Written Answers Nos. 605-627
606. Deputy Jennifer Whitmore asked the Minister for Health if he will create a roadmap for the return to practice of podiatry practitioners; if a support package for the podiatry sector will be established similar to that created for the dentistry sector; and if he will make a statement on the matter. [7982/20]
Amharc ar fhreagraThe Health Act 1947 (Section 31A - Temporary Restrictions) (COVID-19) Regulations 2020 (SI No. 121 of 2020) were signed by the Minister for Health on 7 April 2020.
Schedule 2 of the Regulations sets out essential services that are exempted from the restrictions and therefore can continue to be provided. This includes (at 15(b)) podiatry services as these services are provided by a member of a designated profession within the meaning of section 3 of the Health and Social Care Professionals Act 2005 (No. 27 of 2005).
The Government has put in place a suite of measures to support small, medium and larger businesses that are negatively impacted by COVID-19. In addition, the Department of Business, Enterprise and Innovation has published a Return to Work Safely Protocol, which is designed to support employers and workers to put measures in place that will prevent the spread of COVID-19 in the workplace. The Health and Safety Authority also provides information and advice for employers and employees in this regard.
607. Deputy Denise Mitchell asked the Minister for Health if funding for a brace for a person (details supplied) has been denied; and if funding will be made available for same. [7995/20]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for attention and direct reply to the Deputy.
608. Deputy Cormac Devlin asked the Minister for Health when vital services will resume for children living with severe disabilities that require regular physiotherapy, speech and language therapy, occupational therapy and respite care; and if he will make a statement on the matter. [8016/20]
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.
609. Deputy Cormac Devlin asked the Minister for Health the measures taken to ensure section 39 organisations remain available to support their vulnerable customers during and after the Covid-19 pandemic; and if he will make a statement on the matter. [8017/20]
Amharc ar fhreagraAs the Deputy will be aware, health and social personal services are by their nature varied and complex. In some instances, the HSE itself delivers these services directly and in other circumstances, the HSE relies upon funded providers to deliver these services on its behalf. Sections 38 and 39 of the Health Act 2004 legally underpin
(a) the provision of services by non-statutory providers on behalf of the HSE (Section 38); and
(b) the provision of services similar or ancillary to a service that the HSE may provide (Section 39).
Amongst Section 39 voluntary organisations are hospices, mental health providers, nursing home and homecare providers, small community-based groups and social care services. In the context of the Covid-19 pandemic, each HSE Community Healthcare Organisation (CHO) has an Area Crisis Management Team and all services have plans in place for providing supports during this period to ensure continuity of service provision. The HSE holds weekly teleconferences with key stakeholders, including Section 39 service providers, to identify and respond to challenges at local level,
As part of the HSE COVID 19 response, there is a requirement on each of the Area Crisis ManagementTeams to establish a number of Residential Care & Home Support Covid-19 Response Teams (CRT)to address COVID -19 outbreaks in their area. The purpose of these CRTs is to support the prevention, identification, and management of COVID 19 outbreaks across residential care facilities and Home Support services. These teams provide support across a range of nursing and medical care areas as well as Infection Prevention and Control. The teams also support residential care facilities/Approved centres in the catchment area whether they are public, Section 38, Section 39 or private facilities, and across the care groups of Older People, Disability, & Mental Health. In addition, they also address identified clusters of concern in the Home Support services, as determined by Public Health.
The HSE has put in place a structured governance process through which Section 39 organisations experiencing financial difficulties due to the Covid-19 public health emergency can engage to ensure, where appropriate, continuity of essential services provided by these agencies.
Finally I would like to acknowledge the vital role played by voluntary organisations, including those funded by the HSE under Section 39 of the Health Act, in ensuring a flexible and person-centred response to ensure continued support for our most vulnerable citizens during this challenging period, and as we prepare for the next phase of the response.
