Written Answers Nos. 628-646
628. Deputy Louise O'Reilly asked the Minister for Health the details of the proposed catch-up programme for screening services such as BreastCheck, CervicalCheck and BowelScreen for the thousands of scheduled screening tests which have been postponed or missed due to Covid-19; the details of additional capacity confirmed to ensure that this catch-up can take place; and if he will make a statement on the matter. [8171/20]
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.
629. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the private hospital sector is being fully utilised to deal with all procedures throughout the Covid-19 health emergency; the extent to which patients with private health insurance have access to their consultant and or hospitals; and if he will make a statement on the matter. [8190/20]
Amharc ar fhreagraThe 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.
Guidance on patient pathways to mitigate the risks associated with the delivery of non-covid care, for patients and healthcare workers, and support safe delivery of care has been developed under the auspices of the Expert Advisory Subgroup of NPHET (EAG) and approved in principle by NPHET. The HSE advise that the latest occupancy data for inpatients in private hospitals indicates that overall in-patient occupancy has increased to 51%.
The HSE advise that preliminary figures show that as of 25th May, 7,605 patients had been discharged from private hospitals having undergone an inpatient procedure since the arrangement between the HSE and private hospitals came into force. In the same period 26,007 daycase procedures took place in private hospitals, as well as 35,073 diagnostic appointments and 20,407 outpatient appointments.
Under the terms agreed with the hospitals, provision has been made to ensure continuity of care for patients who were in a private hospital or receiving a course of treatment when the arrangement was agreed. These patients will be treated as public patients and will be prioritised based on clinical needs, as with any other public patient. It is intended that each patient will remain under the care of their existing consultant, where that can be facilitated and if that is not possible, they will be transferred to the care of another consultant as a public patient.
630. Deputy Bríd Smith asked the Minister for Health the interventions made by his Department and the HSE in meat processing plants in relation to the Covid-19 outbreak; and the inspections undertaken by public health bodies in these plants [8197/20]
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.
631. Deputy Bríd Smith asked the Minister for Health the number of patients released from acute hospitals to residential nursing homes since January 2020; if a protocol was in place in relation to Covid-19 in the transfer of these patients; and if he will make a statement on the matter. [8198/20]
Amharc ar fhreagraThe HSE through the Health Protective Surveillance Centre has developed an extensive body of guidance and support tools to assist in the management of COVID-19 cases, including in relation to decisions on transfer of patients/residents between care facilities 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 4.1, 04/05/2020.
The decision to discharge patients from hospital to nursing home settings is subject to clinical assessment. Discharges to nursing homes and other settings are a regular, daily feature of a functioning health system. The period from early March to mid-April saw an increase in the number of such discharged patients as the health system prepared itself for the expected ‘surge’ in COVID-19 cases. From an older person’s perspective, being admitted for longer than necessary increases the risk of a patient contracting a healthcare associated infection and/or deconditioning. The vast majority of these discharges took place from the 10th March onwards, when clear public health guidance was in place.
On the 10th March 2020, the HSE issued Interim Guidance on Transfer between Care Facilities, which included 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 pandemic. 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 a 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.
With regard to the query raised in respect of numbers of patients, this data is not readily available to my Department but I will follow up with the HSE to seek further information.
632. Deputy Gary Gannon asked the Minister for Health the consideration that has been given to the protection of persons serviced by the community and voluntary sector in terms of appropriate provision of PPE to reduce danger of Covid-19 transmission from asymptomatic workers and volunteers to service users; and if he will make a statement on the matter. [8221/20]
Amharc ar fhreagraThe current advice from the HSE, regarding personal protective equipment (PPE), is as follows:
"Personal protective equipment (PPE) is valuable as an additional protection for patients and staff. It should only be used where it is likely to be beneficial as outlined in the HSE Personal Protective Equipment PPE guidance: (https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/infectionpreventionandcontrolguidance/ppe/). It should not be used in other settings where it does not provide any benefit. The unnecessary use of PPE will deplete stocks and increases the risk that essential PPE will not be available to help protect you, your colleagues and patients when needed".
