Written Answers Nos. 1501-1521
1501. Deputy Pádraig Mac Lochlainn asked the Minister for Health if he will provide an update on the work of the inter-departmental Period Poverty Implementation Group established two and a half years ago and chaired by his Department; and if he will make a statement on the matter. [56560/23]
View answer1502. Deputy Pádraig Mac Lochlainn asked the Minister for Health the reason for the delay in progressing his commitments following Government support of the Free Provision of Period Products Bill 2021 and implementation of the recommendations of the Discussion Paper on Period Poverty jointly published by him and the Minister for Children, Equality, Disability, Integration and Youth three years ago; and if he will make a statement on the matter. [56561/23]
View answer1503. Deputy Pádraig Mac Lochlainn asked the Minister for Health the dates on which the inter-departmental Period Poverty Implementation Group has met since its inaugural meeting on 8 July 2021 to date, in tabular form; and if he will make a statement on the matter. [56562/23]
View answer1504. Deputy Pádraig Mac Lochlainn asked the Minister for Health the annual budgetary amount allocated to the work of the inter-departmental Period Poverty Implementation Group from 2021 to date, in tabular form; and if he will make a statement on the matter. [56563/23]
View answerI propose to take Questions Nos. 1501, 1502, 1503 and 1504 together.
Following the publication of a Plan International Survey in 2018, which found that 10% of teenage girls were significantly impacted by period poverty, Private Members’ Motions on the topic were passed in both Houses of the Oireachtas and a sub-committee of the National Strategy for Women and Girls Strategy Committee was set up to consider the issue.
The resulting Period Poverty in Ireland Discussion Paper was published in February, 2021 and can be accessed at the following link: www.gov.ie/en/publication/264f4-period-poverty-in-ireland-discussion-paper-period-poverty-sub-committee-national-strategy-for-women-and-girls-20172020-february-2021/
Government has agreed that the recommendations of the Period Poverty in Ireland Discussion Paper be taken into account and that cross-Government, inter-Departmental, inter-agency and societal support for implementation measures should be sought, including from voluntary and private sector organisations that provide services funded by the State, as well as from public service providers.
The Department of Health has established an inter-Departmental Period Poverty Implementation Group ("IG"), with representation from most Government Departments, to achieve cross sectoral input and to co-ordinate oversight of implementation measures recommended by the Discussion Paper. The Group has now met on six occasions (as laid out in tabular form below), most recently in December 2023. Various bilateral meetings have also been held between officials of this Department, other Government Departments, State agencies and NGOs and representatives of the Scottish Government.
|
Meeting |
Date |
|
1st |
08/07/21 |
|
2nd |
17/11/21 |
|
3rd |
07/03/22 |
|
4th |
14/12/22 |
|
5th |
24/05/23 |
|
6th |
13/12/23 |
The purpose of the IG is to implement the recommendations of the Discussion Paper; to improve access to period products for those who may need them, and to widen the knowledge base regarding the incidence and impacts of period poverty in Ireland. The Group is overseeing and co-ordinating the roll-out of period dignity measures. These include:
• Expanding provision of free period products in the bathrooms of public buildings and publicly funded services
• Partnering with services and NGOs to provide period products to those most in need
• Supporting the evidence base through further research in this area, through representative surveys
The annual budgetary amount allocated to the Department of Health and HSE for period poverty mitigation from 2021 to date is listed in tabular form below:
|
Year |
Total |
Dept. Health |
HSE |
|
2021 |
€0 |
€0 |
€0 |
|
2022 |
€714,000 |
€514,000 |
€200,000 |
|
2023 |
€814,000 |
€514,000 |
€300,000 |
|
2024 |
€914,000 |
€614,000 |
€300,000 |
In terms of implementation, the most urgent focus is on supporting those most in need (e.g., the homeless, those living with addiction, minorities including Travellers, Roma and refugees and those experiencing consistent poverty).
The Department of Health and the HSE are progressing implementation of a period dignity support programme through HSE Social Inclusion, with a focus on Travellers and Roma; this commenced with a pilot programme in Community Health Organisation 5 (CHO5, based in the South-East) in 2022.
Following initial positive results, the HSE extended similar supports to other CHOs in the second half of 2022, with additional funding in 2023 and 2024. Depending on numbers of Travellers and Roma in each CHO, some are also widening provision out to other vulnerable groups, working with community organisations and facilities.
