Written Answers Nos. 556-577
557. Deputy Seán Crowe asked the Minister for Health if he will consider including nitrous oxide use in their surveys conducted by his Department on recreational drug use in Ireland in view of the increasing unauthorised use and dangers it presents to those that use it recreationally. [12590/20]
Amharc ar fhreagraThe National Institute of Drug Abuse (NIDA) in the USA considers Nitrous Oxide as an inhalant which covers solvents, aerosols and gases found in household products. It is legitimately used as an anaesthetic in medical and dental situations and in the catering industry.
The HSE has alerted young people about the danger of using nitrous oxide through a media release in January, it has updated content on Drugs.ie outlining the effects and risks associated with nitrous oxide use, and produced an advice booklet for parents on how to talk to young people about the risks associated with drug and alcohol use.
The Prevalence of Drug Use and Gambling in Ireland and Drug Use in Northern Ireland is a survey of over 7,000 randomly selected people, aged 15 years and over, and asks them about their drug use, on a life time (ever used), last year (recent use), and last month (current use) basis.
The survey is carried out according to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) standards. Data from the previous surveys allow trends and comparative analysis between surveys to inform policy decisions and service delivery.
Fieldwork and data collection for the most recent 2018/19 Drug Prevalence Survey is completed, and the first results are due to be reported in late 2020.
The HSE collaborated with Trinity College Dublin to conduct an online survey of 1,000 people, in 2019 on drug trends among Irish festival attendees. This included a specific question on nitrous oxide. The results of the study are due to be published soon.
The Department of Health co-operates and exchanges information on a continuous basis with the EMCDDA and other international fora about emerging trends in drug use and collaborates in studies and information sharing regularly.
‘I’m aware of the reported increase in nitrous oxide use. This is a dangerous substance that may lead to serious health effects. It’s important that we increase awareness of the health risks associated with nitrous oxide misuse among young people, parents and youth organisations.’
558. Deputy Seán Crowe asked the Minister for Health if his Department has issued guidance on the resumption of dance classes in view of the physical and mental health benefits it provides to its patrons which includes the elderly that may be in need of a resumption of exercise and social interaction following their period of cocooning. [12591/20]
Amharc ar fhreagraAs the Deputy is no doubt aware, the Government confirmed the move to Phase 2 of the Roadmap for Reopening Society & Business from Monday, 8 June 2020. Information and advice about the restrictions that have been eased as part of Phase 2 and the measures that are now in place are available on the Government website at http://www.gov.ie/phase2.
Under Phase 2 you should not travel beyond your county, or 20 kilometres from where you live if crossing county boundaries, to participate in any social, recreational and exercise activities.
The Health Act 1947 (Section 31A - Temporary Restrictions) (COVID-19) (No. 2) Regulations 2020 (SI No. 206 of 2020) which came into operation from 8 June 2020 until 29 June 2020, allows for groups of up to 6 people who are not from the same household to visit another household indoors and up to 15 people who are not from the same household to meet outdoors for social, recreational and exercise activities.
The Deputy may wish to note however that the HSE’s advice available at https://www2.hse.ie/conditions/coronavirus/cocooning.html and the Health Protection Surveillance Centre (HPSC) 'Guidance on cocooning to protect people over 70 years and those extremely medically vulnerable from COVID-19' offers practical assistance as we move through a new phase of the roadmap and advises that people who are at very high risk of severe illness from COVID-19 should continue to protect themselves and stay at home as much as possible to minimise all non-essential contact with people who are not cocooning themselves.
It is also important to note that everyone involved in any social, recreational and exercise activities must adhere to social distancing measures, minimise contact, not share equipment and practice strict hygiene etiquette. A log should be kept of everyone involved for contact tracing purposes.
The Government also agreed to bring forward actions in the remaining phases of the Roadmap and plan for four phases rather than the five originally indicated. Work is underway to consider how best to achieve this aim and more information will be made available in the coming weeks.
