Written Answers Nos. 336-367
336. Deputy Bernard J. Durkan asked the Minister for Children, Equality, Disability, Integration and Youth if appropriate health and multi-disciplinary assistance including occupational therapy, speech and language therapy is available in the case of a person (details supplied); and if he will make a statement on the matter. [11492/24]
View answerAs this question refers to service matters, I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible. The Deputy will likely be aware that the industrial action by certain Forsa grades in the HSE has been suspended. The HSE has indicated that they have recommenced issuing replies to questions but there is a significant backlog of PQs and Reps to be responded to and has advised that they are working to get through these as soon as possible while at the same time managing the volume of current PQs and Reps.
337. Deputy Colm Burke asked the Minister for Health to set out in tabular form the current waiting times for elderly home support services across the different regions nationally, and what action his Department is taking to reduce these waiting times; and if he will make a statement on the matter. [11317/24]
View answerAs this question refers to service matters, I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible. The Deputy will likely be aware that the industrial action by certain Forsa grades in the HSE has been suspended. The HSE has indicated that they have recommenced issuing replies to questions but there is a significant backlog of PQs and Reps to be responded to and has advised that they are working to get through these as soon as possible while at the same time managing the volume of current PQs and Reps.
338. Deputy Mick Barry asked the Minister for Health to report on the reports of deaths in Cherry Orchard hospital; if he will initiate a full investigation into the matter; and if he will make a statement on the matter. [11200/24]
View answerIn May 2023, a HIQA inspection identified concerns in relation to the flooring in both the Sycamore and Willow Units at Cherry Orchard Hospital. These presented a significant potential health and safety risk. A subsequent HSE review indicated that the flooring has underlying structural issues which require immediate remedial work.
The HSE has decided to close both Units and relocate the residents to Clondalkin Lodge in the first instance, which is a private nursing home, on a temporary basis while the necessary structural works are completed. However a resident and their families are free to choose a nursing home that is suitable to their needs. It is expected that the works will take a minimum of 1 year to complete.
The residents of Cherry Orchard Hospital are being moved to more suitable accommodation on a phased basis. The phased move will have due regard to their needs, current proximity to each other and relationships within the unit.
The safety and wellbeing of residents and staff is the primary concern. All appropriate options were considered before committing to this move.
The HSE is working in consultation with residents, their families and staff while giving full consideration to health and safety concerns and regulatory compliance.
There is on-going monitoring and risk assessment to ensure that there is no immediate hazard to residents.
The HSE has reassured me that each care plan for this temporary move will include therapeutic input required and a review of charges to ensure that no one experiences adverse financial exposure. All additional charges will be covered by the HSE for the duration of the works.
There will be a medical social worker and an Assisted Decision Making lead available on site for the duration of this move. In addition, all residents have on site details for an independent advocate service should they wish to contact them.
I have been advised that there is no impact on other structures on the campus as the issues relate solely to the two modular buildings Willow and Sycamore units.
As of 27 February, 40 Residents are currently transferred from Cherry Orchard Campus and 22 residents currently remain on-site.
The HSE have been closely monitoring the situation since transfers began last November. In the absence of sufficient data to indicate the move to alternative accommodation has lead to an earlier than expected loss of life, there is no immediate need to initiate an investigation into this matter. This does not mean that an investigation can be fully ruled out at any future time.
