Wednesday, 27 Sep 2023

Written Answers Nos. 128-143

Qualifications Recognition

Questions (128)

Michael Healy-Rae

Question:

128. Deputy Michael Healy-Rae asked the Minister for Health to provide an update on a case (details supplied); and if he will make a statement on the matter. [41680/23]

Written answers

Minister for Health

As the Deputy will be aware, the Medical Council is the statutory agency responsible for the registration and regulation of doctors in Ireland. Any doctor wishing to practice medicine in Ireland must first register with the Medical Council. The Council is fully committed to supporting medical practitioners arriving from Ukraine and it has a dedicated webpage for Ukrainian doctors available at www.medicalcouncil.ie/ukraine/ and a dedicated email address [e-mail] with further information on registration requirements and the supports available.

In order to safely practise independently as a doctor, medical graduates must undertake a year long internship unless that training has been specifically incorporated in their degree programme. Under current legislation, only doctors who have undertaken medical studies in certain EEA/EU states can apply for Internship registration on the Medical Council’s register. The full list of eligibility criteria for Internship in Ireland can be found on the HSE's website. Holders of medical degrees from Ukraine would need to complete their internship in their home country or in another jurisdiction before they could be registered here.

Health Services

Questions (129)

Pearse Doherty

Question:

129. Deputy Pearse Doherty asked the Minister for Health when a Cross Border Directive NIPHCS appeal decision will be made (details supplied); the average waiting times for such decisions; and if he will make a statement on the matter. [41681/23]

Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Health Services Staff

Questions (130)

Michael Creed

Question:

130. Deputy Michael Creed asked the Minister for Health if, arising from the recruitment and retention difficulties faced in the public health service in the context of nursing post, if he will outline the proposals, if any, for an overview of this issue by the Heath and Safety Authority in terms of our public hospitals; the interaction, if any, that has taken place between the HSE and the HSA in this regard; the Health and Safety skillset requirements in the public health service required to address this problem going forward; and if he will make a statement on the matter. [41712/23]

Written answers

Minister for Health

Recruitment of nurses and midwives continues in line with the Government’s commitment to increasing the nursing and midwifery workforce. There are 6,568 more nurses and midwives in the workforce since 2020. Based on available evidence provided by the OECD, figures show that Ireland has the fourth highest number of practising nurses per capita in Europe with 13.4 practising nurses per 1,000 population. This is an increase on the 2021 figure of 12.8.

In addition to recruitment, I am committed to growing the national supply of nurses and midwives in Ireland. I am working with the Minister for Further and Higher Education, Research Innovation and Science with the intention of doubling nursing and midwifery training places over the next 5-8 years. Over the last three years, undergraduate training places for nurses and midwives have increased by over 400 places (approximately 25%). For 2023/2024, there are over 250 additional places across the Republic of Ireland Higher Education Institutions. Adding to this number for this year, my Department and the Department of Health in Northern Ireland have agreed a one-off arrangement supporting an All-Island approach to increasing training places for student nurses and midwives.

Retention of our current nursing and midwifery students is a priority for me and the Deputy will be aware that I recently invested €9 million to support student nurses and midwives to attend their mandatory clinical practice placements throughout their education programme.

The Framework for Safe Nurse Staffing and Skill Mix is an evidence-based approach to determining nurse staffing levels that puts safety and patient needs first, focusing on delivering positive patient outcomes. The Framework is national policy in Adult General and Specialist Medical and Surgical wards since 2018 and in Emergency Care Settings since 2022. Where implemented, the Framework, has demonstrated positive impacts for patients, staff, and organisations. Specifically, evidence is available from the Framework for Safe Staffing of positive impacts on retention of nurses including a reduction in intention to leave.

National implementation of the Framework is a priority for me. The Government invested €56 million since 2020 to support implementation. This provides for over 2,000 additional Whole Time Equivalent Registered Nurses and Healthcare Assistants to date and will continue to drive recruitment in line with increasing demands.

Clinical nurse and midwife specialist posts and advanced practice posts offer career pathways supporting retention of our workforce, while optimising the nursing and midwifery contribution to meeting population health needs. In November 2021, I increased the target for the number of nurses and midwives practicing at advanced level from 2% of the nursing and midwifery workforce to 3% and I allocated additional funding of €11 million to support this. With this funding, 149 additional WTE Advanced Nurse/ Midwifery Practitioners (ANMP) were recruited in 2022. Budget 2023 has provided funding to recruit an additional 80 WTE ANMPs during 2023 and as of August 2023, the total number of both registered and candidate advanced nursing and midwifery practitioners ANMPs was 1,004 WTE.