The Department have funded 26 Local Authorities and 16 NGOs directly in 2022. 22 local authorities, the Family Resource Centre National Forum (supporting 44 FRCs) and 10 NGOs were supported in 2023. This funding supports the provision of period products in some public buildings and facilities managed by local authorities, as well as supporting family resource centres and charities working with people experiencing homelessness, addiction and/or consistent poverty to provide period products to those in need. Increased funding of €914,000 has been allocated to widen this in 2024.
The Office of Government Procurement launched a Hygiene Supplies and Period Equality Products procurement Framework in June, 2023, supported by the period poverty Implementation Group. The Framework should enable Government Departments, State Agencies and other publicly funded bodies, including schools and the higher education sector, to source period products and no charge dispensers.
A wide range of products, including those that are sustainable and re-usable, are available through suppliers represented on the Framework. Access details are available at the following link; www.gov.ie/en/press-release/adbc1-ministers-of-state-naughton-smyth-publish-framework-agreement-that-allows-the-public-sector-to-easily-purchase-period-products/
A key recommendation of the Period Poverty in Ireland Discussion Paper was to address the limited evidence base – age groups over 19 were not covered by the Plan International Survey. Therefore, menstrual health and period poverty questions were included in the Healthy Ireland Survey, 2022, published on the 5th December, 2022.
The Survey found that 24% of women (and 35% of 15-24 year-olds) have experienced at least one indicator of period poverty and 51% of women are limited on occasion from participation in daily activities by period symptoms. The Survey can be accessed at the following link: www.gov.ie/en/publication/f9e67-healthy-ireland-survey-2022/ .
The Health Behaviours in School-Aged Children Study (which will be published in early 2024) also included a module on period poverty; forthcoming results will give us more detailed information on its incidence in schools.
A Private Members’ Bill, the Free Provision of Period Products Bill, 2021, passed second stage in the Seanad and is now at Committee stage, having been supported by Government. Co-ordinated by the Period Poverty Implementation Group, work is ongoing to implement enabling Discussion Paper recommendations, including the resourcing and development of pilot projects across a number of sectors that will allow more accurate estimates of likely costs, prior to further progression.
1505. Deputy Danny Healy-Rae asked the Minister for Health to ensure funding is put in place for meals services (details supplied); and if he will make a statement on the matter. [56568/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday, 6 October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
1506. Deputy Sean Sherlock asked the Minister for Health the criteria for a medicine reimbursement application to be considered by the HSE’s products committee for reimbursement; the criteria for a medicine to be considered by the HSE’s Drugs Group; and if he will make a statement on the matter. [56569/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1507. Deputy Sean Sherlock asked the Minister for Health the criteria for which reimbursement applications may be eligible for a rapid review assessment only; and the criteria for referring medicines to carry out a full health technology assessment. [56570/23]
View answerThe Rapid Review process has been a core component of the NCPE’s assessment pathway for 14 years. It facilitates the identification of drugs which require additional assessment in the form of a full Health Technology Assessment (HTA), while maintaining a robust appraisal of the relevant clinical and economic evidence for drugs which do not require further assessment. It allows for appropriate resource prioritization within a national HTA agency and is considered to be an efficient way of determining the requirement for a full HTA and targeting resources for those drugs where there is most value in conducting a HTA.
The objective of the Rapid Review is to provide a recommendation to the HSE on the need for a full HTA and, in some cases, on reimbursement. Following the Rapid Review, a full HTA will subsequently be required for those drugs for which additional information and/or analysis is required to inform a reimbursement recommendation. Where a full HTA is not required, a reimbursement recommendation may be made to the decision-maker at this stage. Reimbursement decisions in Ireland are made by the HSE on the basis of decision-making criteria set out in the Health (Pricing and Supply of Medical Goods) Act 2013, which includes additional criteria to those assessed by the NCPE.
Factors which are evaluated during Rapid Review and thus inform the requirement for a full HTA include: the cost of the drug relative to potential comparators; uncertainty in relation to comparative clinical effectiveness; uncertainty in relation to cost effectiveness; and the potential drug budget impact. Further details in relation to Rapid Review recommendations and interpretation are outlined in a recent journal article authored by NCPE staff which is available here: doi.org/10.1007/s40273-021-01093-8 .
