Written Answers Nos. 51-70
51. Deputy Mark Ward asked the Minister for Health for an update on National Clinical Programme funding for eating disorders for 2024; the level of new funding for eating disorders; when the National Clinical Programme will be operating at full capacity; and if he will make a statement on the matter. [1334/24]
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 6th 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.
52. Deputy Ruairí Ó Murchú asked the Minister for Health to provide an update on the establishment of his Department's 'savings and productivity taskforce'; and if he will make a statement on the matter. [2016/24]
View answerThe establishment of the Taskforce is a recognition that despite the unprecedented growth in service provision in the last three years, the health services face considerable pressures, both demographic and inflationary.
The Taskforce will aim to realise savings and maximise productivity across the health services, including, workforce optimisation and procurement. There will also be an emphasis on the future cost of health care, which will consider amongst other things, the impact of demographics and emerging technologies on the health care services of the future.
The Taskforce will compliment ongoing projects in areas such as, the reduction in the health services’ medicines budget, the reduction in both agency and management consultancy costs and the accelerated roll-out of the HSE’s Integrated Financial Management System
A Memorandum for Government in respect of the Taskforce has been prepared for submission to Cabinet for information. It is expected that the memorandum will be submitted to Cabinet in the coming weeks. Work will commence soon on establishing the teams who will have responsibility for driving productivity gains and cost savings across the Taskforce's various strands.
53. Deputy Matt Carthy asked the Minister for Health further to Parliamentary Question No. 508 of 5 December 2023, which centre the two CT scanners and one MRI scanner are based in within the Cavan and Monaghan Hospital group; if a request has been made for additional MRI or CT scanners to be located at Monaghan Hospital; and the status of any such request. [1958/24]
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.
55. Deputy Alan Farrell asked the Minister for Health to provide an update on the use of home STI testing kits; and if he will make a statement on the matter. [1442/24]
View answerFollowing a successful initial pilot in Cork, Kerry and Dublin, funded by the Sláintecare Integration Fund in 2021, the free home STI testing service was gradually expanded in 2021-2022, and launched nationally in October, 2022. €3.5m was allocated to support the scheme in 2023
The scheme has been very successful, adding approximately 33% to national testing capacity. Additional funding of €720,000 to support increasing demand for the scheme has been allocated through Budget 2024, bringing funding this year to €4.22m.
In 2022, through the home STI testing service, 91,123 STI test kits were dispatched, with 4,121 cases of chlamydia and 933 cases of gonorrhoea identified through the service, accounting for approximately 38% and 23% of the notifications for these infections respectively. Preliminary figures for 2023 indicate that just under 110,000 kits were dispatched.
The scheme is reaching many who may have been reluctant to visit STI clinics in person, with more STIs being detected and treated. Approximately 10% of service users are experiencing reactive results. Those receiving reactive results are referred to an in-person STI clinic for confirmational testing, and treatment if required. Since late 2023, on a pilot basis, users with a positive chlamydia result are offered the option of an online assessment and prescription to a community pharmacy of their choice or referred to a participating clinical service for the appropriate follow up and clinical management.
The National Condom Distribution Scheme supports both STI prevention and accessible contraception for men and their partners. Free condoms can be accessed through the national network of STI clinics, participating charity and NGO partners and on participating 3rd level campuses. Since 2023, free condoms have also been supplied with orders for free home STI testing kits.
Whilst STIs are usually easily treatable when detected early, many STIs can cause serious health issues, if undetected and untreated for longer periods of time. STIs are often asymptomatic. The key prevention messages are to use condoms for vaginal, oral and anal sex, and to get tested if experiencing possible STI symptoms, when changing sexual partners, in the event of having multiple, sequential or overlapping partners or if a partner (or former partner) has been diagnosed with an STI.
The ongoing nationwide STI prevention campaign, through www.sexualwellbeing.ie, promotes condom use and free home STI testing alongside a range of other messages supporting positive sexual health and information on how to access testing, treatment, contraception and other related sexual health services. The Health Protection Surveillance Centre provides weekly and annual reports on rates of STI infection nationally, available through www.hpsc.ie/.
56. Deputy Brendan Griffin asked the Minister for Health the up-to-date position regarding the opening of additional beds at West Kerry Community Hospital, Dingle, County Kerry; and if he will make a statement on the matter. [2063/24]
View answerWest Kerry Community Hospital provides important and valued services for people in the West Kerry area. The hospital has 46 beds registered, of which 35 are long-stay beds and 11 are short-stay beds, including 2 respite and 1 palliative care bed. The maximum number of people that can be safely accommodated in the hospital are currently being accommodated.
The intention of the HSE is to continue to sustain the current workforce to maintain the 46 beds in the centre into the future. Considerable efforts are also being made to increase staff numbers and bed capacity in West Kerry as well as facilitating clear pathways for the transition of patients from the acute sector to the community.
