Written Answers Nos. 563-579
563. Deputy Aengus Ó Snodaigh asked the Minister for Health why access to withdrawal of funding for vital diabetic services by the HSE was suddenly withdrawn for a person (details supplied); and if he will make a statement on the matter. [2389/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
564. Deputy Sean Fleming asked the Minister for Health if an application for a full medical card by a person (details supplied) can be fully re-examined; and if he will make a statement on the matter. [2405/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
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.
565. Deputy Chris Andrews asked the Minister for Health if a person (details supplied) will be given an urgent date for surgery. [2408/24]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
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.
566. Deputy John Lahart asked the Minister for Health how do Ireland's hospitals, public and private, deal with radioactive waste; and if he will make a statement on the matter. [2423/24]
View answerManagement of radioactive waste is a matter for the Department of Environment, Climate and Communications in the first instance. The Deputy should relay the question to that Department for response.
567. Deputy Seán Crowe asked the Minister for Health if plans for the proposed ADHD clinic in the CHO7 area are progressing and the date by which they expect operation to commence. [2428/24]
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, 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.
568. Deputy Seán Crowe asked the Minister for Health the reason a person (details supplied) was denied a place on the CAMHS waiting list and was instead referred to charitable organisations; and the reason representations made on his behalf were not answered until the individual had passed their 18th birthday. [2429/24]
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, 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.
569. Deputy John Lahart asked the Minister for Health the new services that are available at the surgical hub at Mount Carmel Hospital, Churchtown Dublin 14 which he recently opened; and if he will make a statement on the matter. [2432/24]
View answerFollowing the opening of the surgical hub in the Reeves Centre at Tallaght University Hospital (TUH), there was a significant decrease in the number of patients waiting for elective day case procedures at TUH. As such, Government decided to advance a minimum of six more surgical hubs, including one in Dublin South at Mount Carmel Hospital.
Work has commenced on site at Mount Carmel Hospital with the first phase due for completion in early 2024. Recruitment is progressing and the HSE has advised that there has been sufficient recruitment of theatre nurses to support Phase 1 opening by Q2. Phase 2 is expected to open by Q3.
The key goals of surgical hubs are to reduce waiting times and waiting lists for inpatient and day case care and support progress towards the 12-week Sláintecare access target. The surgical hub model is aligned to the Sláintecare vision and focuses on increasing separation between emergency and elective care to ensure all in scope procedures are delivered within the 12-week Sláintecare access target.
It is also expected that the transfer of day case activity to the surgical hub will create capacity to deliver additional inpatient surgeries in the main theatres within each catchment area, supporting reductions in inpatient waiting lists and waiting times. The Surgical Hubs will also provide outpatient clinics that will help reduce outpatient waiting lists and waiting times. Additional expected benefits include improved health outcomes for patients, improved patient experience and reduced risk of infections.
570. Deputy Fergus O'Dowd asked the Minister for Health if he will provide an update on the progression and the timeline for the establishment of a commission on care for older people and the establishment of a commissioner for ageing and older people; and if he will make a statement on the matter. [2454/24]
View answerIn furtherance of the commitment in the Programme for Government, on 3 October 2023 the Government approved the proposal from the Minister for Health, Stephen Donnelly, and I for the establishment of a Commission on Care for Older People. Subsequently in Budget 2024 €1.24 million was allocated to support this important initiative.
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. Accordingly, it is envisaged that consideration of matters such as whether there is a need to establish an independent Commissioner for Ageing and Older People will fall within the Commission’s remit.
The Commission will be an independent commission, the members of which will be appointed by Minister Donnelly and I. On 14 December 2023 Minister Donnelly and I announced the appointment of Professor Alan Barrett, Chief Executive of the Economic and Social Research Institute, as Chairperson of the Commission. The other members of the Commission will be appointed in the coming weeks.
571. Deputy Fergus O'Dowd asked the Minister for Health to provide an update on the expansion of community-based care, bringing it closer to home, in line with the Sláintecare Implementation plan since the establishment of the current Government; and if he will make a statement on the matter. [2455/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
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.
572. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to develop and increase access to talk therapies and improve access to specialist expertise, when it is required, in line with Sharing the Vision – a Mental Health Policy for Everyone, across each of the CHO areas, since the establishment of the Government; and if he will make a statement on the matter. [2456/24]
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, 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.
573. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to develop a plan aimed at tackling loneliness and isolation, particularly among older people, as outlined in the Roadmap for Social Inclusion, across each of the CHO areas, since the establishment of the Government; and if he will make a statement on the matter. [2457/24]
View answerEvidence shows loneliness is a significant issue for population health and a number of different studies have linked loneliness to multiple chronic health conditions. Loneliness levels in Ireland are rising, and the pandemic was a major contributory factor to increases in social isolation. Loneliness can be detrimental for our physical and mental health, while reconnecting with others post-COVID-19 pandemic has numerous physical and mental health benefits.
The 2021 Healthy Ireland Survey - which was carried out while significant restrictions were still in place - found a significant increase in isolation and a decrease in the proportion of the population reporting positive mental health. Some 81% reported lower levels of social connectedness and 30% reported worsening mental health since the pandemic started.
Given the detrimental impacts of loneliness, a significant body of work has been undertaken, across diverse areas of the Department of Health and the HSE, to address this. In response to the increase in loneliness which particularly impacts older people, the Ministers for Health and the Chief Medical Officer, supported by Healthy Ireland, developed a nationwide campaign, aimed at older people, to encourage them to rebuild their social connections and re-integrate into their communities. Post-pandemic, with vaccines and sensible precautions, it is safe for older people to reconnect with the world, to say “Hello Again World”, make up for lost time and re-establish important connections with their community.
Social prescribing recognises that health is heavily determined by social factors such as poverty, isolation and loneliness, and offers GPs and other health professionals a means of referring people to a range of non-clinical community supports which can have significant benefits for their overall health and wellbeing. HSE-funded Social Prescribing services are now available in 44 locations across the country. These services are delivered in partnership with community and voluntary organisations such as Family Resource Centres and Local Development Companies, and as part of the Sláintecare Healthy Communities Programme.
Mental health of older people is a priority in Sharing the Vision, Ireland's national mental health policy, with actions including improving access to Mental Health Services for Older People, promoting evidence-based digital mental health interventions in the general population and with older persons, and linking recommendations with the National Positive Ageing Strategy.
Healthy Age Friendly Homes is a support coordination service which seeks to improve the health and wellbeing of older adults and to enable them to remain in their own homes and communities for as long as possible. The programme is an innovative collaboration between Health, Housing, and Local Government, through the Age Friendly Ireland Shared Service.
Referral into the programme can be made by the older person themselves, or by a family member, friend, GP, carer, or member of their community. On referral into the programme, their Local Coordinator will carry out a home visit to conduct a holistic assessment of needs in the areas of health, housing adaptations, home energy assessments and retrofits, community and social supports, and assistive technologies.
Following a successful Sláintecare pilot in 9 local authorities, I secured €5.2m in Budget 2023 in recurring funding to roll the programme out nationally to all 31 Local Authorities. This provides for a Local Coordinator, employed by Age Friendly Ireland (Meath County Council), to be situated in each local authority across the country. The programme will be coordinated nationally across six regions aligned to the six new HSE Health Regions.
A sample of participants were invited to take part in a research study conducted by Maynooth University. Overall, improvements were demonstrated in a number of health and wellbeing indicators, including measures of loneliness.
The HSE have advised that in line with the Enhanced Community Care Programme (ECC), their objective is to deliver increased levels of health care with service delivery reoriented towards general practice, primary care and community-based services. The focus is on implementing an end-to-end care pathway that will care for people at home and over time prevent referrals and admissions to acute hospitals where it is safe and appropriate to do so and enable a “home first” approach.
As part of the ECC Programme, the Integrated Care Programme for Older Persons (ICPOP) model aims to shift the delivery of care for older people away from acute hospitals towards a community based, planned and coordinated care model which is closely aligned to Primary Care and Acute sector partners. The objective of the programme is to improve the quality of life for older people by providing access to integrated care and support that is planned around their needs and choices. This supports them to live well in their own homes and communities without the need to access acute care settings. As of Quarter 3 2023, 94 of the 96 Community Healthcare Networks and 23 of the 30 ICPOP teams have been established across Ireland.
The HSE, in conjunction with ALONE, is also continuing the roll out of a Support Coordination Service across the country. The Support Coordination Service will support older people to live independently at home for as long as possible, through support coordination and access to services such as practical supports, befriending, social prescribing, assistive technology, and also the coordination of linkages to local community groups. This service is being led out under the Enhanced Community Care (ECC) Programme.
