Written Answers Nos. 530-548
530. Deputy Thomas Pringle asked the Minister for Health the reason a person (details supplied) cannot get their primary medical certificate completed in view of the fact it was granted to them in December 2019; and if he will make a statement on the matter. [7290/20]
Amharc ar fhreagraAs the Deputy's question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
531. Deputy Michael McGrath asked the Minister for Health the daily capacity for Covid-19 testing; the response time from test application to test to result; and if he will make a statement on the matter. [7296/20]
Amharc ar fhreagraThe HSE, together with my Department and other bodies, has worked hard in the last two months to develop Ireland’s testing and tracing process, to expand capacity and to reduce turnaround times, and significant progress has been made.
On 14 May the HSE published its Roadmap on Testing and Tracing which confirms capacity is now in place across the full testing pathway to test 15,000 people a day. The HSE advises that the time from referral to receiving an appointment is generally same day. The HSE also advises that the end-to-end median turnaround time from referral to the completion of contact tracing for positive results is now 2.3 days. The end-to-end median turnaround times from referral to result is 2 days or less.
I am confident that the HSE is putting in place the measures to further reduce turnaround times and we are seeing continuing improvement. The HSE continues to streamline the process and to automate where possible. A range of process optimisation measures are being put in place, including automated swab appointments; offering the option to receive positive test results by text and enabling out of hours referrals. These are in addition to measures already in place including IT improvement, automation processes, and streamlined transportation logistics.
533. Deputy Joan Collins asked the Minister for Health the position of a child (details supplied) on the SAT list; and his plans to ensure they receive the help they need from the HSE and for their education [7320/20]
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.
535. Deputy Peter Fitzpatrick asked the Minister for Health if he has been briefed on the matter of hospital discharges into nursing homes (details supplied); if his attention has been drawn to specific evidence that Covid-19 was likely introduced into some nursing homes in this way; and if he will make a statement on the matter. [7363/20]
Amharc ar fhreagraThe HSE through the Health Protection Surveillance Centre has developed an extensive body of guidance and support tools to assist staff in long-term residential care facilities (LTRC), including nursing homes, in their management of COVID-19 cases, including in relation to decisions on transfer of residents, to hospitals, where appropriate.
The current relevant guidelines are the: “Interim Public Health and Infection Prevention Control Guidelines on the Prevention and Management of COVID-19 Cases and Outbreaks in Residential Care Facilities and Similar Units ” (version 4, 4 May 2020).
On the 10th March, the HSE issued preliminary guidance on the transfer of hospitalised patients from an acute hospital to a residential care facility in the context of the global COVID-19 epidemic.
The guidance, based on the best available information at the time, set out the various procedures to be followed, including:
- Patients with COVID-19 should not be transferred to an LTRC until they had two consecutive tests indicating virus not detected;
- Patients who were symptomatic and were contacts of a confirmed COVID-19 case should only transfer if the persons had a test indicating virus not detected and it was possible for that person to be isolated for the relevant incubation period;
- Patients who were asymptomatic and were contacts of a confirmed COVID-19 case should only transfer if it was possible for that person to be isolated for the relevant incubation period;
- Transfers from hospitals with no evidence of spread of COVID-19 should proceed as normal, except patients with respiratory tract infection meeting the then criteria for COVID-19 testing – in those cases testing should be carried out and the result should be virus not-detected before transfer.
COVID-19 emerged first in China in December last and was first confirmed in Europe in January and since has spread widely and rapidly around the globe, disregarding borders, time zones, age and race. As a new virus, the world has been learning as the situation with the virus has evolved and new evidence becomes available.
