Written Answers Nos. 458-480
458. Deputy Jim O'Callaghan asked the Minister for Health to provide an update on the programme for Government commitment to update the National Carers Strategy; when he expects the strategy to be finalised; and if he will make a statement on the matter. [43465/23]
View answerThe Programme for Government contains specific commitments in recognition of the contribution of Family Carers to care provision in Ireland, which will build on the progress to date in the implementation of the National Carers’ Strategy. One of these is to review and update the National Carers' Strategy.
Before commencing work on an update and refresh of the National Carers' Strategy, consideration will need to be given by the Department of Health to the approach to the update and the breadth of stakeholder consultation. A review carried out by Care Alliance Ireland and UCC in 2021 of the Carers' Strategy found that for most actions (40/42), over 90% of carers felt they were still relevant and wanted them retained but that they should be strengthened.
The Programme for Government also commits to developing a ‘Carers Guarantee’ proposal that will provide a core basket of services to carers across the country regardless of where they live. New funding of €2 million was provided in Budget 2021 under the umbrella of the National Carers’ Strategy to improve equity of access to supports for carers across the country, in tandem with the community and voluntary sector. This annual funding delivers substantially on the Carers' Guarantee: €1.9 million has been provided to Family Carers Ireland for the delivery of a broad range of supports to carers, while the remaining €100,000 is supporting a professionally mediated online family carer support group through Care Alliance Ireland.
In addition, the HSE has completed piloting of a Family Carers Needs Assessment in Community Healthcare West over a two-year period from September 2021. The pilot tested the implementation of the FCNA with 100 family carers across a variety of care groups including carers of people with dementia, older people, people with physical and sensory disability and those with mental health issues. It examined how caring affects the family carer, how much care they can realistically provide while still allowing for involvement in other activities, and, crucially, how any needs identified can be addressed. The FCNA was piloted in conjunction with Family Carers Ireland.
459. Deputy Bríd Smith asked the Minister for Health if he will review an application for funding under the Cross Border Directive and-or HSE reimbursement scheme (details supplied) with a view to granting the costs; and if he will make a statement on the matter. [43470/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
460. Deputy Fergus O'Dowd asked the Minister for Health if, further to the Government commitment to develop an action plan to combat loneliness in the programme for Government, the Roadmap for Social Inclusion and the Healthy Ireland Strategic Plan, he will identify the unit in his Department that has responsibility for developing this plan; when the plan will be published; and if he will make a statement on the matter. [43479/23]
View answerEvidence shows loneliness is a significant issue for population health and a number of different studies have linked loneliness to multiple chronic health conditions. Loneliness levels in Ireland are rising, and the pandemic was a major contributory factor to increases in social isolation. Loneliness can be detrimental for our physical and mental health, while reconnecting with others post-COVID-19 pandemic has numerous physical and mental health benefits.
The 2021 Healthy Ireland Survey which was carried out while significant restrictions were still in place, found a significant increase in isolation and a decrease in the proportion of the population reporting positive mental health. Some 81% reported lower levels of social connectedness and 30% reported worsening mental health since the pandemic started.
Given the detrimental impacts of loneliness, a significant body of work has been undertaken, across diverse areas of the Department of Health and the HSE, to address this.
In response to the increase in loneliness which particularly impacts older people, the Ministers for Health and the Chief Medical Officer, supported by Healthy Ireland, developed a nationwide campaign, aimed at older people to encourage them to rebuild their social connections and re-integrate into their communities. Post-pandemic, with vaccines and sensible precautions, it is safe for older people to reconnect with the world, to say “Hello Again World”, make up for lost time and re-establish important connections with their community.
Social prescribing recognises that health is heavily determined by social factors such as poverty, isolation and loneliness, offering GPs and other health professionals a means of referring people to a range of non-clinical community supports which can have significant benefits for their overall health and wellbeing. HSE-funded Social Prescribing services are now available in 44 locations across the country. These services are delivered in partnership with community and voluntary organisations such as Family Resource Centres and Local Development Companies, and as part of the Sláintecare Healthy Communities Programme.
Mental health of older people is a priority in Sharing the Vision, Ireland's national mental health policy, with actions including improving access to Mental Health Services for Older People, promoting evidence-based digital mental health interventions in the general population and with older persons, and linking recommendations with the National Positive Ageing Strategy.
