Wednesday, 11 Oct 2023

Early Childhood Care and Education

Questions (198)

Robert Troy

Question:

198. Deputy Robert Troy asked the Minister for Children, Equality, Disability, Integration and Youth if he will urgently review the level of funding for a community pre-school (details supplied). [44348/23]

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Written answers

Minister for Children, Equality, Disability, Integration and Youth

My Department oversees a Case Management process through which local City and County Childcare Committees (CCCs) and Pobal work together to assess and provide support to early learning and care services experiencing difficulties. This can include help with completing and interpreting analysis of staff ratios and cash flow, as well as more specialised advice and support appropriate to individual circumstances, such as in this case.

In some instances, financial supports may be deemed appropriate in tandem with the Case Management Process following the verification of a service’s need for a financial intervention.

While a service may not be eligible for this support at a point in time, their local CCC and Pobal can continue to provide non-financial operational supports through the Case Management Process. Should the financial situation of a service change in the future, it can be re-assessed for financial supports if deemed appropriate.

I understand that Westmeath CCC has been providing support in the case in question.

Departmental Communications

Questions (199)

Niall Collins

Question:

199. Deputy Niall Collins asked the Minister for Children, Equality, Disability, Integration and Youth if the relevant official from his Department can contact a person (details supplied) immediately; and if he will make a statement on the matter. [44367/23]

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Written answers

Minister for Children, Equality, Disability, Integration and Youth

I can assure the Deputy that relevant officials will contact the person concerned.

Childcare Services

Questions (200)

Brendan Smith

Question:

200. Deputy Brendan Smith asked the Minister for Children, Equality, Disability, Integration and Youth if he is aware of the difficulties facing parents in trying to access childcare for children aged 1-3; if measures will be introduced to support the recruitment and retention of staff as it is the lack of staff numbers in many facilities, with surplus accommodation, that is reducing considerably the number of children aged 1-3 that can be cared for in childcare services; and if he will make a statement on the matter. [44438/23]

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Written answers

Minister for Children, Equality, Disability, Integration and Youth

Core Funding - introduced in September 2022 - has already proven to be effective in expanding capacity, particularly in areas of undersupply and additional funding secured in Budget 2023 for year two of Core Funding provides further opportunity to invest in an additional 3% growth in capacity.

For Year 2 of Core Funding, the budget has increased by 11% to reach €287 million, providing a sustainable platform for investment with increases for all services.

The additional funding for Core Funding Year 2 is being allocated as follows:

• €8.47 million towards funding the natural growth of the sector,

• €6.11 million towards non-staff overheads, to support services with increases to non-staff costs, while maintaining the fee management system,

• €2.2 million towards administrative staff time,

• €4 million towards the removal the year 3 requirement for the Graduates Premiums, underpinned by EROs, and

• €7.22 million for new targeted measures which are aimed at improving the sustainability of smaller and sessional services. These include a flat rate allocation of €4,075 for all sessional-only services, which will benefit approximately 1,700 services delivering ECCE, and a minimum base rate allocation of €8,150, which will benefit small, part time and school-age services.

The network of 30 City/County Childcare Committees across the country are in a position to match children and families to services operating with vacant places and engage proactively with services to explore possibilities for expansion among services, particularly where there is unmet need.

I acknowledge that many early learning and care (ELC) and school-age childcare (SAC) services report staffing difficulties in relation to recruitment and retention. In general, staffing pressures in the sector are caused not by insufficient supply of qualified personnel, but by high levels of staff turnover.

Providers of ELC and SAC are private businesses. As the State does not employ staff in ELC and SAC services, neither I nor my Department can set wage levels or determine working conditions for staff in the sector.

However, there is now, through the independent Joint Labour Committee (JLC) process, a formal mechanism established by which employer and employee representatives can negotiate minimum pay rates for different roles in ELC and SAC services. In line with the provisions of the Industrial Relations Acts, the JLC is independent in its functions, and I do not have a role in its statutory processes.

The Employment Regulation Orders published last year were a significant milestone in efforts to improve pay in the sector. The Orders are being supported by Core Funding – which has an allocation of €259 million in its first year – to support amongst other things, improvements in staff wages, alongside a commitment to freeze parental fees and support for sustainability of services. As announced in Budget 2023, the Core Funding allocation will increase by €28 million for the second year. I understand that the JLC for Early Years Services is continuing to meet in relation to possible further increases in minimum rates of pay.

I am also committed to addressing other challenges which may impact on the recruitment and retention of staff in the sector. In line with commitments in First 5, in December 2021, I launched Nurturing Skills: The Workforce Plan for ELC and SAC, 2022-2028. Nurturing Skills aims to strengthen the ongoing process of professionalisation for those working in ELC and SAC.