These services will support the Enhanced Community Care model and facilitate all Community Health Networks (CHN’s) to deliver a coordinated system of care, integrated around older people’s needs, by collaborating with the Integrated Care Programme for Older Persons (ICPOP) teams, and further expand the ALONE Community and Partnerships to coordinate and deliver services in each Community Healthcare Organisations (CHO).
The end goal of the Support Coordination Service is to improve the quality of life for older people by improving access to integrated care through working with provider partners, statutory bodies, volunteers, and to provide the right level of care, in a timely manner, in an appropriate location, ideally in a setting of older people’s choice.
Over many years, both Day Care and the Meals on Wheels service have proven to be important components of the community services offered to older people, particularly in rural communities. In May 2023 I announced the allocation of €5.25 million funding for Meals on Wheels and Day Centres for older people to organisations across the country.
Budget 2024 has seen increased investment in both areas building on recent investment to support these services. Community services are the backbone of social care provision and play an important part in keeping older people out of hospital and in their own homes and communities for longer. We will be investing an additional €2.7 million in 2024 for Day Care Services, which includes an additional €500,000 provided to increase the provision of in-home dementia day care and an additional €1 million for Meals on Wheels nationally.
Acknowledging the disproportionately negative impact of the pandemic on older persons, the Programme for Government (2020) commits to the establishment of a commission on care that will ‘assess how we care for older people and examine alternatives to meet the diverse needs of our older citizens’, learning the lessons from COVID 19. On 3 October 2023 the Government approved the proposal that the Minister of State for Mental Health and Older People and I brought forward for the establishment of a Commission on Care for Older People, for which €1.24 million was allocated in Budget 2024. 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. The Commission will be an independent commission, the members of which will be appointed by Minister Donnelly and I. On 14 December 2023 we announced the appointment of Professor Alan Barrett, Chief Executive of the Economic and Social Research Institute, as Chairman of the Commission. The other members of the Commission will be appointed in the coming weeks.
The Roadmap for Social Inclusion 2020 - 2025: Ambition, Goals and Commitments was published in January 2020. The primary ambition of the Roadmap was to “Reduce consistent poverty to 2% or less and to make Ireland one of the most socially inclusive countries in the EU. The Roadmap for Social Inclusion is an overarching statement of Government strategy, which acknowledges the range of sectoral plans already in place that have social inclusion as a core objective, in areas such as education, health, children and childcare, community development and housing. These plans remain key to ensuring that social inclusion is at the core of public policy and service strategy across all government departments and services.
574. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to further support the nursing homes support scheme (the fair deal) to provide assistance when staying at home may no longer be an option, since the establishment of the Government; and if he will make a statement on the matter. [2458/24]
View answerFair Deal was designed to protect and support vulnerable older people, to ensure equal access to nursing home care based on what they could afford. This gives certainty to people and families.
Government funding for Fair Deal is to support vulnerable older people at a time in their lives where full-time care is essential.
This Government will continue to prioritise the best interests of nursing home residents to ensure that their welfare, care and well-being is ensured whilst simultaneously ensuring that nursing home care is accessible and affordable for everyone. It is vitally important that people are cared for in the most appropriate settings. This remains my number one priority.
In 2019, the Nursing Homes Support Scheme funding (NHSS) budget was €985.8m. Year-on-year the NHSS budget has increased: in 2023 I secured a funding increase of €40 million for the NHSS. An additional €45.6 million has been allocated to support nursing homes in Budget 2024, including a new €10 million fund to support private and voluntary nursing homes with HIQA compliance.
Overall, €1.4 billion of the total Health Budget was allocated last year to support over 22,700 people under Fair Deal. This will increase to nearly €1.5 billion for 2023, and I am cognisant that the budget must support all residents under Fair Deal for the full calendar year. This funding is allowing an increase in rates by the National Treatment Purchase Fund (NTPF) of 6% on average per negotiation of Deeds. The NHSS now caters for over 23,000 residents.
It is also recognised that the duration of contracts have shortened and that this increase in funding will go toward continuing to help nursing homes with inflationary costs in 2024.
The provision of free PPE and oxygen to private nursing homes continues, as of May 2023 this has cost approximately €77 million.