However, similar to other hospitals in remote locations, staff recruitment challenges have unfortunately had an impact. Cork Kerry Community Healthcare continues to endeavour to recruit staff to increase the number of community beds for the region and maximise the services available. The HSE will continue to seek qualified and interested candidates through recruitment campaigns undertaken at the national, regional, and local level.
57. Deputy Gino Kenny asked the Minister for Health if he is aware that the NCHDs in an organisation (details supplied) have said that they expect to call a ballot for industrial action in response to the recruitment freeze announced recently; and if he will make a statement on the matter. [1650/24]
View answerIn May 2023, an instruction issued from the CEO of the HSE to temporarily pause recruitment across Managerial/Administration grades. This was part of a suite of control measures due to the HSE surpassing it's funded recruitment targets for the year.
By November 2023, the recruitment pause was further extended to include most staff categories, excluding Consultant appointments and Graduate Nurses and Midwives and Doctors in formal approved Training Programmes.
There has been significant and ongoing growth in NCHD numbers. As of October 2023, the total NCHDs workforce stands at 8,679 WTE. This is an increase of 664 WTE year-to-date (2023). Since 2019, NCHDs have grown by 1,883 WTE.
I established The National Taskforce on the Non-Consultant Hospital Doctor (NCHD) Workforce in September 2022 in order to enhance working conditions for NCHD's in Ireland. This is an ongoing process whereby I receive regular reports and updates from the Taskforce to implement improvements concurrently.
I am aware that on the 18th December 2023, the IMO announced that they expect to call a ballot for industrial action in the New Year in response to the current recruitment pause. It is essential that industrial peace is upheld in the interests of our health service. NCHDs are a critical part of the health service and the Government and I continue to recognise their importance.
58. Deputy Brendan Smith asked the Minister for Health when grant aid will be approved for smaller scale nursing homes to carry out upgrading work following the recommendations of HIQA; and if he will make a statement on the matter. [2050/24]
View answerOn December 19th, 2023, Minister Butler announced a new €10 million scheme to improve infection prevention and fire safety in private and voluntary nursing homes. The Nursing Home Resident Safety Improvement (RSI) Scheme will provide funding towards structural works carried out in compliance with standards published by the Health Information and Quality Authority (HIQA) under Regulation 27 (Protection against infection) and Regulation 28 (Fire precautions).
Up to €25,000 will be available to each qualifying nursing home for eligible works under this scheme. Nursing homes may also claim retrospectively for works covered by this scheme if they were carried out since 1 January 2020.
The commencement date for the RSI scheme is 1st January, 2024 and the closing date for receipt of applications is 15th November, 2024.
This scheme is a vouched scheme which is open to all operational voluntary and private nursing homes registered with HIQA and the National Treatment Purchase Fund (NTPF) as of 1 January 2024 and in receipt of payment under the National Nursing Homes Support Scheme (NHSS) for the provision of long-term residential care services.
The HSE will administer the scheme and make payments to the Nursing Homes. The National Treatment Purchase Fund (NTPF) will administer the application process and provide support and advice to the HSE.
Nursing homes whose applications are approved will have their payments processed and released on a quarterly basis by the Health Service Executive (HSE).
All funding through this scheme should be used to fund works in line with the Nursing Homes compliance plan outlined to HIQA as part of their inspection process.
The Budget 2024 allocation of funding for this scheme is €10 million. The total maximum amount that can be claimed by an individual nursing home under this scheme is €25,000.
Further details of Scheme rules and the application process are being finalised and will be circulated to all eligible Nursing Homes when available in the coming weeks.
59. Deputy Paul McAuliffe asked the Minister for Health for an update on the delivery of publicly funded IVF treatment. [2093/24]
View answerAs the Deputy may be aware, a commitment to “introduce a publicly funded model of care for fertility treatment” is included in the Programme for Government.
The Model of Care for Fertility was developed by the Department of Health in conjunction with the HSE’s National Women & Infants Health Programme (NWIHP) to ensure that fertility-related issues are addressed through the public health system at the lowest level of clinical intervention necessary.
This Model of Care comprises three stages, starting in primary care (i.e., GPs) and extending into secondary care (i.e., Regional Fertility Hubs) and then, where necessary, tertiary care (i.e., IVF and ICSI (intra-cytoplasmic sperm injection)), with patients being referred onwards through structured pathways.
Phase One of the roll-out of the Model of Care has involved the establishment, at secondary care level, of Regional Fertility Hubs within maternity networks, in order to facilitate the management of a significant proportion of patients presenting with fertility-related issues at this level of intervention. Patients are referred by their GPs to their local Regional Fertility Hub, which provides a range of treatments and interventions.
Phase Two of the roll-out of the Model of Care relates to the introduction of assisted human reproduction (AHR) treatment, including IVF, provided through the public health system at tertiary level. In particular, the first steps have been taken towards achieving the ultimate objective of Government, which is a wholly publicly-provided fertility service.
