Child and Adolescent Mental Health Services Data

Ceisteanna (172)

Niamh Smyth

Ceist:

172. Deputy Niamh Smyth asked the Minister for Health the number of young persons on the waiting list for CAMHS in counties Cavan, Meath and Monaghan to date; the length of time they have been on the list; and if he will make a statement on the matter. [42635/19]

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.

Child and Adolescent Mental Health Services Staff

Ceisteanna (173)

Niamh Smyth

Ceist:

173. Deputy Niamh Smyth asked the Minister for Health the number of vacant posts in whole-time equivalent terms in the CAMHS service by CHO in tabular form. [42636/19]

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.

Disability Services Provision

Ceisteanna (174)

Niamh Smyth

Ceist:

174. Deputy Niamh Smyth asked the Minister for Health the status of works on a new site (details supplied); when works are likely to commence; and if he will make a statement on the matter. [42637/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The 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.

Primary Care Centres Provision

Ceisteanna (175)

Maureen O'Sullivan

Ceist:

175. Deputy Maureen O'Sullivan asked the Minister for Health the status of the primary healthcare centre in Finglas, Dublin 11. [42638/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Finglas remains a priority for the Department and HSE as one of the communities considered most in need of access to primary care services.

Dublin City Council (DCC) is purchasing a site in Finglas and has agreed with the HSE that a Primary Care Centre (PCC) can be provided on a portion of this site.  Approval to proceed has been granted by the HSE Board and the HSE National Property Review Group (PRG). The terms of agreement for the transfer of land from DCC to HSE are currently being finalised. It is expected that the site acquisition process will be completed in the next few months. 

It is important to recognise that all capital development proposals must progress through a number of approval stages, in line with the Public Spending Code, including detailed appraisal, planning, design and procurement, before a firm timeline or funding requirement can be established.

The delivery of capital projects is a dynamic process and is subject to the successful completion of the various approval stages, which can impact on the timeline for the delivery of projects.

General Practitioner Services

Ceisteanna (176)

Maureen O'Sullivan

Ceist:

176. Deputy Maureen O'Sullivan asked the Minister for Health if his attention has been drawn to the fact that there are delays in obtaining doctors' appointments in the Ballymun healthcare centre and persons are often left over a week waiting to get an appointment; and if he will make a statement on the matter. [42639/19]

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.

Disability Diagnoses

Ceisteanna (177)

Maureen O'Sullivan

Ceist:

177. Deputy Maureen O'Sullivan asked the Minister for Health the waiting lists for children to be diagnosed on the spectrum for autism in the Dublin 9 and 11 areas; and the way in which this compares to the national average. [42640/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The 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.

Medicinal Products Reimbursement

Ceisteanna (178)

Louise O'Reilly

Ceist:

178. Deputy Louise O'Reilly asked the Minister for Health the weighting percentages to be used as part of the upcoming HSE FreeStyle Libre review decision making process that will be given to criteria (details supplied); and if he will make a statement on the matter. [42645/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

Medicinal Products Reimbursement

Ceisteanna (179)

Louise O'Reilly

Ceist:

179. Deputy Louise O'Reilly asked the Minister for Health if the reimbursement dataset will specifically cover only current HSE funded users of FreeStyle Libre; and if the health technology assessment review will compare total blood glucose strip usage spend year on year. [42646/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

Dental Services Provision

Ceisteanna (180)

Niamh Smyth

Ceist:

180. Deputy Niamh Smyth asked the Minister for Health the status of the provision of dental services for post-primary children in counties Cavan and Monaghan; the days the service is in operation; his plans to increase resources in this area to allow for an extension of this service and hours provided per week in either county; and if same will be implemented to cover annual leave. [42647/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this is a service matter it has been referred to the HSE for attention and direct reply to the Deputy.

Disabilities Assessments

Ceisteanna (181, 182, 183, 184, 185)

Richard Boyd Barrett

Ceist:

181. Deputy Richard Boyd Barrett asked the Minister for Health if all school age teams have a full complement of specialists to allow multidisciplinary assessment and interventions; if, in particular, a team (details supplied) has the complement; and if he will make a statement on the matter. [42649/19]

Amharc ar fhreagra

Richard Boyd Barrett

Ceist:

182. Deputy Richard Boyd Barrett asked the Minister for Health the way in which children are prioritised for the school age team assessment; if it follows the national policy for prioritisation for persons with disabilities; and if he will make a statement on the matter. [42650/19]

Amharc ar fhreagra

Richard Boyd Barrett

Ceist:

183. Deputy Richard Boyd Barrett asked the Minister for Health if assessments of needs by school age teams have a long waiting list; if parents can have private assessments done and still avail of interventions and supports from the appropriate specialists on the teams; and if he will make a statement on the matter. [42651/19]

Amharc ar fhreagra

Richard Boyd Barrett

Ceist:

184. Deputy Richard Boyd Barrett asked the Minister for Health if each child has to have a second full multidisciplinary assessment after having one with the early intervention team when moving to primary school when the child reaches the age of five; and if he will make a statement on the matter. [42652/19]

Amharc ar fhreagra

Richard Boyd Barrett

Ceist:

185. Deputy Richard Boyd Barrett asked the Minister for Health if staff in the early intervention and school age teams are replaced while on leave and maternity leave; and if he will make a statement on the matter. [42655/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 181 to 185, inclusive, together.