559. Deputy Seán Crowe asked the Minister for Health if he will he provide details of the specific measures or changes he has introduced in the past 12 months to reduce the waiting lists for the removal of cataracts; the number of people on the current waiting list; the estimated waiting time for an individual to get an assessment; and the estimated waiting time for an individual to get an operation. [12592/20]
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 National Public Health Emergency Team (NPHET), 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.
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.
Where possible, hospitals are working to find innovative ways to enable service provision, which include virtual clinics for some outpatient 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).
Reducing waiting time for patients for hospital operations and procedures is a key priority for Government. In recent years, my Department has worked with the HSE and the National Treatment Purchase Fund (NTPF) and made considerable improvements to access for patients waiting for high volume procedures and life limiting procedures including cataracts. At the end of July 2017, the number of people waiting for a cataract procedure was 10,024. As of the end of May 2020, there were 5,985 patients waiting for a cataract procedure. Of these, 862 are waiting over 9 months which represents a reduction of 80% when compared to July 2017.
A key development in improving access to Ophthalmology services was the opening of a stand-alone high-volume consultant-led cataract theatre by the University of Limerick Hospital Group in Nenagh Hospital in 2018, with the intention that it would facilitate patients from surrounding geographical areas to avail of their treatment there.
My Department, the HSE and the NTPF 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.
The NTPF have advised my Department that they are unable to provide cataract waiting times for outpatient appointments as only specialty level data is collected for outpatient appointments. The NTPF have instead provided the average wait time for an Ophthalmology outpatient appointment in the attached document. The national average waiting time for an inpatient cataract procedure is also provided.
National Average Wait Time for an Outpatient Ophthalmology Appointment as at 28/05/2020
|
Date |
Specialty |
Average wait time (days) |
|
28/05/2020 |
Ophthalmology |
439 |
National Average Wait Time for an Inpatient Cataract Procedure as at 28/05/2020
|
Date |
Specialty |
Average wait time (days) |
|
28/05/2020 |
Cataracts |
173 |
560. Deputy Seán Crowe asked the Minister for Health the number of older persons waiting for home care packages in CHO 7; and the number that were on the waiting list at this time in 2019. [12593/20]
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
561. Deputy Seán Crowe asked the Minister for Health his plans to work with the Department of Transport, Tourism and Sport to address the gap in supports following the withdrawal of the motorised transport grant and the mobility allowance particularly for drivers with a physical impairment. [12594/20]
Amharc ar fhreagraAt the whole of Government level, the National Disability Inclusion Strategy 2017-2021 sets the overall framework for the equal participation of people with disabilities in society. Monitoring of the implementation of the Strategy is being overseen by the National Disability Inclusion Strategy Steering Group which includes representatives of Government Departments, the National Disability Authority, other agencies and members of the Disability Stakeholders Group.
Under the Strategy, the Department of Transport, Tourism and Sport has responsibility for the continued development of accessibility and availability of accessible public transport and is committed to the continued development of accessible public transport in recognition of the importance of such services to the lives of people with disabilities. Under that Department's accessibility policy 'Transport Access for All', there has been ongoing key accessibility improvements made to public transport infrastructure and services in recent years based on the concept of mainstreaming public transport. This is in addition to other to other transport supports available to persons with disabilities in the State, for example the Disabled Drivers and Disabled Passengers scheme, operated by the Revenue Commissioners; the Free Travel Scheme operated by the Department of Employment Affairs and Social Protection; and CLÁR funding, approved by the Minister for Rural and Community Development, to voluntary organisations providing transport for people with significant mobility issues.