As an interim measure, funding has been made available to support access to AHR treatment via private providers. This publicly funded (privately provided) service commenced in September 2023. As well as IVF and ICSI, this allocation is being used to provide, initially through private clinics, IUI (intrauterine insemination), which can, for certain cohorts of patients, be a potentially effective, yet less complex and less intrusive treatment.
Referrals for AHR treatment by private providers commenced in the week beginning September 25th 2023 after details of how the new initiative would be initially rolled out – including regarding the set of criteria prospective patients should meet to access fully-funded AHR services and the specific services to be funded were agreed by the Department and NWIHP and agreed by Cabinet in July 2023. The criteria were agreed following consultation with experts in the field of reproductive medicine and include criteria in respect of the age of the intending birth mother, body mass index (BMI) and the number of children a couple already have. They are very much in keeping with those applied in other jurisdictions, even though in most European countries, for instance, such treatments are only partially funded and require often significant out-of-pocket payments by patients. More details on public fertility services including information on the new publicly-funded AHR treatment initiative, are available from the HSE at: www2.hse.ie/conditions/fertility-problems-treatments/fertility-treatment/ .
As expected, there has been a significant increase in the numbers of patients being referred from their GPs to one of the six Regional Fertility Hubs since the new AHR treatment initiative was announced. Many of these patients will be managed in these Hubs without the need to undergo invasive IVF or ICSI treatment. In total, as at the end of Friday, January 12th 2024, a total of 227 referrals for AHR treatment have been made by the Hubs, and this number should continue to increase over the coming weeks and months as the new service provision beds down further.
I want to reassure the Deputy that my Department and the Government are focused, through the full implementation of the Model of Care for Fertility, on ensuring that patients receive care at the appropriate level of clinical intervention and then those requiring, and eligible for, advanced AHR treatment such as IVF will be able to access same through the public health system. The underlying aim of the policy to provide a model of funding for AHR, within the broader new AHR regulatory framework, is to improve accessibility to AHR treatments, while at the same time embedding safe and appropriate clinical practice and ensuring the cost-effective use of public resources.
60. Deputy Pádraig O'Sullivan asked the Minister for Health if he will provide an update on the Strategic Review of General Practice; if he will outline the key stakeholders; when he expects the review to conclude considering the many issues facing GP practice and GP capacity at present; and if he will make a statement on the matter. [1979/24]
View answerThe Strategic Review of General Practice commenced last year and is currently underway. My Department are leading the review with HSE support and input from key stakeholders. As per the terms of reference, the key areas that will be examined are GP training, GP capacity, the eHealth agenda, Out of Hours reform, and the support model for General Practice. Key stakeholders include GP representative and training organisations, representatives of other healthcare professions, and representatives of other organisations actively engaged with general practice. Further information on the review is available from the Department's website.
The review is to be completed this year. Following it's completion a paper is to be presented to me outlining the findings of the review and setting out recommended actions to respond to the identified findings.
It is worth noting that the Government has undertaken measures to increase GP capacity and improved access to services. Increased annual investment of over €211 million was provided for under the 2019 GP Agreement, providing for increased GP fees, supports and new services. A further €30 million has been provided for under the GP Agreement 2023 for practice supports to expand and retain practice staff. The annual intake of doctors into the GP training programme has been increased by 80% from 2015 to 2023; there were 286 new entrants to GP training in 2023 and it is planned to increase the number of places for new entrants to 350 for this year. Furthermore, the joint HSE ICGP non-EU Rural GP Programme commenced last year with the intention of bring up to 100 non-EU GPs to Ireland in 2023, and it is planned to bring up to 250 more non-EU GPs here by the end of this year.
61. Deputy Marian Harkin asked the Minister for Health his views on the poor performance by the Government on the delivery of commitments and progress for family carers as outlined in the family carer scorecard 2023 published by an organisation (details supplied); and if he will make a statement on the matter. [1701/24]
View answerThe Government recognises the essential role that family carers play in the provision of care in Ireland. Every day, family carers through their selfless hard work, knowledge and compassion enhance the quality of life of the most vulnerable in our society. As highlighted by the Family Carers Ireland Scorecard 2023, responsibility for improving the situation for family carers is overseen by a number of different Government Departments. The Government acknowledges that there is still more work to be done and that it should be noted that many commitments are to be delivered over the lifetime of the Government. Nevertheless, much work related to the Programme for Government commitments has already been accomplished or commenced, as set out below.
Department of Health
Carers’ Guarantee
In the area of health, for which I am directly responsible, annually recurring funding of €2 million was provided in Budget 2021 under the National Carers’ Strategy to improve equity of access to supports for carers across the country. This funding is an important step towards delivering on the Programme for Government commitment to develop a Carers’ Guarantee, providing a more standard package of supports to family carers in every region, in tandem with the community and voluntary sector. €1.9 million of this funding is being channelled through Family Carers Ireland for the delivery of a broad range of supports to carers, while the remaining €100,000 is supporting the development and delivery of online supports through Care Alliance Ireland.