In addition, the HSE’s Health Protection Surveillance Centre (HPSC) publishes 'Guidance on cocooning to protect people over 70 years and those extremely medically vulnerable from COVID-19', the latest version (version 1.4 17 May) of this guidance states the following:
"Visits from people who provide essential support to you such as healthcare, personal support with your daily needs or social care should continue, but carers and care workers must stay away if they have any of the symptoms of COVID-19. They may find this guidance for Health and Social care workers
(https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/infectionpreventionandcontrolguidance/healthandsocialcareworkers/Guidance-HealthSocialCareWorkersWhoVisitHomes.pdf) who visit homes useful. All people coming to your home should wash their hands with soap and water for at least 20 seconds on arrival to your house and often whilst they are there".
633. Deputy Gary Gannon asked the Minister for Health if and the way in which the commitment he made during the debate in Seanad Éireann on the Health (Preservation and Protection and other Emergency Measures in the Public Interest) Act 2020, has been delivered, which ensures appropriate access to independent advocacy support for those detained under section 11(5) of the Act; the way in which his related commitment to engage with civil society organisations and opposition Senators and TDs regarding the development of regulations in respect of detention under the Act has been delivered; and if he will make a statement on the matter. [8222/20]
Amharc ar fhreagraSection 11 of the Health (Preservation and Protection and other Emergency Measures in the Public Interest) Act 2020 inserted section 38A in the Health Act 1947. Section 38A of the Health Act 1947 provides for the detention and isolation of persons in certain circumstances. Having regard to matters set out in section 38A(2), a medical officer of health may order in writing the detention and isolation of a person where the medical officer of health believes in good faith that a person is a potential source of infection from Covid-19 and that such person cannot be effectively isolated, refuses to remain or appears unlikely to remain in his or her home or other accommodation arranged, or agreed, by the HSE. Section 38A(5) provides that a person who is the subject of an order may request that his or her detention be reviewed by a medical officer of health, other than the officer who makes the order concerned, on the grounds that he or she is not a potential source of infection.
There is no Ministerial regulation making power under the provisions of section 38A. Decisions are made by a medical officer of health, who must act in good faith and have regard to the provisions of the section.
I understand from the HSE that no person has to date been the subject of a detention order under section 38A of the Health Act 1947. I also understand that the HSE is currently in the process of finalising protocols and procedures and support arrangements in relation to section 38A of the Act.
634. Deputy Seán Crowe asked the Minister for Health the number of children on the waiting list for early years disability services for HSE in south western areas of Dublin; if the waiting time is 29 months from the date the referral was received (details supplied); the reason for the long delays in the area which predate Covid-19; if some children will miss out on supports in view of the fact they will be too old for early years intervention; the number of children on the list; if his attention has been drawn to the fact that this will impact the current lists; if waiting times vary dependent on resources; and the additional resources that will be provided to the area to reduce numbers and waiting times in order to comply with the Disability Act 2005, in view of the lengthening waiting lists [8244/20]
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.
635. Deputy Seán Crowe asked the Minister for Health the number of persons on waiting lists and the demand for home help nationwide by CHO area, in tabular form. [8245/20]
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.
636. Deputy Seán Crowe asked the Minister for Health if there have been unusually high clusters of deaths or cases of Covid-19 in public or private nursing homes in south western areas of Dublin [8246/20]
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.
637. Deputy Matt Carthy asked the Minister for Health his views on whether the charge of €50 applied for a phone consultation with out-of-hours general practitioner services is excessive; if he will work with stakeholders to reduce the fee in view of the fact some consultations can be brief in nature; and if he will make a statement on the matter. [8265/20]
Amharc ar fhreagraUnder the GMS scheme, the HSE contracts GPs to provide medical services to medical card and GP visit card holders. The GMS contract stipulates that GPs must make suitable arrangements to enable contact to be made with them, or a locum/deputy, for urgent cases outside normal practice hours. Most GPs choose to participate in GP out of hours cooperatives to meet this contractual obligation.
In response to the COVID-19 pandemic, patient in-person contact with GPs has been curtailed as much as possible to help prevent the spread of the virus. Nurse and doctor advice is provided over the phone where appropriate, and only patients who are clinically assessed as requiring a face to face consultation with a doctor are referred for an appointment.
GPs are reimbursed by the HSE for medical services provided to medical card or GP visit card holders, while patients who do not hold a medical card or GP visit card access GP services on a private basis, and the fees charged by GPs for services to private patients are a matter of private contract between the GP and their patients.