Nurturing Skills includes specific actions for moving to a graduate-led ELC workforce by 2028, establishing a career framework for staff working in the ELC and SAC sector, including role profiles and qualification requirements, and the strengthening of career pathways. Nurturing Skills also includes actions to support the recruitment and retention of staff with the necessary qualifications, and ongoing staff training and development, to create a workforce which feels valued and is motivated to deliver the best possible service to children.??

I am committed to supporting providers in responding to current staffing challenges. Over the coming weeks, a sub-group of the Early Learning and Childcare Stakeholder Forum will be convened to discuss current staffing pressures and additional measures that may be needed.

Some €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:

• Building Blocks - Improvement Grant;

• Building Blocks - Capacity Grant; and

• Building Blocks - Innovation Grant.

Under the Building Blocks - Improvement Grant, €9 million was allocated earlier this year in grants ranging from €35,000 to €75,000 for energy upgrades and retrofit projects, which has supported services in need of upgrading, such as kitchen refurbishments, roof repairs and the replacement of flooring. This scheme is now closed and my Department does not have further funding available in either 2023 or 2024 under the Building Blocks - Improvement Grant.

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. Pillar 2, the Building Blocks – Capacity Grant, will fund an expansion of existing services in areas of undersupply. Funding will also be provided to support the development of new services, where most needed.

General Practitioner Services

Questions (201)

Thomas Pringle

Question:

201. Deputy Thomas Pringle asked the Minister for Health his views on GPs refusing medical card patients access to their lists in line with an agreement made with GPs in 2023 and how a patient can get a GP service if they move from one end of the country to the other under the GMS scheme; and if he will make a statement on the matter. [44182/23]

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Written answers

Minister for Health

Patient choice of doctor is a bedrock principle of the GMS Scheme for medical card and GP visit card holders. For the vast majority of individuals concerned their choice of doctor is accommodated and they are registered with their GMS GP of choice. In 2022 (last full year data available) out of a total of about 348,000 individuals who were approved for either a GP Visit Card or Medical Card, 3,927 individuals were unable to secure placement with their doctor of choice, or 1.1% of the total. In addition, 3,701 existing GMS patients were reassigned following a change in their place of residence.

For the small number of individuals unable to locate a GP themselves, the long standing process whereby the HSE may assign an eligible person to a GP’s GMS panel remains in place, in accordance with the GMS contract. Where a patient who holds a medical card or GP visit card experiences difficulty in finding a GP to accept them as a patient, the person concerned having unsuccessfully applied to at least three GPs in the area (or fewer if there are fewer GPs in the area) can apply to the HSE National Medical Card Unit which has the power to assign that person to a GP's GMS patient list.

The GP Agreement 2023, which provides for the expansion of GP care without charges to all children under 8 years and to those who earn up to the median household income, does contain arrangements in relation to the assignment of card holders/applicants to GP GMS panels. However, these arrangements do not prevent the assignment of patients and rather are in place to help the equitable distribution of assigned patients across the panels of participating GPs.

In addition, as per the Agreement, a joint HSE and Irish Medical Organisation working group is being established to review the operation of the patient assignment protocol with a view to ensuring that it is framed and operating in a fair, patient- and GP-centred manner.

Abortion Services

Questions (202)

Carol Nolan

Question:

202. Deputy Carol Nolan asked the Minister for Health further to Parliamentary Question No. 644 of 3 October 2023, if any research has been conducted or commenced by his Department into the likely number of safe access zones which will be created by the Bill; and if he will make a statement on the matter. [44230/23]

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Written answers

Minister for Health

I am committed to ensuring safe access to termination of pregnancy services.

Officials from my Department have worked with the Office of the Attorney General, and other relevant stakeholders to develop the Health (Termination of Pregnancy Services) (Safe Access Zones) Bill 2023 .

This Bill designates Safe Access Zones of 100 meters from an entrance or exit to the land and buildings that form part of the premises where obstetricians/gynecologists and general practitioners provide services. The Zones will also apply to hospitals that provide acute inpatient services within the meaning of Section 51 of the Health Act 1970. I am not in a position to specify the exact number of zones.

Within those Zones certain conduct aimed at impeding access or influencing decisions in relation to termination of pregnancy services will be prohibited. Such conduct only becomes an offence if it continues after a Garda warning has been issued.

Hospital Equipment

Questions (203)

Niamh Smyth

Question:

203. Deputy Niamh Smyth asked the Minister for Health the reason the replacement grant for an MRI machine in Monaghan Hospital was not granted; and if he will make a statement on the matter. [44233/23]

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Written answers

Written answers

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

The total allocation for mental health services in 2024 is approximately €1.3 billion, which is the fourth year in a row in which the mental health budget has been increased. This significant investment will enable continued policy implementation and service improvement in line with our national mental health policy, Sharing the Vision. This year’s budget allocation builds on the investment this Government has made over the last number of years to deliver the policy priorities of Sharing the Vision through the provision of mental health supports across a broad continuum from mental health promotion, prevention and early intervention, to acute and specialist mental health service delivery, and enabling us to continue to deliver our vital services to as many people as possible, as we move into 2024.