National Carers’ Strategy
Government policy on family carers is set out in the 2012 National Carers' Strategy which provides the strategic direction for future policies, services and supports provided by Government departments and agencies for carers. The Strategy is designed around a core vision which recognises and respects carers as key care partners who are supported to maintain their own health and well-being, care with confidence and participate as fully as possible in economic and social life. Oversight of the Strategy is led by my Department, with individual Government Departments leading on action areas that fall within their remit.
Extension of GP Visit Cards to carers in receipt of the Carer’s Support Grant
Since September 2018, individuals in receipt of either a full or half-rate Carer's Allowance or Carer's Benefit are automatically eligible for a GP visit card. On foot of this measure, as of December 2023, 7,098 people in receipt of either full or half-rate Carer's Allowance or Carer's Benefit have gained GP Visit Card eligibility. It is also noted that many carers may have already held a medical card or GP visit card prior to this policy change.
A range of other measures have also been introduced in recent years to expand access to GP Care including the automatic awarding of a GP visit card to all people over 70 in 2015 and as provided for in Budget 2023, eligibility for GP visit cards was extended to people who earn up to the median household income (€46,000 or less). Over 400,000 additional people, who otherwise would have attended their GP on a private basis, are expected to become eligible for free GP care under this expansion. It is envisaged that these measures will be supported by a significant package of additional capacity supports to GP practices.
It is likely that many of those currently in receipt of the Carer Support Grant will be among those positively affected by this expansion, although an estimate of the exact number is not currently available.
Commission on Care for Older Persons
On 3rd October 2023 the Government approved my proposal, in collaboration with the Minister of State for Older People, to establish an independent Commission on Care for Older Persons. The Commission will examine the provision of health and social care services and supports for older persons and make recommendations to the Government for their strategic development. Subsequently, a cross-departmental group will be established under the auspices of the Commission to consider whether the supports for positive ageing across the life course are fit-for-purpose and to develop a costed implementation plan for options to optimise these supports. €1.243 million was secured in Budget 2024 to support the work of the Commission, which is due to formally commence early this year.
Statutory Home Support Scheme
My Department is currently developing a regulatory framework for home-support providers with the aim of ensuring that all service-users are provided with high-quality care. This will comprise of primary legislation for the licensing of home support providers, regulations for home support which will set out the minimum requirements that a provider must meet to obtain a licence, and Health Information and Quality Authority national standards. The Heads of Bill are currently being drafted by my Department with a view to bringing the Heads of Bill to Government for approval early this year.
Mental Health Services
The National Treatment Purchase Fund (NTPF) works with public hospitals, to offer and provide funding for treatment to clinically suitable long waiting patients who are on an acute hospital inpatient/day case waiting list for surgery, having been referred on to such a list following clinical assessment by a consultant/specialist at an outpatient clinic. As psychological services are not inpatient/day case or outpatient waiting lists within an Acute hospital setting, they do not meet current NTPF criteria.
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. This will enhance the delivery of vital services to as many people as possible over 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 the 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. A priority for the HSE under its annual Service Plans is to improve access to the HSE Child Care Psychology service, and to the specialist CAMHS service, and to reduce waiting lists for both.
Department of Children, Equality, Disability, Integration and Youth
Disability Services
Budget 2024 saw further increases to funding for specialist disability services with a total of €2.8bn committed for next year across a range of service areas including residential, respite, children’s services, adult day services, personal assistance and home support. The precise level of delivery of services for people with disabilities, based on the funding provided in the Budget, will be set out in the HSE’s National Service Plan for 2024.
The Disability Action Plan 2024–2026, was published in December 2023. This plan supports the implementation of the Disability Capacity Review, in accordance with the Programme for Government commitment. The Action Plan sets targets for addressing demographic pressures, making significant progress on unmet needs, working to replace remaining congregated and institutional residential care with community-based models, and continuing the reform towards individualised, person-centred models of service while growing service capacity appropriately.
Residential Services
Demand for full-time residential placements within designated centres is extremely high. The HSE profiles those actively seeking specialist disability services, including residential services, using a profiling tool, the Disability Services Management Application Tool (DSMAT) which it has developed.
DSMAT is a support to the CHO areas in their decision-making processes, representing an indicator of need. This means that services are allocated on the basis of greatest presenting need and associated risk factors, noting that needs can change.
Residential services make up the largest part of the Specialist Disability Services funding disbursed by the HSE – approximately 58% of the total budget. Approximately 90 service providers provide residential services to over 8,000 individuals throughout the country. The HSE advise that, as of September 2023 there were 8,355 residential places for people with a disability, delivered predominantly by section 38 and section 39 organisations funded under the Health Act 2004.