Nevertheless, as the specific query raised by the Deputy is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
339. Deputy Seán Crowe asked the Minister for Health the total number of children on a waiting list for their first appointment to CAMHS in the CHO7 area; and the number of those waiting more than six months. [11209/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
340. Deputy Seán Crowe asked the Minister for Health the average length of treatment an individual receives in the CAMHS system. [11210/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
341. Deputy Seán Crowe asked the Minister for Health to outline the referral pathway to the ADHD clinic in the CHO7 area. [11211/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
342. Deputy Peadar Tóibín asked the Minister for Health if he has investigated the potential misuse of ambulances for personal use within the NBS; and the number of ambulance vehicles parked outside offices during the day or being used to drive to and from work by staff. [11218/24]
View answerAs this is an operational matter for the National Ambulance Service (NAS) I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
343. Deputy Michael Lowry asked the Minister for Health the plans in place for a unit for older persons in Clonmel following the transfer of residents to a new residential care services unit (details supplied); and if he will make a statement on the matter. [11227/24]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE recently ended the industrial action which commenced on 6 October 2023. As a consequence, members in these grades were not engaging with political forums or processes. As a result of the accumulated backlog, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
344. Deputy Michael Lowry asked the Minister for Health if there are any specific factors that would restrict the allocation of palliative care support beds to an existing unit (details supplied) once the current residents have been transferred to the new residential care services; and if he will make a statement on the matter. [11228/24]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE recently ended the industrial action which commenced on 6 October 2023. As a consequence, members in these grades were not engaging with political forums or processes. As a result of the accumulated backlog, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
345. Deputy Michael Lowry asked the Minister for Health if he will request HSE Estates to supply a copy of the report in relation to the status of the roof in a care centre (details supplied); and if he will make a statement on the matter. [11229/24]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE recently ended the industrial action which commenced on 6 October 2023. As a consequence, members in these grades were not engaging with political forums or processes. As a result of the accumulated backlog, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
346. Deputy Michael Ring asked the Minister for Health to quantify the amount of money spent on the treatment purchase fund in each of the last five years, in tabular form; and if he will make a statement on the matter. [11233/24]
View answer351. Deputy Michael Ring asked the Minister for Health the countries where treatment was delivered under the treatment purchase fund in each of the past five years, in tabular form; and if he will make a statement on the matter. [11248/24]
View answerThe National Treatment Purchase Fund (NTPF) was established under the Health (Corporate Bodies) Act 1961, with the function of providing hospital treatment for citizens and the collection and validation of information in relation to waiting lists. Its role was extended in 2009 (via the Nursing Home Support Scheme Act, 2009) to provide for negotiations with private nursing homes in the context of fees payable for Fair Deal clients. In providing hospital treatment the NTPF works with both pubic hospitals (insourcing) and private hospitals (outsourcing) . In order to ensure competitive pricing as part of their outsourcing programme, the NTPF works with private hospitals from a panel agreement and engages in procurement processes through e-tender. The clinical suitability of the patient to avail of NTPF funded treatment is determined by the public hospital. The availability of capacity for the specific procedure required by the patient is a factor in the selection of treatment provider, as well as the ability and willingness of the patient to travel to another hospital to avail of treatment.
In relation to the particular queries raised by the Deputy, the NTPF has advised my Department that treatment funded by the NTPF took place within the State and in Northern Ireland in each of the last five years. The attached table outlines the amount of funding drawn down each year by the NTPF from 2019 to 2023.
National Tretament Purchase Fund Amounts Drawn Down 2019-2023
|
Year |
€ |
|
2019 |
€75,000,000 |
|
2020 |
€80,000,000 |
|
2021 |
€110,000,000 |
|
2022 |
€125,000,000 |
|
2023 |
€190,000,000 |
Source: NTPF Certified Annual Financial Statements 2019-2022, Draft Annual Financial Statements 2023
347. Deputy Mark Ward asked the Minister for Health if he has the statutory powers under Section 34 of the Mental Health Act 2001 to regulate CAMHS; if he will do so as it is the primary recommendation made by the Mental Health Commission in its report on CAMHS; why he has not done so to date; and if he will make a statement on the matter. [11235/24]
View answerNo, neither I nor the Minister for Health have the statutory powers under Section 34 of the Mental Health Act 2001 to regulate community CAMHS. The proposed use of section 34 to regulate community CAMHS would be beyond the scope of what that section provides for and would fail the principles and policies test, leaving any regulation made thereunder legally unsound and very vulnerable to legal challenge.
Internal legal advice on the use of section 34 of the 2001 Act supports this view.
A robust legal framework is necessary to underpin any regulation. This is as true in mental health services as in any other sector. For example, the regulation of approved centres (including inpatient CAMHS), and the power of the Inspector of Mental Health Services to inspect these services, is set out in detail across the Mental Health Act 2001, particularly sections 51, 52 and 69, as well as all of Part 5 of the Act. The Mental Health Act 2001 (Approved Centres) Regulations provide a further legal basis for the regulation of approved centres.
The only way to ensure the regulation of all community mental health services has a proper legal basis is through primary legislation that includes a robust legal framework setting out powers related to registration, regulation, and inspection of such services, and including provisions related to enforcement and penalties for noncompliance.
