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Gnáthamharc

Tuesday, 30 Jun 2020

Written Answers Nos. 546-574

Mental Health Policy

Ceisteanna (546)

Holly Cairns

Ceist:

546. Deputy Holly Cairns asked the Minister for Health if representatives from a college were invited to the launch of Sharing the Vision - a Mental Health Policy for Everyone; and if not, the reason therefor. [13506/20]

Amharc ar fhreagra

Freagraí scríofa

The revised policy, Sharing the Vision – A Mental Health Policy for Everyone, was launched on Wednesday 17 June, by Minister for Mental Health and Older People Jim Daly. 

This policy was developed following a process of research into international innovation and best practice in mental health and an extensive national consultation of over 1,000 service users, family members, friends and carers and other stakeholders and the final draft was agreed by cabinet Social Policy Committee in December 2019.

Once a date was confirmed, an invitation was issued to all email contacts on an Eventbrite stakeholder consultation list the evening before the launch as this list would reach over 300 individuals and organisations who had registered for mental health events previously. The list may have missed several organisations who were not on previous Eventbrite invitations. The lack of invitation is unfortunate, but the department was bound by an extremely tight turn-around time. Many individuals associated with the member organisations named would have received an invitation.

Hospital Facilities

Ceisteanna (547)

Brendan Smith

Ceist:

547. Deputy Brendan Smith asked the Minister for Health when the proposed additional accommodation will be provided in view of the increasing demand on facilities at Cavan General Hospital; and if he will make a statement on the matter. [13523/20]

Amharc ar fhreagra

Freagraí scríofa

As the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.

Departmental Staff

Ceisteanna (548)

Jennifer Whitmore

Ceist:

548. Deputy Jennifer Whitmore asked the Minister for Health if his Department has established a working from home policy for its employees; and if he will make a statement on the matter. [13539/20]

Amharc ar fhreagra

Freagraí scríofa

In line with the current Government directive, my Department has arranged that the majority of staff are working from home, except for those employees who are essential in the workplace. 

The Department of Public Expenditure and Reform is due to issue central guidelines for civil service organisations (Working from Home during COVID-19 - Guidance for Civil Service Organisations) which will assist all Departments in our implementation and management of remote working during the pandemic. 

In the longer term, we are collaborating with our colleagues in other Government Departments and with the Department of Public Expenditure and Reform in relation to the central development of a formal remote working policy in the civil service.

Midwifery Services

Ceisteanna (549)

Jennifer Whitmore

Ceist:

549. Deputy Jennifer Whitmore asked the Minister for Health the status of the Cavan-Monaghan unit; if no downgrading of the unit will take place; and if he will make a statement on the matter. [13557/20]

Amharc ar fhreagra

Freagraí scríofa

Firstly, I would like to be clear that, as evidenced in the Programme for Government, this Government is fully committed to the implementation of the National Maternity Strategy.  

The Strategy outlines  a new model of care for maternity services with three care pathways - Supported, Assisted and Specialised - ensuring that women receive the right care, from the right professional, at the right time in the right place.  In line with that model of care, pregnant women deemed to be at normal risk will be offered, and encouraged to avail of, care in the Supported Care pathway.  Key to realising this goal is the development and expansion of community midwifery services, as recommended in the Strategy.  In that context, any cessation or diminution of midwifery led services is not in line with the recommendations of the Strategy.

My Department has requested, and is awaiting, a full report from the National Women & Infants Health Programme regarding the MLU in Cavan.  The Programme has advised that a review is underway within the RCSI Hospital Group, led by the Group Clinical Director for Maternity Services in conjunction with the Directors of Midwifery from Our Lady of Lourdes, Drogheda and the Rotunda Hospitals.  My Department has sought assurances that any proposals, emanating from the RCSI review, will serve to ensure the future of the MLU in Cavan and that it will operate in line with the National Maternity Strategy.