In accordance with the National Service Plan 2023, the HSE received funding to provide a range of residential supports including:
• 43 additional residential places in response to current need (at end of September 2023, 103 new emergency residential places were developed).
• Support 18 delayed transfers of care in line with the Winter Plan (at end of September 2023, 27 people received new residential places with 3 further receiving home care packages).
• Provide 23 residential care packages to young people ageing out of Tusla services in line with the Joint Protocol (at end of September 2023, 25 packages were developed).
This reflects the Government commitment to augmenting disability services, with an overall increase in recent years from €1.7bn at the close of 2017 to close to €2.8bn in 2024. In residential services for adults and children, €20.5m in extra funding has been provided.
Respite Services
Successive Budgets have provided additional funding for respite services. €5m funding was provided in Budget 2021 for the development of nine additional centre-based respite services, along with a range of alternative respite projects including Saturday clubs, breakaway schemes, and summer schemes. In 2022, €9m was provided to further build the capacity of respite services for children and adults, as well as providing alternative models of respite.
In accordance with the National Service Plan 2023, the HSE:
• Established five additional respite services and increased one service from part time to full time opening to provide 7,872 additional nights to 278 people in a full year.
• Provided 27 additional in-home respite packages to children and young adults in a full year.
• Provided 265 day-only respite packages to 180 people in a full year.
Budget 2024 provided for an additional €15m in New Development funding for Respite. The HSE National Service Plan for 2024 will set out how this money will be spent in order to provide additional respite both as day sessions and overnight stays.
Day Services
HSE-funded day programmes for people with disabilities support over 20,000 people and include a range of centre-based and community-based activities. Substantial progress has been made over the past decade in supporting people to participate in mainstream activities and in the life of their community under the New Directions policy. Since 2015, a process to attend to the needs of young people leaving school and rehabilitative training programmes has been implemented, now known as ‘the school leaver process’. The Government has provided €18.2m in new development funding for school leavers in 2024.
Assessment of Need
The Government recognises the challenges around the Assessment of Need (AON) and acknowledges that there is more work to be done to address these challenges, particularly on waiting lists and the impact that high AON demand has on service provision. To address these issues, an allocation of funding in Budget 2023 and Budget 2024 was provided to facilitate CHOs to procure diagnostic ASD assessments through the private sector. The total amount involved was approximately €16m. Private providers are currently contracted by the HSE and Lead Agencies to provide assessments. The Roadmap for Services launched in October will be examining the matter of AON from a wider perspective than what has happened to date, with the future development of solutions to the challenges of AON taking account of all stakeholder input, including that of families.
Department of Social Protection
Enhanced State Pension Provision for Family Carers
The Government agreed to enhanced State Pension provision for people who have been caring for incapacitated dependents for over 20 years. It will do this by attributing the equivalent of paid contributions to long-term carers to cover gaps in their contribution record. This is the first time in the history of the State that such a scheme will be in place.
These contributions will be treated the same as paid contributions for State Pension (Contributory) entitlement only and can be used to satisfy the minimum 520 contributions condition. The Long-Term Carer's Contributions (LTCC) will be available to those who provided full time care for 20 years (1040 weeks) or more to an incapacitated dependent. The periods of caregiving do not need to be consecutive.
In September 2023, the Department of Social Protection introduced a system to allow carers to register their caring periods. This will facilitate the expeditious processing of LTCC upon enactment of the legislation. Individuals can apply for the long terms carers contributions at MyWelfare.ie
The legislation required to introduce the LTCC is contained in the Social Welfare (Miscellaneous) Bill 2023 and is currently in the Oireachtas, with the scheme being fully implemented from January 2024.
Income Supports
The Carer’s Allowance is the main scheme by which the Department of Social Protection provides income support to carers in the community. Carer’s Allowance is a support for carers on low incomes who live with and look after people who need full-time care and attention. In 2023 the expenditure on the Carer’s Allowance scheme is estimated to be over €1 billion. At the end of November 2023 there were 95,598 recipients of Carer’s Allowance.
The conditions attached to payment of Carer’s Allowance are consistent with the overall conditions that apply to social assistance payments generally. This system of social assistance supports provides payments based on an income need with the means test playing the critical role in determining whether or not an income need arises as a consequence of a particular contingency, be that illness, disability, unemployment or caring. The application of a means-test not only ensures that the recipient has an income need but also that scarce resources are targeted to those with the greatest need.
Over the last number of Budgets, the Government has introduced many increases and once-off payments to support carers. Significant improvements to capital and income disregards for carers were also made over the last few years. Since June 2022, cumulative increases to the Carer’s Allowance income disregards of €117.50 for a single carer and €235.00 for a carer who is part of couple. These are the highest income disregards in the social welfare system.