The COVID-19 Temporary Assistance Payment Scheme (TAPS) was established in April 2020 in response to a public health emergency to provide support to private and voluntary nursing homes to mitigate and respond to the impacts of COVID-19. The core concept of the scheme when it was established was that the State would provide additional funding to those nursing homes that require it to contribute towards costs associated with COVID-19 preparedness, mitigation and outbreak management.
Over €151 million has been claimed by nursing homes under the Temporary Assistance Payment Scheme (TAPS) since its introduction. The Outbreak Assistance element of the scheme was extended, with a gradual reduction of the threshold for maximum monthly claim amounts applying to claims from 01 March 2023. The scheme ceased at the end of April 2023. The approach taken by the Department of Health fully considered the changed situation with regard to COVID-19 in Ireland, and the inherently temporary nature of the scheme.
The Government is conscious of the financial challenges faced by the nursing home sector, especially smaller and voluntary nursing homes that may not have access to the same economies of scale as larger homes or groups.
To that end the Government has provided substantial support to the private and voluntary nursing home sector over the pandemic. A €10 million scheme (TIPS) was established in 2022 to support private and voluntary nursing homes with increases in energy costs, covering 75% of year-on-year cost increases up to a monthly cap of €5,250 per nursing home, over the period of July-December 2022. This scheme was extended for a second time to the end of June 2023.
As of 31 January 2024, €8,469,533.80 has been claimed by 366 nursing homes under the scheme. The scheme ran from 1 July 2022 to 30 June 2023.
The Department of Health continues to engage with the National Treatment Purchase Fund on further measures to support the sector.
575. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to ensure that no nursing homes support scheme resident is charged for services they do not use, since the establishment of the Government; and if he will make a statement on the matter. [2459/24]
View answerThe Nursing Homes Support Scheme (NHSS), commonly referred to as Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost.
The NHSS covers the cost of the standard components of long-term residential care which are:
• Nursing and personal care appropriate to the level of care needs of the person;
• Bed and board;
• Basic aids and appliances necessary to assist a person with the activities of daily living; and
• Laundry service.
Costs not covered by the NHSS include those individually incurred for items like social activities, newspapers and hairdressing. This may also include medical services such as therapies and some medical equipment. A person's eligibility for other schemes, such as the medical card scheme or the drugs payment scheme, is unaffected by participation in the NHSS or residence in a nursing home. In determining the services covered by the NHSS it was considered very important that the care recipient and the taxpayer would be protected and would not end up paying for the same services twice. For this reason, medications and aids that are already prescribed for individuals under an existing scheme are not included in the services covered by the NHSS, as this would involve effectively paying twice for the same service.
It is important to state that residents of nursing homes should enjoy the same levels of support and access to services for which they are eligible as when they lived in their own homes. It is acknowledged that the reason they require 24-hour levels of support is due to their level of dependency, which in turn may require access to clinical services including hospital and other outpatient appointments in the community.
The Department of Health does not currently hold data relating to additional charges in private nursing homes; these vary according to each individual nursing home depending on the services offered. It is important to note that it is private nursing homes who hold responsibility for delivering care to their residents in line with their terms of registration and the relevant regulations under the Health Act 2007. It is clear that under the terms of the NHSS Act 2009, private nursing homes should not levy additional charges on NHSS residents for services coming within scope of the Nursing Home Support Scheme.
Part 7 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 stipulates that the registered provider of the nursing home must agree a contract in writing with each resident on their admission to the nursing home. This contract must include details of the services to be provided to that resident and the fees to be charged. Residents should never be charged fees which are not set out in the contract. The Department of Health and the HSE are not a party to such contracts which are concluded between each resident and their nursing home.
The Competition and Consumer Protection Commission (CCPC) has published consumer protection guidelines for contracts of care in long-term residential care services for older people. The guidelines set out the obligations and responsibilities that providers must adhere to under consumer protection law and are aimed at providing greater transparency, clarity and certainty for consumers.
Concerns about additional charges should in the first instance be taken up with the nursing home provider. Where an individual is not satisfied with the response they receive, they may wish to take their complaint further by seeking a review from the Office of the Ombudsman.
The Department of Health is currently reviewing the available evidence and a focused piece of work to examine the issue in relation to additional charges is underway.
There are a number of separate factors driving this issue and potential actions to address each of these are being considered.