Once the full report has been received, my Department will work with the National Women & Infants Health Programme to ensure that any additional supports which are required to secure the future of community midwifery services in Cavan, will be put in place.  This will ensure that the choice of the Supported Care pathway remains available to women attending Cavan General Hospital for maternity services.

National Maternity Strategy

Ceisteanna (550)

Jennifer Whitmore

Ceist:

550. Deputy Jennifer Whitmore asked the Minister for Health the status of the implementation on the National Maternity Strategy; his views on whether implementation is being carried out within the original timeframe; and if he will make a statement on the matter. [13558/20]

Amharc ar fhreagra

Freagraí scríofa

Ireland's first National Maternity Strategy - Creating a Better Future Together 2016 - 2026 was published in January 2016.  It represents a significant development in the delivery of national maternity policy that will fundamentally change how maternity care is delivered. 

The National Women & Infants Health Programme was established in the HSE to lead the management, organisation and delivery of maternity, gynaecology and neonatal services across primary, community and acute care.   As implementation of the Strategy is being driven by the Programme, I have asked the Health Service Executive to reply to you directly with the specific information requested.

Covid-19 Pandemic

Ceisteanna (551)

Sorca Clarke

Ceist:

551. Deputy Sorca Clarke asked the Minister for Health if he will intervene in the developing situation with nursing and midwifery staff of Midlands Regional Hospital, Mullingar that are due to return from maternity leave having utilised all of their other leave entitlements and are now being forced to consider leaving their careers due to the lack of available childcare. [13588/20]

Amharc ar fhreagra

Freagraí scríofa

I understand that the HSE has circulated the Guidance and FAQs for Public Service Employers during COVID-19 in relation to working arrangements and temporary assignments across the Public Service prepared by DPER to all public health sector managers advising that staff with caring responsibilities should be facilitated to attend work and/or work from home in a flexible manner to the greatest extent possible. 

HSE management are providing a range of additional flexible work patterns, changes to rosters, remote working, changes to parental leave arrangements and other adjustment measures to staff.

The HSE has provided additional clarification to managers in relation to working arrangements for those with caring responsibilities by way of circular. This circular clearly sets out that if employees cannot work outside the home and cannot perform their current role remotely, the employee is still to be considered as actively on duty and available to work from home, and may be assigned work outside the employee’s usual core duties.

I have asked the HSE to revert to the Deputy directly in relation to this issue.

Cancer Services

Ceisteanna (552)

Sorca Clarke

Ceist:

552. Deputy Sorca Clarke asked the Minister for Health the number of persons in County Longford that have had cancer screening appointments cancelled due to Covid-19; and the additional resources which will be made available to ensure these vital and potentially lifesaving programmes can adequately deal with the additional numbers on their waiting lists. [13590/20]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Cancer Services

Ceisteanna (553)

Sorca Clarke

Ceist:

553. Deputy Sorca Clarke asked the Minister for Health the number of persons in County Westmeath that have had cancer screening appointments cancelled due to Covid-19; and the additional resources which will be made available to ensure these vital and potentially lifesaving programmes can adequately deal with the additional numbers on their waiting lists. [13591/20]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Hospital Appointments Status

Ceisteanna (554)

Sorca Clarke

Ceist:

554. Deputy Sorca Clarke asked the Minister for Health the reason a person (details supplied) must wait for an appointment. [13598/20]

Amharc ar fhreagra

Freagraí scríofa

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.

In response to the Covid-19 pandemic the HSE had to take measures to defer all non-urgent elective scheduled care activity, including outpatient clinics. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by the World Health Organisation, and the National Action Plan published on 16 March. The trajectory of the disease means there is now an opportunity for increasing the provision of non-covid care including more routine care.  

My Department, the HSE and the National Treatment Purchase Fund are currently working together to estimate the impact of Covid 19 on Scheduled Care waiting lists, in order to be prepared to address any backlog or pent up demand. My Department continues to ensure that the resources available throughout our health system are best utilised at this unique and challenging time.

In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.