It is important to note that there are a range of other supports for carers provided by the Department of Social Protection which are not based on a means assessment, such as the Carer’s Support Grant, Carer’s Benefit and Domiciliary Care Allowance.
Department of Rural and Community Development
Seniors Alert Scheme
The Department of Rural and community Development is responsible for the Seniors Alert Scheme (SAS) which encourages community support for vulnerable older people in our communities through the provision of personal monitored alarms to enable them to live securely in their homes with confidence, independence and peace of mind. Funding is available under the scheme towards the purchase by a registered community-based organisation of a personal alarm or pendant.
The current version of the scheme came into effect in September 2021 and along with the provision of free monitoring for the first year and a revision of the living alone requirements, introduced a new key feature in the additional option of a digital alarm, for use with web-based connections.
The SAS is a demand–led scheme, and at the moment, everybody that has applied to the scheme, and who meets the eligibility criteria, has been approved. Since 2016, and as of November 30 last year, almost 122,000 participants have been approved for the Scheme nationally.
Initial discussions have taken place between officials from my Department and the Department of Rural and Community Development to consider the potential role of the SAS as part of the increased use of assistive technologies aimed at supporting people to continue to live independently within their communities.
In addition, a national publicity campaign will be launched shortly, to further raise awareness around the scheme and encourage families and individuals to avail of this potentially lifesaving equipment. While the campaign will have a national reach, it will have a particular focus on the regions with current low take up and will be availing of the most recent census data in this regard.
Department of Education
Appropriate School Places
Over the last number of years, the Department of Education and the National Council for Special Education (NCSE) have introduced a number of strategic initiatives to plan for and provide sufficient special class and special school places. These initiatives are bearing fruit with almost 1,300 new special classes sanctioned and seven new special schools established over the last four years.
The Department of Education engages intensely with the NCSE in relation to the forward planning of new special classes and additional special school places. This forward planning work is well underway ahead of the 2024/25 school year. As a result of this forward planning, in 2023, the Department of Education announced the establishment of two special schools for the 2023/24 school year, with further capacity being expanded in 11 other special schools. In December 2023 a further four special school were announced for the 2024/25 school year. Along with the two new special schools, 386 new special classes – 252 at primary and 134 at post-primary level – have been sanctioned by the NCSE to open in the 2023/24 school year.
Department of Finance
Home Carer Tax Credit
Significant progress has been made to increase the Home Carer Tax Credit (HCTC) over the last two Budgets to support stay-at-home parents and those with caring responsibilities. In Budget 2023 the HCTC was increased by €100 from €1,600 to €1,700 per annum, which equated to a 6.3 per cent increase and benefitted approximately 67,000 households, primarily married one-earner couples with children. Likewise, in Budget 2024 the HCTC was increased by a further €100 from €1,700 to €1,800, per annum, which represented a 5.9 per cent increase and is estimated to benefit around 80,500 households.
Department of Housing, Local Government and Heritage
Housing Adaptation Grant Scheme
Funding for the Housing Adaptation Grants for older people and people with a disability has been increasing year on year since 2014. The 2024 Exchequer provision is €74.5 million or €93.125 million when accounting for the 20% local authority contribution. This is an Exchequer increase of €8 million in 2024 and will facilitate the payment of over 13,000 grants.
Since the launch of the scheme in November 2007, significantly increased levels of activity continue to be experienced by local authorities with over 150,000 grants being paid to older people and disabled people. This has facilitated those applicants to remain in their own homes and communities, and in many cases preventing premature entry to residential care.
Ensure appropriate mix of housing, including universally designed units and accommodation for older people/disabled people
The Department of Housing, Local Government and Heritage jointly published the National Housing Strategy for Disabled People 2022-2027 with my Department and the Department of Children, Equality, Disability, Integration and Youth in January 2022 and jointly published the National Housing Strategy for Disabled People 2022 – 2027 Implementation Plan on 22 June 2023.
The Strategy and Implementation Plan will operate under the framework of Housing for All-A New Plan for Ireland, published in September 2021, which provides a new housing plan for Ireland to 2030 with the overall objective that every citizen in the State should have access to good quality homes through a steady supply of housing in the right locations, with economic, social and environmental sustainability built into the system. The strategy sets out, over four pathways, a broad suite of measures to achieve its policy objectives together with a financial commitment of in excess of €4 billion per annum. The Plan is committed to ensuring that affordable, quality housing with an appropriate mix of housing design types provided within social housing, including universally designed units, is available to everyone in Irish society, including disabled people.
The Building Regulations - Part M (Access and Use) already underpins the principle of Universal Design. In addition, the Design Manual for Quality Housing provides practical information on delivering quality housing for sustainable communities which includes how the principles of universal design may be economically incorporated into dwellings. The design approach to social housing seeks to eliminate barriers to accessibility for all users – particularly disabled and older people.