The Framework Agreement on the Supply and Pricing of Medicines (2021-2025) outlines that the NCPE endeavour to complete the Rapid Review within a 4-week timeframe. The NCPE review process involves critical appraisal of the Applicant submission using standard formal criteria, independent targeted literature review, validation of inputs and assumptions and independent clinical opinion. In summary, the formal criteria assessed by the NCPE Review Group include:
• The disease epidemiology and the eligible population.
• The licensed indication and the proposed place in therapy of the pharmaceutical within relevant treatment guidelines and clinical pathways.
• Potential comparators (defined as current standard of care treatments). Clinical opinion may be sought to establish clinical pathways and current standard of care for patients in Ireland.
• The robustness of the clinical and safety evidence, in particular whether there is direct clinical trial evidence versus current standard of care to determine comparative effectiveness and safety.
• Economic considerations, including the cost of the drug relative to potential comparators, and net and gross drug budget impact estimates.
• Other indications for which the drug is being investigated or for which a license is sought.
• The outcomes of HTAs from other jurisdictions, if available at the time of assessment.
• The critical appraisal of the Rapid Review submission determines the requirement for a full HTA. The criteria that may deem a full HTA unnecessary in order for reimbursement to be recommended at this stage are:
• Robust clinical efficacy data indicating that the drug is non-inferior or is superior relative to the standard-of-care comparator(s) while being equal or lower in cost;
• A small eligible population with an unmet need and a low estimated net drug budget impact.
• A low estimated net drug budget impact, along with the potential for a system to allow usage to be restricted to particular subgroups or indications (e.g. via the High Tech Hub or a Managed Access Programme). This may facilitate a positive recommendation. Here, the NCPE will recommend reimbursement if a process may be introduced to ensure that the appropriate place in therapy / net drug budget impact may be realised as outlined in the Applicant submission.
• Similarly, where there is no evidence of therapeutic advantage associated with a drug that is considerably more expensive than the appropriate comparator(s), a full HTA may be deemed unnecessary in order to make a recommendation against reimbursement.
• Where the clinical efficacy and safety is similar to current standard of the care, the NCPE may advise a price reduction (so that the drug is equal or lower in cost relative to the comparator) in order to recommend reimbursement.
• Therefore, there are multiple criteria involved in the determination of the Rapid Review recommendation and this is made by careful consideration of the evidence and the experience and judgement of the NCPE Review Group.
1508. Deputy Sean Sherlock asked the Minister for Health the steps he is taking to ensure equality of access to medicines between public patients and private insurance payers for oncology medicines, in view of the fact that private insurers have declared they will make medicines available post-licencing by the European Medicines Agency on an individual patient-basis, and public patients do not avail of these medicines approximately two years post-licensing by the European Medicines Agency; and if he will make a statement on the matter. [56571/23]
View answerThe Health (Pricing and Supply of Medical Goods) Act 2013 provides a rigorous process for the assessment of new medicines for reimbursement. This allows taxpayers to be confident both that the right medicines are chosen, and that those medicines are approved at a price that can sustainably be afforded in a budget-limited health service. Economic assessment is valuable to stretch the funds granted to the HSE as far as possible, allowing them to provide a range of services as well as innovative medicines for all citizens.
The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the 2013 Act. Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency (EMA) or the Health Products Regulatory Authority. In line with the 2013 Act, and the national framework agreed with industry, a company must first submit an application to the HSE to have a new medicine added to the reimbursement list.
The timing of company applications for reimbursement in different countries can vary for a number of reasons, not least the available market share in each country. Once a company responsible for the commercialisation of a new medicine receives market authorisation, it can apply for reimbursement in the country (or countries) of its choice. Ireland, by virtue of its size and market share, may not always be prioritised by a company in the first stages of marketing a new product. Describing timelines for reimbursement from EMA approval to HSE reimbursement approval does not consider this important factor and misrepresents the process, as statutorily the HSE is precluded from approving or assessing a drug for reimbursement a drug until an application is received from the company holding the market authorisation.
When an application is made to have a product added to the reimbursement list in Ireland, the HSE is required, under the 2013 Act, to decide within 180 days of receiving the application, to either add the medicine to the reimbursement list or refuse to reimburse the medicine. In assessing the application, the HSE is required by statute to consider a range of criteria including the magnitude of the clinical effect, cost effectiveness, budget impact, opportunity cost and unmet need.