My officials are in the final months of drafting a new Mental Health Bill that will comprehensively address the regulation of all community mental health services, for adults and for children. The Bill will also provide a revised approach to the involuntary admission process, an overhauled approach to consent to treatment provisions, a more human rights-centred approach, additional safeguards for people accessing inpatient services, and a new, discrete Part of the Bill related to the care and treatment of children and young people. I will introduce the Bill to the Oireachtas in the summer Dáil session, following its finalisation and publication.
348. Deputy Mark Ward asked the Minister for Health the number of individuals that have been seen by the national clinical care programme for self-harm and suicide related ideation by year since it was established; the number of individuals that received a follow up appointment after being discharged for the same time period; the services offered to these individuals; and if he will make a statement on the matter. [11238/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
349. Deputy Johnny Guirke asked the Minister for Health the number of people that were on the waiting list for homecare packages in County Meath, at the end of each year from 2015 to 2023, in tabular form. [11239/24]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE recently ended the industrial action which commenced on 6 October 2023. As a consequence, members in these grades were not engaging with political forums or processes. As a result of the accumulated backlog, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
350. Deputy Johnny Guirke asked the Minister for Health the number of people that were on the waiting list for homecare packages in County Westmeath, at the end of each year from 2015 to 2023, in tabular form. [11240/24]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE recently ended the industrial action which commenced on 6 October 2023. As a consequence, members in these grades were not engaging with political forums or processes. As a result of the accumulated backlog, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
352. Deputy Paul Murphy asked the Minister for Health in relation to the funding crisis facing the Understanding and Managing Adult ADHD Programme (UMAAP) currently delivered via ADHD Ireland and the recent decision by the HSE to withdraw funding for UMAAP in 2024; and if he will instruct the HSE to reverse this decision and ensure the continuation of this vital programme. [11268/24]
View answerADHD has long been recognised as one of the most common psychiatric disorders in children and it is now known to persist into adulthood. Core symptoms include inattention, hyperactivity and impulsivity.
It can cause many issues in areas such as personal and social relations, education and occupation, managing money and organising life in general, there is also an increased risk of having other mental health difficulties with it such as anxiety and depression.
Children can access ADHD assessments through the National Educational Psychological Service. In addition to this, as per the CAMHS Operational Guidelines, CAMHS take referrals for children and adolescents up to age 18 with moderate to severe ADHD.
I am aware that prior to the inception of the National Clinical Programme for Adults with ADHD which I launched in 2021, there were no specific ADHD public services available for Adults in Ireland.
The NCP for ADHD is delivered as part of the HSE’s mental health service provision to ensure an integrated, person-centred response to adults with ADHD. The programme includes both assessment and treatment of the disorder and works collaboratively with voluntary agencies. It envisages a national service of ADHD teams, with each Team comprised of Consultant Psychiatrist, Senior Psychologist, Senior Occupational Therapist, Clinical Nurse Specialist Mental Health, and an administrator.
Enhancement of specialist mental health services such as ADHD is a key priority for myself as a Minister, the Government as a whole and the HSE. Since 2021, over €3 million has been made available for funding ADHD posts from Programme for Government funding. This has enabled the set-up of 5 ADHD Teams with recruitment of over 25 posts, and two more teams are currently in development with posts funded for them.
In addition, as part of the National Clinical Programme adults funding of €150,000 was allocated to facilitate a collaboration with ADHD Ireland and the UCD School of Psychology to develop an ADHD app and the UMAAP Programme (Understanding and Managing Adult ADHD Programme). Both the ADHD App and the UMAAP Programme have proven to be two very positive resources for people with ADHD.
The UMAAP Programme is delivered as a 5-week workshop, and its aim is to provide education and tools for adults on how to manage ADHD.
I am pleased to confirm that further to recent discussions between the Department of Health and the HSE to finalise 2024 mental health funding, ADHD Ireland will be provided with funding for provision of the UMAAP Programme in 2024 and beyond. I look forward to launching the UMAAP Programme in April as agreed with ADHD Ireland.
353. Deputy Mark Ward asked the Minister for Health for a timeframe for the fully domestic provision of gender and sexual health services which are in line with international best practice and based on informed consent; and if he will make a statement on the matter. [11273/24]
View answerAs the Deputy may be aware, the HSE has identified the need to develop an updated and integrated Model of Care for transgender services, informed by the best evidence-based clinical care for individuals who express gender incongruence or dysphoria.