611. Deputy Aindrias Moynihan asked the Minister for Health the plans in place for the reopening of learning and disability services for adults and children that are closed due to Covid-19 restrictions; and if he will make a statement on the matter. [8067/20]
Amharc ar fhreagraI am informed that HSE Disability Services is now moving from the current crisis-response phase to the next phase, which will be one of recovery and safe reinstatement of supports and services critical to people with disabilities and their families. In this context, the HSE are in the process of detailed planning in order to recover these services in line with the Governments' Roadmap. This will be supported by way of assurance and oversight from the HSE's Chief Clinical Officer along with the NPHET, to ensure the HSE does so in a safe manner. HSE will continue to adhere to public health requirements while also reflecting key policy and legal requirements forming under the UN Convention on the Rights of People with a Disability. This means that services, whilst being delivered in new ways, will gradually be re-introduced to people with disabilities.
The HSE have established a number of Working Groups to design and propose how services can be safely reintroduced. This will be achieved as a collaborative process involving out colleagues within the disability umbrella organisations.
Please note that many educational services for children with disabilities are under the remit of the Department of Education and Skills and the deputy may wish to direct enquiries in that regard to my colleague, the Minister for Education.
612. Deputy Dessie Ellis asked the Minister for Health the status of the availability of psychiatric services at James Connolly Memorial Hospital, Blanchardstown for those that present at the hospital with mental health issues; his views on whether it is acceptable that on 19 May 2020 up to seven persons that presented to the hospital with mental health issues had to wait up to 24 hours before they were assessed; and if he will make a statement on the matter. [8072/20]
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.
613. Deputy Dessie Ellis asked the Minister for Health when the HSE addiction tier 4 residential service (details supplied) will be reopened; if the asymptomatic persons presently accommodated in the facility would be better accommodated in other facilities that are available to house same in order that this facility be reopened as soon as possible to help reduce the risk of deaths from substance misuse and underlying mental health issues; and if he will make a statement on the matter. [8073/20]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
614. Deputy Marc Ó Cathasaigh asked the Minister for Health if reassurance will be provided to the thousands of women whose BreastCheck and CervicalCheck appointments have been cancelled due to the Covid-19 crisis that their appointments will be rescheduled and the backlog cleared in a timely manner; and if he will make a statement on the matter. [8091/20]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
615. Deputy Marc Ó Cathasaigh asked the Minister for Health the way in which he plans to deal with secondary school students that missed their HPV vaccine (dose 2) and MenACWY vaccines and young children that missed scheduled childhood vaccines due to the Covid-19 crisis; and if he will make a statement on the matter. [8092/20]
Amharc ar fhreagraThe HSE National Immunisation Office is responsible for managing vaccine procurement and distribution, developing training and communication materials for the public and health professionals.
As the question raised by the Deputy is a matter for the National Immunisation Office, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
616. Deputy Marc Ó Cathasaigh asked the Minister for Health the way in which he plans to deal with the backlog in elective procedures that have built up in University Hospital Waterford and other hospitals nationwide due to the Covid-19 crisis; and if he will make a statement on the matter. [8093/20]
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 Organisation, 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.
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, 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.
Where possible, hospitals are working to find innovative ways to enable service provision, which include virtual clinics for some out-patient department 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).
In relation to specific plans for elective procedures at University Hospital Waterford, as this is a service issue, I have asked the HSE to respond to the Deputy directly.
617. Deputy Norma Foley asked the Minister for Health the status of an orthopaedic appointment for a person (details supplied). [8102/20]
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 Organisation, 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.
618. Deputy Norma Foley asked the Minister for Health the status of a medical card application by a person (details supplied). [8106/20]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.
619. Deputy Norma Foley asked the Minister for Health the status of an urgent appointment for a person (details supplied) at Our Lady’s Children’s Hospital, Dublin. [8107/20]
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 Organisation, 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.
620. Deputy Bernard J. Durkan asked the Minister for Health when approval will issue from the Medical Council of Ireland in the case of a person (details supplied); and if he will make a statement on the matter. [8108/20]
Amharc ar fhreagraNon-EU qualified applicants are required to pass or be exempt from the Medical Council's pre-registration exam, known as the PRES, in order to be registered with the Council and to practise as a medical doctor in Ireland.
