Wednesday, 21 Feb 2024

Written Answers Nos. 136-156

International Protection

Questions (136)

Peter Burke

Question:

136. Deputy Peter Burke asked the Minister for Children, Equality, Disability, Integration and Youth if he will advise on a case (details supplied). [8268/24]

Written answers

Minister for Children, Equality, Disability, Integration and Youth

My Department has been at the forefront of the cross-governmental response to the displacement of Ukrainian people caused by the 2022 invasion. As of February, we are proving accommodation to over 56,000 people in short term accommodation and over 17,000 people in pledged accommodation and the offer a home scheme.

The accommodation provided to people fleeing the conflict in Ukraine by my Department is mainly temporary in nature and given the number of people that are being accommodated it is not possible to develop tailored solutions for individuals or families, unless it is for a serious medical need as agreed with the HSE. In seeking to address immediate accommodation needs, safety and security are the paramount considerations.

Outside of State funded temporary accommodation, Beneficiaries of Temporary Protection (BOTPs) are entitled to make their own private arrangements including potentially availing of pledged accommodation, and can avail of some supports to do so. Those wishing to avail of pledged accommodation in any given area should contact the Local Authority in that area or the Irish Red Cross pledge process. The Irish Red Cross can be contacted by email at [e-mail] or by phoning 1800 50 70 70.

International Protection

Questions (137)

Ged Nash

Question:

137. Deputy Ged Nash asked the Minister for Children, Equality, Disability, Integration and Youth to provide information on a matter (details supplied); and if he will make a statement on the matter. [8362/24]

Written answers

Minister for Children, Equality, Disability, Integration and Youth

Contractual arrangements for the International Protection Accommodation Service (IPAS) accommodation centres are deemed confidential and commercially sensitive.

It would not serve the public interest to divulge the value of contracts held to contractors for services, as it could prejudice the Department's negotiating position to deliver value for money with respect to other accommodation providers and locations.

International Protection

Questions (138)

Ged Nash

Question:

138. Deputy Ged Nash asked the Minister for Children, Equality, Disability, Integration and Youth if he will explore in full a proposal to do a technical study of the D Hotel in Drogheda to establish if the facility can be operated as a dual function hotel accommodating both tourists and international protection applicants; and if he will make a statement on the matter. [8365/24]

Written answers

Minister for Children, Equality, Disability, Integration and Youth

I thank the Deputy for his question and his continued engagement on this matter. As indicated yesterday to the Deputy in the Dáil chamber, officials in my Department are in discussions with the property owner to investigate different configurations which may allow for the retention of some space within the property to continue to provide a service to the general public. It is not clear at this stage if this will be possible, however discussions are ongoing. As the Deputy will be aware, I plan to meet with representatives from the Drogheda business community on this matter.

General Practitioner Services

Questions (139)

Barry Cowen

Question:

139. Deputy Barry Cowen asked the Minister for Health for an update on when the registrations office in the health centre in Tullamore will reopen. [8117/24]

Written answers

Minister for Health

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

Hospital Staff

Questions (140)

Marc MacSharry

Question:

140. Deputy Marc MacSharry asked the Minister for Health if he will provide an update with regard to the staffing of the new community hospital in Ballyshannon; if he is aware that the delay in the opening of this state-of-the-art facility is serving to put undue pressure on medical professionals and facilities in other hospitals in the north-west region; and if he will make a statement on the matter. [8121/24]

Written answers

Minister of State at the Department of Health

As 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.

Mental Health Services

Questions (141)

Richard Bruton

Question:

141. Deputy Richard Bruton asked the Minister for Health if he has reviewed the submission from an organisation (details supplied); if he plans to publish a roadmap for service improvement, as has been done for disability services; and if he has considered the proposal for the regulation of CAMHS under the Mental Health Act 2001. [8122/24]

Written answers

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

I am familiar with the organisation, and the submission, referred to by the Deputy. I, and the HSE, have met with this organisation over recent times in relation to improving youth mental health care overall.

I firmly support the regulation of all mental health services, including community CAMHS, and I have been progressing priority legislation to underpin this regulation.

The Government recognises the importance of ensuring all mental health services, both inpatient and community, and both adult and child and adolescent, are fully registered, regulated, and inspected by the Mental Health Commission in its role as the independent regulator of mental health services.

Under the Mental Health Act 2001, the Mental Health Commission registers, inspects, and regulates all inpatient mental health services, including inpatient CAMHS. The current Mental Health Act 2001 does not include any provisions for the registration or regulation of community mental health services and therefore, it is not considered that the Act provides the necessary legal basis to expand the Commission’s regulatory remit.

The expansion of the Mental Health Commission’s role into regulating all community mental health services, including community CAMHS, is being addressed in the forthcoming Mental Health Bill. This new Bill is a complex and lengthy piece of legislation. It will provide the necessary legal underpinning to ensure that the Mental Health Commission can regulate all community services. Additionally, the Bill will overhaul the involuntary admission and detention process, modernise provisions related to consent to treatment, provide enhanced safeguards for people accessing inpatient treatment, and provide a new, discrete Part that relates exclusively to the care and treatment of children and young people.

