Written Answers Nos. 725-749
725. Deputy Gary Gannon asked the Minister for Health if the fast tracking process of opioid substitution therapy implemented as part of the NPHET response to protect vulnerable groups deemed to have an increased risk of contracting Covid-19 will be maintained. [9511/20]
Amharc ar fhreagraAs the Deputy's question relates to a service issue it has been referred to the HSE for direct reply.
726. Deputy Gary Gannon asked the Minister for Health the phase under which therapy services to children usually a mixture of occupational therapists and speech and language therapists can expect to return to delivering therapy services to children according to the Roadmap for Reopening Society and Business. [9514/20]
Amharc ar fhreagraAs the Deputy's question relates to a service matter , it has been referred to the HSE for direct reply.
727. Deputy Seán Crowe asked the Minister for Health the location and name of the private hospitals that were taken in charge during the Covid-19 pandemic; the number of beds that this entailed by hospital in tabular form; the number of beds per day that were used for public patients on a daily basis by hospital since the Covid-19 pandemic in tabular form; when the contract is proposed to end; and the estimated eventual cost in this regard. [9525/20]
Amharc ar fhreagraA major part of the Government's Action Plan in response to Covid-19 was to substantially increase the capacity of public healthcare facilities to cope with the anticipated additional demand. In order to urgently ramp up capacity for acute care facilities, an arrangement was agreed with the private hospitals to use their facilities as part of the public system on a temporary basis, to provide essential services. A Heads of Terms of an Agreement between the HSE and the Private Hospitals was agreed at the end of March 2020 and all 18 of the acute private hospitals signed up to it. Under the arrangement, all patients in the private hospitals are treated as public patients and their treatment is prioritised based on clinical need. Provision was made under the agreement to allow for continuity of care for patients who were in a private hospital or attending for treatment at the time the Heads of Terms of the Agreement were agreed, on the grounds that these patients would be treated as public patients.
The agreement was reviewed at the end of May and the Government decided that the existing arrangement should not be extended beyond the end of June. It has however mandated the HSE to negotiate a new arrangement with private hospitals which would provide the HSE with full access to private hospital capacity in the event of a surge of Covid-19 and separately with ongoing agreed access, to enable the HSE to meet essential and elective care needs.
Under the agreement payment to the private hospitals is on a cost only Open Book model whereby the hospitals are to be reimbursed only for the operating costs properly incurred during the period. The costs that will be covered will be limited to normal costs of operating the hospital. While the private hospitals are paid a monthly sum equal to 80% of estimated monthly costs, the hospitals will only receive their actual operating costs when these have been verified. The final cost will be verified by independent firms of accountants appointed by the HSE and the private hospitals and there will be an arbitration mechanism in place in the event of any disagreement. As the funding of the agreement is based on cost recovery, validated costs will not be available until the agreement is completed, however it is estimated that the cost of the agreement will be of the order of €300m.
As the hospitals are private enterprises, the detailed information regarding payments to individual hospitals or hospital groups is commercially sensitive and therefore in line with the Heads of Terms regarding confidentiality these details will not be published. In the interests of transparency, it is intended to publish summary financial information regarding the arrangement in due course.
The HSE has been working with National Treatment Purchase Fund (NTPF) to establish a mechanism to allow for return of electronic data from Private Hospitals. This system went live on the week ending 18th May with guidance issued to private hospitals around the process for submission of data. In order to ensure early reporting of activity the HSE has put a manual data reporting system in place with private hospitals. This supports the return of a limited dataset which remains subject to validation based on electronic data returns through the NTPF.
While the current dataset does not provide for the full range of information the Deputy has requested, details regarding bed occupancy and the volume of procedures undertaken by private hospital’s are set out in the attached document.