The 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.

Ambulance Service Data

Ceisteanna (186)

Niamh Smyth

Ceist:

186. Deputy Niamh Smyth asked the Minister for Health the number of paramedics assigned to counties Cavan and Monaghan; the stations they are assigned to; the number of ambulances operating in the counties; the stations they are operating from; the rota of same per day; the area they cover; and if he will make a statement on the matter. [42659/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this is a service issue, I have asked the HSE to reply to you directly. 

Health Services Staff

Ceisteanna (187)

Niamh Smyth

Ceist:

187. Deputy Niamh Smyth asked the Minister for Health if he will review the hours and finance being made available for a position (details supplied); and if he will make a statement on the matter. [42660/19]

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.

Cancer Screening Programmes

Ceisteanna (188)

Niamh Smyth

Ceist:

188. Deputy Niamh Smyth asked the Minister for Health the time women in counties Cavan, Monaghan and Meath are waiting on smear test and CervicalCheck results to return to their general practitioners; and if he will make a statement on the matter. [42678/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Significant progress has been made in reducing turnaround times for smear tests. Medlab Pathology, which reported a backlog of 55,000 smear tests in May 2019, completed the processing of these tests in August this year, having ceased accepting new tests from 1 May. This marks a welcome milestone for the programme. Two laboratories now provide services for CervicalCheck; the Coombe Women and Infants University Hospital and Quest Diagnostics. 

As of 10 October, the HSE reported that average turnaround times for both the Coombe and Quest are now 6 weeks. The HSE reports that it hopes to sustain these average turnaround times going forward, which will ensure that women and their GPs get their results in a reasonable time period.  

In relation to the specific data requested, I have asked the HSE to respond directly to the Deputy.

Primary Care Centres Data

Ceisteanna (189)

Niamh Smyth

Ceist:

189. Deputy Niamh Smyth asked the Minister for Health the number of primary care centres in counties Cavan, Monaghan and Meath; the services being provided by each location; his plans for further investment in services at these locations; if there are vacancies waiting to be filled at these centres in tabular form; and if he will make a statement on the matter. [42680/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.

Hospital Discharges

Ceisteanna (190)

Thomas P. Broughan

Ceist:

190. Deputy Thomas P. Broughan asked the Minister for Health the way in which he is addressing the rising number of delayed discharges from hospitals resulting from deficiencies in nursing home and home care provision. [42686/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

A delayed transfer of care (DTOC) (formerly known as a delayed discharge) is a patient who has been deemed clinically fit for discharge from an acute bed but whose discharge is delayed because they are waiting for some form of on-going support or care following their discharge. 

Our hospitals, emergency departments in particular, are under ongoing pressures with regard to demand for services. My Department is committed to progressing measures in the short, medium and longer term to deal with this issue and its underlying factors. There has been a sustained focus in recent years on reducing delayed transfers of care and enabling patients to be discharged from hospital sooner. Over the years additional funding has been provided for home supports, for transitional care, for the Nursing Homes Support Scheme, for aids and appliances and to provide increased capacity in both the acute and community settings.  

This year, services are being stretched more than ever, with demand consistently outstripping supply and over the last number of weeks we have seen significant increases in delayed transfers of care. While the HSE maximises the use of resources, prioritising those requiring discharge from acute hospitals, there is a growing demand for egress support.

The Department of Health is engaging extensively with the HSE in the context of planning for winter, including the response to the current challenge. An additional €26m has been made available for the last quarter of 2019 to support the hospital and community system to improve patient egress. The investment is supporting home support and transitional care as well as keeping the waiting time for access to support under the Nursing Homes Support Scheme (NHSS) at 4 weeks to the end of the year. The HSE were authorised to take immediate action in that regard last month, and released significant support to over 700 people to take up places under the NHSS and over 300 transitional care bed approvals. My Department is continuing active engagement with the HSE with regard to planning for the winter ahead. 

Under Budget 2020, the Government has made improved access to home support services a priority. We have committed to an additional investment of €52 million in Budget 2020 to bring the total funding for home supports to €487 million in 2020. In 2020 the HSE will deliver over 19.2 million hours of home support, representing a substantial increase of 1 million hours more than this year’s target.   