To this end, the Age Friendly Homes Programme began in 2021 as a two-year pilot project, with the overall objectives to prevent early or premature admission to long-term residential care; enable older people to continue living in their homes or in a home more suited to their needs; help older people to live with a sense of independence and autonomy and support older people to be and feel part of their communities. Funding of €5.2 million has been allocated in Budget 2023 to roll-out the Healthy Age Friendly Homes Programme nationally in 2023.
The HSE, in conjunction with ALONE, is also continuing the roll out of a Support Coordination Service across the country. This service supports older people to live well at home independently, and for as long as possible, through support coordination and access to services such as, but not limited to; practical supports, befriending, social prescribing, assistive technology, and coordinated linkages to local community groups in their area. This service is being led out under the Enhanced Community Care (ECC) Programme, a strategic reform programme in line with Sláintecare proposals and priorities which seeks to deliver new and enhanced services and support the move toward a more community-centric model of healthcare.
As part of the ECC programme, the Integrated Care Programme for Older Persons (ICPOP) model aims to shift the delivery of care for older people away from acute hospitals towards a community based, planned and coordinated care model which is closely aligned to Primary Care and Acute sector partners. The objective of the programme is to improve the quality of life for older people by providing access to integrated care and support that is planned around their needs and choices. This supports them to live well in their own homes and communities without the need to access acute care settings. As of Quarter 2 2023, 23 ICPOP teams have been established across Ireland, with 30 expected to be established in total by year end.
The HSE have advised that in line with the Enhanced Community Care Programme (ECC), their objective is to deliver increased levels of health care with service delivery reoriented towards general practice, primary care and community-based services. The focus is on implementing an end-to-end care pathway that will care for people at home and over time prevent referrals and admissions to acute hospitals where it is safe and appropriate to do so and enable a “home first” approach.
The ECC Programme was allocated €240m for the establishment of 96 CHNs, 30 Community Specialist Teams for Older People, 30 Community Specialist Teams for Chronic Disease, national coverage for community intervention teams and the development of a volunteer-type model for CHN’s in collaboration with Alone.
An integral component to maintaining people well at home and in their community is collaboration with the ALONE Organisation and there is now full national coverage of the ALONE across the nine Community Healthcare Organisations.
1. The HSE works in collaboration with ALONE, an organisation that offer a volunteer type model to support CHN’s. Specifically in relation to older people in the Community, including those who are lonely, isolated, frail or ill, homeless, living in poverty, or are facing other difficulties services are being developed in conjunction with ALONE.
2. ALONE assists older people with a suite of tailored supports such as practical supports, befriending, phone services, social prescribing and assistive technology to improve physical, emotional and mental wellbeing to enable older people live independently with an improved quality of life (over 24, 791 older people have been supported directly through Alone services from January – June 2023).
3. ALONE provides a point of contact for older persons to assist in navigating and accessing a wide range of services including health, social care, and government services both local and national, and in areas provide support to Specialist Teams for Older Persons within the hospital setting.
4. ALONE received over 8585 referrals (Jan to June 2023) from a variety of sources such as Hospitals, Primary Care teams, community sources, self-referrals, referrals from family and members of the public.
5. ALONE provided 18,000 new interventions this year supporting older people who have difficulties in areas such as housing, isolation and loneliness, finance and legal, physical health, mental health, personal care, technology, safety and security etc.
The HSE continues to engage and work with ALONE, who are reaching a large cohort of older people through their services and helping them live healthy lives at home and addressing such issues as loneliness and isolation. This is playing an important role in ensuring appropriate use of primary care and hospital services across Ireland.
The Government is committed to ensuring that those living with dementia have access to the right services and supports to help them to live well in their communities and have invested €12.16 in dementia services and supports in 2023: €4.86 million has been provided for the National Dementia Strategy and €2.1 million for the full resumption of dementia-specific day care services. The Government have also prioritized investment valued at €5.2 million to allocate a minimum of 15% of 5 million new home support hours to people with dementia, up from 5% in 2021 and 11% in 2022. This investment is in addition to €5.9 million provided for the implementation of the National Dementia Strategy in 2021, and a further €7.3 million in 2022.
Acknowledging the disproportionately negative impact of the pandemic on older persons, the Programme for Government (2020) commits to the establishment of a commission on care that will ‘assess how we care for older people and examine alternatives to meet the diverse needs of our older citizens’, learning the lessons from COVID 19. In 2022 preliminary research was undertaken within the Department of Health in preparation for the establishment of the commission on care, the scoping and planning for which are being further advanced as a priority in 2023.