In order that the Deputy be provided with the most up to date financial position, I have referred your question to the HSE and asked them to respond to you directly.
|
Hospital |
Inpatient Beds |
Daybed Capacity |
Critical Care Capacity |
In-patient occupancy |
|
|
Aut Even |
Kilkenny |
71 |
18 |
21% |
|
|
Beacon Hospital |
Dublin |
166 |
38 |
15 |
38% |
|
Blackrock Clinic |
Dublin |
152 |
34 |
12 |
42% |
|
Bons Secours Cork |
Cork |
183 |
52 |
10 |
67% |
|
Bons Secours Dublin |
Dublin |
107 |
66 |
35% |
|
|
Bons Secours Galway |
Galway |
73 |
36 |
8 |
42% |
|
Bons Secours Limerick |
Limerick |
10 |
27 |
15% |
|
|
Bons Secours Tralee |
Tralee |
87 |
39 |
83% |
|
|
Galway Clinic |
Galway |
134 |
54 |
19% |
|
|
Hermitage Clinic |
Dublin |
88 |
61 |
8 |
57% |
|
Kingsbridge Sligo |
Sligo |
10 |
9 |
0% |
|
|
Mater Private Cork |
Cork |
60 |
15 |
46% |
|
|
Mater Private Dublin |
Dublin |
196 |
27 |
9 |
49% |
|
Sports Surgery Clinic Santry |
Dublin |
63 |
21 |
8% |
|
|
St Francis |
Dublin |
48 |
17 |
0% |
|
|
St. Vincent’s Private |
Dublin |
180 |
7 |
6 |
82% |
|
UPMC Kildare |
Kildare |
25 |
10 |
69% |
|
|
UPMC Whitfield |
Kilkenny |
60 |
57 |
47% |
728. Deputy Seán Crowe asked the Minister for Health the number of organ transplants carried out in each of the past five years; if over 450 organ donations have been declined due to the fact the next of kin were unsure of their relatives wishes; his plans to change end of life protocols in relation to organ harvesting and donations; and if he has new plans to increase transplant capacity in the health system. [9526/20]
Amharc ar fhreagraTransplantation remains the only available treatment for heart, lung and liver end stage failure. It is the most cost-effective treatment for end-stage kidney disease, and it brings enormous clinical and social benefits to patients who would otherwise remain on dialysis.
The number of deceased donors has remained relatively static over the last decade and world wide the most significant problem affecting transplant programs today is the shortage of suitable organs to transplant.
The reality of organ donation and transplantation is that very limited number of people die in circumstances where organ donation is a possibility. For transplantation to take place, an organ has to be clinically determined to be medically suitable based on a risk benefit analysis to the recipient.
An average of 281 transplants were carried out annually over the past 5 years, with 274 transplants carried out in 2019 (see table below). Up to 30th April 2020, 63 transplants have taken place (31 deceased kidney, 8 living kidney, 15 liver, 1 pancreas, 3 heart and 5 lung transplants).
A range of initiatives are and have been taken by my Department to increase the availability of organs for donation. These include:
- the establishment of a National Organ Procurement Service;
- the appointment of clinical leads for organ donation and organ donation nurse managers in each Hospital Group;
- the planned National Organ Retrieval Service; and
- the retrieval of organs in more complex donor cases.
The National Service Plan 2020 provides for additional funding of €0.5m for the development of a dedicated National Organ Retrieval service. This funding will facilitate the move to increase deceased cardiac donations and will allow for the expansion of the criteria for acceptable donor donations. This funding is particularly important to meet the expected additional demands on transplant services following the introduction of the Human Tissue (Transplantation, Post-Mortem, Anatomical Examination and Public Display) Legislation & the opt-out system of organ donation.
Table of Transplants 2015 -2019
|
|
2015 |
2016 |
2017 |
2018 |
2019 |
|
Transplants |
|
|
|
|
|
|
Kidney |
153 |
172 |
192 |
167 |
153 |
|
Liver |
61 |
58 |
62 |
56 |
66 |
|
Heart |
16 |
15 |
16 |
18 |
15 |
|
Lung |
36 |
35 |
36 |
28 |
38 |
|
Pancreas |
0 |
0 |
5 |
5 |
2 |
|
|
|
|
|
|
|
|
Total Transplants |
266 |
280 |
311 |
274 |
274 |
729. Deputy Seán Crowe asked the Minister for Health if his attention has been drawn to works being carried out or when work will resume on the new National Children’s Hospital. [9527/20]
Amharc ar fhreagraThe National Paediatric Hospital Development Board (NPHDB) has statutory responsibility for planning, designing, building and equipping the new children's hospital. I have referred your question to the NPHDB for direct reply.