This investment is focused on enabling older people to remain at home and, as appropriate, provision of hours will also be targeted at times of peak demand in Winter 2020, at the beginning and end of the year, to ensure more timely egress from hospital for our older citizens. Over the last two years, an additional €45million has been provided to the Nursing Homes Support Scheme budget. In 2020, the NHSS will see a further investment into its budget of €45 million, bringing its total annual budget to €1.03 billion.

While I am mindful of the present pressures and challenges, there is a need for longer term planning and action. Last year I established an expert working group to carry out an independent expert review of delayed transfers of care. The review was established in recognition of the need to identify focused actions that will ensure that older people who are fit for discharge from hospital are supported to return to their homes and communities as early as possible. The Group reported its findings in November 2018.

The review recognised that delayed transfers of care are caused by a multitude of factors and it made nine recommendations which include the development of a national policy to provide for a more consistent approach to recording delayed discharges, strengthening data collection, standardising definitions and ensuring consistent discharge guidelines.  The report underlines the importance of hospitals and communities working together to improve patient flow. This is in line with the overall direction of an integrated care approach, expanding community-based care to bring care closer to home, as outlined in Sláintecare. 

I subsequently requested the HSE establish an appropriate multi-disciplinary structure to progress implementation of the recommendations. Arising from this a HSE Implementation Group has been established. I have also established and chair a Cross Divisional Oversight Group within the Department of Health to oversee the HSE’s implementation of the recommendations. Work is progressing well and last month the HSE hosted a collaborative learning event amongst staff to assist with the development of medium to long-term solutions.

Respite Care Services Provision

Ceisteanna (191)

Róisín Shortall

Ceist:

191. Deputy Róisín Shortall asked the Minister for Health if respite will be provided for a child (details supplied) in Dublin 11; and if he will make a statement on the matter. [42694/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The 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. 

The Programme for Partnership Government states that the Government wishes to provide more accessible respite care to facilitate full support for people with a disability.

As the Deputy's question relates to an individual case, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Health Services Staff Data

Ceisteanna (192)

Brendan Howlin

Ceist:

192. Deputy Brendan Howlin asked the Minister for Health the number of occupational therapists in each of the hospitals in the south-east area (details supplied); the criteria determining the numbers in each hospital; and if he will make a statement on the matter. [42696/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Assisted Human Reproduction

Ceisteanna (193)

Niamh Smyth

Ceist:

193. Deputy Niamh Smyth asked the Minister for Health the details of a scheme (details supplied); the criteria for same; the way in which a person is eligible for such a scheme; the waiting list for same; the hospitals from which it is being operated; the way in which a person receives a referral; and if he will make a statement on the matter. [42702/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

In parallel with the ongoing drafting of assisted human reproduction (AHR) legislation, officials in my Department, in conjunction with the HSE, have been developing a model of care for infertility, which incorporates a public funding element.  This work has also included examining proposals for the allocation of a related €1 million fund which was announced by An Taoiseach in December 2018. 

Accordingly, options in relation to the parameters of such a model, including the type of factors the Deputy refers to, are still under consideration, and I expect to be in a position to make an announcement in the coming weeks. 

It should be noted that while AHR treatment is not currently funded by the Irish Public Health Service, a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Arrangements administered by the HSE.  Medicines covered by the High Tech Arrangements must be prescribed by a consultant/specialist and authorised for supply to the client’s nominated community pharmacy by the High Tech Hub managed by the Primary Care Reimbursement Service.  The cost of the medicines is then covered, as appropriate, under the client’s eligibility, i.e., Medical Card or Drugs Payment Scheme.  I understand that the impact on the total cost of AHR treatment for individuals who avail of these schemes is not insignificant.

In addition, there is other support available in that patients who access IVF treatment privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme. 

Overall, the development of a model of care will help to ensure the provision of safe, effective and accessible infertility services at all levels of the public health system as part of the full range of services available in obstetrics and gynaecology.

Assisted Human Reproduction Legislation

Ceisteanna (194)

Niamh Smyth

Ceist:

194. Deputy Niamh Smyth asked the Minister for Health the way in which private sector IVF is regulated; the further plans he has in place in the area; and if he will make a statement on the matter. [42703/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Currently there is no specific legislation in Ireland governing assisted human reproduction (AHR). However, certain aspects of the operation of fertility clinics are regulated. SI No. 158 of 2006 (Quality and Safety of Human Tissues and Cells) Regulations govern the quality and safety standards in the donation, procurement, testing, processing, preservation, storage and distribution of human tissues and cells, including gametes and embryos.  Under these Regulations the Health Products Regulatory Authority (HPRA) is empowered to authorise and monitor tissue establishments involved in the donation, procurement, testing, processing, preservation, storage and distribution of human tissues and cells intended for human applications.