At a local level, Mental Health Day Services provided by the HSE are available to those who may require them, which provide mental health and medication supports, as well as wider assistances associated with daily living. In addition, in May this year an additional €5.25 million funding was announced for meals on wheels and day centres for older people to organisations across the country.
The Roadmap for Social Inclusion 2020 - 2025: Ambition, Goals and Commitments was published in January 2020. The primary ambition of the Roadmap was to “Reduce consistent poverty to 2% or less and to make Ireland one of the most socially inclusive countries in the EU.
At the end of 2022, 39 of Roadmap commitments were either fully achieved or achieved with ongoing delivery, with a further 4 commitments in progress on schedule with ongoing delivery, and delivery on 26 commitments in progress.
The Roadmap for Social Inclusion is an overarching statement of Government strategy, which acknowledges the range of sectoral plans already in place that have social inclusion as a core objective, in areas such as education, health, children and childcare, community development and housing. These plans remain key to ensuring that social inclusion is at the core of public policy and service strategy across all government departments and services.
While the action plan to combat loneliness has not yet been specifically resourced within the Department, as outlined above, the issue of loneliness is being addressed through a significant number of different workstreams and initiatives.
461. Deputy Fergus O'Dowd asked the Minister for Health to respond to concerns raised by an organisation (details supplied) on the use of disposable vapes; and if he will make a statement on the matter. [43480/23]
View answerMy current legislative priority is the Public Health (Tobacco Products and Nicotine Inhaling Products) Bill, which 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.
Measures contained in the Bill include:
• A prohibition on the sale of nicotine inhaling products to those aged under 18.
• The creation of a licencing system for the retail sale of nicotine inhaling products. Retailers will need to apply for a licence, renew it annually, and pay a fee.
• A prohibition on the sale of nicotine inhaling products from self-service vending machines, temporary or moveable premises, and events aimed at children.
• A prohibition on the advertising of nicotine inhaling products near schools, in cinemas, or on public transport.
• The introduction of new penalties for retailers who commit offences related to nicotine inhaling products.
The Public Health (Tobacco Products and Nicotine Inhaling Products) Bill completed the Second Stage on 15 June 2023 and is next at Committee Stage on 12 October 2023. It is expected to be enacted in this legislative session.
Further effective regulation of nicotine inhaling products is complex. Successful actions on public health issues require multiple evidence-based interventions in order to affect usage. Each aspect of the product, including pricing, advertising, packaging and sale needs to be addressed in order to have a successful impact. There are a range of options for how best to regulate these products while taking into consideration their relative harm compared to combustible tobacco products. In the context of all of these considerations, options for the development of further and comprehensive legislation on nicotine inhaling products will be examined.
My colleague Ossian Smyth, Minister of State in the Department of Environment, Climate and Communications, recently held 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. I will work with Minister Smith to provide any assistance that will ensure that this important measure is enacted as soon as possible.
Regarding the concerns raised relating to educating children on the dangers on vaping through the SPHE modules, I have referred this part of the query to the HSE for answer.
462. Deputy Peadar Tóibín asked the Minister for Health if he will ensure that there is sufficient provision for ring-fenced funding in budget 2024 to cover the running costs of meals-on-wheels services. [43481/23]
View answerOver many years, both Day Care and the Meals on Wheels service have proven to be important components of the community services offered to older people, particularly in rural communities.
In May 2023 I announced the allocation of €5.25 million funding for Meals on Wheels and Day Centres for older people to organisations across the country.
Budget 2024 has seen increased investment in both areas building on recent investment to support these services. Community services are the backbone of social care provision and play an important part in keeping older people out of hospital and in their own homes and communities for longer. We will be investing an additional €2.7 million in 2024 for Day Care Services and an additional €1 million for Meals on Wheels nationally.
463. Deputy Alan Dillon asked the Minister for Health if there is a proposal not to fund any new medicines that are approved for Irish patients in 2024; if so, the justification for this proposal; and the impact this will have on patients with cancer or rare diseases, and children in Ireland. [43482/23]
View answerPending the outcome of the budgetary process, it is not possible to state the level of funding for new medicines in 2024. Any health measures introduced will be in the context of the implementation of the health commitments in the Programme for Government and the funding available to progress healthcare priorities.
