Written Answers Nos. 344-359
344. Deputy Thomas P. Broughan asked the Minister for Health his plans to appoint a full-time consultant endocrinologist at Beaumont Hospital, Dublin 9; and if he will make a statement on the matter. [8353/18]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to you directly.
345. Deputy Thomas P. Broughan asked the Minister for Health the measures his Department is taking to address the waiting list of over 300 transgender persons awaiting a diagnosis to progress towards hormone replacement therapy in view of the fact that just 28 persons have been seen by a psychiatrist within the past 12 months; and if he will make a statement on the matter. [8354/18]
Amharc ar fhreagraAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
346. Deputy Thomas P. Broughan asked the Minister for Health if he will meet a group (details supplied) and a representative of a charity to discuss the issues surrounding transgender healthcare; and if he will make a statement on the matter. [8355/18]
Amharc ar fhreagra365. Deputy Ruth Coppinger asked the Minister for Health his plans to meet persons (details supplied) and organisations to discuss issues regarding the provision of transgender healthcare. [8454/18]
Amharc ar fhreagraI propose to take Questions Nos. 346 and 365 together.
I acknowledge receipt of the request for meetings from the individuals and organisation mentioned by the Deputy. My Office will be in touch with the individuals concerned as soon as a decision has been made.
347. Deputy Thomas P. Broughan asked the Minister for Health the reason there are just two physicians prescribing hormone replacement therapy to transgender persons nationally; the measures he is taking to increase this number; and if he will make a statement on the matter. [8356/18]
Amharc ar fhreagra364. Deputy Ruth Coppinger asked the Minister for Health if the transgender healthcare system, in particular the low number of endocrinologists and psychiatrists that operate the diagnosis model, will be examined; and if he will make a statement on the matter. [8453/18]
Amharc ar fhreagra366. Deputy Ruth Coppinger asked the Minister for Health if the number of medical doctors who prescribe hormone replacement therapy for transgender persons will be increased; and if he will make a statement on the matter. [8455/18]
Amharc ar fhreagra408. Deputy Clare Daly asked the Minister for Health his plans to address the shortcomings in transgender healthcare here; and if he will make a statement on the matter. [8706/18]
Amharc ar fhreagra415. Deputy Clare Daly asked the Minister for Health his plans to address the medical diagnostic model in place here whereby a transgender person must overcome several barriers to seek a psychiatric diagnosis in order that they may access an unrestricted treatment, hormone replacement therapy, which is widely available to others. [8773/18]
Amharc ar fhreagraI propose to take Questions Nos. 347, 364, 366, 408 and 415 together.
Transgender-specific guidelines have been developed by WPATH (World Professional Association for Transgender Health) and the Endocrine Society (who updated their guidelines in 2017). These guidelines were devised by experts in transgender healthcare, along with members of the International Transgender, Transsexual and LGBT community.
A proposed model of care for transgender children, adolescents and adults was submitted by the HSE Quality Improvement Division to the HSE Divisions of Primary Care, Mental Health and Acute Hospital programme. The model was developed in consultation with key treating clinicians, planners, policy makers, advocates and service users.
The guidelines recommend a comprehensive multidisciplinary psychosocial assessment prior to commencement of hormone therapy by endocrinology services. The assessment focuses on more than just assessment for the possible diagnosis of Gender Dysphoria. The guidelines highlight several criteria which must be met prior to referral for hormonal intervention. It is important that co-morbid conditions are identified and addressed, and that people access the supports that they need to manage co-morbid difficulties, which can impact on response to medical transition (including hormone treatment).
International best practice involves an assessment by a multi-disciplinary team and shared decision making in the best interests of the individual. Both WPATH and the Endocrine Society Guidelines 2017 specify the assessment must be carried out by a mental health professional (s) with experience in transgender healthcare and possess specific skills. Endocrinologists and General Practitioners (GPs) do not possess these skills, and require access to the multidisciplinary team as described. GPs would only see a small number of gender variant individuals during their lifetime in clinical practice, and would not be in a position to build up the requisite skillset outlined in WPATH and Endocrine Society Guidelines or have the time resource to conduct a comprehensive evaluation.
Informed consent is essential, whereby benefits and risks of hormone treatment and surgery are discussed with individuals seeking these interventions. Although regret rates are low, it can happen and can also lead to high levels of psychological distress. Healthcare providers work with people to try to prevent negative outcomes. The emerging evidence on good outcomes following medical and/or surgical transitioning is based on use of multi-disciplinary psychosocial assessment, fulfilment of criteria for hormones and on-going psychological support throughout the process. It is important that psychological support is available to individuals before, during and after transitioning.
Prescription of hormone blockers and cross-sex hormones for transgender people is relatively new. Significant side effects can occur with cross sex hormones including irreversible physical changes and infertility. There is a lack of long-term research on outcomes. For these reasons the decision to prescribe should only be made by specialists (i.e. Endocrinologists) in consultation with other professionals involved in the assessment process. Shared decision-making is in accordance with best practice internationally. Prescriptions can then be supported by local GPs with specialist guidance.
The Best Practice approach as outlined above is endorsed in the Service Development Model as developed by the Quality Improvement Division of the HSE in 2017, in collaboration with TENI. This model is providing the framework for the development of National Gender Clinics and MDTs for children and adults, funded by the Acute Hospitals and Mental Health Divisions of the HSE. Recruitment will commence to develop these national teams in 2018. This investment in new posts in 2018 which includes one consultant endocrinologist (adult services), one consultant endocrinologist (paediatric services), one social worker (adult services), one speech and language therapist (adult services), one senior psychologist (adult services), one senior psychologist (paediatric services), one clinical nurse specialist (Paediatric services), two administrative support officers (adult and paediatric services) is a concerted measure by the HSE to address the waiting times and immediate service needs of children, adolescents and adults in transition. It is envisaged that these National Teams will be in place in 2018, pending successful recruitment campaigns.
The HSE, across a number of programmes including mental health, acute hospitals, primary care and social inclusion, is committed to building services for this community in accordance with International Best Practice.
353. Deputy Tony McLoughlin asked the Minister for Health if his attention has been drawn to concerns from the Leitrim public participation networks, PPN, regarding emergency ambulance response times in County Leitrim; and if he will make a statement on the matter. [8376/18]
Amharc ar fhreagraAs this is a service issue, I have asked the HSE to respond directly to you.
354. Deputy Louise O'Reilly asked the Minister for Health if his attention has been drawn to a service level agreement, SLA, between the HSE and a company (details supplied); the type of services provided for the duration of the SLA; the number of hours per week for each type of service; the number of staff involved in the provision of these services; and if he will make a statement on the matter. [8377/18]
Amharc ar fhreagraThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
355. Deputy Louise O'Reilly asked the Minister for Health the number of child intensive care unit beds in hospitals; the locations of each; and the care plan in the event of mass casualties. [8385/18]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to you direct.
356. Deputy Louise O'Reilly asked the Minister for Health the number of adult intensive care unit beds in hospitals; the locations of each; and the care plan in the event of mass casualties. [8386/18]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to you directly.
357. Deputy Róisín Shortall asked the Minister for Health the number of persons on a waiting list for physiotherapy in primary care by CHO, age category and time waiting. [8419/18]
Amharc ar fhreagraAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
358. Deputy Róisín Shortall asked the Minister for Health the number of persons on a waiting list for occupational therapy by CHO, age category and time waiting. [8420/18]
Amharc ar fhreagraAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
359. Deputy Róisín Shortall asked the Minister for Health the number of persons on a waiting list for speech and language therapy by CHO, age category and time waiting. [8421/18]
Amharc ar fhreagraAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