Cancer Services

Ceisteanna (555)

Cathal Crowe

Ceist:

555. Deputy Cathal Crowe asked the Minister for Health if the criteria will be revised for funded access to pembrolizumab in view of the fact that many of those diagnosed with cancer have been medically advised to access the drug are being informed they are unable to do so due to the stage of their illness [13600/20]

Amharc ar fhreagra

Freagraí scríofa

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.    

Section 19 (4) of the Health (Pricing and Supply of Medical Goods) Act 2013 prohibits the HSE from making a relevant decision except in accordance with the criteria specified in Schedule 3 of the Act.  In that respect the HSE is required to have regard to the following criteria:  

1. the health needs of the public

2. the cost effectiveness of meeting health needs by supplying the item concerned rather than providing other health services,

3. the availability and suitability of items for supply or reimbursement, or both, under Section 59 of the [Health] Act of 1970,

4. the proposed costs, benefits and risks of the item or listed item relative to therapeutically similar items or listed items provided in other health service settings and the level of certainty in relation to the evidence of those costs, benefits and risks,

5. the potential or actual budget impact of the item or listed item,

6. the clinical need for the item or listed item,

7. the appropriate level of clinical supervision required in relation to the item to ensure patient safety,

8. the efficacy (performance in trial), effectiveness (performance in real situations) and added therapeutic benefit against existing standards of treatment (how much better it treats a condition than existing therapies) and,

9. the resources available to the Executive.

In line with the 2013 Health Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the reimbursement list.

Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.  Marketing authorisations specify the particular formulation, the route of administration, the dosage, the indications for use, any contraindications, detailed warnings and information on the known safety profile, including adverse reactions associated with use of the product. The conditions of the marketing authorisation are laid down in the Summary of Product Characteristics (SmPC) which accompanies and forms part of the marketing authorisation.  

Pembrolizumab has been granted marketing authorisation for a number of indications and is included on the HSE reimbursement list for some of those indications. In addition, a number of other indications are currently being assessed for reimbursement.

As the Deputy will be aware, the Government decision of 11 May 2018 put in place a package of support measures for the women and families affected by the issues related to CervicalCheck.  Those measures included medicines which might not be approved for reimbursement including Pembrolizumab, once they are prescribed by the treating clinician.

The establishment of such a comprehensive support package reflected the impact of the lack of disclosure of the result of clinical audit and the ensuing controversy on individual women and their families. 

Following that decision, concerns were raised regarding the provision of Pembrolizumab to other cervical cancer patients on the same basis as encompassed by the Government decision of 11 May 2018.  In the light of those concerns, following discussions between the Department and the HSE, the HSE has put in place arrangements, on an exceptional basis, to facilitate access to Pembrolizumab for cervical cancer patients on a case-by-case basis in public hospitals, when a treating clinician determines that this is in the patient’s best interests. It is important to note that all prescribing decisions will be entirely a matter for the treating clinician, in line with patient safety protocols and the Medical Council Guide to Professional Conduct and Ethics.

Clinical trials for various immunotherapies, including pembrolizumab, are ongoing globally for a range of other possible indications which may receive marketing authorisation in the EU over the next number of years. Each of those indications will be considered for reimbursement as market authorisations are granted and applications received.

Mental Health Services

Ceisteanna (556)

Catherine Connolly

Ceist:

556. Deputy Catherine Connolly asked the Minister for Health when a facility (details supplied) closed since March 2020 will reopen; and if he will make a statement on the matter. [13601/20]

Amharc ar fhreagra

Freagraí scríofa

My Department and the HSE have ensured that there has been a continued focus on meeting the needs of people living with dementia throughout the period of the COVID-19 pandemic.  Through the Dementia Understand Together Campaign, led by the HSE and working with the Alzheimer Society of Ireland (ASI), a range of initiatives and resources have been developed, to ensure that people living with dementia stay safe, well and connected, during this time of crisis. 