In this regard, the HSE is in the process of establishing a multi-disciplinary team and the position of Clinical Lead for Transgender Services has been offered to an applicant. This person, once in place, will lead the team to design and agree a Model of Care for transgender healthcare in Ireland and to form an implementation plan.
It is important that the HSE is given time and space to consider all of the issues and develop a Model of Care that will appropriately serve those who are experiencing gender incongruence / dysphoria.
There is a clear and well-established approach to the development of this model of care which will incorporate best available clinical evidence and incorporates input from healthcare professionals, patient advocates and those with lived experience.
My department welcomes the development of a model of care which will deliver a high quality seamless and integrated service for people with gender identity issues.
354. Deputy Catherine Connolly asked the Minister for Health the reason for the decision to discontinue HSE funding for a programme (details supplied); when the decision was made; the details of the analysis on which the decision was based; the details of any analysis carried out into the expected impact of the withdrawal of funding; the details of any engagement he or his Department has had with adult ADHD advocacy and representative groups in relation to the withdrawal of funding to this programme; and if he will make a statement on the matter. [11286/24]
View answerADHD has long been recognised as one of the most common psychiatric disorders in children and it is now known to persist into adulthood. Core symptoms include inattention, hyperactivity and impulsivity.
It can cause many issues in areas such as personal and social relations, education and occupation, managing money and organising life in general, there is also an increased risk of having other mental health difficulties with it such as anxiety and depression.
Children can access ADHD assessments through the National Educational Psychological Service. In addition to this, as per the CAMHS Operational Guidelines, CAMHS take referrals for children and adolescents up to age 18 with moderate to severe ADHD.
I am aware that prior to the inception of the National Clinical Programme for Adults with ADHD which I launched in 2021, there were no specific ADHD public services available for Adults in Ireland.
The NCP for ADHD is delivered as part of the HSE’s mental health service provision to ensure an integrated, person-centred response to adults with ADHD. The programme includes both assessment and treatment of the disorder and works collaboratively with voluntary agencies. It envisages a national service of ADHD teams, with each Team comprised of Consultant Psychiatrist, Senior Psychologist, Senior Occupational Therapist, Clinical Nurse Specialist Mental Health, and an administrator.
Enhancement of specialist mental health services such as ADHD is a key priority for myself as a Minister, the Government as a whole and the HSE. Since 2021, over €3 million has been made available for funding ADHD posts from Programme for Government funding. This has enabled the set-up of 5 ADHD Teams with recruitment of over 25 posts, and two more teams are currently in development with posts funded for them.
In addition, as part of the National Clinical Programme adults funding of €150,000 was allocated to facilitate a collaboration with ADHD Ireland and the UCD School of Psychology to develop an ADHD app and the UMAAP Programme (Understanding and Managing Adult ADHD Programme). Both the ADHD App and the UMAAP Programme have proven to be two very positive resources for people with ADHD.
The UMAAP Programme is delivered as a 5-week workshop, and its aim is to provide education and tools for adults on how to manage ADHD.
I am pleased to confirm that further to recent discussions between the Department of Health and the HSE to finalise 2024 mental health funding, ADHD Ireland will be provided with funding for provision of the UMAAP Programme in 2024 and beyond. I look forward to launching the UMAAP Programme in April as agreed with ADHD Ireland.
355. Deputy Michael Healy-Rae asked the Minister for Health when a person will get an appointment in University Hospital Kerry (details supplied); and if he will make a statement on the matter. [11287/24]
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.
356. Deputy Thomas Gould asked the Minister for Health the average cost of an addiction nurse per year. [11291/24]
View answerAs this refers to a service matter, I have sent this PQ to the HSE for direct response. 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.
357. Deputy Thomas Gould asked the Minister for Health the average cost of an outreach worker per year. [11292/24]
View answerAs this relates to the funding of a particular role, I have referred to HSE for direct response.
358. Deputy Thomas Gould asked the Minister for Health the average cost of an addiction case worker per year. [11293/24]
View answerAs this refers to a service matter, I have sent this PQ to the HSE for direct response. 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.
359. Deputy Thomas Gould asked the Minister for Health the funding provided to a service (details supplied) in 2023 broken down by funding purpose, in tabular form. [11294/24]
View answerAs this refers to a service matter, I have sent this PQ to the HSE for direct response. 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.