464. Deputy Alan Dillon asked the Minister for Health the amount the Government spent on new medicines in each of the years 2021, 2022 and 2023; and the projected spend on new medicines in 2024, if the current spending is cut; and if he will make a statement on the matter. [43483/23]
View answerThe State is committed to providing timely access to new and innovative medicines to all patients. €50 million in funding was allocated for the approval of new medicines in Budget 2021, €30m in 2022, and a further €18 million in Budget 2023 which will provide access to new innovative medicines for patients.
The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
The HSE in its decision making considers the 5 year budget impact of each new medicine notwithstanding that the budget of the HSE is set on an annual basis. The year 1 costs of most medicines represent a fraction of the overall costs of those medicines when fully introduced.
The HSE has confirmed that:
In 2021, 29 new medicines and 21 new uses of existing medicines and 2 expansions of reimbursement were approved at an additional cost of €477m over the first 5 years of those decisions. The cost of these medicines in 2021 was €34.39 million.
In 2022, 30 new medicines and 30 new uses of existing medicines were approved at an additional cost of €178m over the first 5 years. The cost of these medicines in 2022 was €9.36 million.
As 2023 has not yet concluded, a figure for the amount spent on new medicines in 2023 cannot be provided at this time.
Pending the outcome of the budgetary process, it is not possible to state the level of funding for new medicines in 2024. Any health measures introduced will be in the context of the implementation of the health commitments in the Programme for Government and the funding available to progress healthcare priorities.
465. Deputy Alan Dillon asked the Minister for Health the progress that has been made on implementing the recommendations made by an organisation (details supplied) on the reimbursement of new medicines; which recommendations have been implemented to date; which recommendations have not been implemented to date; and the timeline for implementing the remaining recommendations. [43484/23]
View answerIn February, I published the Mazars Review which examined the governance arrangements around the HSE’s Drug Pricing and Reimbursement Process. The Report found that the reimbursement process is operating in line with the legislation and that it is delivering results in line with international norms. I fully support the recommendations contained in the Mazars report around improving the process, increasing transparency, providing easier access, and supporting value for money.
An implementation group has been established between my Department and the HSE to consider and progress the various recommendations contained in the Report. The membership of the Group includes representatives of the Drugs Group, the HSE, the NCPE, and the Department of Health. The Working Group has met frequently since its establishment, to consider the involvement of patients, agencies, industry, and clinicians, in each stage of the reimbursement process.
Targeted stakeholder consultation commenced on the 31st of May and concluded on the 20th of June. The insights gained from stakeholders will be considered by the Group as it continues its work on progressing the various recommendations of the Review. A report on this will be submitted to me in the coming months.
466. Deputy Alan Dillon asked the Minister for Health the Government's priorities for funding new medicines; how the Government balances the need to provide access to new medicines with the need to be fiscally responsible; and the Government's plans to ensure that all patients in Ireland have access to the medicines they need, regardless of their ability to pay. [43485/23]
View answerThe State is committed to providing timely access to new and innovative medicines to all patients. €50 million in funding was allocated for the approval of new medicines in Budget 2021, €30m in 2022, and a further €18 million in Budget 2023 which will provide access to new innovative medicines for patients.
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 (NCPE). The NCPE conducts health technology assessments (HTAs) for the HSE and makes recommendations on reimbursement to assist HSE decisions. The NCPE uses a decision framework to systematically assess a drug's clinical and cost effectiveness as a health intervention.
Multiple initiatives exist to try to ensure value for money in the medicines purchased. These include the Framework Agreements on the Supply and Pricing of Medicines 2021-2025, a set of Agreements negotiated with Industry to provide medicines for the HSE at sustainable prices. These are expected to lead to between €600m-700m less being spent on medicines over the course of the Agreements. The extra headroom provided by these savings will allow the HSE to do more with their resources.
To ensure access to medicines, in February, I published the Mazars Review which examined the governance arrangements around the HSE’s Drug Pricing and Reimbursement Process. The Report found that the reimbursement process is operating in line with the legislation and that it is delivering results in line with international norms. I fully support the recommendations contained in the Mazars report around improving the process, increasing transparency, providing easier access, and supporting value for money.