730. Deputy Sorca Clarke asked the Minister for Health the outpatient appointments that were cancelled in the primary care centres in County Westmeath due to Covid-19; and the current revised waiting list numbers by department in tabular form. [9547/20]
Amharc ar fhreagraAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
731. Deputy Sorca Clarke asked the Minister for Health the outpatient appointments cancelled in the primary care centres in County Longford due to Covid-19; and the current revised waiting list numbers by department in tabular form. [9548/20]
Amharc ar fhreagraAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
732. Deputy Sorca Clarke asked the Minister for Health the outpatient appointments cancelled in Mullingar Regional Hospital, County Westmeath due to Covid-19; and the current revised waiting list numbers by department in tabular form. [9549/20]
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.
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.
The data requested by the Deputy concerning waiting list figures for Mullingar Regional Hospital by Specialty is outlined in the attached documents. This information is also available on the NTPF website at: https://www.ntpf.ie/home/nwld.htm.
In regard to outpatient appointments cancelled at Mullingar Regional Hospital due to Covid-19, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
|
Midland Regional Hospital Mullingar IPDC Waiting List by Specialty - April 2020 |
|
0-3 Mths |
3-6 Mths |
6-9 Mths |
9-12 Mths |
12-15 Mths |
15-18 Mths |
18-24 Mths |
Grand Total |
|
|
Anaesthetics |
1 |
3 |
0 |
4 |
||||
|
Dermatology |
11 |
11 |
||||||
|
General Medicine |
50 |
13 |
1 |
2 |
2 |
1 |
69 |
|
|
General Surgery |
160 |
46 |
27 |
7 |
5 |
8 |
2 |
255 |
|
Gynaecology |
91 |
22 |
8 |
0 |
121 |
|||
|
Grand Total |
313 |
84 |
36 |
9 |
7 |
9 |
2 |
460 |
Midland Regional Hospital Mullingar Outpatient Waiting List by Specialty - April 2020.
|
0-3 Months |
3-6 Months |
6-9 Months |
9-12 Months |
12-15 Months |
15-18 Months |
18-21 Months |
21-24 Months |
24-36 Months |
36-48 Months |
48+ Months |
Grand Total |
|
|
Dermatology |
33 |
26 |
0 |
0 |
0 |
1 |
0 |
214 |
170 |
183 |
627 |
|
|
General Medicine |
657 |
597 |
474 |
403 |
307 |
218 |
163 |
39 |
101 |
75 |
2 |
3036 |
|
General Surgery |
636 |
590 |
511 |
348 |
81 |
22 |
17 |
1 |
0 |
2206 |
||
|
Gynaecology |
367 |
291 |
318 |
208 |
85 |
57 |
56 |
62 |
4 |
1448 |
||
|
Haematology |
50 |
44 |
45 |
36 |
20 |
19 |
17 |
19 |
250 |
|||
|
Neurology |
26 |
28 |
26 |
29 |
25 |
12 |
0 |
146 |
||||
|
Ophthalmology |
40 |
39 |
28 |
3 |
0 |
0 |
0 |
0 |
110 |
|||
|
Orthopaedics |
8 |
20 |
19 |
7 |
9 |
3 |
66 |
|||||
|
Paediatrics |
173 |
144 |
109 |
57 |
12 |
2 |
497 |
|||||
|
Grand Total |
1990 |
1779 |
1530 |
1091 |
539 |
333 |
254 |
120 |
320 |
245 |
185 |
8386 |
733. Deputy Patricia Ryan asked the Minister for Health the average waiting time for urgent and non-urgent patients that are waiting on an appointment with the child and adolescent mental health services in County Kildare; his plans to improve this; and if he will make a statement on the matter. [9563/20]
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.
734. Deputy Sorca Clarke asked the Minister for Health the status of a MRI for a person (details supplied). [9565/20]
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.
Access to Home Support is based on assessment of the person’s needs by the HSE and having regard to the available resources and the competing demands for the services from those people with assessed needs. As the particular queries raised in regard to a scan and a home support package are operational matters, I have asked the HSE to respond to the Deputy directly.
735. Deputy Eoin Ó Broin asked the Minister for Health the status of the work of the Obesity Policy Implementation Oversight Group Reformulation sub-group in its priority of setting of targets for food and drink reformulation and a roadmap for reformulation action to achieve such targets; when the submission of a report with the targets and roadmap is expected; and if he will make a statement on the matter. [9566/20]
Amharc ar fhreagra738. Deputy Eoin Ó Broin asked the Minister for Health if work has been undertaken to review evidence for fiscal measures on products that are high in fat, sugar and salt to reduce their consumption as per Action 1.10 of A Healthy Weight for Ireland: Obesity Policy and Action Plan 2016-2025; and if he will make a statement on the matter. [9569/20]
Amharc ar fhreagraI propose to take Questions Nos. 735 and 738 together.