Community services such as day care play an important role in enabling people with dementia to continue living in their communities.  My Department and the HSE are undertaking work to determine the current level of service delivery in the community and to set out plans, including associated required capacity, to resume services, including day services, in line with the Roadmap for Reopening Society and Business and the ‘Return to work safely’ protocol. This process will take on board the learning of the current period, including the possibility of delivering services in a new way, and the requirement to adhere to public health guidance. This means that services, whilst being delivered in new ways, will gradually be restored to older people, including people with dementia. 

As the specific issue raised relates to a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Eating Disorders

Ceisteanna (557)

Violet-Anne Wynne

Ceist:

557. Deputy Violet-Anne Wynne asked the Minister for Health the amount of funding allocated for the clinical programme on eating disorders in 2018, 2019 and 2020, in tabular form; and if he will make a statement on the matter. [13608/20]

Amharc ar fhreagra

Freagraí scríofa

As this is as service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possiblel

National Children's Hospital

Ceisteanna (558)

Seán Crowe

Ceist:

558. Deputy Seán Crowe asked the Minister for Health if he has a concern that work on the National Children’s Hospital site beside St. James’s Hospital has all but ceased and that scaffolding is being removed by contractors; the updated position regarding this flagship project aside from the Covid-19 restrictions; the reason for the delay; and if these continuous problems will impact on the final cost of the project. [13619/20]

Amharc ar fhreagra

Freagraí scríofa

I am aware that construction work on the new children’s hospital site beside St. James’s Hospital stopped on 31 March 2020 as a result of the Covid-19 pandemic.

I understand that since the commencement of the easing of restrictions on 18 of May, the National Paediatric Hospital Development Board (NPHDB) has been engaging with the main contractor in relation to the earliest possible reopening of the site.  I have been informed that some matters remain unresolved at this time and that construction has not recommenced.

I am anxious that the hospital be completed as quickly as possible on behalf of children, young people and their families. The NPHDB has statutory responsibility for planning, designing, building and equipping the new children's hospital and I have referred your question to the NPHDB for direct reply.

Covid-19 Pandemic

Ceisteanna (559, 573)

Éamon Ó Cuív

Ceist:

559. Deputy Éamon Ó Cuív asked the Minister for Health the reason churches and other places of worship irrespective of size are being restricted to allowing only 50 attendees over the coming weeks; the reason the number allowed does not relate to the size of the church and to general social distancing rules; and if he will make a statement on the matter. [13631/20]

Amharc ar fhreagra

Bernard Durkan

Ceist:

573. Deputy Bernard J. Durkan asked the Minister for Health when churches and places of worship will be allowed to reopen in the context of easing Covid-19 restrictions; the specific guidelines which need to be adhered to in respect of public health advice by the NPHET; and if he will make a statement on the matter. [13706/20]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 559 and 573 together.

As the Deputy is aware, on 19 June 2020, the Taoiseach, on behalf of the Government, announced the restrictions that would be eased and the measures that will be in place in Phase 3 of the Roadmap for Reopening Society & Business. On Thursday 25th June the Government confirmed the move to Phase 3 of the Roadmap from Monday, 29 June 2020. Information and advice about the restrictions that have been eased as part of Phase 3 and the measures that are now in place are available on the Government website at https://www.gov.ie/en/publication/d06271-easing-the-covid-19-restrictions-on-29-june-phase-3/

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. This will be subject to continued progressive improvements in the health indicators identified in the Framework for Future Decision-Making described in the Roadmap.

The Deputy will may wish to note that religious buildings and places of worship may now be reopened. Further detail on the precise arrangements that are intended to apply to their operation during this period will be made available as soon as possible.

Hospital Data

Ceisteanna (560)

Róisín Shortall

Ceist:

560. Deputy Róisín Shortall asked the Minister for Health the average weekly bed occupancy rate in each of the 19 private hospitals covered by the deal with the State, for each of the weeks from 1 May 2020; and the number of patients treated weekly in each case. [13640/20]

Amharc ar fhreagra

Freagraí scríofa

A 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 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.  