The principal factors in determining how quickly a reimbursement decision is made are the price at which a manufacturer applies for the reimbursement of a product and the level of engagement by the applicant company with the HSE’s rigorous assessment process as to its clinical and cost-effectiveness.
In terms of the time taken from application to a decision on reimbursement, the HSE advise that the biggest impediments to achieving the 180-day timeline is often the failure of companies to provide sufficient evidence to support the efficacy of some medicines, and the need for the HSE to get involved in protracted negotiations in seeking to achieve better prices for the State.
In 2024, there will be significant investment in additional staff resources to enhance the HSE’s medicines pricing and reimbursement process. This is a recommendation of the working group established following the publication of the Mazars ‘Review of the Governance Arrangements and the Resources in place to support the HSE’s reimbursement and pricing decision-making process’ in February 2023.
Investing in this capacity will support agencies to operate to the fullest of their ability, providing timely and efficient evaluation of medicines for reimbursement.
The State?is committed to providing timely access to new and innovative medicines to all patients. Budgets 2021 - 2023 provided almost €100 million of dedicated funding for new drugs. This enabled the HSE to approve 148 new drugs, 61 of which are for cancer.
I have secured a further €20 million in funding for new medicines in 2024. I will also ensure that my Department, the HSE and all relevant agencies and stakeholders place a priority focus on achieving the most efficient and effective use of available resources across the acute and community settings, supporting cost reduction which can then be considered for reinvestment, as appropriate.
As Minister for Health, I regulate the private health insurance market. This is a voluntary market, which is underpinned by certain principles, including minimum benefit, that are set out in law. The Health Insurance Act 1994 (Minimum Benefit) Regulations 1996 require insurers to offer a minimum level of cover to every insured person. I do not have a role in the commercial decision-making of any private health insurer.
Private Health Insurance companies operate as commercial entities in a competitive private health insurance market. Beyond prescribing under the Regulations the minimum level of coverage that health insurers must provide, I am not in a position to direct any insurer to provide cover for any particular procedure or service or medicine, or direct how that cover is to be provided.
1509. Deputy Róisín Shortall asked the Minister for Health if he is aware of public hospitals refusing GP referrals for DEXA scans (details supplied); the reason for this policy in a number of hospitals; the steps being taken to address this; and if he will make a statement on the matter. [56579/23]
View answerAs this Parliamentary Question relates to an operational issue, it is a matter for the HSE. However, members of the Oireachtas are advised that the HSE is currently not in a position to answer PQs due to industrial action. It is hoped that normal services will resume soon. In the meantime, this Department will continue to refer PQs to HSE for their direct reply as soon as possible.
1510. Deputy Sean Sherlock asked the Minister for Health the amount that was paid by the HSE to recruitment companies in each month in 2023; the specific areas for which these companies were recruiting in the health service; and the number of staff that were successfully recruited each month for the same period, in tabular form. [56583/23]
View answerAs this Parliamentary Question relates to an operational issue, it is a matter for the HSE. However, members of the Oireachtas are advised that the HSE is currently not in a position to answer PQs due to industrial action. It is hoped that normal services will resume soon. In the meantime, this Department will continue to refer PQs to HSE for their direct reply as soon as possible.
1511. Deputy Jennifer Murnane O'Connor asked the Minister for Health the steps he is taking to address the significant rise in sexually transmitted diseases (details supplied); if he intends to launch a new public health campaign to highlight this rise and encourage safe sex practises and testing; the status of the new national sexual health strategy; the timeline he is working towards; and if he will make a statement on the matter. [56593/23]
View answerThe National Sexual Health Strategy, 2015-2020, (NSHS), was launched in October 2015 and is implemented by the HSE Sexual Health and Crisis Pregnancy Programme (SHCPP), who oversee sexual health services.
Following stakeholder consultation and an independent review, the Strategy is currently being refreshed; an updated version is currently being drafted and will be published in Q1-2, 2024. The Review of the NSHS, conducted by Crowe Ireland and published in March, 2023, identified 56 Priority Actions, of which 49 were assessed as having been successfully progressed.
STI rates, which are rising both nationally and internationally, will be considered as a priority in redrafting the NSHS as will resourcing for STI prevention, testing, diagnosis and treatment.