A Healthy Weight for Ireland’, the Obesity Policy and Action Plan (OPAP), was launched in September 2016 under the auspices of the Healthy Ireland agenda. The OPAP covers a 10-year period up to 2025 and aims to reverse obesity trends, prevent health complications and reduce the overall burden for individuals, families, the health system, and the wider society and economy. The OPAP is based on the best available evidence in the Irish and international literature, and is informed by established international models and frameworks.
In relation to measures dealing with the level of consumption of products high in fat, sugar and salt (HFSS), the Sugar Sweetened Drinks Tax has already been introduced and commenced on 1st May 2018. The current focus in this area is on putting in place a reformulation programme for HFSS food and drink, under Action 3.1 of the OPAP, “Agree food industry reformulation targets and review progress ”. To this end the Reformulation sub-group of the Obesity Policy Implementation Oversight Group (OPIOG) has been working on a roadmap for reformulation, including targets for reductions in salt, sugar, saturated fats and calories, and a proposed approach to achieve these targets. A draft roadmap has been considered by the OPIOG and a consultation with stakeholders subsequently took place. The submissions received as a result of that consultation process are being examined and it is expected that a report with the targets and final version of the roadmap will be submitted in the coming months.
Additionally, Ireland is participating in a Joint Action under the 3rd EU Health Programme called Best ReMaP (which stands for Best practice in Reformulation, Marketing and Public Procurement). The Joint Action is awaiting final approval form the EU Commission, but it is hoped that work will commence in the autumn. One of the work packages under this Joint Action is on reformulation, and this will be beneficial in assisting Ireland to achieve progress in its actions under the reformulation roadmap.
736. Deputy Eoin Ó Broin asked the Minister for Health further to Parliamentary Question No. 805 of 5 March 2020, if the timeframes for the installation of first device scheduled for November 2020 with second room becoming operational in May 2021 is still on track; if the device located in Cork University Hospital has resumed full functionality; and if he will make a statement on the matter. [9567/20]
Amharc ar fhreagraAs this is a service delivery matter, I have referred the question to the HSE for direct reply.
737. Deputy Eoin Ó Broin asked the Minister for Health the progress within the Saolta group to progress the development of the acute stroke unit in Letterkenny University Hospital; and if he will make a statement on the matter. [9568/20]
Amharc ar fhreagraI am advised by the Saolta University Health Care Group that staff have been recruited in line with the funding allocation for the development of a Stroke Unit at Letterkenny University Hospital.
The designation of the Stroke Unit is being impacted by COVID-19 requirements. It is hoped that designation will occur later in the year as COVID-19 measures at the hospital evolve.
739. Deputy Sean Fleming asked the Minister for Health when essential elective surgery that had been planned to take place but was postponed due to the Covid-19 crisis will resume throughout the health service; and if he will make a statement on the matter. [9571/20]
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
740. Deputy James Browne asked the Minister for Health his plans to progress the implementation of eating disorder teams in CHOs here; and if he will make a statement on the matter. [9585/20]
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.
741. Deputy James Browne asked the Minister for Health the position regarding the establishment of a task force on mental health; and if he will make a statement on the matter. [9586/20]
Amharc ar fhreagraWork on a revised mental health policy has been on-going and a final draft was agreed by the cabinet Social Policy Committee in December 2019. The government must next review and approve the policy at which point the policy can then be published. This policy was developed following a process of research into international innovation and best practice in the field of mental health and an extensive national consultation of over 1,000 service users, family members, friends and carers, and other stakeholders. The revised policy contains an implementation roadmap that organises recommendations into short (0-6 months); medium (6-18 months) and long term (beyond 18 months) actions that will be costed within the various time frames allocated.
The revised policy recommends the establishment of a National Monitoring and Implementation Committee (NIMC) to oversee the implementation of the policy over the next ten years. In addition, the policy recommends that a national mental health and wellbeing strategy be developed by Healthy Ireland.
The Department of Health would consider that the process which led to the finalisation of the new policy was very comprehensive as regards research and consultation, including detailed engagement with the Oireachtas Committee on the Future of Mental Health and with many other stakeholders, and therefore a high-level taskforce is not warranted at this stage. Our focus now is on setting up a focussed comprehensive implementation process with the HSE, once the new policy is approved by Government.