360. Deputy Thomas Gould asked the Minister for Health the average cost of an addiction counsellor per year. [11295/24]
View answerAs this refers to a service matter, I have sent this PQ to the HSE for direct response. 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.
361. Deputy Maurice Quinlivan asked the Minister for Health if an assessment for a person (details supplied) will be expedited; and if he will make a statement on the matter. [11296/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
362. Deputy Alan Dillon asked the Minister for Health if consideration is being given to the establishment of a dedicated Intestinal Failure Unit in Ireland; and if he will make a statement on the matter. [11298/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
363. Deputy Colm Burke asked the Minister for Health the proposed start date for the implementation of the proposals in the National Clinical Programme for Ophthalmology, and in particular the transfer of care of children aged 8+ years to local private optometrists; and if he will make a statement on the matter. [11299/24]
View answerSight testing, eye examinations and optical appliances are provided to medical card holders by ophthalmologists, optometrists and dispensing opticians through the Community Ophthalmic Services Schemes (COSS). Patients may access these services following a referral by a healthcare professional such as their general practitioner.
All children, including those not covered by a medical card, receive a vision screen while in national school from a Public Health Nurse. The Health Service Executive (HSE) provides optical services free of charge to pre-school children and national school children referred from child health service and school health service examinations who are discovered to have sight problems. These children are referred to the appropriate consultant for treatment. In such circumstances, these services will continue to be provided until the child has reached the age of 16.
The HSE Primary Care Eye Services Review Group Report, published in June 2017, highlighted the limitations of the current model of service delivery and set out the way forward for a significant amount of eye services to be delivered in a primary care setting. The Report estimated that 60% of existing outpatient activity could be moved to primary care thus enabling hospital services to focus on patients who require more specialist diagnostics or treatments.
The National Clinical Programme for Ophthalmology has developed a model of care which details how the realignment of eye services from the acute hospitals to the community will be undertaken. Included in current priorities is transferring the care of children aged 8+ years to the care of local private optometrists.
A project team with a wide-ranging membership was established in late 2019 / early 2020 to progress this initiative. The work of the team was paused due to the requirement to focus resources on the COVID 19 pandemic. However, the project team has been reconvened and is progressing matters in relation to this initiative. I have requested that the HSE develop a full implementation plan for consideration by my Department.
364. Deputy Colm Burke asked the Minister for Health when the commitment to increase the fees payable to contractors for a standard eye examination under the Community Ophthalmic Services Scheme will occur; to clarify if this fee will now be equal to the eye test fee payable to contractors under the Department of Social Protection's optical benefit scheme; and if he will make a statement on the matter. [11300/24]
View answerThe Community Ophthalmic Services Scheme (COSS) is a national fee-per-item scheme which was introduced in 1979. Under the COSS, medical card holders aged over 16 years can be seen by ophthalmologists, community ophthalmic physicians, optometrists or dispensing opticians.
Eligible patients can receive an eye examination and be provided with prescribed optical appliances in accordance with a national schedule of approved optical appliances.
The Health Professionals (Reduction of Payments to Ophthalmologists, Optometrists and Dispensing Opticians) Regulations 2013 (SI 274 of 2013) sets the fees for optometrists and dispensing opticians under the Community Optometric Services, Community Spectacle Dispensing Services and Health Amendment Act Card Schemes.
I am committed to increasing the fee payable to contractors for a standard eye examination under the COSS, to ensure parity with that payable for the same exam under the Department of Social Protection’s Treatment Benefit Scheme. This is a priority for my Department, and work with stakeholders is ongoing to implement this change as soon as possible.
365. Deputy Colm Burke asked the Minister for Health to confirm what steps are being taken to ensure that home and community care services are responsive to the evolving healthcare needs of the aging population and the high waiting lists in Ireland; and if he will make a statement on the matter. [11302/24]
View answer374. Deputy Colm Burke asked the Minister for Health what action his Department is taking to address recruitment and retention challenges within the home and community care workforce to ensure a consistent and qualified staff; and if due consideration would be given to increasing the wages of homecare supporters in order to increase the number of individuals in this position; and if he will make a statement on the matter. [11312/24]
View answerOn 3 October 2023 the Government approved the proposal put forward by the Minister for Health and I for the establishment of a Commission on Care for Older Persons. The Commission will examine the provision of health and social care services and supports for older persons and make recommendations to the Government for their strategic development. In addition, 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 comprised of independent experts and will be supported by a secretariat from the Department of Health. The Commission will be comprised of independent experts and will be supported by a secretariat from the Department of Health.