As occurs each year following the Budget, discussions will now take place with the HSE on details relating to specific service initiatives in the context of preparing the HSE Service Plan 2024, including that for Mental Health.

Health Services

Questions (207)

Bríd Smith

Question:

207. Deputy Bríd Smith asked the Minister for Health if there are any plans to trial the use of curved paddles (details supplied) in the carrying out of mammograms given the high number of women who report pain and/or discomfort during breast screening; if he will consider that this may help improve the numbers returning for subsequent mammograms; and if he will make a statement on the matter. [44251/23]

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Written answers

Minister for Health

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Medical Aids and Appliances

Questions (208)

Michael Healy-Rae

Question:

208. Deputy Michael Healy-Rae asked the Minister for Health the status of a hearing aid application for a person (details supplied); and if he will make a statement on the matter. [44274/23]

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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

Questions (209)

Michael Healy-Rae

Question:

209. Deputy Michael Healy-Rae asked the Minister for Health if he will address a matter (details supplied); and if he will make a statement on the matter. [44278/23]

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Written answers

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

The Maskey report on CAMHS in South Kerry was published on 26 January 2022. In April 2022, the Government approved a compensation scheme for individuals identified as affected by the Maskey Report. As I have indicated on many occasions in the public domain, the Maskey Report was a shocking and disturbing revelation and I apologised on behalf of the Governement for the hurt and stress caused to the young people concerned and their families. In addition, the HSE accepted all the findings in the Report, apologised fully and is wholly committed to the implementation of all 35 of its recommendations.

Good progress has been made on this overall, including the three national audits in relation to CAMHS and arising from the Maskey Report on South Kerry, namely the recently published national review of CAMHS prescribing practice; the national audit of compliance with the CAMHS Operational Guidelines; and a qualitative review of service user experiences being undertaken by UCC. These reports will be given full and proper consideration by the Government.

Separately, CAMHS teams have worked closely with the Mental Health Commission over the last year or so to develop and implement improvement plans as needed following the Interim and Final Reports of the Commission on CAMHS nationally.

Covid-19 Pandemic

The Department of Social Protection administer the Supplementary Welfare Allowance (SWA) Scheme and the Fuel Allowance, which may assist individuals in meeting the costs associated with operating medical devices. Further information on these can be found, respectively, at:

www.gov.ie/en/collection/d5554-supplementary-welfare-allowance/

www.gov.ie/en/service/00aa38-fuel-allowance/.

In addition, energy suppliers are required to establish, maintain and regularly update a register of vulnerable customers. Vulnerable customers include:

• Those who are critically dependent on electrically powered equipment. This includes (but is not limited to) life protecting devices, assistive technologies to support independent living and medical equipment, or

• Those who are particularly vulnerable to disconnection during winter months for reasons of advanced age or physical, sensory, intellectual or mental health.

There are a range of additional protection measures in place for registered vulnerable customers. Energy suppliers are required to provide customers with a free and easy way to register as a vulnerable customer. Further information regarding this can be found at:

www.cru.ie/need-assistance/vulnerable-customers/.

In Budget 2023, every household in Ireland received three €200 energy credits, totalling €600. These payments were made between November 2022 and April 2023.

Budget 2024 announced that three further energy credits of €150 each will be paid to households over the coming months.

There are also a range of Health Service Executive (HSE) administered schemes that assist individuals in meeting their medical costs.

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. The HSE afford applicants the opportunity to furnish supporting documentation to determine whether undue hardship exists and to fully take account of all relevant circumstances that may benefit them in assessment, including medical evidence of costs and certain expenses.

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.

The Drug Payment Scheme (DPS) ensures that no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines who are not eligible for a medical card.

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%.

Health Services

Questions (219)

Claire Kerrane

Question:

219. Deputy Claire Kerrane asked the Minister for Health if he will advise on the National Clinical Programme for the treatment of ADHD in adults which has yet to be extended to the Community Healthcare West; when funding for this service will be forthcoming; if those who urgently require service can receive care in a different community health area that is providing the same service; and if he will make a statement on the matter. [44307/23]

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Written answers

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

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

Ambulance Service

Questions (220)

Alan Dillon

Question:

220. Deputy Alan Dillon asked the Minister for Health if compulsory overtime is taken into consideration when calculating pensions within the ambulance service; and if he will make a statement on the matter. [44313/23]

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Written answers

Minister for Health

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