The Design Manual is intended to guide local authorities and Approved Housing Bodies, and their consultants, on the design of social housing including the internal layouts of individual social homes. The manual includes guidance on the approach to ‘Housing for People with Disability’ and specific design approaches developed with the input of the Centre for Excellence in Universal Design in the National Disability Authority.
62. Deputy Mark Ward asked the Minister for Health for an update on the National Clinical Programme funding for self-harm and suicide related Ideation; the level of new funding for self-harm and suicide related ideation; and when the National Clinical Programme will be operating at full capacity. [1335/24]
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 6th 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.
63. Deputy Alan Dillon asked the Minister for Health for an update on plans to provide additional bed capacity at Mayo University Hospital; and if he will make a statement on the matter. [2012/24]
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.
64. Deputy Marian Harkin asked the Minister for Health in response to the recent ESRI report on the provision of long-term residential care, what plans are being put in place to secure sufficient long-term care capacity in the north west region, in particular, and in other more rural counties; and if he will make a statement on the matter. [2085/24]
View answerAs Minister for Mental Health and Older People, I welcome the recent ESRI report: Long-term Residential Care in Ireland: Developments since the onset of the Covid-19 pandemic. The report brings into focus some the challenges facing the long-term residential care sector in Ireland which the Government continues to address to provide short-term stability and long-term growth to this sector.
Long-term residential care is a crucial part of the overall continuum of care and public Community Nursing Units (CNU) play a vital role in the provision of long-term care across the country. The Government is committed to continued investment in healthcare infrastructure which supports the highest quality care for our older population and provides equitable access to this care in every region, including the north-west.
This investment includes the CNU programme, which was launched to ensure that up to 90 of our public Community Nursing Units would be refurbished or replaced to ensure the best quality environments for our older people. As of Q3 2023, 47 projects have reached construction completion. Construction is under way on several more facilities, while the remainder are at various stages of review, appraisal, design, and tender.
A clear indication of the Government’s desire to plan appropriately for the future, in the context of an ageing population, is the update of the 2018 Health Service Capacity Review, which is currently being progressed. This is particularly important given changes in the health and wider operating environment since the original 2018 review was undertaken. This work will forecast future capacity requirements in acute care, primary care, and in social care services for older persons (residential and homecare services) up to 2040.
Government has also approved the creation of Regional Health Areas, requiring significant restructuring of health and social care organisation in Ireland, underpinned by regional population-based planning and resource allocation models. A national framework for health and social care capacity planning, creating the tools and infrastructure to support consistent, data driven, regional planning will be a critical success factor for this work.
High-quality design, planning, and construction is vital in creating safe environments that enable high quality residential care for older people. I have therefore committed to creating new design standards for long-term residential care settings for older people (public, private, and voluntary).
On the 19 December 2023, I announced a public consultation on a Design Guide for Long-Term Residential Care Settings for Older People. The Department of Health, in conjunction with the Health Service Executive (HSE) and the Health Information and Quality Authority (HIQA), is currently seeking the views of the public on a draft Design Guide for Long-Term Residential Care Settings for Older People and the feedback received will inform the final version of the design guide.
65. Deputy Aindrias Moynihan asked the Minister for Health what measures are being taken to ensure adequate GP services available in County Cork; and if he will make a statement on the matter. [2031/24]
View answerGPs are self-employed practitioners and therefore may establish practices at a place of their own choosing. There is no prescribed ratio of GPs to patients and the State does not regulate the number of GPs that can set up in a town or community.
Under the GMS scheme, the HSE contracts GPs to provide medical services without charge to medical card and GP visit card holders. Currently, there are 2,518 GPs contracted to provide services under the GMS Scheme. Where a vacancy arises in a practice with a GMS contract, the HSE becomes actively involved in the recruitment process to find a replacement GP. As of the 1st December last, there are two GMS GP vacancies in County Cork, one in Cork City and the other in Youghal.
For GMS patients unable to locate a GP themselves, the Health Service Executive may assign an eligible person to be included on a medical practitioner's GMS list, in accordance with the GMS contract.
The Government is aware of the workforce issues currently facing general practice, including the limited access to GP services in certain areas, and is working to ensure that general practice is sustainable in all areas into the future.
Under the 2019 GP Agreement additional annual expenditure provided for general practice has been increased now by €211.6m. This provides for significant increases in capitation fees for participating GMS GPs, and new fees and subsidies for additional services. Improvements to GP’s maternity and paternity leave arrangements and a support for GPs in disadvantaged urban areas, have also been provided for. In addition, the enhanced supports package for rural GP practices was increased by 10%.
The GP Agreement 2023, which provided for the expansions of GP care without charges to those who earn up to the median household income and to children aged 6 & 7, includes additional capacity supports to enable the expansion and retention of staffing within general practice. It includes additional supports for GP Out of Hours services also.