Drafting of this Bill has been prioritised and it is now in its final months of drafting. It will be introduced to the Oireachtas in the summer legislative session, which begins in April.

Work also continues to improve CAMHS at service level with many actions being progressed under implementation of Sharing the Vision, our national mental health policy, to enhance mental health services across a broad continuum. The Sharing the Vision implementation Plan 2022-2024 is overseen by the National Implementation and Monitoring Committee (NIMC). The Plan sets out individual programme pathways of implementation for each of the 100 policy recommendations for three years. The NIMC publishes regular reports on implementation progress and minutes of the Steering Committee meetings.

Year-on-year funding for mental health services increased by €74 million from €1.221 billion in Budget 2023 to nearly €1.3 billion in 2024, and with a strong focus on investing in child and youth mental health. This is the fourth consecutive year of an increase for mental health services, and highlights in real terms the importance this Government places on the mental health of those living in Ireland.

CAMHS receives €146.5 million in dedicated funding annually. In addition to this, approximately €110 million in funding is provided by the Government to community-based mental health organisations and NGOs each year to deliver supports and services. A significant proportion of this is dedicated to supporting young people. I recently announced a further €10 million in funding for mental health to support the delivery of clinical programmes and youth mental health. This again highlights the Government’s recognition of mental health as a central component to overall health,  and to reform youth mental health care in line with the policies Sharing the Vision and Connecting for Life.

For the first time in the history of the State we now have a dedicated National Office for Child and Youth Mental Health in the HSE. This is a very significant development which I delivered and it will improve leadership, operational oversight, and management of all service delivery and improvements. Both a new HSE National Clinical Lead for Child and Youth Mental Health and a new HSE Assistant National Director for Child and Youth Mental Health have recently taken up post.

There continues to be growing demand for CAMHS across the country with over 22,000 referrals last year. Between 2020 and 2021, referral rates into CAMHS increased by 33%, while the number of new cases seen increased by 21%.

It is acknowledged that there is a variation of referral acceptance across CAMHS teams, and this is an area being prioritised by the HSE to help improve access to CAMHS and to address CAMHS waiting lists. The HSE is taking account of the recent Maskey and Mental Health Commission reports on CAMHS, and is currently finalising a Youth Mental Health Service Improvement Plan which will set out agreed actions for focused service improvement through identified, timely, and measurable actions.

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

In addition, the HSE continues to progress three national audits in relation to CAMHS arising from the Maskey Report on South Kerry. These were the national review of CAMHS prescribing practice and the national audit of compliance with the CAMHS Operational Guidelines, both of which were recently published. In addition, a qualitative review of service user experiences is being undertaken by UCC. These reports will be given full and proper consideration by the Government.

There are 77 CAMHS teams in operation nationally, of which 2 are specialist Eating Disorder teams with one in CHO4 and one in CHO7. A further specialist Eating Disorder CAMHS team for CHO2 is in development. In addition, there are four baseline CAMHS Intellectual Disability teams resourced nationally. There are also 4 CAMHS in-patient units nationally.

Staffing in community CAMHS has increased in recent years, with an increase of 500 full time equivalent posts between 2011 and 2024. I secured funding for additional new posts under Budget 2024, with a focus on child and youth mental health posts.

CAMHS is a specialist service and can only accept children or adolescents where there is evidence of a moderate to severe mental health difficulty present. Access to CAMHS is detailed in the HSE Clinical Operational Guidelines which sets out the core functions and remit of CAMHS and indicates referral pathways to this specialist service. As such, CAMHS is not suitable for children or adolescents whose difficulties primarily are related to learning problems, social problems, behavioural problems, or mild mental health difficulties.

Evidence shows that only 2% of children and young people need the support of the specialist CAMHS multidisciplinary teams. Access is on the basis of prioritised clinical assessment and all referrals to CAMHS are assessed by a multidisciplinary team.

It is important to state that there continues to be growing demand for CAMHS, with the 75 community teams nationally delivering around 225,000 appointments for children and young people annually. The expected activity under the HSE National Service Plan 2024 projects CAMHS referrals received of around 23,000, with around 13,700 of these referrals expected to be seen by CAMHS in line with operational guidelines. CAMHS teams, along with the wide range of other youth mental health supports provided by or on behalf of the HSE, make a crucial and real difference to the lives of many vulnerable young people, and their families, each year.

The Deputy can rest assured that I, and the Government, remain fully committed to the development of all aspects of mental health services nationally.

Healthcare Policy

Questions (142)

Richard Bruton

Question:

142. Deputy Richard Bruton asked the Minister for Health if a scoliosis unit, or task force in relation to same, has been set up within the Department; and if he will make a statement on the matter. [8123/24]

Written answers

Minister for Health

Firstly, I want to acknowledge that waiting lists for scoliosis and spina bifida services are unacceptably long. I am acutely conscious of the burden that this places on patients and their families.