My Department is currently developing a Health and Social Care Workforce Projection Model. The Model will provide demand and supply projections of numbers required in medicine, nursing and health and social care professionals (HSCP). Work on developing demand and supply projections and gap analysis is currently underway and due to be completed later this year. The ultimate objective of this work is the development of scenario-based projections of health and social care workforce supply and demand which informs a set of recommendations for ongoing strategic health and social care workforce planning.

Increased recruitment and retention strategies by the HSE have contributed to record-breaking growth in the healthcare workforce with significant career development and progression and educational/development opportunities being offered.

The Health Information and Quality Authority (HIQA), in their role as statutory regulator, monitor standards across the public health service against the National Standards for Safer Better Healthcare to help drive improvements in the quality and safety of healthcare services in Ireland. One of the eight themes in the National Standards for Safer Better Healthcare is Workforce. HIQA recognises that a service’s workforce is one of its most important resources in delivering safe, high-quality care and support.

The National Standards for Safer Better Healthcare state that it is important that the members of the workforce are skilled and competent to deliver quality care and support and that the workforce is planned, structured, and managed to deliver the service’s quality and safety outcomes. One of the key standards that HIQA inspect against is that service providers organise and manage their workforce to achieve the service objectives for high quality, safe and reliable healthcare. This is to ensure service providers plan and organise their services to ensure there are enough staff with the necessary qualifications, skills, and experience to deliver safe high-quality care to service users at all times.

With regard to the Health and Safety Authority (HSA), my Department is not aware of any specific interactions between the HSE and HSA related to this matter. The HSA is under the remit of the Minister for Enterprise, Trade and Employment, and as such, the Deputy may wish to raise those elements of his question directly with Minister Coveney.

Medical Cards

Questions (131)

Mairéad Farrell

Question:

131. Deputy Mairéad Farrell asked the Minister for Health the number of medical card holders in each county, in tabular form; and if he will make a statement on the matter. [41718/23]

Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Medical Cards

Questions (132)

Mairéad Farrell

Question:

132. Deputy Mairéad Farrell asked the Minister for Health the number of dentists in each county who are currently part of the DTSS, in tabular form; if he will provide an update on the work he and his Department are doing to ensure access to dental care for medical card holders; and if he will make a statement on the matter. [41719/23]

Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Departmental Priorities

Questions (133)

Neasa Hourigan

Question:

133. Deputy Neasa Hourigan asked the Minister for Health his plans for the development of a national diabetes register; and if he will make a statement on the matter. [41724/23]

Written answers

Minister for Health

As part of Budget 2023, €2.6 million was allocated to implement a number of initiatives aimed at improving diabetes care, including commencing the development of a National Diabetes Registry, the commencement of a National Paediatric Audit of Type 1 Diabetes, and two further initiatives related to gestational diabetes. These initiatives focus on improving our information on diabetes patients and health services and improving the provision of care for women with gestational diabetes.

The development of a National Diabetes Registry will have a long-term benefit on patient care by facilitating benchmarking of individual care against guideline recommendations and QI feedback to practitioners, and on the provision of appropriate health services by providing reliable information to healthcare planners and policymakers.

My Department and HSE National Clinical Programme for Diabetes are currently engaged in preparatory work for phase 1 of this multi-year project.

Disease Management

Questions (134)

Marian Harkin

Question:

134. Deputy Marian Harkin asked the Minister for Health if he will consider including all glaucoma eye drop medication in the long-term illness scheme for people with diabetes; and if he will make a statement on the matter. [41728/23]

Written answers

Minister for Health

The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, including the Long Term Illness Scheme, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.

In line with the 2013 Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the formal Reimbursement list. Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority. There are formal processes which govern applications for the pricing and reimbursement of medicines, and new uses of existing medicines, to be funded and/or reimbursed.

In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact. HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics.

Therefore, this matter has been referred to the HSE for attention and direct reply to the Deputy.

Health Services Staff

Questions (135)

Róisín Shortall

Question:

135. Deputy Róisín Shortall asked the Minister for Health if the 6,000 additional staff across acute and social care services announced in Budget 2023 have been recruited; to provide a breakdown, in tabular form, by discipline and recruitment status; and if he will make a statement on the matter. [41733/23]

Written answers

Minister for Health

As this is an operational matter for the Health Service Executive, the HSE has been asked to reply directly to the Deputy.