Under Registration Rule 2(c). applicants may seek an exemption from the PRES if they hold a higher qualification which is recognised by the Council for the purpose of an exemption and fulfil all the criteria set out in rules. Upon receipt of the relevant documentation, the Medical Council determine whether an applicant qualifies for an exemption. In the event an applicant does not qualify for an exemption, it is open to the applicant to pursue registration via the PRES.
621. Deputy Éamon Ó Cuív asked the Minister for Health when the temporary measures he introduced as part of his response to the Covid-19 pandemic in relation to doctors being allowed to prescribe abortion pills after a teleconference with a patient rather than a physical visit, as required heretofore, will be rescinded in view of the reduction of pressure of work on general practitioners in recent weeks and the assurance by general practitioners to all patients that it is safe to visit their general practitioner; and if he will make a statement on the matter. [8125/20]
Amharc ar fhreagra622. Deputy Éamon Ó Cuív asked the Minister for Health the medical advice given to him before he changed the regulations in relation to the need for a physical visit to a doctor before abortion pills could be prescribed, which he said was in response to the changed circumstances due to Covid-19; who gave this advice; whether he is willing to publish the advice given to him on this matter; and if he will make a statement on the matter. [8126/20]
Amharc ar fhreagraI propose to take Questions Nos. 621 and 622 together.
As part of the Government’s ongoing efforts to protect public health and limit the spread of COVID-19, the Department of Health and the HSE worked together to put new arrangements in place to temporarily allow termination of pregnancy services in early pregnancy to be provided remotely.
For the duration of the COVID-19 public health emergency, where the need for social distancing, reducing personal contacts and reducing the burden on medical practitioners are paramount, it will be possible for a woman to access a termination under section 12 of the Health (Regulation of Termination of Pregnancy) Act 2018 (i.e. before 12 weeks) from her medical practitioner by telephone or video conference consultation.
The arrangement enabling remote consultation will lapse once the public health emergency is declared over, and the normal functioning and requirements of the original Model of Care for early pregnancy will resume (i.e., visits to medical practitioners).
623. Deputy Sorca Clarke asked the Minister for Health if there are grant schemes available to those with medically certified mobility issues to assist in the purchase of mobility scooters. [8159/20]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for attention and direct reply to the Deputy.
624. Deputy Sorca Clarke asked the Minister for Health the number of persons in counties Longford and Westmeath that have been approved for initial or an increase in home help hours but have yet to receive them. [8162/20]
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.
625. Deputy Sorca Clarke asked the Minister for Health the status of an operation for a person (details supplied). [8165/20]
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 Organisation, 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.
626. Deputy Louise O'Reilly asked the Minister for Health if he will provide a breakdown of the health workers that have contracted Covid-19 including those that have died by grade and location, that is, acute, community and so on, age range and whether they are directly employed or employed by a contractor or agency; and if he will make a statement on the matter. [8169/20]
Amharc ar fhreagraAs this is an operational matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
627. Deputy Louise O'Reilly asked the Minister for Health the person or body responsible for the construction of a Covid-19 implementation plan inclusive of resources, human and financial for congregational settings; the way in which the plan was drafted; the person or body that drafted the plan; when it was completed; when it was shared with all facilities and service providers in congregational settings; and if he will provide a copy of the minutes of the meetings in which the plan was drawn up and a copy of the plan. [8170/20]