I committed €19 million under the 2022 and 2023 Waiting List Action Plans to tackle these waiting lists. This investment has supported an increase in the number of spinal procedures undertaken in both 2022 and 2023, with 509 and 464 procedures carried out respectively, compared to 380 in 2019.

Progress is being made on the waiting lists for spinal procedures, despite the significant increase in demands and referrals compared to previous years. At the end of December 2023 there were 231 children on the waiting for spinal procedures (excluding suspensions), which is a 5% reduction compared to the end of 2022, and 78 active patients waiting over 4 months, which is a 13% reduction compared to the end of 2022. I had hoped, and expected, to see more significant reductions to the waiting lists given the funding that was allocated. However, despite undertaking a record number of spinal procedures over the last two years, the expected reductions in the waiting list were offset by a significant increase in demand and referrals compared to previous years.

At my request, a dedicated Paediatric Spinal Surgery Management Unit has been established in Children's Health Ireland and the Clinical Specialty Lead for Spinal Surgery commenced in post in January 2024. This Unit, which is coordinated cross-city, is focusing on the management and delivery of spinal surgery, including reform of the waiting lists. I have met the clinical lead who is now building up a team around him.

I also intend to convene a dedicated stakeholder taskforce for these services. I met with some patient advocacy groups on Monday 19 February, to discuss the terms of reference for this taskforce. The process of establishing this Taskforce is ongoing.

I will continue to drive progress on Scoliosis and Spina Bifida services as priority areas under the Waiting List Action Plan 2024.

Medical Internships

Questions (143, 146)

Paul Kehoe

Question:

143. Deputy Paul Kehoe asked the Minister for Health for an update and details on medical internships and English language courses for Ukrainian doctors; the number of doctors who have been able to access this training already and future capacity; and if he will make a statement on the matter. [8126/24]

Paul Kehoe

Question:

146. Deputy Paul Kehoe asked the Minister for Health the difference between the medical system in Ireland versus Germany, France, the Czech Republic, Latvia, Italy, Slovakia and Poland where Ukrainian doctors have been able to register and work, secure internships, access English training or take up other medical positions as they train, but only a small number have been able to do so in Ireland where we are told there is a lack of State funded special language courses for doctors and a complicated medical qualification confirmation procedures in comparison with some other EU member states; and if he will make a statement on the matter. [8131/24]

Written answers

Minister for Health

I propose to take Questions Nos. 143 and 146 together.

I fully share the Deputy’s wish to see doctors and other health professionals fleeing the war in Ukraine gaining registration with their respective regulators and taking employment here. Officials from my Department, the HSE and the health profession regulators have been actively working towards this for some time now. Following an initial assessment it became clear that specialist English language training would be needed to enable doctors to meet the necessary standard. My Department made €1m available for training and registration costs in 2023 and a further €200,000 is available this year.

I am advised that following an initial assessment, 132 practitioners have either completed or are undertaking a 2, 4 or 12 week training programme. To date, thirteen groups of students have begun training, the last having commenced just this week. Eleven doctors and one dentist passed the exam on the first sitting and a further eight doctors and two dentists passed it on the second sitting. The exams continue to be taken on a rolling basis and many candidates are either awaiting results or have tests booked in the coming months. As the Deputy will appreciate there are unique challenges faced by these students in coping with their learning and living environments, family commitments and the emotional difficulty of being displaced by the war. Each person’s circumstances are different and while some choose to take the test immediately on completion of the course, others wish to take it later after further practice.

The Medical Council is responsible for the registration of doctors and has re-iterated its commitment to facilitating the registration and integration of Ukrainian doctors seeking to practise in Ireland, especially in light of the challenges posed by displacement. Recognising the unique circumstances of these doctors, the Council has put in place comprehensive measures to support their registration process, reflecting Ireland's broader commitment to offering refuge and professional opportunities to those affected by the crisis in Ukraine.

Doctors from Ukraine, depending on their qualifications and experience, may apply for registration in the General, Specialist, or Supervised Division of the Medical Register. For General registration, applicants benefit from the directives that allow doctors with qualifications from outside the EU, who have practised for a minimum of three years in an EU member state, exemption from the Pre Registration (PRES) exams, streamlining their path to registration. Others may need to navigate the PRES examination process or secure an exemption based on higher qualifications deemed acceptable by the Council.

To support these applicants effectively, the Medical Council has established an internal working group, engaged with Ukrainian representatives in Ireland, and provided targeted information through dedicated communication channels. These efforts are continuing and during the upcoming College of Anaesthesiologists of Ireland Annual Scientific Congress in May an expert panel of speakers from the College of Anaesthesiologists and the Council will give guidance to doctors from Ukraine and others under International Protection on the process for applying for entry to the Medical Council Specialist Division of the Register.