The Commission will be an independent commission, the members of which were 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 Chairperson of the Commission. On 29 February 2024 we announced the appointment of the remaining members. The Commission is due to be formally established in the coming weeks.
The Enhanced Community Care Programme aims to increase levels of healthcare provision in the community setting, thereby reorienting the focus of care delivery away from the acute hospital system, towards general practice, primary care, and community based services. The focus is on implementing an end to end care pathway that cares 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.
The work that has been undertaken by the Integrated Care Programme for Older People (ICPOP) over recent years, has shown that improved outcomes can and are being achieved particularly for older people who are frail, through a model of care that allows the specialist multidisciplinary team engage and interact with services at a local level, in their diagnosis and ongoing care.
This model is now being implemented at scale, with the rollout of Community Specialist Teams (CST) for Older People (ICPOP) to support local services and GPs to respond to the specialist needs of older people, bridging and linking the care pathways between acute and community services to improve access to and egress from acute hospital services.
These CSTs service a population on average of 150,000 and are being co-located together in ‘hubs’ located in or adjacent to Primary Care Centres reflecting a shift in focus away from the acute hospital towards general practice and a primary care and community based service model. The services are fully aligned with the acute system with clinical governance being provided though the relevant model 4 or 3 hospitals, but with the services being delivered in the community setting.
For the first 8 months of 2023 (latest data available), of the total patient contacts of the ICPOP Community Specialist Teams (CSTs), the following outcomes were achieved:
• 71% were discharged home,
• 6% were admitted to acute hospital,
• 4% were admitted to long term care,
• 13% of people (target is 10%) were reviewed on same day / next day of referral, reflecting timely review by the team of more urgent cases, and
• 64% of people (target 55%) assessed by the CSTs have a Clinical Frailty Score (CFS) of 5-9, representing more severe frailty, demonstrating that progress is being made in prioritising complex and more frail patients and therefore supporting community based intervention and avoiding admission to the acute setting.
This demonstrates that the ICPOP teams are seeing complex and more frail patients urgently, and that most of such cases are discharged home as opposed to having to go to an acute hospital.
Improving access to home support is a priority for the Government. Since Budget 2021 my Department has provided approximately €230 million in additional funding. Preliminary data indicates that over 22 million hours of home support were provided in 2023, exceeding the HSE’s target, and over 55,000 people were in receipt of home support at the end of 2023. The HSE is expected to meet its targets again in 2024. In addition, the minimum proportion of new home support hours ringfenced for people with dementia will increase from 5% in 2021 to 18% in 2024.
An estimated 5,863 people were assessed and waiting on care at the end of 2023. Of these, an estimated 3,067 people on the waiting list were waiting to commence a new service and an estimated 2,796 people were waiting on additional service. The waiting list is predominantly due to the shortage of care workers to deliver services. Addressing this shortage is a priority for Government.
In March 2022, I established the cross departmental Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants. It set out to examine the challenges in front line carer roles in the home support and long term residential care sectors. The report was published on 15 October 2022 with 16 recommendations. Implementation of the recommendations is being overseen by a cross departmental Implementation Group, chaired by the Department of Health. Progress delivered includes securing an improved rate for home support which delivers on commitments for sectoral reform such as payment for travel time, paying carers the National Living Wage at a minimum, and bringing legacy rates in line with the new revised rates of funding.
The implementation group met for the third time on 1 February 2024 and a progress update will be published shortly. The most recent progress report was published in October 2023 which can be viewed below: www.gov.ie/en/publication/66dd1-strategic-workforce-advisory-group-on-home-carers-and-nursing-home-healthcare-assistants/.
366. Deputy Colm Burke asked the Minister for Health to clarify why the statutory scheme, which is essential for developing a homecare sector that is accessible, sustainable and accountable, has been delayed and the impact this delay has on society; and if he will make a statement on the matter. [11303/24]
View answerThe programme for Government commits to ‘Introduce a statutory scheme to support people to live in their own homes, which will provide equitable access to high-quality, regulated home care’. Work is ongoing within the Department across four broad areas to progress this commitment: (i) Regulation of home support providers; (ii) the examination of future funding options for home support services; (iii) working with the HSE to develop a reformed model of service delivery for home support; and (iv) implementation of the recommendations of the Strategic Workforce Advisory Group.