562. Deputy Brendan Smith asked the Minister for Health further to Parliamentary Question No. 424 of 9 June 2020 and comments by a person (details supplied) regarding the need to deal with the Covid-19 pandemic issues on an all-Ireland basis, the outcome of recent discussions he has had with members of the Northern Ireland Executive on this important issue; and if he will make a statement on the matter. [12602/20]
Amharc ar fhreagraThere has been significant engagement between the Ministers for Health, the Chief Medical Officers, and the Departments of Health in Ireland and Northern Ireland throughout this pandemic. There have also been regular ‘Quad’ calls co-chaired the Tánaiste and Minister for Foreign Affairs, the Secretary of State for Northern Ireland with the First Minister and deputy First Minister to discuss the response to COVID-19, which the Ministers of Health for Ireland and Northern Ireland have also attended.
The engagement to date has been very pragmatic and constructive.
The administrations are seeking to adopt similar approaches, where it is appropriate to do so on the advice of respective Chief Medical Officers.
Respective plans for the gradual and controlled easing of restrictions have been discussed given the importance of implementing consistent approaches wherever possible
A Memorandum of Understanding was formally agreed by the Chief Medical Officers of the Department of Health and the Department of Health in Northern Ireland on 7 April to strengthen North South co-operation on the public health response to the COVID-19 pandemic.
The MOU focuses on facilitating greater co-operation on areas such as: public health messaging, research, programmes of behavioural change, ethics, evidence base/ modelling, and public health and non-pharmaceutical measures.
All parties recognise that in terms of public health measures in both jurisdictions, that it will be important to maintain strong North/South collaborative arrangements and, wherever possible, consistency of approach.
563. Deputy Jennifer Whitmore asked the Minister for Health the status of the Jigsaw mental health service for County Wicklow announced in 2019 and due for 2019 or 2020; if there will be delays due to Covid-19; and if he will make a statement on the matter. [12604/20]
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.
564. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the reason HSE cervical screening services remain paused (details supplied); when he plans to resume essential cervical screening appointments. [12605/20]
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.
566. Deputy Gary Gannon asked the Minister for Health the average current Covid-19 testing capacity available per day; and the current testing level in view of the fact that it is reported that approximately 10,000 additional tests could be carried out per day. [12635/20]
Amharc ar fhreagraA robust, 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. Having such a robust process with sufficient capacity and quick turnaround is also one of a number of core criteria in determining when it is safe for countries to reduce restrictive public health measures.
There is now capacity in place to undertake 15,000 tests per day/100,000 tests per week. It is important to note that while this level of capacity is available on a continuing basis, this does not mean that this number of tests will be undertaken each day/week. While we are in a positive position of not needing this full capacity at present, it is critical that we have it available to us when it is needed. The testing and contact tracing operational and resource model has been designed to flex up and down as needed to match an increase in demand, it has been stressed tested at higher activity levels and is capable of responding quickly to changes in demand.
COVID-19 testing demand and activity levels are influenced by a range of factors including prevalence of the virus, testing strategy and case definition, and testing capacity, and there have been considerable fluctuations over the last three months. In more recent weeks, the level of demand has been relatively low in line with the current lower levels of prevalence of the virus. In the last week 18,984 tests were carried out, meaning an average of over 2,700 tests daily. This is likely to increase, however, from this week as a further programme of testing of staff in nursing homes commences.
Attached is a link to the new Covid-19 data hub: https://covid19ireland-geohive.hub.arcgis.com/ where up to date information on the number of tests completed can be found.
567. Deputy Gary Gannon asked the Minister for Health if he will consider allowing incoming and returning visitors and or citizens to avail of and pay for the spare Covid-19 testing capacity to confirm if these persons have the virus; and if the test is negative can they dispense with the 14-day isolation requirement. [12636/20]
Amharc ar fhreagraAs the number of indigenous cases here declines and Ireland eases some restrictions, the relative importance of the risk of importation of cases from overseas increases. Ultimately, the progress towards suppression of community transmission which has been achieved and which should allow for greater resumption of social and economic life in Ireland could be endangered.