Notwithstanding approaches in other countries, the Council, in order to maximise patient safety, is obliged to ensure that all doctors it registers meet the necessary standards to practice medicine here. The Council does offer guidance on alternative evidence for those unable to meet all the document requirements immediately. This proactive approach, including the provision of information and support through various stages of the application and examination process, underscores the Council's commitment to integrating Ukrainian medical professionals into the Irish healthcare system, supporting both the individuals affected and the broader community.

Since the activation of the EU Temporary Protection Directive (2001/55 EC) by the EU Council Decision EU 2022/382 on 4 March 2022, a total of 48 Ukrainian doctors seeking refuge in Ireland have submitted applications for registration through the Professional Registration Examination System (PRES) Route. Of these, one doctor has successfully passed PRES Level 3 and is now registered on the General Division, while the remaining applicants are at various stages of the application process. Thirteen doctors are preparing for the PRES Level 3 exam, with some having already passed PRES Level 2 or an accepted alternative exam, and one undergoing registration on the Supervised Division. Twenty-five doctors are preparing for the PRES Level 2 exam and they have selected from dates scheduled across 2024. An additional eight applications are currently under assessment for outstanding documents or information. I am also advised that thirteen dentists have gained full registration and a further 82 have been offered a period of adaptation which will assist them to be registered when completed.

Medical Internships

Questions (144)

Paul Kehoe

Question:

144. Deputy Paul Kehoe asked the Minister for Health if Ukrainian doctors are able to access the non-EU GP training; and if he will make a statement on the matter. [8127/24]

Written answers

Minister for Health

GP recruitment is ongoing under the joint HSE and ICGP non-EU GP Training Programme. 112 non-EU GPs were recruited last year under the training programme with 75 having started in GP practice at year end.

Detailed information on the programme, including information on the eligibility criteria for applicants, is available from the ICGP website. As per the eligibility criteria, the programme is open to doctors who have a general practice qualification from a jurisdiction that is not currently recognised as equivalent to criteria in Ireland, due to variances in the curricula and training duration in their country of origin. To be eligible for the programme an applicant must also have obtained their primary medical degree from a non-EU country. Determination as to the eligibility of any individual seeking to join the non-EU GP programme is made by the ICGP, which is the body responsible for the training of GPs in Ireland.

Under the programme, doctors work in general practice for a 2-year period following which they can take up an Irish GMS contract (the normal training period is four years). The programme targets the placement of GPs to rural areas and areas with lower levels of services provision. This will further increase capacity in general practice and access to services in these areas.

Following the programme’s success in 2023, funding has been made available for the planned recruitment of up to 250 more non-EU GPs this year.

Dental Services

Questions (145)

Paul Kehoe

Question:

145. Deputy Paul Kehoe asked the Minister for Health the number of Ukrainian dentists who have been able to secure dental-related positions in Ireland; and if he will make a statement on the matter. [8128/24]

Written answers

Minister for Health

The Dental Council of Ireland is the regulator for the dental profession in Ireland. The Council is responsible for establishing, maintaining and publishing a Register of Dentists and a Register of Dental Specialists and to provide for the registration and the retention of dentists names in these registers.

As of the 16th of February 2024 13 Ukrainian dentists have received full registration with the Dental Council. This is an increase since the December 2023 in which there was 10 Ukrainian dentists who obtained full registration. Officials in my Department are in regular contact with the Dental Council on this matter.

The Dental Council have opened an application process for Ukrainian dental professionals. To date 143 of the 162 applications have been reviewed by the Council. This process includes a period of adaptation in which dentists can undertake the full scope of their practice.

The Dental Council have also established a mentorship programme whereby Ukrainian dentists can practice under the mentorship of an established registered dentist. This mentorship process applies when deemed necessary by the Dental Council to gain all the requirements to obtain full registration, such as English language proficiency. These new processes were finalised in August 2022.

It is welcoming to hear that all enquiries who are mainly Ukrainian professionals contacting the Council about registration have been responded to so far.

Question No. 146 answered with Question No. 143.

Hospital Appointments Status

Questions (147)

Barry Cowen

Question:

147. Deputy Barry Cowen asked the Minister for Health for an update on the case of a person (details supplied); and when the person concerned can expect an appointment in the Royal Victoria Eye and Ear Hospital, Dublin. [8138/24]

Written answers

Minister for Health

Under 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.

Health Promotion

Questions (148)

Louise O'Reilly

Question:

148. Deputy Louise O'Reilly asked the Minister for Health if he will commission a report on the commercial determinants of health; if, like the CMO in Wales, his Department will examine the strategies and approaches used to promote products and choices that can have a positive and a negative influence on our health; and if he will make a statement on the matter. [8164/24]

Written answers

Minister of State at the Department of Health

The World Health Organisation (WHO) guidance on Commercial Determinants of Health, defines these as “the private sector activities that affect people’s health, directly or indirectly, positively or negatively”. Commercial determinants can impact a wide range of risk factors- such as smoking, alcohol use, air quality, obesity, physical inactivity and health outcomes, including non-communicable disease, cancer, mental and physical health.