Medical Aids and Appliances

Questions (136)

Matt Carthy

Question:

136. Deputy Matt Carthy asked the Minister for Health if, following the outsourcing of children's incontinence wear to a private provider (details supplied), the HSE can compel the provider to supply the same brand that was issued by the primary care service, as opposed to the less effective product now being supplied to parents of children with complex and special needs; and if he will make a statement on the matter. [41751/23]

Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Hospital Appointments Status

Questions (137)

Martin Browne

Question:

137. Deputy Martin Browne asked the Minister for Health if the numerous referrals issued by GPs in the case of a person (details supplied) are being given adequate priority given their recurrent tonsillitis; his views on the fact that no appointment date has been given to the patient, despite a number of referral letters indicating the persistent and painful nature of their tonsillitis being issued to the hospital concerned; and his views on how the family concerned is faced with the prospect of having to avail of a private service in order to have the child's tonsillectomy carried out. [41753/23]

Written answers

Minister for Health

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.

Hospital Facilities

Questions (138)

Thomas Gould

Question:

138. Deputy Thomas Gould asked the Minister for Health whether he is aware of issues with staff car parking in Cork University Hospital and Cork University Maternity Hospital; and if he will make a statement on the matter. [41801/23]

Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Hospital Procedures

Questions (139)

Mairéad Farrell

Question:

139. Deputy Mairéad Farrell asked the Minister for Health to confirm how cases at a hospital (details supplied) will be decided; and if a lottery system will be used. [41879/23]

Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible. 

Hospital Services

Questions (140)

Mairéad Farrell

Question:

140. Deputy Mairéad Farrell asked the Minister for Health the rationale for a decision (details supplied). [41880/23]

Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible. 

Hospice Services

Questions (141)

Mairéad Farrell

Question:

141. Deputy Mairéad Farrell asked the Minister for Health if he has plans to expand capacity at a hospice (details supplied). [41881/23]

Written answers

Minister for Health

A Government decision was made in October 2022 to approve the re-designation of four adult hospice organisations from section 39 status to section 38. The four hospices are: Galway Hospice, St. Francis Hospice Dublin, Milford Care Centre, and Marymount Hospice.

The re-designation of section 39 service level agreements with the HSE to section 38 agreements is a necessary policy change. This will ensure the continued sustainability and provision of specialist palliative care services across Ireland. It will result in all voluntary specialist palliative care providers for adults being aligned as section 38 organisations.

The re-designation will provide a sustainable model of care for adult specialist palliative care services in Ireland and ensure the provision of these core services into the future. It will provide financial and staffing sustainability to ensure that these providers of adult specialist palliative care services can continue their vital work.

Specialist adult in-patient palliative care services provided by voluntary hospices are unique within the broad range of Section 39 organisations due to the consultant led, complex clinical care they provide. These service providers are supporting people with life limiting illnesses to remain at home and in their communities while receiving specialist palliative care.

A key recommendation of Sláintecare is the provision of universal access to palliative care. Specialist palliative care services provide care to approximately 12,000 patients a year. Approximately 70% of inpatient and 74% of community adult specialist palliative care services are provided by voluntary hospices. The re-designation of these four hospice organisations will ensure that the right care is delivered in the right place and at the right time.

The Department of Health is working in collaboration with our HSE counterparts in progressing this significant piece of work.

As Minister, I am fully committed to the continued development of palliative care services across the country. As part of budget 2023, an allocation of €3.7million has been provided for new measures in palliative care. The new measures to be implemented will enhance the provision of adult and children’s specialist palliative care services across the country and will allow for the commencement of a new palliative care policy for adults due to be published this year. The new policy will reflect the changes in end-of-life care including increased demand for adult palliative care, the shift towards care in the community, the emphasis in Sláintecare on addressing geographic variations in the provision of both community and hospital palliative care services, and developments in international best practice.

The Palliative Care Budget increased to a total national service plan allocation in 2022 of €121.9 million from a national service plan allocation of €119 million in 2021. In 2023, the budget is €130.1m.

Care Services

Questions (142)

Mairéad Farrell

Question:

142. Deputy Mairéad Farrell asked the Minister for Health what plans there are to increase the availability of staff to increase care hours for patients (details supplied). [41882/23]

Written answers

Minister of State at the Department of Health (Deputy Mary Butler)

As this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Hospital Equipment

Questions (143)

Réada Cronin

Question:

143. Deputy Réada Cronin asked the Minister for Health whether it is the policy of his Department that a patient who has been on long-term palliative care and whose fragility puts them at particular risk of bedsores and dermatological breakdown, cannot have access to an airbed in hospital, despite relying on one at home; the reason, given that such a bed would need to be rented by the HSE; and if he will make a statement on the matter. [41883/23]

Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.