However, in view of the recent requests, the Department of Health proposes that such a task force could be established as a sub-committee of the NIMC and work with the members of the Healthy Ireland mental health promotion strategy group to expand provision of existing Covid-19 interventions.
This approach maximises collaboration and efficiency and ensures a strong implementation focus while minimising duplication of work, given that the proposed taskforce would carry out similar work to developments already afoot. Additionally, as the same personnel who have been involved in the above developments are likely to be involved in future developments going forward, this avoids duplication and creates space for mental health plans to be created without risk of overlap. The development of such a structure would take account of priority needs identified during and following Covid-19.
With regards to the provision of mental health services during Covid-19, a planning Group (HSE, Department of Health, NGO sector) has been established to plan for additional current and/or anticipated needs as the crisis extends in duration. There are existing HSE guidelines, published in 2014, on ‘Psychosocial and Mental Health Needs following Major Emergencies’. These guidelines recognise that prior to, during and following national emergencies there would be a need to support certain members of the population with their emotional, cognitive, social and physical needs.
The HSE is continuing to provide all community services, in so far as possible, while following Covid-19 guidelines to ensure the protection of patients and staff. At present, there is a range of existing services which offer online text and telephone supports to people seeking mental health information and advice. These include Samaritans, Pieta House, MyMind, Turn2Me; Aware, Crisis Text Ireland, Shine, BeLongTo, LGBT Ireland, Jigsaw, Bodywhys and Childline. The YourMentalHealth.ie website provides a ‘one-stop-shop’ portal for people seeking information, supports and services, including information on accessing urgent help and a mental health text messaging support service is available 24 hours a day, 7 days each week to connect people with trained volunteers. NGOs currently funded by the HSE are being supported and encouraged to develop updated responses to the Covid-19 outbreak. Details of these services are listed on the HSE website, www.yourmentalhealth.ie, and information on available services is also provided through the free mental health telephone information line, 1800 111888.
In order to respond to the anticipated additional needs of the population during this crisis, additional online services are being delivered to support the population, including online counselling, expanded crisis textline support and online life skills training, building on existing pilot schemes and developments in digital mental health in recent years.
742. Deputy Richard Boyd Barrett asked the Minister for Health if he will provide all the minutes of the expert advisory group, the advices and position papers provided to NPHET and the minutes of the vulnerable and elderly subgroup of NPHET as previously requested through the Covid inquiries line and directly with the CMO at the Special Committee on Covid-19 Response; and if he will make a statement on the matter. [9589/20]
Amharc ar fhreagraThe National Public Health Emergency Team (NPHET) was established on 27 January last in response to the emergence of Covid-19 in Wuhan, China. Since that time, it has met 33 times. In addition to the Expert Advisory Group, a number of sub-groups have also been established to support the work of the NPHET, including on:
- Acute Hospitals
- Behavioural Change
- Guidance and Evidence Synthesis
- Irish Epidemiological Modelling Advisory Group (IEMAG)
- Health Legislation Subgroup
- Medicines and Medical Devices Criticality Subgroups
- Pandemic Ethics Advisory Group
- Vulnerable People Subgroup
- Health Sector Workforce Subgroup
Throughout the progression of the Covid-19 pandemic, there have been enormous efforts made to ensure that the activities and recommendations of NPHET were being appropriately communicated. As such, a dedicated space on the Government's website has been set aside to ensure that all updates are accessible from one location, at https://www.gov.ie/en/campaigns/c36c85-covid-19-coronavirus/. All of the agendas and minutes of the NPHET meetings are being published at this location, and at present these documents are available up to the meeting of 8 May last. In addition, the advice which is presented to the Minister for Health following a meeting of the NPHET is also published, and is currently available up to 22 May.
Minutes of the Expert Advisory Group were published on this website on 27 May last. The minutes of the 13 meetings which took place in February and March are currently available, and it is anticipated that the minutes of the meetings which took place in April will be published during the week commencing 1 June, with minutes of the meetings which took place in May to follow as soon as they become available. Minutes of the Vulnerable People Subgroup are also available on the website, up to 7 May 2020. I am advised that a process has been established to also enable the release of the various working papers that have been considered by NPHET at its meetings.