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.  

My Department has been advised by the HSE that as of June 22, 11,531 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 46,298 daycase procedures took place in private hospitals, as well as 71,967 diagnostic appointments and 44,865 outpatient appointments. Utilisation rates show that as of 22nd June 2020, 53% of private inpatient beds were in use, up from 43% at the start of May.  

In relation to the more detailed breakdown requested concerning the average weekly bed occupancy rate in each of the 18 private hospitals covered by the deal with the State, for each of the weeks from 1 May 2020; and the number of patients treated weekly in each case, I have asked the HSE to respond to the Deputy directly.

Covid-19 Pandemic

Ceisteanna (561)

Róisín Shortall

Ceist:

561. Deputy Róisín Shortall asked the Minister for Health the detail of the public health guidance provided to hospitals in relation to health and safety and infection control in both emergency departments and in outpatient clinics; the arrangements in place to ensure adherence to this guidance; and if he will make a statement on the matter. [13641/20]

Amharc ar fhreagra

Freagraí scríofa

As this is an operational matter, the Question has been referred to the Health Service Executive (HSE) for attention and direct reply to the Deputy.

Covid-19 Pandemic

Ceisteanna (562)

Róisín Shortall

Ceist:

562. Deputy Róisín Shortall asked the Minister for Health the reason for the delay in publishing the roadmap for the recommencement of non-Covid-19 health services which was promised three weeks ago; and when it will be published. [13642/20]

Amharc ar fhreagra

Freagraí scríofa

The Covid-19 pandemic has led to an unprecedented interruption to normal health services both in the community and acute hospitals. While many vital services were maintained or restructured to respond more appropriately to Covid-19 related risks and evolving needs, other services were suspended or delivered on a reduced basis.

To ensure services are re-introduced in a safe, clinically aligned and prioritised way, the HSE have published a Strategic Framework for ‘Service Continuity in a Covid Environment’. This document was published on June 8th and can be found at the following link https://www.hse.ie/eng/services/news/newsfeatures/covid19-updates/service-continuity-in-a-covid-environment-a-strategic-framework-for-delivery.pdf .

The implementation of the Framework will ensure service resumption is done in an integrated and phased manner. It will consolidate new ways of working and build on international knowledge.  

While not all services can return to previous levels immediately, many health services have already resumed, particularly for priority cases. The HSE are currently developing a Service Continuity Roadmap for the resumption of services across the health system.

Covid-19 Pandemic

Ceisteanna (563, 564)

Richard Boyd Barrett

Ceist:

563. Deputy Richard Boyd Barrett asked the Minister for Health if he will provide each of the advices and directions from the expert advisory group to NPHET in relation to the original Roadmap for Reopening Society and Business, the accelerated roadmap, the one metre versus two metre social distancing advice, travel and quarantine restrictions and the wearing of face coverings; and if he will make a statement on the matter. [13647/20]

Amharc ar fhreagra

Richard Boyd Barrett

Ceist:

564. Deputy Richard Boyd Barrett asked the Minister for Health if each of the minutes from the expert advisory group to NPHET for May and June 2020 will be made available; and if he will make a statement on the matter. [13648/20]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 563 and 564 together.

The Deputy may wish to note that the Expert Advisory Group minutes up to mid-May and all Expert Advisory Group advices to the NPHET for the same period have been made available on the Department of Health's website. 

Further minutes and advices will be published on an ongoing basis and work is underway to facilitate publication of the next batch of Expert Advisory Group documentation as soon as possible.

Covid-19 Pandemic

Ceisteanna (565)

Richard Boyd Barrett

Ceist:

565. Deputy Richard Boyd Barrett asked the Minister for Health the plans in place for a second wave of Covid-19 in the view of the fact that a number of major hospitals are now working at 100% capacity and that the health service should only be running at 80% to provide for surge capacity; and if he will make a statement on the matter. [13649/20]

Amharc ar fhreagra

Freagraí scríofa

The initial focus for acute hospital preparedness for Covid-19 was on building up surge capacity to ensure the maximum possible number of critical care and general acute beds were available to cope with the predicted number of Covid-19 cases requiring hospitalisation.