An implementation group has been established between my Department and the HSE to consider and progress the various recommendations contained in the Report. The membership of the Group includes representatives of the Drugs Group, the HSE, the NCPE, and the Department of Health. The Working Group has met frequently since its establishment, to consider the involvement of patients, agencies, industry, and clinicians, in each stage of the reimbursement process.
Targeted stakeholder consultation commenced on the 31st of May and concluded on the 20th of June. The insights gained from stakeholders will be considered by the Group as it continues its work on progressing the various recommendations of the Review. A report on this will be submitted to me in the coming months.
Regarding ability to pay, people who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card.
In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. Medical card eligibility is primarily based on an assessment of means and is not granted on the basis of any particular condition.
In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
Under the Drug Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
Individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
467. Deputy Martin Browne asked the Minister for Health the progress made to date in the urgent and emergency care operational plan for 2023 at University Hospital Limerick; the progress made to date in immediately addressing the overcrowding and capacity issues at University Hospital Limerick ahead of a further increase due to winter demand; if further use will be made of Nenagh, Ennis and St. John's hospitals in addition to the measures taken already; the additional measures put in place in communities across the mid-west to reduce presentations at UHL; and if he will make a statement on the matter. [43488/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
468. Deputy Mattie McGrath asked the Minister for Health if private autism assessments can be funded under the National Treatment Purchase Fund; if so, the steps; and if he will make a statement on the matter. [43489/23]
View answerThe NTPF was established under the Health (Corporate Bodies) Act 1961, with the function of providing hospital treatment for citizens and the collection and validation of information in relation to waiting lists. Its role was extended in 2009 (via the Nursing Home Support Scheme Act, 2009) to provide for negotiations with private nursing homes in the context of fees payable for Fair Deal clients.
Notwithstanding the fact that Primary Legislation would be required to expand the NTPF’s role there are other core factors that may militate against a role for the NTPF in the area identified by the Deputy in the short to medium term.
Firstly, there is the nature of private capacity in the context of hospitals versus community services. Currently, NTPF treatments are purchased from hospitals (institutions) through panel agreements with the relevant providers; community services are predominately provided via individual practitioners.
In addition, careful consideration would need to be given to the impact of the purchasing of private capacity on long-term expansion of public capacity within primary care, and ensuring appropriate skill mix to meet the needs of people including children with more complex needs.
Any changes would need to be widely consulted upon, analysed, and planned prior to enactment. The NTPF could potentially play a role in the future. However, there are foundational issues as outlined above that need systematic reform and development to enable an NTPF style approach.
469. Deputy Neasa Hourigan asked the Minister for Health his plans to introduce mandatory fortification of foodstuffs with folic acid following his Department's Folic Acid Policy Committee report on the matter; and if he will make a statement on the matter. [43498/23]
View answerThe Healthy Ireland Framework has brought a new focus on the importance of health promotion and the need for cross-Government and cross-sectoral co-operation to prevent ill-health. The Healthy Ireland Framework has enshrined the principles of prevention and early intervention within all policies, with a particular emphasis on the early years.
Following the publication of healthy eating guidelines for the general population in 2016, it was recognised that dietary intake of folate remains sub optimal In Ireland. A multidisciplinary Committee was established by the Department of Health to review the evidence in support of folic acid supplementation to prevent neural tube defects (NTD). Recommendations published in the 2019 report “Folic Acid Supplementation” by the Department of Health, outline several mechanisms to improve folic acid intake for women of child-bearing age and thereby reduce the risk of neural tube defects.
One key recommendation given at the time was to consider the requirements for food fortification with folate. The Committee recognised that this option is dependent on a range of issues including food consumption patterns and preferences, supply chain issues, implications of Brexit, as well as the significant undertaking in terms of resources and timing involved. These issues would need to be worked through before any further consideration could be given to mandatory food fortification.
Ireland does not have any national mills and relies on the UK for up to eighty per cent of its flour supply. After undertaking a public consultation on the proposal to introduce mandatory fortification of UK flour with folic acid, the UK Government and devolved administrations decided to proceed with the mandatory fortification of non-wholemeal wheat flour and legislate on this basis in 2021.
Up to this point fortification of flour was conducted on a voluntary basis. The voluntary addition of vitamins and minerals to foods is regulated by means of Regulation (EC) No 1925/2006, which aims to ensure that fortified foods are safe, and to allow for the proper functioning of the internal market. This regulation permits the addition of folic acid to foods in compliance with its rules.