Some countries have implemented, or are considering implementing, requirements for a recent negative RT-PCR test. The ECDC advice is that the evidence base is unclear. Covid-19 testing is a point in time test and only detects if you have the virus at time of testing. It confers no guarantee that the individual with a 'not detected' result before travelling is not incubating the infection or the level of virus is below detectable levels at the time of the test as the virus incubation period is known to be 214 days.
Waiving self-quarantine requirements on the basis of a negative test on arrival would be at odds with testing policy domestically in Ireland, where there is no scenario where testing is used to expedite a reduction of restrictions. While a positive test for a suspected case will escalate contact tracing protocols, asymptomatic close contacts – even with two negative tests - are required to restrict their movements for the remainder of the 14 day period.
In the absence of a test that definitively shows that a passenger arriving from overseas neither has nor is incubating the virus, the public health advice for passengers arriving into the State from overseas is to self-isolate for 14 days – the duration of possible incubation. I would ask that all persons arriving into the State follow this advice, and indeed all public health advice, as closely as they can. Persons arriving from Northern Ireland, international transport workers, including airline and maritime workers, and supply chain workers are not asked to self-isolate.
Information for those who are self-isolating and for people living with those who are self-isolating is published by the HSE on www.hse.ie. Information resources on self-isolation are also available on the website of the HSPC, and these have been translated into a number of languages.
568. Deputy Gary Gannon asked the Minister for Health if he will extend Covid-19 testing to all community-based health officials, community care workers and their clients and each user of primary care centre facilities. [12637/20]
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.
Anyone, including 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.
As the issue regarding Covid-19 testing is an operational matter I have also asked the Health Service Executive to respond directly to the Deputy as soon as possible.
570. Deputy Gary Gannon asked the Minister for Health if the State will automatically retain full ownership of and access to any maternity hospital built on the site leased from a registered charity (details supplied) after the 99-year lease has expired; and if he will make a statement on the matter. [12639/20]
Amharc ar fhreagra571. Deputy Gary Gannon asked the Minister for Health if the Comptroller and Auditor General has been consulted in respect of the terms of the proposed 99 year lease of land from a registered charity (details supplied) and the building of a national maternity hospital; if a business case been prepared in respect of the lease as required under the public spending code; if so, if it includes a cost effectiveness analysis; and if he will make a statement on the matter. [12640/20]
Amharc ar fhreagraI propose to take Questions Nos. 570 and 571 together.
Officials in my Department are engaging with, and obtaining legal advice from, the Chief State Solicitor's Office in relation to the all of the documents comprising the legal framework for the new National Maternity Hospital (NMH) at Elm Park, including the Lease. The Deputy may wish to note that the legal agreement, when finalised, will be brought to Government for approval. The Comptroller and Auditor General has not been consulted regarding the terms of the proposed lease.
As I have outlined to the Deputy in a recent PQ response, the Lease has yet to be finalised, and in those circumstances, it would not be appropriate for me to comment on any specific provisions. However, the position regarding the continuity of maternity care at the site, after the 99 year term of the Lease has expired, has been considered in full.
A comprehensive Final Business Case is being developed for the NMH project and I understand that work on this is well advanced. This Final Business Case is being developed in accordance with the Public Spending Code.
572. Deputy Holly Cairns asked the Minister for Health if the guidelines will be changed to enable persons travelling on ferries to offshore islands social distance at 1 m with compulsory facemasks in order to ensure the viability of the services. [12659/20]
Amharc ar fhreagraThe National Public Health Emergency Team (NPHET) provided guidance in relation to face coverings in its advice to Government in relation to Phase 2 of the Roadmap for Reopening Business & Society on 4 June.
The NPHET advice sets out circumstances under which the wearing of a non-medical face covering is recommended. These are when using busy public transport, when in indoor public areas including retail outlets, by people visiting the homes of those who are cocooning, by people who are being visited in their homes by those who are cocooning, all visitors to residential care facilities and in indoor work environments where it is difficult to maintain a two-metre distance. The wearing of face coverings in other environments should accommodate individual judgement or preference or where it is difficult to maintain a 2-metre distance. Based on current advice, there are no plans to make the wearing of face coverings mandatory in the circumstances outlined by the Deputy.