Healthy Ireland supports a range of initiatives across Government departments, agencies and civil society to promote “physical and mental health and wellbeing to their full potential, where wellbeing is valued and supported at every level of society and is everyone’s responsibility.” Policies contained in the Healthy Ireland strategic implementation plan (HISIP) include the National Physical Activity Plan, the National Sexual Health Strategy, the National Mental Health Promotion Plan and the National Obesity Policy Action Plan.

The Department of Health has made progress in reducing exposure to tobacco and alcohol, ever since the smoking ban was introduced as a health promotion initiative in 2004. Recently, the Public Health (Tobacco Products and Nicotine Inhaling Products) Act 2023 forms part of a comprehensive suite of reforms- including the prohibition on the sale of tobacco products and nicotine inhaling products to those aged under 18- to reduce smoking and its harmful effects. The Minister for Health is also developing legislation to further regulate tobacco and nicotine inhaling products.

The Public Health (Alcohol) Act was enacted in 2018 with 28 of the 31 provisions now commenced. The Act seeks to address the high volumes and harmful patterns of consumption of alcohol prevalent in Ireland through a suite of measures including minimum unit pricing, the regulation of advertising and sponsorship, the display of products in mixed retail outlets and the regulation of the sale and supply of alcohol.

In the past year, the Minister has signed into law the Public Health (Alcohol) (Labelling) Regulations 2023, provided for under section 12 of the Act and commenced the Broadcast Watershed provision of the Public Health (Alcohol) Act, which will come into effect in 2026 and 2025 respectively.

From an obesity and nutrition perspective, A Healthy Weight for Ireland, the Obesity Policy and Action Plan (OPAP), was launched in September 2016 under the auspices of the Healthy Ireland Framework (Healthy Ireland: A Framework for Improved Health and Wellbeing 2013-2025). It was developed in recognition of the growing need for a coordinated policy response to the increasing problem of obesity in Ireland and the increasing burden placed on individuals and society.

OPAP covers a 10-year period up to 2025 and aims to reverse obesity trends, prevent health complications, and reduce the overall burden for individuals, families, the health system, and the wider society and economy. It recognises that obesity is a complex, multi-faceted problem and needs a multi-pronged solution, with every sector of society playing its part. Childhood obesity is a key priority under OPAP, as is reducing the inequalities seen in obesity rates, where children (and adults) from lower socioeconomic groups have higher levels of obesity. OPAP is well aligned with the World Health Organisation in terms of the breadth of policy measures that have been introduced or are being considered in order to address the obesity epidemic.

Under OPAP, commitment was given to “develop proposals for a levy on sugar-sweetened drinks”, and “review the evidence…for fiscal measures on products that are high in fat, sugar and salt.”

Following a proposal developed by this Department in consultation with stakeholders, the Department of Finance introduced the Sugar-Sweetened Drinks Tax (SSDT) in 2018. The SSDT has now been in operation for more than five years. Initial indications are that the tax has had a positive impact, particularly in terms of encouraging drinks producers to reduce the sugar content in their products.

In August 2023 the Department issued a request for tender for an external evaluation of the SSDT with the outcomes of interest to include anyone, or all, of the following:

- the extent to which the tax was successful in realizing the objectives as stated in the original policy document and set out below:

(1) that individuals reduce consumption of sugar sweetened drinks by reducing the amount consumed or switching to healthier choices.

(2) that industry reformulates products to reduce (not necessarily remove) levels of added sugar in the drinks products.

- other impacts that the tax may have on public health as identified by recent studies, such as evaluations of dental outcomes and also the measurement of the impact on metabolic markers;

- subgroup analysis focusing on the effect on groups such as those overweight/obese, children, lower income individuals/families.

A contract for the evaluation was awarded in September 2023. The evaluation is ongoing, and we expect it to be complete in April 2024. The Department intends to publish it in a timely manner.

The Department of Finance has been consulted as part of the evaluation. This Department will be engaging with the Department of Finance in considering the findings of the evaluation.

Step three of the Obesity Policy and Action Plan – A Healthy Weight for Ireland’ (OPAP, DOH 2016) relates to food reformulation. It aims to ‘secure appropriate support from the commercial sector to play its part in obesity prevention and agree food industry reformulation targets and review progress’.

To achieve this, a Food Reformulation Subgroup of the Obesity Policy Implementation Oversight Group developed a Roadmap for Food Product Reformulation in Ireland (Department of Health, 2021).

To deliver the Roadmap, the Food Reformulation Task Force, a strategic partnership between Healthy Ireland and the Food Safety Authority of Ireland (FSAI), was established in 2021.

The Food Reformulation Task Force is tasked with implementing the Roadmap and monitoring the progress made in modifying the nutrient profile in processed packaged food over a four year programme up to 2025.

