UN Convention on the Rights of Persons with Disabilities

Ceisteanna (521)

Fiona O'Loughlin

Ceist:

521. Deputy Fiona O'Loughlin asked the Minister for Health the additional health service resources that will be required for the ratification of the UN Convention on the Rights of Persons with Disabilities. [10159/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The purpose of the UN Convention on the Rights of Persons with Disabilities is to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and to promote respect for their inherent dignity.  

It is intended that the final legislative amendments needed to enable Ireland to comply with the Convention will be contained in the Disability (Miscellaneous Provisions) Bill 2016 sponsored by the Minister for Justice and Equality and in a stand-alone Bill on deprivation of liberty.

The Department of Health is continuing to progress draft legislation to provide legislative clarity on the issue of deprivation of liberty which will add a new Part to the Assisted Decision-Making (Capacity) Act 2015.  These provisions will have resource implications for the health services which will be quantified as proposals are being refined.

The question of additional health service resources to meet any other requirements that may arise under the Convention will be considered in due course.

Mental Health Services

Ceisteanna (522)

Fiona O'Loughlin

Ceist:

522. Deputy Fiona O'Loughlin asked the Minister for Health when he expects the practice of admitting children and young persons to adult mental health units to cease. [10160/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The reduction in the numbers of children admitted to adult psychiatric units is a priority for the HSE Mental Health Services and for myself. It is fully accepted that admission to an age appropriate facility is in the best interest of the child.

Where a child requires admission to an in-patient bed, a bed in a Child and Adolescent Mental Health Services (CAMHS) unit is sought in the first instance. A decision to admit to an adult unit is made only if a CAMHS admission is not feasible. Where such admissions take place HSE Standard Operating Procedures apply. An admission to an adult unit must be advised to the Mental Health Commission and is generally to a separate area in the adult unit with appropriate supervision.

Most child admissions to adult units are for children in the 16-17 age bracket. The HSE advises that admission to an adult unit may often be more appropriate for the individual and to avoid any impact on younger children in CAMHS in-patient units. Children admitted to adult units are provided with special support by the HSE.  

Progress in this area has been significant since 2008 when there were 247 such admissions to adult units in that year. This declined to 81 in 2017, despite a background of increasing demands overall on Child and Adolescent Mental Health services. CAMHS has seen a 26% increase in referrals between 2012 and 2017.

It is important to note, that the number of  admissions  does not necessarily equate to the actual number of children admitted, as an individual child may be admitted on more than one occasion in any given year. In 2017, there was a total of 307 CAMHS admissions, of which 226 (74%) were to age appropriate units and 81 (26%) of admissions of Children were to Adult Units. The temporary closure of some CAMHS beds, such as the Linn Dara Unit in Dublin, influenced the admission rates to adults units in 2017.

In terms of bed days used, in 2017, based on the most recent figures available, 96.9% of bed days used were in Child and Adolescent Inpatient Units. Performance generally continues to be above the HSE Service Plan target figure of 95%, and indications are that where a child has been admitted to an adult acute in-patient unit, the length of stay has been kept to a minimum.

The HSE Service Plan allows for some operational flexibility surrounding emergency placements in Adult Units, particularly where very short-term placements take place.  Full account is taken of all relevant factors such as the preferences of all those involved, and geographical factors relating to access or visiting. In this context, the HSE continues to closely monitor on a weekly basis all child admissions to adult units with a view to minimising such admissions.

I and departmental officials regularly meet with the HSE to review various mental health issues including the potential for further improvement on age appropriate CAMHS admissions. Relevant data is regularly published on the HSE website and is subject to regular monitoring by the Department of Health. Bearing in mind all the circumstances, I am satisfied that, where children have to be placed short-term in adult mental health units, the Executive makes any special arrangements necessary to protect and monitor these young people.

Home Help Service Data

Ceisteanna (523)

Fiona O'Loughlin

Ceist:

523. Deputy Fiona O'Loughlin asked the Minister for Health the number of extra home help hours that will be provided in 2018 relative to 2017; and if he will make a statement on the matter. [10161/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Government is committed to promoting care in the community so that people can continue to live with confidence, security and dignity in their own homes for as long as possible. To support this, we plan to establish a new statutory scheme for the financing and regulation of home care services. The Department is currently engaged in a detailed process to progress this.

In the meantime, the Department and HSE are continuing efforts to incrementally improve the existing services. As detailed in its National Service Plan, the HSE is streamlining home care services by moving towards a single funded service. This combines the funding for home help and standard home care packages which will operate as a single home support service from 2018 onwards.  