Regulation
The Department of Health continues to develop a regulatory framework for home support providers. This will consist of primary legislation for the licensing of providers, secondary legislation in the form of regulations, and HIQA national standards who, along with the Chief inspector will have the legal authority to grant, amend or revoke a license. Consultation on the draft HIQA standards for home support will go out for public consultation in 2024 when the scope and content of regulations have been finalised.
Drafting of the primary legislation has been added to the priority list for the Spring Legislative session and the General Scheme is expected to be published this quarter.
Funding
The Department of Health is currently examining a range of funding options for home support. The Economic and Social Research Institute (ESRI) undertook a programme of work on behalf of the Department of Health on the potential demand for, and cost of, home support.
www.esri.ie/publications/home-support-services-in-ireland-exchequer-and-distributional-impacts-of-funding
www.esri.ie/publications/demand-for-the-statutory-home-care-scheme
A rapid response from the European Observatory on Health Systems was commissioned and published in March 2023. It is titled: “Improving Home Care Sustainability in Ireland. Are user charges a promising option?”
eurohealthobservatory.who.int/publications/i/improving-home-care-sustainability-in-ireland-are-user-charges-a-promising-option
Further research is currently underway to enhance the evidence base.
Workforce
Delivering this enhanced capacity requires substantial recruitment and strategic workforce challenges are in evidence in the sector. The Government has started implementing the 16 recommendations of the Strategic Workforce Advisory Group set up to examine these challenges in the sector.
Implementation of the 16 recommendations is underway by a cross departmental group, chaired by the Department of Health. The group meets quarterly and publishes progress reports thereafter. A meeting was held on 1st February 2024 with updates to be published shortly. The most recent progress report was published in October 2023 which can be viewed below:
www.gov.ie/pdf/?file=https://assets.gov.ie/275876/c0889fbf-3f9c-4235-9e79-e1240790fac7.pdf#page=null.
Reformed Model of Service Delivery
The DoH is working in partnership with the HSE and others on the continuing reform of the model of service delivery for home support. Funding has been provided for establishment of a National Home Support Office and the Head of Service, and a number of other posts have been recruited. Work is ongoing regarding the development of an IT system which will enhance the quality and efficiency of service delivery.
The HSE will prioritise implementation of interRAI care needs assessment as the single assessment tool for home support services and have included 18,100 interRAI assessments in the 2024 HSE Service Plan. The testing of interRAI in 4 pilot sites provided learning regarding operational aspects of home support services. The Centre for Effective Services evaluation report May 2023 included a list of recommendations to support interRAI rollout nationally. The Department of Health are monitoring implementation plans in order that a single assessment tool will underpin person centred services and appropriate, equitable and timely resource allocation.
367. Deputy Colm Burke asked the Minister for Health to confirm what action his Department is taking in conjunction with local authorities and community organizations to strengthen the overall support system for individuals receiving home and community care; and if he will make a statement on the matter. [11304/24]
View answerAs Minister of State for Mental Health and Older People, I am committed to supporting healthy and positive ageing throughout the life course, to ensuring that the Sláintecare vision of ‘the right care, in the right place, at the right time’ is realised for all people living in Ireland as they age and to support older people to remain in their own home for as long as possible. This commitment is reflected in a wealth of recent policies, strategies and initiatives that the Department of Health is part of.
Age Friendly Ireland
Since 2009, an Age Friendly programme has been developed in each of the 31 Local Authority areas following application of a consistent methodology and governance structure which supports cities and counties to be more inclusive of older people by addressing their expressed concerns and interests under the eight defined World Health Organization (WHO) programme headings. This WHO informed programme involves a multi-agency, multi-sectoral approach to age-related planning and service provision. Established in 2018 as a shared service function of the Local Government sector, Age Friendly Ireland coordinates the national Age Friendly Cities and Counties programme. The national Age Friendly Ireland Office is hosted by Meath County Council on behalf of the Local Government sector.