Current priority sexual health deliverables include:
• Providing sexually transmitted infection (STI) services, including HIV, through the national network of 23 STI clinics and through additional capacity for the free home STI testing scheme. An additional €720,000 has been allocated for this in Budget 2024 ;
• HIV prevention, including HIV Fast-Track Cities, Pre-Exposure Prophylaxis (PrEP) and Post Exposure Prophylaxis (PEP) programmes, research and public information campaigns to counter stigma. An additional €600,000 to support PrEP services was allocated in Budget 2024;
• Expanding access to free contraception, through the free contraception scheme for women and National Condom Distribution Service (NCDS). The free contraception scheme will be expanded to include 31 year-olds on 1st January, 2024;
• Prioritising monitoring, evaluation and research regarding sexual health, including progressing a comprehensive population survey on sexual health;
• Monitoring emerging STIs and changes in pathogenicity and/or transmissibility of existing pathogens;
• Improving sexual health education, training and resources, including schools, higher and further education, through www.sexualwellbeing.ie , in partnership with relevant NGOs, through the HSE Education Support Team in partnership with the DoE, NCCA and PDST and through resources such as Spun Out, Jigsaw, Busy Bodies, Making the Big Talk Many Small Talks, and more.
• Developing a Model of Care for sexual health services
The free home STI testing scheme was launched on a nationwide basis in October, 2022 and is available in every county across Ireland. Anyone who is aged 17 or over can order a free STI test to their home or to any other valid postal address in Ireland. Further information on how to access this service can be found at www.sexualwellbeing.ie .
The scheme has been very successful, adding circa 33% of additional STI testing capacity nationally. Those experiencing a reactive result are invited for in-person appointments at one of the 23 public STI clinics for confirmatory testing and treatment, if indicated.
Communication campaigns and information resources regarding STIs are ongoing and include national campaigns such as #Respectprotect for young audiences (18-30 years) and Man2man.ie for gay, bisexual and other men who have sex with men (gbMSM). Comprehensive information on sexual health and wellbeing, contraception and how to access sexual health services is available on www.sexualwellbeing.ie
The #Respectprotect campaign for young adults is supported by a Sexual Wellbeing outreach team who attended college and nightlife events and concerts to promote safer sex messages, promote access to condoms and lubricant and STI/HIV testing.
The Gay Health Network (GHN) and the HSE work in partnership to deliver the man2man.ie national website and online campaigns to raise awareness about HIV/STIs and prevention, including PrEP, PEP, condom use and testing.
Despite huge advances in HIV treatment, there is a continued existence of HIV-related stigma in Irish society, with a significant impact on people living with HIV. A national HIV stigma campaign in early 2020 focused on the fact that someone on effective treatment cannot pass on HIV to partners, referencing the U=U (undetectable = untransmittable) message. This message continues to be promoted through communications campaigns, with an extended stigma campaign with gbMSM is under development, in collaboration with the gbMSM community.
The HSE is involved in several projects that aim to reduce HIV-related stigma and discrimination in healthcare settings, including an intervention mapping approach to reduce HIV-related stigma in a hospital setting (led by NUIG), and the development of a HIV stigma education module (led by RCSI).
HIV and STI rates are monitored by the Health Protection Surveillance Centre; summary annual reports and weekly STI reports are published and available on the HPSC website at www.hpsc.ie/ .
1512. Deputy Pádraig O'Sullivan asked the Minister for Health if he has approved staff for the HSE and the NCPE to work on the reimbursement system; the number of staff approved; if he can provide any additional information; and if he will make a statement on the matter. [56610/23]
View answerFollowing the announcement of the budget allocation for my Department, I have issued a Letter of Determination to the HSE outlining my priorities and funding levels for 2024. This will be the basis on which the HSE will draw up its National Service Plan (NSP) for 2024. The HSE is required to prepare and submit an NSP within 21 days of receipt of the letter of determination. Once I have agreed and signed off on it, the NSP will be published in due course.
1513. Deputy Pádraig O'Sullivan asked the Minister for Health if the additional €92 million allocated to health as part of the revised estimates volume will include funding for new drugs in 2024; how much of that funding will be allocated to new drugs; if he will provide further information and clarity on the matter; and if he will make a statement on the matter. [56612/23]
View answerA record almost €3 billion, nearly €1 in every 8 spent by the State on health, will be spent this year on medicines. This is an unprecedented level of investment in supporting patients through the availability of the latest and wide range of medicines.
It is important that medicines expenditure is sustainable for the State and that we strive to maximise the available investment. This will enable us to provide as many people as possible with access to the necessary medicines.