The Department has no baseline data on additional charges in private nursing homes in Ireland. To address this gap and to inform the above analysis, Department officials devised an anonymous provider survey, in collaboration with HIQA and representatives of private nursing home providers, to obtain a data sample. The survey closed on 20 December 2023 and the data submitted is currently being reviewed.
576. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to ensure that the best possible safeguards are in place to protect our friends and family in nursing homes, since the establishment of the Government; and if he will make a statement on the matter. [2460/24]
View answerSafeguarding adults who may be at risk of abuse, harm, and neglect by others in the context of their interactions with the health and social care sector, including in nursing homes, is a key objective of the Department of Health, every statutory body under its aegis and every relevant service that interacts with such adults.
In the health and social care sector, a framework of standards, policies and procedures for safeguarding adults who may be at risk of abuse, harm, neglect, and exploitation within the sector, including in nursing homes, is in place, and further measures are being developed to strengthen this framework.
Cross-sectoral legislative provisions relevant to adult safeguarding are also applied throughout the health and social care sector, including, for example, legislation in relation to reporting certain offences against children or vulnerable persons to An Garda Síochána, vetting, equal status and assisted decision-making.
Existing governance measures
Key governance provisions currently in place include:
• The significant inspection and other regulatory powers of the Health Information and Quality Authority (HIQA) and the Mental Health Commission (MHC) in relation to the quality and safety of healthcare and social care provision generally (under the Health Act 2007 and the Mental Health Acts).
• The roles of health and social care professional regulatory bodies (including CORU, the Irish Medical Council, the Nursing and Midwifery Board of Ireland, the Dental Council of Ireland and the Pharmaceutical Society of Ireland) in relation to, inter alia, professional registration requirements and professional codes of conduct.
• Joint National Standards for Adult Safeguarding developed by HIQA and the MHC and approved by the Minister for Health, that apply to all regulated health and social care centres, including nursing homes.
Existing operational safeguarding measures
The existing framework also includes a range of operational structures and procedures, including in particular the HSE’s national operational adult safeguarding policy Safeguarding Vulnerable People at Risk of Abuse – Policy and Procedures (2014), which is in place primarily in all HSE and HSE-funded social care settings.
The HSE has put in place a range of structures and processes to support and further develop its national operational adult safeguarding policy, including:
• A HSE National Safeguarding Office leading policy development and oversight.
• Clear guidelines set out in the existing policy for HSE and HSE-funded staff to follow in cases of suspected abuse or neglect of adults at risk (including a “zero tolerance” approach to abuse, meaning that abuse must be reported by staff in all instances).
• An adult safeguarding policy and procedures training programme, and a requirement that staff must attend training (the training is also accessible to non-HSE and HSE-funded services).
• Social work-led teams ("Safeguarding and Protection Teams") in each of the 9 HSE Community Healthcare Organisation (CHO) areas.
• Over 2,000 designated safeguarding officers nominated by service providers and provided with additional training.
• Implementation planning for a revision by the HSE of its operational adult safeguarding policy which is expected to extend the policy beyond the social care pillar and to all HSE and HSE-funded services.
Policy and legislation development – health and social care sector
The Department of Health remains committed to ensuring that the best possible safeguards are in place to protect any of our service users who may be at risk of abuse, including such service users in any setting (including nursing homes) where health or social care services are provided to them.
The Department is at an advanced stage of developing a national policy to further strengthen existing protections in the health and social care sector. Draft policy proposals have been finalised and will be the subject of an imminent public consultation, details of which will be announced very shortly.
The intention is that the policy will apply to all public, voluntary and private healthcare and social care settings. Subject to Government approval of this national sectoral policy, legislation as required to underpin the approved policy will thereafter be prepared. The introduction of safeguarding legislation remains a priority for me.
In addition, work is also ongoing on the drafting of legislation to enhance the oversight and regulation of nursing homes, which will include provision for a broader suite of enforcement tools for the Chief Inspector of Social Services. I hope that this Bill will be published in this Spring session.
Furthermore, Nursing Homes Expert Panel funding has been provided for an increase of 18 posts in the HSE's nine Community Healthcare Organisation (CHO) Safeguarding and Protection Teams (9 Social Work Team Leaders, 9 basic grade Social Workers). All these positions have been funded for 2024 and all posts have been filled.
577. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to increase the number of specialist palliative care beds countrywide over the five years of government, ensuring that there will be a hospice serving every region in the country, since the establishment of the Government; and if he will make a statement on the matter. [2461/24]
View answerSince 2020, there have been new openings of specialist inpatient palliative care units in Wicklow (15 beds), Mayo (12 beds), and Waterford (20 beds). This means that CHO8 is now the only community healthcare organisation without at least one specialist palliative care inpatient unit.
In December 2021, I announced €10million in once-off funding to support a number of voluntary organisations including members of the voluntary hospice group and national organisations involved in end-of-life and bereavement care. €3million of this funding was allocated to progress plans for three new hospices in the Midlands, Drogheda and Cavan.
This provision of €1million for each of these three new hospice developments will be used for the development of architectural plans, the planning application processes and to commence early ground works as appropriate for the Cavan, Midlands and Drogheda developments. Funding has been released to the CHOs for drawdown as required.
With regard to Drogheda, the HSE continues to work with Newgrange Hospice Charity on the planning and development of the Drogheda Hospice. This work involves HSE Estates, CHO8 and the Newgrange Hospice Charity.
In September 2022, an Taoiseach Micheál Martin, announced €20million in capital funding for the development of a 20-bed specialist palliative care inpatient unit in Tullamore. The development will provide a hub for the provision of specialist palliative care services across the Midlands, including day care, outpatient, inpatient and community services. A tender competition took place in 2023 to secure the services of a design team for this project. A design team was appointed at the end of May 2023. The design process is ongoing.
In relation to the delivery of a specialist palliative care unit at St Christopher’s Hospice in Cavan, I have been informed by the HSE that the design of the hospice has been agreed by the Architects, Trustees and HSE Personnel (Estates, National Representatives and Service providers). Full planning permission has been granted by Cavan County Council for this build. Following the tendering process and selection of successful builders, it is anticipated that construction would commence in Q1 of 2024. Capital funding of 4 million euro has been successfully secured in the first instance to enable this project.
Once these planned hospices are open, there will be an inpatient unit in every region of the country, providing specialist palliative care inpatient services for people with complex needs, a hub for the existing specialist palliative community homecare teams and supporting the discharge of patients from acute hospitals.
At the beginning of 2021 the HSE announced an additional €10.68 million in recurring annual funding for the voluntary hospice sector from 2021 onwards. Funding was allocated to hospices that make up the Voluntary Hospice Group: Our Lady’s Hospice and Care Services, Harold’s Cross, Blackrock and Wicklow; St Francis Hospice, Raheny and Blanchardstown; Marymount Hospice, Cork; Milford Care Centre, Limerick; North West Hospice, Sligo; and Galway Hospice.
The redesignation of the four adult hospice organisations (Milford, Marymount, Galway and St. Francis) from Section 39 service level agreements with the Health Service Executive (HSE) to Section 38 agreements will take place this February 2024. The redesignation will provide a sustainable model of care for adult specialist palliative care services in Ireland and ensure the provision of these core services into the future. The government is providing a total of €18.6 million to achieve this.
578. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to support community specialist palliative home care teams in all HSE areas, fund designated homecare packages, and resource specialist palliative care provided in hospices, since the establishment of the Government; and if he will make a statement on the matter. [2462/24]
View answerIn Ireland, specialist palliative care services are delivered by the HSE in partnership with voluntary agencies to provide integrated, high quality and accessible palliative care to patients and their families. Specialist palliative care is provided by multidisciplinary teams in acute hospitals, specialist palliative care inpatient units (hospices) and in community settings by community palliative care teams (homecare teams). Consultants in palliative medicine have contracted hours across all three settings ensuring seamless transitions and integrated services for patients and their families.
A fully developed specialist palliative care unit (hospice) comprises in-patient beds, out-patient services and bereavement services. In 2023, there were 14 specialist palliative care inpatient units (hospices) providing a total of 276 beds across the country. This is an increase of 49 beds since 2020. Recent developments include the opening of new hospices in Wicklow (2020), Mayo (2019) and Waterford (2021). Plans are progressing for three further units in Drogheda, Tullamore and Cavan to ensure all regions have access to a specialist palliative care inpatient unit in line with national policy.
In 2022, there were 4,118 admissions to specialist palliative care inpatient units. This represents a 22.78% increase in comparison to 2020 (3,354). 97% of patients were admitted within 7 days of referral. Due to the ongoing Fórsa action, performance figures for 2023 are based on available data from January to August 2023. An anticipated increase in admissions to specialist palliative care inpatient units is expected to be 10% up on 2022 admissions.