When referred to in the context of the Roadmap for Food Product Reformulation in Ireland, food reformulation means improving the nutritional content of commonly consumed processed foods and drinks. This is achieved by reducing energy (calories) and target nutrients (saturated fat, sugar, and salt) to ensure a healthier food supply. Specifically, the Roadmap sets targets for the reduction of energy (calories) and sugar by 20% and salt and saturated fat by 10% between 2015 and 2025. The current programme is voluntary; outcomes of the reformulation programme will be evaluated to guide future policy options.

Reducing the marketing of foods high in fat, salt and sugar is a policy initiative that has been identified in OPAP as it can impact food consumption behaviour. Coimisiún na Meán was established in March 2023 further to the provisions of the Online Safety and Media Regulation Act 2022 (“OSMR Act 2022”).

As the regulator for broadcasting in Ireland, Coimisiún na Meán is to establish a regulatory framework for online safety, update the regulation of television broadcasting and audiovisual on-demand services, and transpose the revised Audiovisual Media Services Directive into Irish law. Officials from the Department of Health have met with officials from An Coimisiún to discuss implementing codes that would restrict the marketing of high fat, sugar and salt foods and beverages to children and will continue to engage with An Coimisiún going forward.

The Department commissioned an evaluation of progress implementation of OPAP by University College Cork (UCC) in 2021 which was published in 2022. The review of OPAP suggests that many policy options that the WHO European Regional Obesity Report 2022 recommends on managing obesity throughout the life course, are in progress of being implemented.

As OPAP is coming to an end in 2025, officials in the Department are in the early stages of planning the successor. At present there are no plans to commission a separate report into the commercial determinants of health, as the Institute of Public Health and other research colleagues, have commenced research in this area. In preparation for the next OPAP, examination of recent research and best practice relating to healthy eating promotion and prevention, management, and treatment of overweight and obesity will be taken into consideration, including studies relating to commercial determinants of health.

Health Promotion

Questions (149)

Louise O'Reilly

Question:

149. Deputy Louise O'Reilly asked the Minister for Health the number of times officials from his Department, in health and well-being and the food unit, have met with Coimisiún na Meán; if he can outline the dates of and delegates attending each meeting, as well as the topics of discussion; and if he will make a statement on the matter. [8165/24]

Written answers

Minister of State at the Department of Health

Coimisiún na Meán was established in March 2023 further to the provisions of the Online Safety and Media Regulation Act 2022 (“OSMR Act 2022”) www.irishstatutebook.ie/eli/2022/act/41/enacted/en/html. The OSMR Act 2022 amended the Broadcasting Act 2009, www.bai.ie/en/download/128802/, to establish Coimisiún na Meán and dissolve the Broadcasting Authority of Ireland (“BAI”).

In addition to undertaking the functions of the BAI as the regulator for broadcasting in Ireland, Coimisiún na Meán is to establish a regulatory framework for online safety, update the regulation of television broadcasting and audiovisual on-demand services, and transpose the revised Audiovisual Media Services Directive into Irish law.

The Health and Wellbeing Unit in the Department of Health has met bilaterally with Comisiún na Meán on two occasions. The first meeting took place on June 6th 2023 on Microsoft Teams, where the Head of Healthy Ireland and an official at AP level met with Niamh Hodnett, Online Safety Commissioner in An Coimisiún, as well as 3 other officials. The main topics of discussion at this meeting were centred around the establishment of An Comisiún and the work that was going to be undertaken for the first set of online safety codes.

The second meeting between the Health & Wellbeing Unit and An Coimisiún took place on the 25th of January 2024 in the Department of Health. In attendance were the Head of Healthy Ireland and officials at AP and AO level, and the Director of Codes & Rules from Coimisiún na Meán. Issues discussed at this meeting were the outcome of the EU Joint Action Best ReMaP, the Nutrient Profile Model, the Work Programme of the Coimisiún, the consultation on the online safety code that was that was out at the time (which the Department of Health submitted a response to) and how progress could be made on addressing unhealthy foods and beverages within the codes. Both the Department and the Coimisiún na Mean agreed to work together and with other relevant stakeholders to progress this agenda.

Officials from Food Unit in the Department of Health have not met with officials from Coimisiún na Meán.

Food Industry

Questions (150)

Louise O'Reilly

Question:

150. Deputy Louise O'Reilly asked the Minister for Health if, and which, industry trade bodies have signed up to the Roadmap for Food Product Reformulation in Ireland; and if he will make a statement on the matter. [8166/24]

Written answers

Minister of State at the Department of Health

Step three of the The Obesity Policy and Action Plan – A Healthy Weight for Ireland’ (OPAP, DOH 2016) relates to food reformulation. It aims to ‘secure appropriate support from the commercial sector to play its part in obesity prevention and agree food industry reformulation targets and review progress’.

To achieve this a Food Reformulation Subgroup of the Obesity Policy Implementation Oversight Group developed a Roadmap for Food Product Reformulation in Ireland (Department of Health, 2021).