The very infectious nature of the COVID-19 virus makes it difficult to prevent and control in residential care settings - an experience replicated internationally. Interrupting transmission of the COVID-19 virus is the main goal of public health measures and it is clear from our experience that the scale of effect of interruption of transmission is influenced by a number of factors. The most important way to protect our older population, whether living at home or in a LTRC setting, has been to reduce the amount of disease present in our community. If we can keep the rate of disease low this means that we protect both the staff and residents in LTRC. The transmission of the virus, particularly in respect of LTRCs is multifactorial and its introduction into any setting could be the result of a number of factors, including it being introduced unknowingly by asymptomatic residents or staff. This is why the substantial package of published guidance continues to evolve and be updated in line with new national and international evidence and guidance. Regular research is undertaken of national and international literature to ensure that the best available information and evidence is considered in this rapidly evolving environment.
536. Deputy James Lawless asked the Minister for Health the status of the provision of care to a person (details supplied); and if he will make a statement on the matter. [7381/20]
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 an individual case, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
537. Deputy Duncan Smith asked the Minister for Health when he expects outpatient clinics for non-urgent procedures and assessments for children to reopen and accept clients; the impact there will be on waiting times for these services; and if he will make a statement on the matter. [7406/20]
Amharc ar fhreagraIn response to the Covid-19 pandemic the HSE had to take measures to defer all non-urgent elective scheduled care activity, including outpatient clinics. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by the World Health Organization, and the National Action Plan published on 16 March. The trajectory of the disease means there is now an opportunity for increasing the provision of non-Covid care including more routine care
The National Public Health Emergency Team (NPHET) has approved a number of recommendations relating to protecting and maximising the delivery of essential time-critical non-Covid-19 care alongside Covid-19 care. On 5 May, NPHET agreed that its recommendation of 27 March, in regard to the pausing of all non-essential health services should be replaced, in relation to acute care, with a recommendation that delivery of acute care be determined by appropriate clinical and operational decision making. Application of the essential risk mitigating steps set out in the guidance developed under the auspices of the NPHET Expert Advisory group will have operational implications, which will impact on throughput. The HSE is currently engaging with hospital groups to assess the impact of these guidelines on activity. The completion of this work should enable non-urgent elective care to resume within the necessary constraints, including paediatric appointments and procedures.
Where possible, hospitals are working to provide services in a different way, which includes virtual clinics for some outpatient department appointments. Children’s Health Ireland (CHI) is amongst those hospitals that are engaging in the use of telehealth and virtual clinics to facilitate outpatient appointments. The HSE website provides details on services currently available and operational in each hospital on its website. This information is reviewed frequently and provides up-to-date announcements on services available at each site (https://www2.hse.ie/services/hospital-service-disruptions/hospital-service-disruptions-covid19.html).
My Department, the HSE and the National Treatment Purchase Fund are currently working together to estimate the impact of Covid 19 on Scheduled Care waiting lists, including paediatric waiting lists, with a view to informing activity going forward. As the system continues to deliver Covid-19 and non-Covid 19 care side-by-side over a more prolonged period, my Department and the HSE will continue to work closely together to protect essential non-Covid 19 acute care and progress the provision of more routine non Covid-19 care.
538. Deputy Joe O'Brien asked the Minister for Health his plans to ensure CAMHS is adequately resourced to deal with the increased strain on the mental health of young persons during the Covid-19 pandemic; and the extent to which he is liaising with the Department of Education and Skills in view of the exceptional pressure on leaving certificate students [7420/20]
Amharc ar fhreagraThe development of all aspects of mental health services for young people, as reflected in the HSE Service Plan 2020, remains a priority for Government. Services have benefited from significant additional investment over recent years, which has resulted in an overall provision of €1.026 billion for HSE Mental Health this year. This represents an increase of €315m since 2012, and an increase of €39m over 2019. The additional €39m includes €13m for the continued rollout of new developments this year.
There are currently 71 Child and Adolescent Mental Health Service (CAMHS) teams, 4 CAMHS inpatient units and 3 Paediatric Liaison Teams. Approximately 18,000 children were expected to be referred to the HSE CAMHS service this year, with around 11,000 expected to be seen by CAMHS professionals. In each region, individual cases professionally assessed as requiring urgent access to CAMHS received priority.