The acute hospital system and critical care service coped, largely due to the success of public health measures in flattening the curve and the fall-off in non-Covid care. The additional demand for critical care was met by surge ICU capacity, with clinical staff redeployed from other hospital services and locations. However, this was in the context of low levels of care being provided in other areas of the hospital.

The need to increase critical care capacity is a key learning of the pandemic response. Accordingly, consideration is being given to permanent strategic critical care capacity requirements, and the Department and the HSE are currently engaging in this regard.

On 8 June 8 the HSE published a Strategic Framework for ‘Service Continuity in a Covid Environment’. The document can be found at the following link https://www.hse.ie/eng/services/news/newsfeatures/covid19-updates/service-continuity-in-a-covid-environment-a-strategic-framework-for-delivery.pdf .

In the framework document the HSE outline the key actions for delivery to protect surge capacity. The key actions include;

1. Complete a service review and assessment of additional capacity / alternatives for service provision e.g Private hospitals, field hospitals, Community Assessment Hubs.

2. Develop continuity plans, including risk stratification, for the reintroduction and reduction of services within hospital groups and CHOs, to prepare for a potential COVID surge. 

3. Develop and implement pathways and support services across community and acute settings in order to promote hospital avoidance.

The implementation of the Framework will ensure service resumption is done in an integrated and phased manner. It will consolidate new ways of working and build on international knowledge.

Covid-19 Pandemic

Ceisteanna (566)

Richard Boyd Barrett

Ceist:

566. Deputy Richard Boyd Barrett asked the Minister for Health his plans to increase capacity permanently across the health service in order to ensure that in the event of a second wave of Covid-19, there will be immediate availability for Covid-19 patients to be separately cared for to other patients; his plans for emergency departments and for Covid-19 specific hospitals in this regard; and if he will make a statement on the matter. [13650/20]

Amharc ar fhreagra

Freagraí scríofa

Health services must strive to deliver a safe service in all circumstances. In order to mitigate the spread of Covid 19 in health settings public health guidelines in relation to social distancing must be followed.  

The Programme for Government, Our Shared Future, commits to the provision of more health services in the community, increases in capacity, including bed, ICU and critical care capacity. It recognises that even before the impact of COVID-19 on our health service, significant additional capacity was required across all aspects of care to provide access to quality services and to meet the needs of our growing population. It specifically commits to continue to invest in healthcare infrastructure and equipment, together with the recommendations of the Capacity Review, in line with Project Ireland 2040 and to ensure capacity for a COVID-19 rapid response, including bed and ICU capacity and for non-COVID emergencies into the longer term, by utilising some private hospital capacity, if necessary.  

The Capacity Review found that the net requirement, in a reform scenario, is for an additional 2,590 hospital beds by 2031 (inpatient, day case, critical care) with an immediate requirement for 1,290 beds to address overcrowding and to ensure hospitals operated at 85% occupancy in line with other OECD countries. Approximately 770 of these beds have been provided. The National Development Plan provides for the full 2,590 beds by the earlier date of 2027.

The initial focus for acute hospital preparedness for Covid-19 was on building up surge capacity to ensure the maximum possible number of critical care and general acute beds were available to cope with the predicted number of Covid-19 cases requiring hospitalisation.

The acute hospital system and critical care service coped, largely due to the success of public health measures in flattening the curve and the fall-off in non-Covid care. The additional demand for critical care was met by surge ICU capacity, with clinical staff redeployed from other hospital services and locations.

The need to increase critical care capacity is a key learning of the pandemic response. Accordingly, consideration is being given to permanent strategic critical care capacity requirements, and the Department and the HSE are currently engaging in this regard.  