Similarly, cooperatives that provide out of hour GP services are private companies and therefore the fees charged to their private patients are a matter of private contract between the company and their patients. I have no role in relation to the fees charged by individual GPs or GP out of hours service providers for private consultations.
638. Deputy Matt Carthy asked the Minister for Health the hospitals which source human milk supplies from a location (details supplied); the hospitals which purchase human milk from abroad; the reason for importing human milk in these instances; if all human milk supplies are tested for pseudomonas; and if he will make a statement on the matter. [8266/20]
Amharc ar fhreagraAs the question relates to service matters, it has been referred to the HSE for direct reply to the Deputy.
639. Deputy Matt Carthy asked the Minister for Health the number of employers that were provided with the Covid-19 test results of their employees; the number of workers involved in each instance; his views on whether this breaches patient confidentiality; if he will issue an instruction that such procedures cease; and if he will make a statement on the matter. [8267/20]
Amharc ar fhreagraI have sought a specific report from the HSE in relation to this matter. This will set out the circumstances under which results were not communicated to individual workers in affected meat plants and in long term residential care facilities, and the actions that are being taken to ensure that communication of the results of individual COVID-19 tests is directly to the individual.
640. Deputy Gino Kenny asked the Minister for Health when nursing homes can allow visitors once they have outdoor space while visitors would observe physical distancing; and if he will make a statement on the matter. [8279/20]
Amharc ar fhreagraI am aware of how difficult the current restrictions on visiting are for both nursing home residents and their families, however, the current expert guidance should be adhered to. The primary responsibility of managing the risk of infection with Covid-19 and for control of outbreaks lies with the residential care facility, within their responsibilities for resident care and infection control. This responsibility is referred to in the 2016 National Standards for Residential Care Settings for Older People in Ireland. Appropriate evidence-based guidance to support the work of health and social care providers on a range of issues, including infection prevention and control, has been developed by the HSE and the HPSC and is updated regularly, as appropriate, and made available on their websites. On 5th May, the HPSC published 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. These are available on the HPSC website. This guidance provides the most up to date advice and information on the public health management and infection prevention and control measures, to inform and advise local planning and management in community residential facilities.
The Taoiseach recently announced a Roadmap for the future easing of restrictions on a phased basis. Phase 3, from 29 June, will see the commencement of a phased approach to visiting at hospitals, residential healthcare centre and other residential settings bearing in mind the particular features of types of settings and each individual centre, also considering Personal Protective Equipment (PPE) availability and other protections.
All nursing homes, public and private continue to be regulated by the Health Information and Quality Authority (HIQA) and have a duty to ensure continued adherence to the existing regulatory and standards framework in the discharge of their duties.
641. Deputy Richard Boyd Barrett asked the Minister for Health the breakdown of Covid-19 deaths by age, profession, socio-economic class, gender and details of underlying illnesses; and if he will make a statement on the matter. [8280/20]
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.
642. Deputy Richard Boyd Barrett asked the Minister for Health the number of staff recruited to the health service since the outbreak of the Covid-19 crisis; the status of the contracts for these staff including the formal employer of these staff; if these contracts are permanent or temporary; and if he will make a statement on the matter. [8281/20]
Amharc ar fhreagraI have asked the HSE to respond directly to the Deputy.
643. Deputy Richard Boyd Barrett asked the Minister for Health his plans and timeline to permanently increase the capacity in the health service in order that it can run at 80% capacity rather than near to 100% as it was prior to outbreak of Covid-19 to ensure public health physical distancing rules and safe staffing levels can be complied with and extra capacity for crises in addition to tackling the waiting lists and accident and emergency overcrowding; his views on whether this requires permanently retaining all private hospital capacity under the control of the HSE; and if he will make a statement on the matter. [8282/20]
Amharc ar fhreagraOn 5 May 2020, the National Public Health Emergency Team (NPHET) agreed that its recommendation of 27 March to pause all non-essential health services should be replaced 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 NPHET Expert Advisory group will have operational implications that will impact on throughput.
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.
The HSE is currently working to develop a continuity of services plan to examine how healthcare activity suspended during Covid-19 can be resumed while maintaining acute occupancy at 80% to provide for surge capacity in the event of a further wave of Covid-19. This work should enable non-urgent elective care to resume within the necessary constraints.