The ‘mandatory addition’ of vitamins and minerals for public health reasons, such as the fortification of staple foods with folic acid, is not covered by this regulation. The European Commission does not envisage the harmonisation of the mandatory addition of nutrients, such as folic acid, across the EU. It is up to Member States to decide if they wish to introduce alternative measures such as mandatory food fortification with folic acid.
In addition, the labelling of a compound food containing a fortified ingredient must comply with the provisions of Regulation (EU) No 1169/2011, to ensure that it shall not be misleading for the consumer.
In the event of any proposal to revise existing legislation a regulatory impact analysis would need to be conducted. Before any policy position is finalised on folic acid fortification, stakeholder consultation would need to be carried out on a national basis. Once a policy position has been formed, the Department would need to notify the Commission via the Technical Regulation Information System (TRIS) system of Ireland’s intention to introduce fortification of flour with folic acid. Ireland would be required to demonstrate that evidence-based analysis, public stakeholder consultation and cross Government collaboration had taken place to justify why Ireland is considering mandatory fortification. To give an estimation of predicted timelines, the consultation process is still ongoing in the UK, two years post announcement of mandatory fortification.
With this in mind, other actions are needed to optimise both FA supplement use and dietary folate in the short-term. It is recommended that all women considering pregnancy take a 400-microgram (mcg) supplement of folic acid per day when planning a pregnancy and for the first 12 weeks of pregnancy and this is described in The Nutrition in Pregnancy, national clinical guideline that was developed in 2019 to promote the link between good nutrition during pregnancy and a favourable pregnancy outcome.
Under the phase 2 of the First 5 strategy implementation plan, it has been identified that parents, families and communities will be supported to engage in and promote positive health behaviours among babies and young children, starting from the pre-conception period. Enhanced integration and communication of Folic Acid supplement advice will continue under several relevant programmes being operated by the Health and Wellbeing Division, Primary Care, Obstetrics and Gynaecology and Sexual Health services.
470. Deputy Michael Healy-Rae asked the Minister for Health if a bus service can be offered to a person (details supplied) who attends a day care centre; and if he will make a statement on the matter. [43502/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
471. Deputy Thomas Gould asked the Minister for Health if, in view of the large increase in numbers of people presenting to services identifying as being addicted to smoking crack cocaine, he will provide additional funding for residential treatment services. [43503/23]
View answerThe 2019-20 Irish National Drug and Alcohol Survey published by the HRB notes that, ‘overall, recent cocaine use had increased significantly among males and to a lesser extent among females.’ The survey indicated that 2.3 percent of the population reported use of the drug in the last year.
The number of people accessing treatment for cocaine and ‘crack’ cocaine has increased steadily. The most recent figures published by the HRB indicate that Cocaine was the most common drug reported in 2022, accounting for 34.0% of all cases, a 25.7% increase from 2021. Cocaine was also the most common main drug among new cases in 2022, like the previous two years.
Enhancing access to, and the delivery of, drug and alcohol services in the community is a strategic priority under the national drugs strategy for the period 2021-2025. The strategic action plan 2023-2024 sets out the key actions to progress under this priority.
In 2022, €850,000 in additional funding was provided for an HSE-led initiative to reduce the health-related harms from cocaine and ‘crack’ cocaine. The funding supports models of best practice in cocaine treatment, including the development of training programmes for addiction service staff nationally. It also provided for the establishment of targeted interventions in disadvantaged communities worst affected by cocaine and ‘crack’ cocaine.
gov.ie - Minister for Public Health, Wellbeing and the National Drugs Strategy announces €850,000 for HSE-led initiative to reduce the health-related harms from cocaine and ‘crack’ cocaine (www.gov.ie)
I recently announced additional funding of €500,000 to expand the provision of community-based services for cocaine and crack cocaine. This new funding will build on last year’s HSE led €850,00 cocaine initiative. This funding has provided for a geographical spread of cocaine services in each CHO.
gov.ie - Minister for Public Health, Wellbeing and the National Drugs Strategy announces increased funding of €500,000 for cocaine services (www.gov.ie).
Furthermore, Budget 2023 provided an additional €0.9m in funding to ensure the sustainability and increase the capacity of residential treatment services. This funding will be used to commission additional treatment episodes. The Government is committed to the maintenance and expansion of residential addiction treatments/episodes.