Home support services are a particular area of focus in Budget 2018, with an additional €18.25m allocated. The additional resources bring the budget for the direct provision of home support services to €408m delivering over 17m home support hours to about 50,500 people. This compares with the estimated 16.34m hours delivered to 50,000 people last year.  In addition 235 intensive home care packages will provide 360,000 home support hours for people with complex needs.

Health Services Staff Recruitment

Ceisteanna (524)

Fiona O'Loughlin

Ceist:

524. Deputy Fiona O'Loughlin asked the Minister for Health if he will report on recruitment initiatives in CHO7, particularly in the Lakeview unit, Naas hospital and CAMHS in Kildare town; and if he will make a statement on the matter. [10162/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Vaccination Programme

Ceisteanna (525)

Fiona O'Loughlin

Ceist:

525. Deputy Fiona O'Loughlin asked the Minister for Health his plans to promote increased uptake of the 'flu vaccine across all categories of persons and not only those deemed at risk; and if he will make a statement on the matter. [10163/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

In Ireland the National Immunisation Advisory Committee (NIAC) an independent committee of the Royal College of Physicians of Ireland which comprises experts in a number of specialties including infectious diseases, paediatrics, and public health makes recommendation on vaccination policy in Ireland. Their recommendations are based on the prevalence of the relevant disease in Ireland and international best practice in relation to immunisation. This season (2017/18) the HSE procured the trivalent inactivated seasonal influenza vaccine for all those in the recommended at risk groups and health care workers and carers. The trivalent vaccine used in Ireland is the most widely used influenza vaccine in Europe.

NIAC is considering the need to expand the current recommendations for influenza vaccine, including the potential community wide benefit of extending recommendations to include all children.

Initial evidence suggests that the vaccine provides higher protection against the Influenza A strains than recent years (H3N2 & H1N1). While it is less effective against the B strains predominating this year, people who received the flu. Vaccination remains the most effective means of preventing infection by seasonal influenza viruses and can reduce severe disease that can lead to hospitalisation and death.

The influenza vaccine purchased by HSE is based on WHO advice on the composition of influenza virus vaccines for use in the 2017/8 northern hemisphere Flu season which issued on 2 March 2017. It recommended that trivalent vaccines for use in the 2017-2018 northern hemisphere influenza season contain the following:

- an A/Michigan/45/2015 (H1N1)pdm09-like virus;

- an A/Hong Kong/4801/2014 (H3N2)-like virus; and

- a B/Brisbane/60/2008-like virus.

Influenza vaccine is most effective when circulating viruses are well-matched with viruses contained in vaccines. Due to the constant evolving nature of influenza viruses, the WHO Global Influenza Surveillance and Response System – a system of National Influenza Centres and WHO Collaborating Centres around the world – continuously monitors the influenza viruses circulating in humans and updates the composition of influenza vaccines twice a year. For many years, WHO has updated its recommendation on the composition of the vaccine (trivalent) that targets the three most representative virus types in circulation (two subtypes of influenza A viruses and one influenza B virus) and since the 2013–2014 northern hemisphere influenza season, a fourth component is recommended to support quadrivalent vaccine development. Quadrivalent vaccines include a 2nd influenza B virus in addition to the viruses in trivalent vaccines.

The HSE Communications Plan which launched on the 2 October 2017 had an initial focus on Health Care Workers. Radio adverts commenced on the 9 October and ran for three weeks. There were further radio ads over the holiday period when ILI rates exceeded the baseline threshold for the first time. People aged 65 and over as well as pregnant women were the primary audiences for the radio campaign, which also reached medically at risk groups and Health Care Workers as they make up a more generic radio audience. Digital advertising and promotions targeting risk groups, the over 65s, pregnant women and healthcare workers and likewise there will be options for further campaigns when flu levels go above the threshold.

The HSE “Under the Weather” website gives advice to people on what to do if they suspect they are developing influenza. Health is one of the themes of the cross-sectoral ‘Be Winter Ready’ campaign which launched on 8 November 2017.

The HSE reviews and updates its influenza plans, including the communications strategy, taking into account the lessons learned from previous years, with a view to targeting key groups to get the greatest impact in terms of people receiving the influenza vaccine.

Treatment Abroad Scheme

Ceisteanna (526)

Fiona O'Loughlin

Ceist:

526. Deputy Fiona O'Loughlin asked the Minister for Health the number of persons in County Kildare who applied for the treatment abroad scheme in 2017; and if he will make a statement on the matter. [10164/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this is a service matter, this query has been referred to the Health Service Executive for direct reply to the Deputy. 