The Healthy Age Friendly Homes Programme
The Healthy Age Friendly Homes Programme is a cross-government collaboration between the Department of Health, HSE, and Local Government. It provides a model of care which supports older people to remain in their own homes where possible, to avoid hospital admission through the provision of care in the community, and to ultimately avoid early or unnecessary admission to residential care. Participants can be referred into the programme by family members, friends, healthcare providers, social prescribers, members of the community (for example, Gardaí), or self-refer themselves. On referral into the programme, a Local Coordinator carries out a home visit and conducts a holistic needs assessment for the older person in the areas of health, housing, community and social supports, and assistive technologies. The Coordinator agrees a personal plan with each individual and supports them to access the appropriate services and supports in their local communities.
During the course of the programme’s pilot across nine sites between 2021 and 2023, local coordinators have carried out 4,845 home visits and provided 9,030 supports to older people. An evaluation conducted by Maynooth University has demonstrated improvements in measurements of older peoples’ self-reported health status, quality of life, loneliness, social supports, self-efficacy, and functional ability. A final evaluation report is due to be published in spring 2024.
The cross-sectoral nature of this programme is the first of its kind, with key partners including the HSE, Department of Housing, Local Government and Heritage, Age Friendly Ireland, and SEAI. The approach taken by the programme has been cited by the World Health Organisation as a best practice example for the provision of person-centred integrated care for older people. Most recently, it has also been highlighted as a case study in the first progress report of the UN Decade of Ageing published in November 2023.
I allocated €5.2m in funding in Budget 2023 to expand from nine pilot sites to roll out nationally. This funding provides for at least one Healthy Age Friendly Homes coordinator in each Local Authority to deliver supports and advice to older people nationwide. Following completion of a recruitment campaign, the programme will launch nationally in Spring 2024.
Enhanced Community Care Programme
The Enhanced Community Care Programme, part of overall Sláintecare reforms, aims to increase levels of healthcare provision in the community setting, thereby re-orienting the focus of care delivery away from the acute hospital system, towards general practice, primary care, and community-based services. The focus is on implementing an end-to-end care pathway that cares 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.
Support Coordination Services in the Community
The HSE, in conjunction with ALONE, is 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 co-ordinate 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.
Community Specialist Teams (Hubs)
The work that has been undertaken by the Integrated Care Programme for Older People (ICPOP) over recent years, has shown that improved outcomes can and are being achieved particularly for older people who are frail, through a model of care that allows the specialist multidisciplinary team engage and interact with services at a local level, in their diagnosis and on-going care.
This model is now being implemented at scale, with the rollout of Community Specialist Teams (CST) for Older People (ICPOP) to support local services and GPs to respond to the specialist needs of older people, bridging and linking the care pathways between acute and community services to improve access to and egress from acute hospital services.
These CSTs service a population on average of 150,000 and are being co-located together in ‘hubs’ located in or adjacent to Primary Care Centres reflecting a shift in focus away from the acute hospital towards general practice and a primary care and community-based service model. The services are fully aligned with the acute system with clinical governance being provided through the relevant model 4 or 3 hospitals, but with the services being delivered in the community setting.
Home Support
Improving access to home support is a priority for the Government. The Programme for Government commits to "Introduce a statutory scheme to support people to live in their own homes, which will provide equitable access to high quality, regulated home care". The Department of Health is working on four elements that are essential for meeting this commitment: regulation, funding, reformed service delivery including standardised care needs assessment, and recruitment and retention.
The Department of Health is focused on developing the regulatory framework for providers of home support services before year end. It aims to ensure that all service users are provided with high quality, regulated care. It will consist of primary legislation, regulations and HIQA national standards. This work is at an advanced stage. The Department has ongoing engagement with key stakeholders from the home support sector every quarter.
Improving access to home support is a priority for the Government. Since Budget 2021 we have provided approximately €230 million in additional funding. Preliminary data indicates that over 22 million hours of home support were provided in 2023, exceeding the HSE’s target. The HSE is expected to meet its targets again in 2024. In addition, the minimum proportion of new home support hours ringfenced for people with dementia will increase from 5% in 2021 to 18% in 2024.
Commission on Care
The independent Commission on Care for Older People will examine the health and social care services and supports for older people across the continuum of care and make recommendations for their strategic developments. The Commission members, which includes representatives from the community and voluntary sector, provide expertise across the areas of geriatrics, gerontology, health economics, health policy and management, primary care, health ethics, health technologies, and ageing and disability. The members of the Commission are now in place and work has commenced.