Amharc ar fhreagraSince COVID-19 first emerged in China in December 2019, the Government has taken decisive actions in response to this virus, advised by the National Public Health Emergency Team (NHPET). People living in Long-term Residential Care facilities are particularly vulnerable populations in the context of Covid-19 and have been identified by the World Health Organisation (WHO) to be at a higher risk of being susceptible to infection from this disease and for subsequent adverse outcomes.This is most likely due to their age, the high prevalence of underlying medical conditions and circumstances where high care support with the activities of daily living is required in collective high physical contact environments. These are characteristics of LTRC in Ireland that make them a high-risk centre for Covid-19 outbreak and contagion across residents and staff. The approach by Government has been public health led in line with data, evidence and best practice as it emerges, through advice from the NPHET. The response to COVID-19 in LTRC is based on preparedness, early recognition, isolation, care and prevention of onward spread. This involves case recognition, testing, contact tracing and examining disease patterns including mortality. The actions and measures we have taken in Ireland to support nursing homes and their residents have been taken, and have evolved on foot of, epidemiological data and guidance from the WHO and the European Centre for Disease Prevention and Control (ECDC). These measures have been both society wide (e.g. cocooning), as well as focused specifically on residential facilities.The scope of LTRC covers older people, disability and mental health residential care settings. LTRC facilities provide long-term care and short stay, transitional care and respite support either through the State, the voluntary sector or privately. On 10th March 2020 Interim Guidance on Transfer between Care Facilities was circulated and through HIQA was circulated directly to all LTRC registered centres. On the 11th March 2020 the WHO declared COVID-19 a pandemic and the following day the European Centre for Disease Control (ECDC) published its 6th update to its Rapid Risk Assessment (RRA), 12th March 2020, including new guidance in relation to the implementation of social distancing measures and prevention and control priorities in relation to inter alia LTRCs. On the same day as the ECDC update, NPHET recommended that Ireland move to “delay phase” and social distancing measures were recommended and announced, including:
- Visiting restrictions in long-term care facilities;
- Individuals who have symptoms should self-isolate for a period of 14 days;
- Staggered breaks in work and greater remote working etc.
The Government's COVID-19 Action Plan was published on 16th March 2020 and included key actions relating to the protection of vulnerable groups in community settings, including long-term care settings, through maintenance of existing services and enhanced support actions.
Preliminary Clinical and Infection Control Guidance for COVID-19 in nurse-led Residential Care Facilities (RCF) was published by the HSE and circulated to the nursing homes sector on 17th March 2020. The document provides guidance on general measures to reduce the risk of accidental introduction of COVID-19 into a LTRC, procedures to be followed for clinically suspect residents; guidance on clinical investigations and monitoring and on IPC. The document also provides detailed step-by-step instructions across a range of scenarios.As the disease has progressed, a range of enhanced measures for nursing homes have been recommended by NPHET which are now being implemented by relevant agencies.
Each HSE CHO Area Crisis Management Team (ACMT) has prioritised the needs of all long-term care residents within their areas and has also offered very significant support to the nursing homes in their areas, particularly those with COVID 19 outbreaks. Guidance on the set up of COVID Response Teams was issued on 9th April to support all LTRCs within a CHO area and 23 COVID Response Teams are now in place across the 9 CHO areas. These teams are actively supporting all centres with outbreaks in their area through operational guidance and infection prevention and control (IPC) and Clinical support by Geriatricians etc, and in the most at-risk centres, staff are being deployed or sourced to ensure ongoing safe service delivery.
The establishment and provision of accommodation supports for staff who are living in congregated arrangements has been implemented with approximately 2,000 beds occupied per week.To support designated centres HIQA set up an Infection Prevention and Control Hub providing support to providers and staff via email and phone. This support, guidance and advice includes:
- outbreak preparedness
- outbreak management advice (for example, resident placement, cohorting and special measures where isolations is not possible, transmission and standard precautions)
- understanding HSE advice and its applicability to specific centres
- general support on infection control issues.
Overall a significant package of measures has been adopted to date, including:
- HSE COVID Response Teams across the Community Health Organisations, to provide support and expert guidance to all long-term care residential settings;
- The provision of staffing, PPE, Oxygen, training and other supports to nursing homes;
- The €72.5m COVID-19 Temporary Assistance Payment Scheme;
- A Mortality census;
- HIQA risk assessment of all nursing homes;
- HIQA regulatory assessment framework of the preparedness of designated centres for older people for a COVID19 outbreak;
- Health Protection Surveillance Centre guidance;