Nursing Staff Recruitment

Ceisteanna (527)

Fiona O'Loughlin

Ceist:

527. Deputy Fiona O'Loughlin asked the Minister for Health his plans to retain and recruit front-line staff in the health services including nurses; the number of nursing staff needed in public national hospitals; and if he will make a statement on the matter. [10165/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Notwithstanding significant recruitment and retention challenges, including global shortages, considerable progress has been made in the past four years in growing the numbers of front line staff working in the public health services, including doctors and nurses, as additional resources have become available. 

The number of consultants has increased by 109 in the 12 months ending December 2017 to 2,971 whole time equivalents, and by 415 in the 4 years since December 2013. The number of NCHDS has increased by 270 in the 12 months ending December, 2017 to 6,331 whole time equivalents, and by 1,323 in the 4 years since December 2013. 

It is recognised that retention of doctors is critical to the future growth of the medical workforce.  In July 2013 a Working Group, chaired by Prof. Brian MacCraith, President, Dublin City University, was established to carry out a strategic review of medical training and career structure. The Group made 25 recommendations relating to training and career pathways for doctors with a focus on improving graduate retention in the public health system and planning for future service needs. Initiatives taken on foot of the Group's recommendations include the launch of a  careers and training website, which gives information about each specialty, including details of training pathways and training duration, increasing the number of family friendly training places and the appointment of lead NCHDs across sites.  The MacCraith Implementation Monitoring Group continues its work and has identified the need to progress other key recommendations including protected training time, task transfer and better coverage of training costs incurred by  NCHDs. 

With regard to nurses, the number of nurses and midwives has increased by 942 in the 12 months ending December 2017 to 36,777 whole time equivalents and by 2,599 in the 4 years since December 2013.  In terms of the number of nurses required in public hospitals, the Nursing Recruitment and Retention Agreement, was concluded with the INMO and SIPTU Nursing last year.  This committed the HSE to increasing the number of nurses and midwives by 1,224 additional permanent posts across the health service in 2017.  Indications are that there has been significant growth in the appointment of nurses and midwives in recent months with 942 WTE of the 1,224 posts filled (including student nurses).  The HSE remain committed to the Agreement and efforts will continue to fill the remaining posts.  Funded workforce plans for 2018 are in the process of being developed.  

I can assure the Deputy that the HSE recognises the need to continue to focus on the recruitment and retention of front-line staff, such as doctors and nurses, and that it is committed to making the public health service a more attractive place to work.

Primary Care Centres

Ceisteanna (528)

Fiona O'Loughlin

Ceist:

528. Deputy Fiona O'Loughlin asked the Minister for Health the updated timeframe for the refurbishment of a day care centre (details supplied) further to the appointment of the design team for the project; and if he will make a statement on the matter. [10166/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Vaccination Programme

Ceisteanna (529)

Fiona O'Loughlin

Ceist:

529. Deputy Fiona O'Loughlin asked the Minister for Health if the HPV vaccine is to be extended to boys; when the report of the health technology assessment being carried out by HIQA in respect of the HPV vaccine for boys will be published; and if he will make a statement on the matter. [10167/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC).  NIAC is a committee of the Royal College of Physicians of Ireland comprising of experts in a number of specialties including infectious diseases, paediatrics and public health.  The committee's recommendations are informed by public health advice and international best practice.  All relevant and appropriate information is taken into account when deciding to make changes to the State's immunisation programmes.

NIAC has made a recommendation that the HPV vaccine should be given to boys.  My Department asked the Health Information and Quality Authority (HIQA) to carry out a health technology assessment (HTA).  Work has commenced on the HTA and is expected to be completed in 2018.  Any decision to extend the current programme which offers HPV vaccination to all girls in their first year of second-level education to a programme that also offers vaccination to boys will be informed by the evidence contained in the HTA.

Orthodontic Services Waiting Lists

Ceisteanna (530)

Fiona O'Loughlin

Ceist:

530. Deputy Fiona O'Loughlin asked the Minister for Health the number of persons on the waiting list for orthodontic care; the number of persons waiting over 1, 2 and 3 years, respectively; and if he will make a statement on the matter. [10175/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

This ePQ pertains to hospital waiting lists for orthodontic care.

In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.

Occupational Therapy Staff

Ceisteanna (531)

Thomas P. Broughan

Ceist:

531. Deputy Thomas P. Broughan asked the Minister for Health the HSE's plans to allocate a new full-time occupational therapist to the Kilbarrack health centre, Dublin 5; and if he will make a statement on the matter. [10176/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.