Of further relevance is the Children and Family Relationships (CFR) Act 2015, which reforms and updates family law to address the needs of children living in diverse family types.  Parts 2 & 3 of the  CFR  Act make provision for children conceived through the assistance of a donor.  This includes a requirement for gamete and embryo donations to be made on a non-anonymous basis and the establishment of a National Donor-Conceived Person Register to enable children to access information on their donor and genetically related siblings when they come of age, should they so wish.  Parts 2 & 3 will commence on 5th May 2020.

In addition to these,  the Medical Council provides specific guidance in the area of AHR in the ethical guidelines issued periodically to registered medical practitioners for application in the clinical situations in which they work.  However, these Guidelines have no statutory remit and do not apply to anyone working in the area other than medical practitioners.

Given the lack of specific regulation in this area, the Government approved the drafting of a bill on assisted human reproduction (AHR) and associated areas of research, based on the published General Scheme of the Assisted Human Reproduction Bill.  This comprehensive piece of legislation encompasses the regulation of a range of practices, including: gamete (sperm or egg) and embryo donation for AHR and research; surrogacy; pre-implantation genetic diagnosis (PGD) of embryos; posthumous assisted reproduction; and embryo and stem cell research.  The General Scheme also provides for an independent regulatory authority for AHR.

The Joint Oireachtas Committee on Health published the report of its review of the General Scheme on 11 July 2019, as part of the pre-legislative scrutiny process, which began in January 2018.  This report will be considered as part of the ongoing process of drafting the Assisted Human Reproduction Bill in conjunction with the Office of the Attorney General.

Cannabis for Medicinal Use

Ceisteanna (195)

Jack Chambers

Ceist:

195. Deputy Jack Chambers asked the Minister for Health if there is funding for patients approved for the medicinal cannabis access programme; and if he will make a statement on the matter. [42704/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

On 26th June 2019, I signed legislation which will allow for the operation of the Medical Cannabis Access Programme (MCAP) on a pilot basis for five years. 

Once suitable medical cannabis products are made available by suppliers, the Access Programme will make it possible for a medical consultant to prescribe, in line with the published clinical guidance, a listed cannabis-based product for a patient under his or her care for the following medical conditions, where the patient has failed to respond to standard treatments: 

- spasticity associated with multiple sclerosis; 

- intractable nausea and vomiting associated with chemotherapy; 

- severe, refractory (treatment-resistant) epilepsy. 

It should be noted that currently no medical cannabis products are available for use under the MCAP as it is expected that it will take some time for suppliers to arrange to have their products made available on the Irish market. However I am pleased to say that there are a number of suppliers who have already expressed interest.

Pending full operation of the MCAP, and for medical indications not included in the MCAP, doctors may continue to utilise the Ministerial licencing route to prescribe medical cannabis for their patients, should they wish to do so.

In line with the Chief Medical Officer's advice, the granting of a licence for cannabis for medical purposes must be premised on an appropriate application being submitted to the Department of Health, which is endorsed by a consultant who is responsible for the management of the patient and who is prepared to monitor the effects of the treatment over time

Clinicians may submit an application on behalf of their patients to the HSE for reimbursement approval if the patient has a valid medical prescription for medical cannabis for one of the above medical conditions and have sourced a cannabis-based product which has been prescribed under a Ministerial license.

The HSE has advised that in the previous situations where it considered reimbursement support appropriate, the following steps were completed.

- The patient’s consultant is satisfied that all therapeutic options have been exhausted and is prepared to accept the responsibility for monitoring the patient’s response to the cannabis product.

- A prescriber applies to the Minister for a Ministerial license and this is granted.

- The consultant completes an Individual Reimbursement Form, setting out the therapeutic benefit for the patient. It is important that this is completed in sufficient detail for therapeutic benefit to be demonstrated.

- The Individual Reimbursement Form is considered by the Medicines Management Programme (MMP).

- On review of the documentation, the MMP makes a recommendation for or against reimbursement support for the patient to the HSE, under the patient's eligibility, and informs the Primary Care Reimbursement Service (PCRS) of that recommendation.

If approval is given, the PCRS, when authorised to proceed, will make the necessary arrangements to cover the costs involved for the patient.

Disability Services Data

Ceisteanna (196)

Niamh Smyth

Ceist:

196. Deputy Niamh Smyth asked the Minister for Health the number of residential care places in counties Cavan and Monaghan; the number of persons on the waiting list for residential care in the counties; the length of time they have been waiting; and if he will make a statement on the matter. [42707/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The 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.