Over the last 3 years the State has invested €98 million in new medicines funding to provide 148 new medicines or extended uses for medicines.
In 2024, I have tasked the Health Service Executive, my department, and all relevant agencies and stakeholders to place a priority focus on achieving the most efficient and effective use of available resources. This will require opportunities for savings to be identified and implemented.
€20 million of dedicated funding has been allocated for new medicines in 2024. I have also asked the HSE to ensure it realises at least €10 million in new additional efficiency gains. This money will be re-invested in new drugs and will ensure that the substantial investment in medicines is maximised to treat even more patients with new therapeutic innovations in the years to come.
1514. Deputy Colm Burke asked the Minister for Health if he will increase investment in mental health, including children’s mental health, to ensure that the overall annual allocation for mental health is in line with recommendations made by the WHO and under Sláintecare; and if he will make a statement on the matter. [56623/23]
View answerThe 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 increase in funding for mental health services represents a significant investment which 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 part of the funding allocated to mental health services, new development funding has been secured to advance initiatives on youth mental health, and around priority groups identified within our national suicide prevention strategy Connecting for Life. This new development funding will be focused on increased CAMHS staffing, a new Youth Mental Health app, a referral pilot for children's community services including CAMHS (piloting an approach to service referrals known as ‘No Wrong Door’), the expansion of Suicide Bereavement Liaison Services, and expanding the Traveller Counselling Service to achieve national coverage for the first time.
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.
It should be noted that funding for mental health supports is dispersed across many areas of Government, and there is no single headline funding figure which captures this important figure. For example, the figure of approximately €1.3bn above does not include funding for other parts of the health service that provide mental health services and supports, such as psychotropic medicines funded by the Primary Care Reimbursement Service, liaison mental health services in acute hospitals, some dual diagnosis (addiction and mental health) services, and mental health and well-being promotion.
It also does not include spending by other departments on services that incorporate psychological or mental health supports, such as the Prison and Probation Services, Social Protection, Defence Forces, or the Department of Education.
1515. Deputy Colm Burke asked the Minister for Health if he will create a ring-fenced budget for children’s mental health; and if he will make a statement on the matter. [56624/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday, 6 October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
1516. Deputy Colm Burke asked the Minister for Health if he will take the necessary steps to ensure that expenditure on children’s mental health is made more visible and transparent, including in the annual health budget and via the HSE’s National Service Plan; and if he will make a statement on the matter. [56625/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday, 6 October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
1517. Deputy Colm Burke asked the Minister for Health to provide specific data to identify and track how funds allocated to children’s mental health are spent and what the associated outcomes are for children; and if he will make a statement on the matter. [56626/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday, 6 October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
1518. Deputy Colm Burke asked the Minister for Health if he will put in place a standard operating procedure across all CAMHS teams, without exception, ensuring that all children in all areas receive the same high-quality service and that all staff members are following the same referral criteria in order to guarantee the same quality of care; and if he will make a statement on the matter. [56627/23]
View answerAs the Deputy will be aware, this Government is committed to improving all aspects of Mental Health care, including that for CAMHS and wider youth mental services. This is reflected by the significant new service developments for CAMHS arising from Budget 2024, along with various other initiatives being progressed by the HSE. This includes, for example, the recently established Child and Youth Mental Health Office within the Health Service Executive (HSE), implementation of relevant parts of the national policies Sharing the Vision and Connecting for Life, and the HSE progressing lessons arising from recent report and audits on CAMHS.