It is important to emphasise that the wearing of face coverings is an additional hygiene measure and should not take the place of good hand hygiene, respiratory etiquette and other personal protective public health measures. Face coverings should be used properly, in line with the guidance and to wash hands before putting them on and taking them off.
NPHET, at its meeting on Thursday 11 June, recommended that the focus in the first instance should be on increasing compliance with the current recommendations on the use of face-coverings, through the development and implementation of a national communications campaign.
On the 15th June, the Government and the National Transport Authority launched a national communications campaign which outlines best practice for the use of face coverings in retail outlets, on public transport and in other public locations in which it is difficult to maintain social distancing or where this distance cannot be guaranteed, and will communicate to the public about:
- who should wear face coverings
- in what settings, and
- how to wear and remove face coverings correctly.
Guidance on how to make and safely use face coverings is available on gov.ie/facecoverings and the HSE website. The NPHET keeps the position on the wearing of face coverings under continual review.
The Deputy might note that travel to offshore islands is a matter for my colleague the Minister for the Department of Culture, Heritage and the Gaeltacht who has responsibility for this issue.
573. Deputy Holly Cairns asked the Minister for Health the number of adults with intellectual disabilities residing in acute or long-stay psychiatric settings in Cork city and county between January 2016 and May 2020, in tabular form. [12660/20]
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.
574. Deputy Holly Cairns asked the Minister for Health the number of adults with disabilities residing in nursing settings in Cork city and county between January 2016 and May 2020, by age in tabular form. [12661/20]
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.
575. Deputy Holly Cairns asked the Minister for Health his views on producing a scheme to ensure that persons with disabilities under 70 years of age who are residing in nursing homes but do not have a medical nursing care need can be housed in more appropriate sheltered and supported accommodation services. [12662/20]
Amharc ar fhreagraThe Government’s on-going priority is the safeguarding of vulnerable people in the care of the health service. We are committed to providing services and supports for people with disabilities which will empower them to live independent lives. The health service provides Specialist Disability services to enable each individual with a disability to achieve his or her full potential and maximise independence, including living as independently as possible.
Services are provided in a variety of community and residential settings in partnership with service users, their families and carers and a range of statutory, non-statutory, voluntary and community groups. These services are provided within the available budget.
Although most families would prefer to be able to care for their loved ones at home, for various reasons hospital or nursing home care is at times necessary to meet their care needs and therefore it forms part of their continued care.
In addressing the needs of adults with a disability, the full range of community services available are tailored to meet the needs of the individual. The health service works with local authorities, Government Departments where applicable and other public services as well as the voluntary sector in seeking to tailor services to best fit the needs of the individual.
There are now less than 2,000 people living in a congregated setting, and each year more people are being supported to move into community independent living.
However, the HSE is aware that there are some people with disabilities residing in Nursing Homes. In these cases, people may have enhanced supports in relation to their disability support needs. It is recognised there are a small number of younger people who require full time nursing home care, such as those who have had a stroke or perhaps an acquired brain injury.
The Nursing Home sector is used in developing options to meet the needs of some adults with a disability where no other alternatives are possible. We need to regularly review these individuals to see, if through their care plan, a more appropriate option might be available. In the longer term, the policy is to develop a more tailored service suitable to meet the needs of these service users.
As the Deputy's question relates to provision of services, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
577. Deputy Pat Buckley asked the Minister for Health the status of the mental health budget for 2020; the monthly breakdown of allocation and spending of funds; if funds have been added to planned spending either as front loading or as new funds for the period of the Covid-19 crisis; and the planned expenditure for the remainder of 2020. [12676/20]
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.