I would also like to recall that my Department is continuing to make a large amount of other documentation available through this channel, including the minutes of other NPHET subgroups, the Governance outline of the NPHET process, and the technical notes of the Irish Epidemiological Modelling Advisory Group.
743. Deputy Richard Boyd Barrett asked the Minister for Health his plans for expanding testing into all healthcare settings including regularity with which healthcare workers will be tested and the way in which this will be rolled out to home help; and if he will make a statement on the matter. [9590/20]
Amharc ar fhreagraA robust and real-time process of testing, isolation and contact tracing is central to our public health strategy for containing and slowing the spread of COVID-19, as advocated by the WHO and ECDC.
All healthcare workers meeting the current case definition for COVID-19 are referred for testing in line with current testing criteria. There is extensive guidance in place for healthcare workers and this can be found on the HPSC website:
https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/guidanceforhealthcareworkers/ .
There is also clear guidance in place for the assessment, testing and return to work of healthcare workers.
https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/algorithms/Algorithm%20for%20Testing%20and%20Return%20to%20Work%20of%20Symptomatic%20HCWs.pdf
In addition, current guidance requires the testing of all staff and residents when a new case emerges in a long term residential care facility (including mental health facilities) that have not yet had a case.
As the deputy will be aware, a significant programme of testing across Long Term Residential Care Facilities commenced on 17 April following a NPHET recommendation. Over 100,000 tests have been completed under the residential care facilities mass testing programme. This includes the testing of all staff and residents in facilities that had an outbreak already, and the testing of staff in those facilities that didn't have an outbreak. This testing programme is now complete, and the results and findings will help inform and guide future testing strategy for these facilities. This is being given ongoing consideration by NPHET.
It is important to note that testing is only one element of a comprehensive strategic response to COVID-19. Testing for COVID-19 only provides a point-in-time result. It confers no guarantee that the individual with a 'not detected' result is not incubating the infection or the level of virus is below detectable levels at the time of the test.
Targeted, risk-based testing can yield important data to inform control measures, but does not constitute a control measure in and of itself. Testing should only be undertaken based on a public health risk assessment. A comprehensive response to the COVID-19 pandemic must include a strong focus on infection prevention and control and additional measures such as prompt identification and exclusion from work of symptomatic healthcare workers for example.
744. Deputy Richard Boyd Barrett asked the Minister for Health the new criteria for Covid-19 testing; and if he will provide a report in relation to a number of areas related to testing (details supplied); and if he will make a statement on the matter. [9591/20]
Amharc ar fhreagraA robust and real-time process of testing, isolation and contact tracing is central to our public health strategy for containing and slowing the spread of COVID-19, as advocated by WHO, EC and ECDC. Decisions on the criteria for testing are made by NPHET and are informed by international guidance including from the WHO and ECDC.
The criteria for testing is as follows: A patient with acute respiratory infection (sudden onset of at least one of the following: cough, fever, shortness of breath) AND with no other aetiology that fully explains the clinical presentation”.
On 28 May, NPHET agreed in principle to include in the case definition the sudden loss of smell (anosmia) and loss of taste (ageusia). This decision was subject to updated guidance from the ECDC and the ECDC published its updated case definition on 29 May. This can be found here:
https://www.ecdc.europa.eu/en/covid-19/surveillance/case-definition
In addition, all close contacts are now being tested twice (regardless of whether they have any symptoms) and contacted on a daily basis to monitor symptom development.
The criteria for testing in Long Term Care Facilities is broader than that above in recognition that the elderly may not display typical Covid-19 symptoms. Up to date criteria for testing can be found on the HPSC website.
Testing criteria is kept under review by NPHET as NPHET considers how best to target testing capacity. Our testing strategy will continue to evolve and will be based on public health risk assessments.
Turnaround times are improving rapidly thanks to process improvements and automation. Across community and hospital settings, overall end-to-end median turnaround times (meaning referral to contact tracing complete) last week for positive results was 2.3 days. The end-to-end turnaround time for negative test results is 2 days or less.
With regard to the number of contacts each positive case had, over the last 4 weeks (to 23 May) the median number of close contacts per case is 2. Typically contact tracing is completed on a same day or next day basis.
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.