472. Deputy Michael Fitzmaurice asked the Minister for Health the number of staff suffering from long Covid who have had their employment terminated by his Department (details supplied); and if he will make a statement on the matter. [43524/23]
View answerI can confirm that no staff in my Department have had their employment terminated as a result of suffering from Long COVID.
I have asked the HSE to respond directly to the Deputy in respect of the HSE and the staff of the Section 38 agencies under their aegis.
The information has been sought from the Non-Commercial State Agencies under the aegis of my Department, and their response will be provided to the Deputy by way of separate cover when collated.
473. Deputy Danny Healy-Rae asked the Minister for Health the reason a clinic (details supplied) is being closed down; and if he will make a statement on the matter. [43534/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
474. Deputy Pearse Doherty asked the Minister for Health when a registration application with an organisation (details supplied) will be processed for a person in County Donegal; and if he will make a statement on the matter. [43536/23]
View answerAs the maintenance of the register of Nurses and Midwives is an operational matter for the Nursing and Midwifery Board of Ireland (NMBI), I have referred the question to the NMBI for its attention and direct response to the Deputy.
475. Deputy Paul McAuliffe asked the Minister for Health to provide an update on an operation for a child (details supplied). [43544/23]
View answerUnder 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.
476. Deputy Louise O'Reilly asked the Minister for Health the person or body that will be representing Ireland at the High-level Meeting on Childhood Obesity - A comprehensive framework to reduce childhood obesity in the EU in Spain; and if he will make a statement on the matter. [43547/23]
View answerIn the context of the Spanish Presidency of the Council of the European Union during the second half of 2023, the Spanish Ministry of Health is hosting a high-level meeting on "Childhood Obesity - A comprehensive framework to reduce childhood obesity in the EU". The aim of the meeting is to contribute to the advancement of cross-sectoral policies for the prevention of childhood obesity in the European region and to share a comprehensive vision of its approach.
A Healthy Weight for Ireland, the Obesity Policy and Action Plan (OPAP), was launched in September 2016 under the auspices of the Healthy Ireland Framework (Healthy Ireland: A Framework for Improved Health and Wellbeing 2013-2025). It was developed in recognition of the growing need for a co-ordinated policy response to the increasing problem of obesity in Ireland and the increasing burden placed on individuals and society.
OPAP covers a 10-year period up to 2025 and aims to reverse obesity trends, prevent health complications, and reduce the overall burden for individuals, families, the health system, and the wider society and economy. It recognises that obesity is a complex, multi-faceted problem and needs a multi-pronged solution, with every sector of society playing its part. Childhood obesity is a key priority under OPAP, as is reducing the inequalities seen in obesity rates, where children (and adults) from lower socioeconomic groups have higher levels of obesity. OPAP is well aligned with the World Health Organisation in terms of the breadth of policy measures that have been introduced or are being considered in order to address the obesity epidemic.
The Spanish Presidency has asked Member States to nominate a designated expert to attend the meeting on childhood obesity which takes place on 16th and 17th of October. The policy lead on Obesity in the Health and Wellbeing unit of the Department of Health with responsibility for overseeing the implementation of "A Healthy Weight for Ireland" will be attending for Ireland.
477. Deputy Louise O'Reilly asked the Minister for Health the resources being made available for the research of the evaluation of the sugar-sweetened drinks tax in Ireland; the funding being made available to access data sources such as household panel purchasing data; if sufficient resources will be made available such that a comprehensive study can be carried out; and if he will make a statement on the matter. [43548/23]
View answerA Healthy Weight for Ireland, the Obesity Policy and Action Plan (OPAP), was launched in September 2016 under the auspices of the Healthy Ireland Framework (Healthy Ireland: A Framework for Improved Health and Wellbeing 2013-2025). It was developed in recognition of the growing need for a co-ordinated policy response to the increasing problem of obesity in Ireland and the increasing burden placed on individuals and society.
The OPAP recognised that “implementing evidence-informed regulation, legislation and fiscal measures, [would] increasingly support people to make healthy choices” and committed to developing evidence-based proposals on fiscal measures to support healthy eating and lifestyles. It also undertook to review this evidence, including the effectiveness of implementation of fiscal measures on products that are high in fat, sugar and salt. The Sugar Sweetened Drinks tax, introduced by the Department of Finance in 2018, is the first such fiscal measure in Ireland and the Healthy Ireland Strategic Action Plan (HISAP) 2021-25 committed to “Undertake an evaluation of the sugar sweetened drinks tax against the stated aims of the tax”.