I have asked the HSE to respond directly to the Deputy as soon as possible, in relation to the more detailed operational aspects of the matter raised by him.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday, 6 October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
1519. Deputy Colm Burke asked the Minister for Health if he will review the operation of CAMHS in line with Mental Health Commission recommendations, noting that the current model of care places the onus on a single professional; if he will consider a more multi-disciplinary approach in line with other European countries; and if he will make a statement on the matter. [56628/23]
View answerThe Mental Health Commission final report on Child and Adolescent Mental Health Services (CAMHS) in the State was a welcome contribution to a common objective of improving CAMHS services. Of the 49 Recommendations, many are already being progressed under workstreams arising from the Sharing the Vision Implementation Plan, the Maskey Report, the HSE CAMHS Clinical Operating Guideline (COG) audit and the HSE national audit of prescribing practice. Publication of the HSE CAMHS COG audit is imminent and will offer an insight into the multidisciplinary practices across teams nationally. The purpose of the HSE CAMHS COG is to provide consistency in the service delivery of CAMHS throughout the country. This Operational Guideline applies to all staff engaged in the delivery of CAMHS by, or on behalf of, the HSE in Community and Inpatient settings and ensures a multidisciplinary focus on service delivery. Each CAMHS team has clear accountability structures in place to achieve the delivery of high-quality, safe and reliable services. The Consultant Psychiatrist is the Clinical Lead on the team. Each member of the CAMHS team also has a professional and management reporting relationship through their discipline-specific line management structure. Each member of a CAMHS team has the professional responsibility to carry out clinical work with children and adolescents within their scope of practice, as defined by their professional and regulatory bodies such as the Medical Council, the Health and Social Care Professionals Council (CORU), the Nursing and Midwifery Board of Ireland (NMBI) and the Psychological Society of Ireland (PSI). Each individual CAMHS team member knows their responsibility, level of authority and to whom they are accountable.
The Mental Health Commission plays a vital independent role in supporting and assisting the Department of Health and the HSE in developing and improving mental health services. Both I and the HSE share the Commission’s commitment to ensure the safest and most effective service for children. To this end, on foot of the Maskey report I had extensive engagement with the Commission and encouraged them to undertake a comprehensive review of children’s mental health services as the topic for their annual mental health services review. I was also pleased to offer the necessary resources to the Mental Health Commission to enable this comprehensive review to take place, running in parallel with the HSE national CAMHS audits.
While the Mental Health Commission Interim Report highlighted concerns regarding service delivery and administrative practices in five CHOs, many of these related to operational issues within CAMHS teams that have been recognised and resolved. It is reassuring that the final report identified evidence of clinical audits of open cases during the review of the final four CHOs. This final report, along with the interim report, highlight concerns regarding gaps in governance at corporate and clinical level across CHOs. In highlighting these areas where practices can, and should, be addressed, the Commission provides an opportunity to ensure that the HSE’s services are improved, including a commitment to a multidisciplinary model of care and support.
In addition, the recognition of the need to strengthen the leadership and multidisciplinary focus on CAMHS is evidenced by the establishment of a new Child and Youth Mental Health Office in the HSE and the recent appointments of an Assistant National Director for Child and Youth Mental Health and a Clinical Lead for Child and Youth Mental Health. I believe these recent appointments in senior leadership roles within mental health will further strengthen the national leadership across our mental health services to support all CAMHS practitioners.
The Department of Health looks forward to working with the HSE in the implementation of the Child and Youth Mental Health Service Improvement Programme, which is an initiative to build capacity in CAMHS and Youth Mental Health. The initiative, aims to make services more responsive by recruiting additional expert staff, expanding teams, developing specialist services and clinical programmes and further developing suicide prevention initiatives and primary care mental health services.
I look forward to continuing to engage with the HSE, and specifically with the new office for youth mental health, to ensure that our CAMH services are continually improved with a strong focus on consolidation of the multidisciplinary team and a multidisciplinary model of care.
1520. Deputy Colm Burke asked the Minister for Health if he will investigate professional misconduct within CAMHS in a timely manner in order that the trust of parents and children may be restored; and if he will make a statement on the matter. [56629/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday, 6 October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
1521. Deputy Colm Burke asked the Minister for Health if will consider establishing a national heart failure registry to equip planners and healthcare professionals with the necessary information for the purposes of reducing excessive mortality and curtail hospital admission rates; and if he will make a statement on the matter. [56631/23]
View answerHeart Failure is an important public health issue. The detection and prevention of heart failure is a priority, and the National Clinical Programme for Heart Failure supports many approaches to improving the quality of life for people living with the syndrome. The programme (HSE) is currently engaging with the European Society of Cardiology who have developed a platform to enable registry development on not only heart failure but other cardiovascular conditions. The National Heart Programme are working to initiate the EuroHeart programme cardiovascular database project in Ireland.
There are clear, evidence-based guidelines and excellent Irish case studies of effective models of care in heart failure. Further focus and development will prevent unnecessary hospitalisations and deaths and maximise people’s quality of life.
To understand the remaining challenges, a National Review of our adult Specialist Cardiac Services, which includes heart failure, was commissioned. The Review’s recommendations will inform the future provision of cardiac services nationally including requirements for data to support development. The Report has been presented to my office, which is now under my consideration.