The HSE Service Plan 2020 aims to improve all aspects of mental health care, including the development of CAMHS inpatient and community-based services and their integration with Primary Care and increased access to talk therapies for young people. A new forensic CAMHS unit, the first of its kind nationally, has been built at the new National Forensic Mental Health complex at Portrane. This will provide specialist CAMHS care not previously available within our system.
The Department of Health has worked with the HSE to develop various e-Mental Health responses for CAMHS and other youth services. Approval was recently announced for the new CAMHS Connect service for the HSE West region, which will pave the way for a national roll-out of such a new system. The need for such an approach, and how we plan and deliver our mental health services overall in the future, has been highlighted by Covid-19 and has been prioritised by Government responses to date.
The Department of Health and the HSE, in collaboration with key cross-Government and cross-sectoral partners, has developed a new mental wellbeing campaign. This campaign, hosted on gov.ie/together, offers support and resources to help deal with stress, anxiety and isolation currently experienced by many people, including young people.
The Department of Health and the HSE will continue to work closely with the Department of Education to advise on enhanced mental health supports for young people. Detailed information in relation to the Leaving Certificate is available at http://www.gov.ie/leavingcertificate.
This site contains information on wellbeing supports for Leaving Certificate students. It includes a series of supports on managing wellbeing, coping with uncertainty, managing stress and anxiety, and has been developed by the National Educational Psychological Service. The webpage has links to more individualised support for students to access, should these be needed. The Department of Health has worked with the Department of Education and Skills and the HSE to ensure the most appropriate services and resources are clearly signposted for students.
The Government is satisfied that CAMHS and other youth mental health services are adequately resourced at this time but we will continue to keep the issues raised by the Deputy under close review.
540. Deputy Joe O'Brien asked the Minister for Health if he has considered procuring more sustainable PPE equipment that can be used more than once after proper laundering and disinfecting in view of the fact the Covid-19 pandemic will be here for some time, the cost of PPE equipment is expensive and the equipment is not always available [7428/20]
Amharc ar fhreagraMost personal protective equipment (PPE) is designed for single use and immediate disposal so as to minimise the risk of spreading infection. However, this practice creates a number of issues in terms of cost, sustainability of supply, and environmental impact. With these issues in mind, the HSE is already investigating the possibility of procuring more sustainable PPE, such as reusable surgical gowns which can be sterilised between uses.
542. Deputy Barry Cowen asked the Minister for Health the status of a case of a person (details supplied); and when the person can expect an appointment with the neurosurgical department at Beaumont Hospital, Dublin. [7433/20]
Amharc ar fhreagraUnder 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.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In response to the Covid-19 pandemic the HSE had to take measures to defer all non-urgent elective scheduled care activity, including outpatient clinics. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by the World Health Organization, and the National Action Plan published on 16 March. The trajectory of the disease means there is now an opportunity for increasing the provision of non-Covid care including more routine care. It is envisaged that the private hospitals will play an important role in this regard.
My Department, the HSE and the National Treatment Purchase Fund are currently working together to estimate the impact of Covid 19 on Scheduled Care waiting lists, in order to be prepared to address any backlog or pent up demand. My Department continues to ensure that the resources available throughout our health system are best utilised at this unique and challenging time.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
543. Deputy Michael Healy-Rae asked the Minister for Health when the under-six general practitioner card age will be extended; and if he will make a statement on the matter. [7438/20]
Amharc ar fhreagraOn the 16th December 2019, the Government approved the drafting of legislation which, inter alia, would give effect to the Budget 2020 commitment to provide for the phased expansion of GP care without fees to all children aged 12 years and under. The initial stage of this phased expansion is the provision of GP care without fees to all children aged between 6 and 8 years. Substantial work has been undertaken by officials in this regard.
544. Deputy Michael Healy-Rae asked the Minister for Health the way in which the Pre-Hospital Emergency Care Council, PHECC, plans to deal with EMT students during the Covid-19 period and going forward (details supplied); and if he will make a statement on the matter. [7440/20]
Amharc ar fhreagraThe Pre-Hospital Emergency Care Council (PHECC) is the independent statutory body with responsibility for standards of education in pre-hospital emergency care. Its functions include the conduct of examinations leading to the award of NQEMT. Accordingly, the matter raised by the Deputy has been referred to PHECC for a direct response.
545. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [7447/20]
Amharc ar fhreagraUnder 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.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In response to the Covid-19 pandemic the HSE had to take measures to defer all non-urgent elective scheduled care activity, including outpatient clinics. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by the World Health Organization, and the National Action Plan published on 16 March. The trajectory of the disease means there is now an opportunity for increasing the provision of non-Covid care including more routine care. It is envisaged that the private hospitals will play an important role in this regard.
My Department, the HSE and the National Treatment Purchase Fund are currently working together to estimate the impact of Covid 19 on Scheduled Care waiting lists, in order to be prepared to address any backlog or pent up demand. My Department continues to ensure that the resources available throughout our health system are best utilised at this unique and challenging time.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
546. Deputy Niall Collins asked the Minister for Health if matters raised by a person (details supplied) in correspondence will receive a response; and if he will make a statement on the matter. [7473/20]
Amharc ar fhreagraI can confirm that the correspondence was received in my Department. A response will issue to the Deputy in due course.
547. Deputy Robert Troy asked the Minister for Health if he or his officials have engaged with a person (details supplied) regarding their advice on the significant need to upscale tracing and tracking here in order to avoid a second wave of the Covid-19 virus; and if he will make a statement on the matter. [7474/20]
Amharc ar fhreagraA robust process of testing, isolation and contact tracing is central to Ireland’s public health strategy for containing and slowing the spread of COVID-19, as advocated by the World Health Organization and the European Centre for Disease Control. A testing and tracing process with sufficient capacity and quick turnaround is one of a number of core criteria in determining when it is safe for countries to reduce restrictive public health measures.
The HSE, together with the Department of Health and other bodies, has worked hard in the last two months to develop Ireland’s testing and tracing process, to expand capacity and to reduce turnaround times.
A designated team, led by a senior manager reporting directly to the CEO, has been established in the HSE to oversee the development, management and operation of Ireland’s testing and contact tracing process. This includes responsibility for the scaling up of capacity and the speeding up of turnaround times with a clear focus on achieving ambitious targets and continuous improvement. On 14 May the HSE launched its Roadmap for testing and tracing with clear targets and a range of actions to achieve these targets.
Significant progress has been made over the last two months. 47 community testing centres have been established; over 40 laboratories are processing tests; 9 new contact tracing centres have been set up and some 1,700 public servants have been trained in contact tracing to support the work of public health departments. A quick testing referral pathway for GPs is in place, and new IT systems have been developed or modified. The HSE advise that it now has the capacity to test 15,000 people a day and median turnaround times have continued to improve.
It is important to recognise these systems and capacity have been developed from a standing start and to recognise the tremendous work which has gone into getting us to the point we are now at. It is also important to recognise the context in which this is happening: Ireland is already testing at a higher rate than most countries and our targets are ambitious. Data published on 18 May shows Ireland ranks 4th highest out of 25 EU+UK countries in terms of tests completed as a percentage of the overall population.
Ireland's testing strategy has evolved as our testing capacity has grown. A number of changes have been made to the case definition so that anyone presenting with acute respiratory infection comprising the sudden onset of least one of the following symptoms (cough, fever, shortness of breath) can be referred for testing. A mass testing programme across nursing homes, mental health and disability facilities is nearing completion, and, as of last week, all close contacts of someone with Covid-19 will be automatically referred for testing. Our testing strategy will continue to be kept under review by the National Public Health Emergency Team (NPHET).
In relation to the specific question raised, I have not had any direct engagement with the person referred to and I'm not aware of any engagement with my officials.
548. Deputy Cathal Crowe asked the Minister for Health if he will engage with the owners of a location (details supplied) to explore its potential as a use for pharmaceutical firms in their efforts to research treatment for Covid-19 [7479/20]
Amharc ar fhreagraThis information has been shared with the Department of Health COVID-19 team who are managing and co-ordinating offers of assistance.
