a bill. This Bill was published at the end of June 2023 and initiated in the Houses in early July. Subject to the parliamentary timetable it is intended to have the legislation enacted by the end of the year.
• Mental Health: The Women’s Health Fund provided investment in 2022 to support a range of services for women and girls, including digital mental health services access, improving perinatal mental health supports, enhancing specialist eating disorder supports, providing targeted mental health supports for marginalised women and women in addiction and responding to the needs of young girls at risk of developing psychosis. In March 2023, the Minister for Health launched Embedding Women’s Mental Health in Sharing the Vision – a report by the specialist group on the National Implementation Monitoring Committee (NIMC) Specialist Group on women’s mental health. Work is on-going to implement its recommendations in the delivery of the policy. Work is ongoing on the implementation of the Model of Care for Specialist Perinatal Mental Health Services as a key priority under Sharing the Vision, our national mental health policy. Perinatal mental health services have now been developed in all 19 maternity units/hospitals and provide specialist support to women experiencing mental health difficulties in pregnancy. Perinatal mental health disorders are those which complicate pregnancy and the first postnatal year.
• Physical Activity: The campaign, ‘It’s My Time’, funded by a €300,000 allocation from the Women’s Health Fund and managed by Sport Ireland in collaboration with Healthy Ireland, was run in December 2022 and January 2023, following detailed marketing research on messaging resonating with women in the target demographics. It’s My Time encouraged women to prioritise their wellbeing by getting more physically active on their own terms and in their own time. The campaign ran across digital, video-on-demand, and social media and was supported by various sporting National Governing Bodies and the nationwide network of Local Sports Partnerships.
• Period Poverty: Removal of VAT from period products in Budget 2023. Funding of €714,000 was allocated for period poverty initiatives in Budget 2022, this funding was then increased in 2023 to €814,000. This funding supports period dignity measures rolled out in partnership with the HSE, local authorities and NGOs. In 2023 to date, funding has been provided to 21 local authorities and 11 NGOs, including a significant allocation to the Family Resource Centre National Forum, which is supporting 44 FRCs. The Healthy Ireland Survey, 2022, included a module on menstrual health and period poverty, finding that 51% of women currently having periods experience disruption to participating in daily life (work, school, sports, social events) as a result of symptoms, and that 24% have experience of period poverty.
Additional investment can be seen through the Women’s Health Fund which was established in Budget 2021 to respond to the needs of women in year. The dedicated €10 million has invested in a range of key service areas including cancer screening and immunisation, primary care supports, maternity services and postnatal hubs, gynaecology, mental health and supports for marginalised groups.
In the longer-term, through a population health approach championed in the Sláintecare report, we will be planning services around the health and social care needs of our entire population. Factors that will inform this include age, socioeconomic status, disability status, health care utilisation patterns, ethnicity, and gender. The insights gained from this will form an evidence base that will inform future service planning, workforce planning, review of eligibility, and capital planning. The service needs of women will be considered as part of all this.
Implementation of the services listed above represents significant development and advancement for women's health nationwide, but this remains a work in progress. I am committed to the full implementation of the Women's Health Action Plan 2022-23 and will continue to drive progress in all areas of women's health to fulfil its mandate into the future.
508. Deputy John McGuinness asked the Minister for Health if he will confirm the status of an application for funding submitted by (details supplied); If a positive decision will be expedited as there is an immediate and urgent requirement to provide extra space and services based on the growing numbers attending the centre and the range of services required by patients; and if he will make a statement on the matter. [40975/23]
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.
509. Deputy Aodhán Ó Ríordáin asked the Minister for Health what measures he will take to increase the awareness of the danger for abuse and misuse of the drug pregabalin among the medical community; and if he will make a statement on the matter. [40993/23]
View answerIn 2019, the Medical Council established an ‘Overprescribing Working Group’ to consider issues with overprescribing of controlled drugs within the healthcare system. The aim of the group was to create a forum for stakeholders to share knowledge, experience and ideas on how to address overprescribing of benzodiazepines, Z drugs and Pregabalin, and also to identify strategies to reduce the over prescribing of these drugs in the interest of patient and practitioner safety, and to support prescribers in adherence with guidelines.
The Working Group includes representatives from my Department, the HSE, the Pharmaceutical Society of Ireland, the Irish College of General Practitioners, the Nursing and Midwifery Board of Ireland, the Health Products Regulatory Agency and the Irish College of Psychiatry.
The group is currently working on a report which is examining the impact of the overprescribing of benzodiazepines, Z drugs and pregabalin in Ireland and it is estimated that this report will be finalised next year.
Following examination of the recommendations of this report, I will consider what measures need to be taken to support medical practitioners in the area of safe prescribing and to address any patient safety concerns arising.