There are 32 community specialist palliative care (home care) teams covering all 26 counties. The community specialist palliative care teams work in close partnership with GP’s and primary care teams and provide expert palliative care to both adults and children in all community settings including nursing homes.
In 2022, community palliative care teams provided care to an average of 3,592 patients each month in their own homes. This was an 8.3% increase from 2020 (3,316) and reflects the increased demand for palliative care services in the community. Due to the ongoing Fórsa action, performance figures for 2023 are based on available data from January to August 2023. An anticipated increase in care provided by community palliative care teams to patients in their own homes is expected to be 10% up on 2022 figures.
In partnership with the Irish Cancer Society and Irish Hospice Foundation, the HSE also delivers Night Nursing care to patients receiving specialist palliative care to enable people die at home and provide respite to carers during end-of-life care. In 2023, 2,835 patients received Night Nursing care in their own homes utilising an average of 3.47 nights of care per patient.
Funding provided for specialist palliative care in NSP 2022 (€2.4m) and NSP 2023 (€2.8m) provided for the enhancement of both adult and children’s palliative care services in the community including:
• Additional staffing for community specialist palliative care teams in line with workforce recommendations from 2001 Adult Palliative Care Policy.
• Enhanced provision of Night Nursing Services in partnership with Irish Cancer Society and Irish Hospice Foundation.
• Expansion of LauraLynn Hospice in the Home service.
• Additional Clinical Nurse Specialists to enhance availability of out–of-hours palliative care supports for patients in the community.
579. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to increase resources for the children’s palliative care programme since the establishment of the Government; and if he will make a statement on the matter. [2463/24]
View answerA priority for 2024 is to continue implementing the recommendations from the HSE 2020 report 'Clinical Governance and Operational arrangements for supporting a model of care for children with life limiting conditions towards the end of life in the community in Ireland'. The new HSE Service Plan 2024 will underpin further improvements in children’s palliative care services. A multiagency approach is adopted to provide palliative care to children in their homes. This approach involves: collaboration between primary care, regional paediatricians, and adult community palliative care services - coordinated by the Clinical Nurse Coordinator (CNC) - and supported by paediatric palliative care team located in CHI Crumlin/Temple St. One of the cornerstones of children’s palliative care is to facilitate a fully integrated approach to care.
There have been significant increases in funding to enhance the provision of children’s palliative care services across Ireland in recent years. Across 2021 and 2022, funding was allocated for the recruitment of 12.5 additional whole-time equivalents to enhance the provision of children’s palliative care services across acute and community settings. These posts support the provision of specialist palliative care to children as close to home as possible.
In 2023, a Government allocation of €3.7million was provided for new measures in palliative care. These measures enhance the provision of adult and children’s specialist palliative care services across the country and include funding to support bereavement services for parents and families who have experienced the death of a child. The Palliative Care Budget increased to a total national service plan allocation in 2022 of €121.9 million from a national service plan allocation of €119m in 2021. In 2023, the budget was €130.1m.
Additional resourcing was provided in 2021/2022/2023 to support the Children's Palliative Care Programme. This included:
• €2.3 million in recurring funding to enhance and develop LauraLynn’s Children’s Hospice and outreach services. This funding has been used to increase LauraLynn’s Hospice in the Home Service across Leinster; and supported the opening of new LauraLynn Hubs in Munster and Connaught.
• 8.5 additional Clinical Nurse Coordinators (CNCs) were provided to take the total number of CNCs nationally to 18.5. This will ensure there are two CNCs in each Community Health Organisation.
• 2 Consultants in Paediatric Palliative Medicine, 1 Specialist Register, 3 Clinical Nurse Specialists and a Clerical Officer Grade IV for the Specialist team in Childrens Health Ireland Crumlin. These posts are partially recruited.
• The creation of 4 Regional Paediatricians with a Special Interest in Palliative Medicine for Waterford, Cork, Limerick and Galway to enhance regional leadership and support professionals delivering palliative care to children in their home. It’s expected these posts will be recruited in 2023.
The Department and HSE will continue to progress developments for children’s palliative care services in Ireland, working towards the highest possible quality of end-of-life care and support for children with life limiting illnesses across the country.