These measures help make general practice in Ireland a more attractive career choice for doctors and will see an increase in the number of GPs working in the State, improving access to GP services for patients throughout the country. Figures recently released by the ICGP show that 1,311 medical graduates have applied for GP training in 2024, a notable increase on last year and higher than any previous years.
The number of doctors entering GP training has been increased significantly in recent years, with 286 new entrants in 2023 and 350 places planned for new entrants for this year. Annual intake to the GP training scheme has been increased by over 80% from 2015 to 2023, and the number of new entrant places to be available this year is a 22% increase on last year's intake alone.
Furthermore, GP recruitment is ongoing under the joint non-EU GP Training Programme between the HSE and ICGP. It was planned to bring up to 100 non-EU GPs to Ireland in 2023, and it is now intended to bring to Ireland up to 250 more non-EU GPs by the end of 2024. The programme will help to quickly improve access to GP services, particularly in areas with limited access.
Lastly, my Department and the HSE have commenced a Strategic Review of General Practice. The review, with input from key stakeholders, is examining the broad range of issues affecting general practice, including issues related to GP capacity, and when completed will set out the measures necessary to deliver a more sustainable general practice into the future.
66. Deputy Brendan Griffin asked the Minister for Health the current number of beds open at West Kerry Community Hospital, Dingle, County Kerry; what the full staffing complement is in each category of employee; how this compares with January 2023 and 2022; what efforts are being made to recruit more staff; what success these efforts have reaped in 2022 and 2023; and if he will make a statement on the matter. [2064/24]
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.
67. Deputy Colm Burke asked the Minister for Health to clarify the current position in respect of the transfer of ophthalmology services from Cork University Hospital to South Infirmary-Victoria University Hospital, in view of the fact that a new outpatient's unit and two new theatres have been built; and if he will make a statement on the matter. [1928/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
68. Deputy Réada Cronin asked the Minister for Health the number of qualified and accredited psychotherapists and psychiatrists working within, or attached to, the prison system, currently, and in each of the past five years, in tabular form; the number of prisoners attending same over the same period; and the number of prisoners deemed to have a mental and or psychological illness currently and in the same retrospective period. [54636/23]
View answerThe Deputy may wish to be aware that the number of qualified and accredited psychotherapists and psychiatrists working within, or attached to, the prison system is not under Mental Health, including HSE Mental Health. The question primarily relates to relevant Irish Prison Service (IPS) staff/employees, and potentially is wider than mental health eg Primary Care provision within prisons, attendance figures sought for prisoners etc. The Department of Health does not have primary responsibility for prisoners which is under the remit of the Irish Prison Service. Accordingly the nature of the PQ falls under the remit of the Department of Justice and should be tabled for the Minister for Justice to answer.
69. Deputy David Stanton asked the Minister for Health his plans to provide funding to the HSE to develop a facility (details supplied); and if he will make a statement on the matter. [1745/24]
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.
70. Deputy Marc Ó Cathasaigh asked the Minister for Health the anticipated timeline for the provision of a seven-day-a-week, 8am to 8pm, cath lab service at University Hospital Waterford; the recruitment plan for the additional staff required; and if he will make a statement on the matter. [1792/24]
View answerThe Government is committed to the ongoing development of University Hospital Waterford. Significant additional resources have been allocated to the hospital in recent years to meet the needs of patients. Staffing at the hospital is now approx. 2,707 WTE (November 2023), an increase of 39% since December 2019. The hospital’s budget has increased by 33.3% since 2019 to €268.3 million in 2023, a significant increase in funding in this time period.
The Programme for Government committed to the delivery of a second Cath Lab in University Hospital Waterford (UHW). The second Cath Lab opened on the 4th of September and operates 5 days per week, Monday to Friday, 8am to 6pm. The opening hours for the first Cath Lab were extended to 8am – 8pm Monday to Friday (excluding bank holidays) in Sept 2022.
The HSE has advised that future cardiac developments at the hospital will be guided by the publication of the National Review of Specialist Cardiac Services (NRCS) and its findings. The National Review of Adult Specialist Cardiac Services, Chaired by Prof Philip Nolan commenced in 2018. A Steering Group formed from nominations of interested stakeholders representing medical, professional/technical staff, nursing and patient representatives contributed to the review.
The aim of the Cardiac Services Review is to recommend a configuration for a national adult cardiac service to achieve optimal patient outcomes at the population level with particular emphasis on the safety, quality and sustainability of the services that patients receive. This aligns with the Sláintecare reform programme. In terms of scope, the National Review covers scheduled and unscheduled hospital-based services for the diagnosis and treatment of cardiac disease in adults. and seeks to enhance existing services and optimise their delivery across a region.
The Review faced considerable disruption during the pandemic and completed its work in 2023. The report is finalised, I have reviewed it and a memo for Government is being prepared. The recommendations of the review have been designed to inform the future provision of cardiac services nationally.