The key to maintaining reduced acute hospital occupancy is to address the gap between capacity and demand as set out in the Health Service Capacity Review 2018. The HSE has advised that plans to address the findings of the capacity review are currently being revised in response to the emerging and potential long-term impact of Covid-19, and my Department is continuing to engage with the HSE in this regard.
The Government published its Action Plan in Response to Covid-19 on 16 March. A critical element of the strategy was to put in place an arrangement with the private hospitals to use their facilities as part of the public system, to provide essential additional acute hospital services for the duration of the emergency. The terms of the arrangement reflected the expected Covid-19 pandemic at time of signing. It is in place for three months up to the end of June, with an option to extend it. Under the Terms to the agreement a decision to extend the arrangement must be notified to the private hospitals by the end of this month. The arrangement is currently under review and depending on the outcome a decision will be made on whether to extend or not. Any decision regarding an extension would have to be considered in the context of the evolution of the Covid-19 pandemic and the most effective use of resources in tackling it. Therefore, while there is an option to extend the arrangement, it is not intended that the arrangement will be permanent.
644. Deputy Pat Buckley asked the Minister for Agriculture, Food and the Marine his plans to reopen the greyhound industry as part of the phasing out of the Covid-19 lockdown (details supplied). [7645/20]
Amharc ar fhreagra655. Deputy Sean Sherlock asked the Minister for Agriculture, Food and the Marine when it will be permitted to allow greyhound racing again under the Roadmap for Reopening Society and Business. [7485/20]
Amharc ar fhreagra656. Deputy Michael Healy-Rae asked the Minister for Agriculture, Food and the Marine if he will address a matter regarding the reopening of the greyhound industry (details supplied); and if he will make a statement on the matter. [7491/20]
Amharc ar fhreagraI propose to take Questions Nos. 644, 655 and 656 together.
Bord na gCon is a commercial state body, established under the Greyhound Industry Act, 1958 chiefly to control greyhound racing and to improve and develop the greyhound industry. Bord na gCon is a body corporate and a separate legal entity to the Department of Agriculture, Food and the Marine.
Under the Government's Roadmap for Reopening Society and Business, it is currently envisaged that greyhound racing will recommence in stage 3 of the process which starts on 29th June 2020.
On publishing the Roadmap for the Reopening of Society and Business, the Government expressed a willingness to engage and consult with sectors on possible changes to the timings set out in the plan.
My Department will continue to liaise with all sectors under its remit including Bord na gCon to examine if any changes are possible, bearing in mind the pre-eminence of the protection of public health.
Bord na gCon is fully engaged with my Department officials on this matter.
645. Deputy Róisín Shortall asked the Minister for Agriculture, Food and the Marine the protections in place for workers in meat processing plants; and if he will make a statement on the matter. [7940/20]
Amharc ar fhreagraIn order to address issues in meat plants, Food Business Operators have put in place a range of protective practices and equipment to protect employee safety and these measures may vary slightly from plant to plant, but may include the reduction of throughput rates at the plant, temperature checks on entry into the plant, the extension of operating hours and other safeguards such as “podding”, the provision of additional PPE, the use of perspex screens and the provision of additional facilities to support physical distancing measures.
A national Outbreak Control team has been established by the HSE to deal with all issues relating to Covid 19 in meat plants. My Department is represented on this committee and it is expected that recommendations, including any in relation to testing, will issue from this group in due course. Any clusters of cases in individual meat plants, in common with clusters in other workplaces, are dealt with by local HSE-led outbreak control teams.
646. Deputy Catherine Connolly asked the Minister for Agriculture, Food and the Marine the number of veterinary inspectors recruited in his Department in each of the years 2018, 2019 and to date in 2020; the number of veterinary inspectors that left during the same period; and if he will make a statement on the matter. [7131/20]
Amharc ar fhreagraVeterinary inspectors work in a variety of roles within my Department including food safety, animal health and welfare, certification of exports and provision of laboratory services.
The table below shows the total number of veterinary inspectors recruited by my Department in the years 2018, 2019 and to date in 2020, as well as the total number of veterinary inspectors that ceased their employment with my Department during the same period:
|
2018 |
2019 |
2020 |
Total |
|
|
Recruited Veterinary Inspectors |
21 |
28 |
7 |
56 |
|
Veterinary Inspectors ceased employment with DAFM |
6 |
7 |
2 |
15 |