During the process of development of A Roadmap for Food Product Reformulation in Ireland, workshops were held with members of the food industry, including trade associations, to provide input into the Roadmap.

Since the Task Force was established in 2022, regular events and meetings have been held for and with the food industry and trade associations to inform and clarify food reformulation targets and identify priority food categories for food reformulation. To date the Task Force has held four industry wide events, two in person and two online. Alongside this, the Task Force has held three category focused reformulation meetings which trade associations have supported in organising and attending. The Task Force meet at least twice a year with the Food Safety Authority of Ireland Food Service forum which is composed of representatives of the out of home sector, including trade associations and the Retail Forum which is made up of representative from the retail sector. Finally, the Task Force communicate through their Food Reformulation Network which has over 400 members and keep their webpage up to date with guidance, publications, and updates .

The Task Force met with over 70 stakeholders in 2022, and 113 stakeholders in 2023. Many of these meetings took place with the food industry, meetings were also held with government bodies and agencies, universities, charities and professional organisations. Since 2022, at the request of Food Drink Ireland, the Task Force has facilitated 3-4 meetings per year. Stakeholders have been asked to publish a statement of support and commitment to the ‘Roadmap for Food Product Reformulation in Ireland’. Whilst many stakeholders have statements of support for reformulation, to date no trade association has made a written statement of support specifically for A Roadmap for Food Product Reformulation in Ireland.

An evaluation of the work of the food reformulation taskforce towards the end of the four-year project will be undertaken. The impact of reduction in nutrient targets, improved quality of nutritional composition of packaged and processed foods and, engagement with food industry partners will inform subsequent action. Currently food reformulation is voluntary and further resources to support industry in meeting nutrient reduction targets and or consideration for mandatory legislation will be required as potential policy options based on the outcomes of the taskforce.

Obesity Levels

Questions (151)

Louise O'Reilly

Question:

151. Deputy Louise O'Reilly asked the Minister for Health what work is under way in his Department on the successor to the Obesity Policy and Action Plan; if he can outline what reviews and evidence gathering is under way; and if he will make a statement on the matter. [8167/24]

Written answers

Minister of State at the Department of Health

A Healthy Weight for Ireland, the Obesity Policy and Action Plan (OPAP), was launched in September 2016 under the auspices of the Healthy Ireland Framework (Healthy Ireland: A Framework for Improved Health and Wellbeing 2013-2025). It was developed in recognition of the growing need for a coordinated policy response to the increasing problem of obesity in Ireland and the increasing burden placed on individuals and society.

OPAP covers a 10-year period up to 2025 and aims to reverse obesity trends, prevent health complications, and reduce the overall burden for individuals, families, the health system, and the wider society and economy. It recognises that obesity is a complex, multi-faceted problem and needs a multi-pronged solution, with every sector of society playing its part. Childhood obesity is a key priority under OPAP, as is reducing the inequalities seen in obesity rates, where children (and adults) from lower socioeconomic groups have higher levels of obesity. OPAP is well aligned with the World Health Organisation in terms of the breadth of policy measures that have been introduced or are being considered in order to address the obesity epidemic.

A mid-term evaluation was carried out by UCC which covered the period 2016 to May 2021 which examined implementation and progress on delivery of the actions under the OPAP. Separately, an internal review of the Obesity Policy Action Plan was published by the Department in November 2022 which provided an update on the status of some of the main deliverables in the Ten Steps suite of population-health approaches of the OPAP.

The current OPAP runs through to the end of 2025 and a successor Obesity Policy and Action Plan will be due at the beginning of 2026. Initial discussions have started at official level in the Obesity and Nutrition policy unit in the Department with a view to preparing the development of the next OPAP. Findings from the UCC Evaluation, the internal OPAP review, developments at an EU and international level in the past number of years, including the work of the EU Joint Action Best ReMaP will be key to consideration of the next OPAP. Consultations with stakeholders in due course will also be part of the development of the successor OPAP.

Obesity Levels

Questions (152)

Louise O'Reilly

Question:

152. Deputy Louise O'Reilly asked the Minister for Health what suite of policy options on nutrition for Ireland were identified by the WHO to inform the midterm review of the Obesity Policy and Action Plan; and if he will make a statement on the matter. [8168/24]

Written answers

Minister of State at the Department of Health

A Healthy Weight for Ireland, the Obesity Policy and Action Plan (OPAP), was launched in September 2016 under the auspices of the Healthy Ireland Framework (Healthy Ireland: A Framework for Improved Health and Wellbeing 2013-2025). It was developed in recognition of the growing need for a coordinated policy response to the increasing problem of obesity in Ireland and the increasing burden placed on individuals and society.