As a first step in planning the evaluation a scoping review was undertaken by the Department of Health. This review examined approaches other countries have employed to evaluate similar SSD taxes. The Department also engaged with a number of national and international experts in the evaluation of SSD taxes. Following the completion of this review, the Department identified the need to commission an external evaluation of the SSD tax.
The Department recently undertook a procurement process to acquire the services of a contractor to carry out an evaluation of the Sugar Sweetened Drinks Tax with the objective of measuring the effectiveness of the SSD tax in Ireland. Outcomes of interest in the evaluation may include the following:
- the extent to which the tax was successful in realising the objectives as stated in the original policy document and set out below:
(1) that individuals reduce consumption of sugar sweetened drinks by reducing the amount consumed or switching to healthier choices;
(2) that industry reformulates products to reduce (not necessarily remove) levels of added sugar in the drinks products;
An agreement has recently been reached with the contractor and work on the external evaluation will now commence. This work is expected to cost a maximum of €49,750 (exclusive of VAT). This provides for a wide search for potential data sources and the purchase, where required, of relevant market data and possible fees for extraction of relevant secondary data if available. This work is expected to be completed in the new year. The Department will publish the findings of the evaluation upon completion.
478. Deputy Louise O'Reilly asked the Minister for Health if he will set up a diabetes taskforce of relevant stakeholders to develop a national diabetes strategy that will ensure the provision of optimum care to every person with diabetes; and if he will make a statement on the matter. [43550/23]
View answer547. Deputy Duncan Smith asked the Minister for Health if he will set up a diabetes taskforce of relevant stakeholders to develop a national diabetes strategy that will ensure the provision of optimum care to every person with diabetes; and if he will make a statement on the matter. [43934/23]
View answerI propose to take Questions Nos. 478 and 547 together.
Diabetes is a complex condition that can require management across the entire spectrum of healthcare delivery, including self-management support as well as care delivered through general practice, community specialist care and hospital inpatient specialist care.
The planned delivery of diabetes services is ongoing. As part of Budget 2023, funding was allocated to implement a number of initiatives aimed at improving diabetes care. This includes the commencement of 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.
The inclusion of diabetes as one of four chronic diseases in respect of which GMS patients receive ongoing, planned care from their GP through the Chronic Disease Management Programme also represents a major step forward in assisting those living with diabetes to manage their condition. As part of the recently published GP Agreement of 2023, agreement was secured to include all women who have been diagnosed with gestational diabetes or pre-eclampsia since January 2023 in the CDM Preventative Progamme.
Guidelines for Diabetes prevention and management include the Model of Integrated Care for Patients with Type 2 Diabetes, the Model of Care for the Diabetic Foot (2021) and the National Clinical Guideline for the Management of Adult Type 1 Diabetes. Guidelines are reviewed and amended in line with the most up to date evidence to support best clinical practice and standardisation of care for diabetes patients.
In 2020, the Health Service Executive published The National Framework for the Integrated Prevention and Management of Chronic Disease (2020-2025) which adopted a whole system approach to integrated care for people with Chronic Diseases. It sets out a national framework for an integrated approach to the prevention and management of chronic disease in Ireland over the coming years. This framework was developed in relation to four major chronic diseases, including type 2 diabetes. The framework builds on the existing policies and guidelines, with a focus on health promotion, disease prevention, diagnosis, treatment, disease management and rehabilitation services that are coordinated across different healthcare providers and healthcare settings.
I am aware of the needs of the diabetes community and the challenges faced by those living with the condition. Officials in my Department engage with the HSE Diabetes clinical team in consideration of the future development of diabetes related services.
479. Deputy Carol Nolan asked the Minister for Health if he is aware of the decision by the Health Secretary in the UK to implement a single sex policy in NHS hospitals meaning that transgender women who were born biological males will no longer have access to female-only wards; if he will support such a policy here for the HSE; and if he will make a statement on the matter. [43553/23]
View answerAs this PQ refers to Hospital Management policy, we are referring to the HSE for direct reply.
480. Deputy Steven Matthews asked the Minister for Health if his attention has been drawn to appeals regarding payment of the pandemic payment by frontline workers (details supplied); if the matter is under review; and if he will make a statement on the matter. [43558/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