745. Deputy Richard Boyd Barrett asked the Minister for Health the details of the investigation by the HSPC and HSE of a beef plant in Ballyjamesduff, County Cavan after reports of a possible outbreak at the plant; and if he will make a statement on the matter. [9592/20]
Amharc ar fhreagraAs per the Health Protection Surveillance Centre report of 2 June 2020, a total of 20 COVID-19 outbreaks in meat processing plants are currently under investigation in HSE East, Midlands, Midwest, Northeast, Southeast, South and West. One of those outbreaks includes the plant referred to by the Deputy in Ballyjamesduff.
A National Outbreak Control Team is continuing to coordinate the investigations across all meat processing plants which have been affected by COVID-19. The normal approach is for such an investigation to remain active until at least two incubation periods since the last reported case of an infection have passed. In respect of COVID-19, where the incubation period is currently understood to be a maximum of 14 days, that would imply a period of 28 days before the conclusion of an investigation. A further updated report from the HSE on these matters is currently awaited.
746. Deputy Richard Boyd Barrett asked the Minister for Health if he will provide a detailed report on the research and trials taking place here into vaccines, therapies and antibody testing and specifically in the area of convalescent plasma therapy; and if he will make a statement on the matter. [9593/20]
Amharc ar fhreagraDetailed response provided in the report contained in the following link.
747. Deputy Richard Boyd Barrett asked the Minister for Health the number of Covid-19 deaths in hospitals; the number of these patients that were transferred to an intensive care unit; and if he will make a statement on the matter. [9594/20]
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.
748. Deputy Louise O'Reilly asked the Minister for Health if changes have been made to the private hospital agreement to allow for private consultants to treat existing patients; and if he will make a statement on the matter. [9608/20]
Amharc ar fhreagraA major part of the Government's Action Plan in response to Covid-19 was to substantially increase the capacity of public healthcare facilities to cope with the anticipated additional demand. In order to urgently ramp up capacity for acute care facilities, an arrangement was agreed with the private hospitals to use their facilities as part of the public system on a temporary basis, to provide essential services. A Heads of Terms of an Agreement between the HSE and the Private Hospitals was agreed at the end of March 2020 and all 18 of the acute private hospitals signed up to it. Under the agreement, the HSE has access to 100% of the capacity of those hospitals and they are linked with the Hospital Group for their region. Consultants who work wholly for the private hospitals have been offered temporary locum public patient only (Type A) contracts for the duration of the arrangement. Under the agreement all patients who are being treated in the hospitals will be treated as public patients and will be prioritised based on clinical needs. Provision was made under the agreement to allow for continuity of care for patients who were in a private hospital or attending for treatment at the time the Heads of Terms of the Agreement were agreed, on the grounds that these patients would be treated as public patients.
The arrangement with the private hospitals was reviewed at the end of May and the Government decided that the existing arrangement should not be extended beyond the end of June. It has however mandated the HSE to negotiate a new arrangement with private hospitals which would provide the HSE with full access to private hospital capacity in the event of a surge of Covid-19 and separately with ongoing agreed access, to enable the HSE to meet essential and elective care needs.
749. Deputy Louise O'Reilly asked the Minister for Health the status of the process of hiring a pain management team and consultant full-time post at Children's Health Ireland, Crumlin (details supplied). [9609/20]
Amharc ar fhreagraI know that CHI is aware that the current situation regarding the Paediatric Complex Pain Management Service is a cause of much anxiety and upset for parents and children. CHI has advised my Department that it met with the Complex Pain Patient Advocacy Group on Friday 7 February and advised them that it has written to all families whose children have been attending the complex pain management service in Crumlin or Temple Street to give them an update and contact numbers should they need clinical related advice for their child. CHI also updated the group on how interim services will work with CHI, which is the management of a number of priority patients in the first instance and a focus on communications with families.
The Consultant Anaesthesiologist with a special interest in Paediatric Complex Pain Management in CHI at Crumlin and Temple Street resigned in late 2019. This is a highly specialised position. Funding has been provided in 2020 to develop the Paediatric Complex Pain Management Service, including recruitment of Consultant Anaesthesia/Pain Specialists, Occupational Therapist, Psychologist, Physiotherapist and Advanced Nurse Practitioner. CHI has advised that this service is a priority for actively recruiting these posts through the normal Human Resources processes. It is hoped to fill these positions as soon as possible.
As an interim measure, CHI has secured the services of a Consultant Anaesthesiologist in Northern Ireland who specialises in both Paediatric and Adult Complex Pain Management who is assisting CHI staff in continuing the Paediatric Complex Pain Management Service for patients until these posts commence.