OPAP covers a 10-year period up to 2025 and aims to reverse obesity trends, prevent health complications, and reduce the overall burden for individuals, families, the health system, and the wider society and economy. It recognises that obesity is a complex, multi-faceted problem and needs a multi-pronged solution, with every sector of society playing its part. Childhood obesity is a key priority under OPAP, as is reducing the inequalities seen in obesity rates, where children (and adults) from lower socioeconomic groups have higher levels of obesity. OPAP is well aligned with the World Health Organisation in terms of the breadth of policy measures that have been introduced or are being considered in order to address the obesity epidemic.

A mid-term evaluation was carried out by UCC which covered the period 2016 to May 2021 which examined implementation and progress on delivery of the actions under the OPAP. A copy of this Evaluation is attached for information.

Separately, an internal review of the Obesity Policy Action Plan was published by the Department in November 2022 which provided an update on the status of some of the main deliverables in the Ten Steps suite of population-health approaches of the OPAP.

In preparing the review, the Department of Health sought support from the WHO on identifying Policy Options for better Nutrition in Ireland.

The WHO recommendations are grouped around 5 key themes, set out below:

Theme 1- Healthy Food and Drink Environments

Theme 2- Healthy Diets throughout the Life-course

Theme 3- Health Systems for the Promotion of Healthy Diets

Theme 4- Surveillance, Monitoring, Evaluation and Research

Theme 5: Governance and Intersectoral Alliances

The full review of the OPAP is attached and the WHO Policy Options on Nutrition for Ireland can be found at Appendix 2.

The OPAP Review aligns the Ten Steps in OPAP with the WHO European Regional Obesity Report 2022 which included wide-ranging policy options the WHO recommends for addressing and managing obesity throughout the life-course, in addition to the WHO policy options on nutrition for Ireland.

Evaluation of the Implementation of A Healthy Weight for Ireland

OPAP Review

Disease Management

Questions (153)

Louise O'Reilly

Question:

153. Deputy Louise O'Reilly asked the Minister for Health if his Department is involved in JA PreventNCD, an EU initiative bringing together 25 participating nations to tackle non-communicable diseases; if so, which unit is responsible for this; and if he will make a statement on the matter. [8169/24]

Written answers

Minister for Health

My Department has nominated the National Cancer Control Programme within the HSE to participate as the Irish lead on the JAPreventNCD given its focus on Cancer and other NCD prevention.

Further information on the Project can be found here: ec.europa.eu/info/funding-tenders/opportunities/portal/screen/opportunities/projects-details/43332642/101128023/EU4H?programmePeriod=2021-2027&programId=43332642&freeKeywords=Prevent%20NCD&order=DESC&page=1&pageSize=10

Nursing Education

Questions (154)

Peter Burke

Question:

154. Deputy Peter Burke asked the Minister for Health the reason a student nurse (details supplied) is not entitled to the accommodation allowance to facilitate their work placement; and if he will make a statement on the matter. [8172/24]

Written answers

Minister for Health

As the Deputy may be aware, following approval by Government on 13 December 2022, I was pleased to announce €9 million in additional supports for student nurses and midwives. €5.4m of this funding provides for an enhanced Travel and Subsistence Scheme for eligible students in publicly funded undergraduate nursing and midwifery courses while attending their supernumerary clinical practice placements. Supernumerary students in midwifery, general, combined children's and general, intellectual disability and psychiatric nursing all have the same entitlement.

The Department of Health Circular 4/2023 issued to the HSE on 27 February 2023, set out the revised arrangements.The scheme provides a targeted and more equitable approach to supporting these students and two of it's main features are:

• a new rate of €80 for overnight accommodation along with an increased weekly cap of €300, (for those eligible supernumerary students who require accommodation away from their normal place of residence while attending practice placements)

• supernumerary students on the undergraduate nursing/midwifery programme continue to be entitled to claim for payment of travel expenses necessarily incurred while attending placements, on the basis of receipts provided by the student and certified by the Student Allocation Liaison Officer (SALO) in the clinical partner site. Public transport should be used wherever possible. Where public transport is not available and the use of private transport is necessary to attend placements, a supernumerary student is entitled to claim for payment of these necessarily incurred travel expenses. These should be paid on the same basis as that which applies generally in the public sector.

As individual cases in individual sites are the responsibility of the HSE, I have asked the HSE to respond directly to the Deputy on this matter.

Hospital Appointments Status

Questions (155)

Pa Daly

Question:

155. Deputy Pa Daly asked the Minister for Health when a person (details supplied) can expect to receive an appointment for a surgical procedure; and if he will make a statement on the matter. [8173/24]

Written answers

Minister for Health

Under 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.

Primary Care Centres

Questions (156)

Rose Conway-Walsh

Question:

156. Deputy Rose Conway-Walsh asked the Minister for Health to provide an update on the Ballyhaunis primary care centre; and if he will make a statement on the matter. [8177/24]

Written answers

Minister for Health

As the Health Service Executive (HSE) holds responsibility for the provision, along with the maintenance and operation of Primary Care Centres, I have asked the HSE to respond to the Deputy directly, as soon as possible.