Proposed Legislation

Ceisteanna (532)

John Brady

Ceist:

532. Deputy John Brady asked the Minister for Health when the drafting of a Bill for the introduction of a scheme to replace the former mobility allowance and motorised transport grant scheme will be published; and if he will make a statement on the matter. [10177/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Deputy will be familiar with the background to the closure of both the Mobility Allowance and Motorised Transport Grant schemes in February 2013. Since the closure of the Mobility Allowance, the Government has directed that the Health Service Executive should continue to pay an equivalent monthly payment of up to €208.50 per month to the 4,133 people in receipt of the Mobility Allowance, on an interim basis, pending the establishment of a new Transport Support Scheme.

The Government decided that the detailed preparatory work required for a new Transport Support Scheme and associated statutory provisions should be progressed by the Minister for Health.  The Programme for a Partnership Government acknowledges the ongoing drafting of primary legislation for a new Transport Support Scheme to assist those with a disability to meet their mobility costs. The Health (Transport Support) Bill is on the list of priority legislation for publication in the Spring/Summer session 2018. I can confirm that work on the policy proposals for the new Scheme is at an advanced stage. The proposals seek to ensure that:

- There is a firm statutory basis to the Scheme's operation;

- There is transparency and equity in the eligibility criteria attaching to the Scheme;

- Resources are targeted at those with greatest needs; and

- The Scheme is capable of being costed and is affordable on its introduction and on an ongoing basis.

It is hoped to bring a General Scheme and Heads of Bill to Government shortly, seeking Government approval to the drafting of the Bill for the new Transport Support Payment.

With regard to the Motorised Transport Grant, this scheme operated as a means-tested grant to assist persons with severe disabilities with the purchase or adaptation of a car, where that car was essential to retain employment. The maximum Motorised Transport Grant, which was payable once in any three-year period, was €5,020.  Following closure of the scheme in February 2013,  no further Motorised Transport Grants have been payable.

It is important to note that the Disabled Drivers and Disabled Passengers scheme operated by the Revenue Commissioners, remains in place. This scheme provides VRT and VAT relief, an exemption from road tax and a fuel grant to drivers and passengers with a disability, who qualify under the relevant criteria set out in governing regulations made by the Minister for Finance.  Specifically adapted vehicles driven by disabled persons are also exempt from payment of tolls on national toll roads and toll bridges. Transport Infrastructure Ireland has responsibility for this particular Scheme.

Freedom of Information Data

Ceisteanna (533)

Stephen Donnelly

Ceist:

533. Deputy Stephen S. Donnelly asked the Minister for Agriculture, Food and the Marine the number of freedom of information requests his Department has received in the past eight years; the number which were accepted without further escalation and not accepted respectively; the number requested which were not accepted that were escalated to the Information Commissioner; the number which the Information Commissioner ruled in favour of the person requesting the freedom of information; the number which the Information Commissioner ruled against his Department; the number his Department appealed to the High Court; the number the High Court ruled against his Department in favour of the applicant; the number which were then brought to the Court of Appeal by his Department; and if he will make a statement on the matter. [9285/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Agriculture)

The Freedom of Information data requested is set out in the following table.

In relation to your request for data concerning appeals, I have included data on both internal reviews carried out by more senior members of staff within my Department and on appeals to the Office of the Information Commissioner (OIC).

If a requester is not satisfied with the response of my Department to any aspect of his/her request for information he/she can seek to have the decision re-examined. The internal review of an FOI decision is carried out by a more senior member of staff within my Department. Following the outcome of the internal review of the decision, if a requester is still unhappy with the decision, he/she has the right to appeal the decision to the OIC.

My Department did not appeal any of the OIC decisions in question to the High Court.

Number of FOI.....

2010

2011

2012

2013

2014 

2015

2016

2017

Requests received

214

243

255

275

205

319

347

391

 

 

 

 

 

 

 

 

 

Decisions reviewed internally

28

31

29

31

19

39

22

44

 

 

 

 

 

 

 

 

 

Decisions appealed to OIC

17

4

16

8

10

9

9

12

Decisions affirmed by OIC

4

3

4

4

6

4

1

4

Decisions varied by OIC

5

0

4

1

0

0

3

3

Decisions annulled by OIC

0

0

2

0

1

1

1

0

Appeals to OIC withdrawn

8

1

6

3

3

4

4

3

Appeals to OIC on-going

0

0

0

0

0

0

0

2