There are no plans for Covid 19 specific hospitals at the present. Hospitals have put in place Covid and non Covid patient pathways, in emergency departments and other areas,  to mitigate the risk of infection for patients and staff.

Covid-19 Pandemic

Ceisteanna (567)

Richard Boyd Barrett

Ceist:

567. Deputy Richard Boyd Barrett asked the Minister for Health the current permanent ICU and critical care capacity in the health service; the additional amount that was available during the peak of the Covid-19 crisis; if this capacity fluctuated or reduced in recent weeks; if there are plans to further increase the permanent ICU and critical care capacity; if so, the way this would breakdown between the public health system and the private system; the arrangements i that will exist between the public and private systems in relation to this capacity; and if he will make a statement on the matter. [13651/20]

Amharc ar fhreagra

Freagraí scríofa

In early 2020, baseline permanent adult critical care capacity in Ireland was reported by the National Office of Clinical Audit (NOCA) to be 255 beds. Funding for a further 40 adult critical care beds, and two paediatric critical care beds, was provided as part of the response to Covid-19 in March 2020. Daily situational reports provided by the HSE during recent months have reported potential critical care beds, including surge capacity, to be in the region of 500, with the number open on any given day subject to fluctuation in respect of available staff. Training was provided to over 1,500 nursing staff to allow them to provide support to critical care as required.

The acute hospital system and critical care service has coped effectively during recent months, and this reflects the success of public health measures in flattening the curve.  The additional demand for critical care was met by surge ICU capacity, with clinical staff redeployed from other hospital services and locations.

My Department and the HSE are currently engaging in regard to critical care capacity requirements in the public hospital system. 

Covid-19 Pandemic

Ceisteanna (568)

Cormac Devlin

Ceist:

568. Deputy Cormac Devlin asked the Minister for Health if NPHET will be requested to consider preparing new guidelines for residential centres that allow for the differentiated risk level between nursing homes and social care homes during the next phase of the Covid-19 pandemic; and if he will make a statement on the matter. [13675/20]

Amharc ar fhreagra

Freagraí scríofa

It is recognised that the impact of COVID-19 on society in general as well as on those living in long term residential care setting has been considerable. The introduction of physical distancing, isolation, reduced social activities and restricted contact with family and loved ones has changed the accustomed daily routine and usual dynamic of social interaction for residents of those settings. The focus on interrupting the transmission of the virus is part of a wider requirement to prioritise the wellbeing of residents of disability centres, remain person-centred, be cognisant of their rights as citizens, and to be vigilant that in seeking to prevent infection that these rights are not infringed upon to an extent, or in a manner, that is disproportionate.  

People living in long-term residential care facilities are particularly vulnerable populations in the context of Covid-19 and have been identified by the World Health Organisation (WHO) to be at a higher risk of being susceptible to infection from this disease and for subsequent adverse outcomes.  

The actions and measures we have taken in Ireland to support long term residential care facilities and their residents have evolved on foot of epidemiological data and guidance from the WHO and the European Centre for Disease Prevention and Control (ECDC). These measures have been both society wide as well as focused specifically on residential facilities.  

NPHET advice focused on all LTRC settings and its recommended actions were relevant for all residential care services - older people, disability and mental health.  

NPHET established the NPHET Vulnerable Peoples Subgroup, which has broad membership from across Government Departments, Agencies and key stakeholders. This Subgroup was established to provide oversight and assurance with regard to the specific preparedness, measures and actions that need to be taken to protect vulnerable groups and individuals in society. The specific needs of vulnerable groups, including those with a disability, are being considered at a national level with representation from all Government Departments with responsibility for disability issues as part of an integrated cross government response. The Subgroup held its first meeting on 6th March and across Government Departments such as Education and Justice, the HSE and Disability Federation Ireland the interests of people with disabilities on the group were represented.  

The HSE continues to plan the re-establishment of vital non-COVID-19 supports and services. This includes very careful and detailed work on the part of the Disability Sector with national guidance and will result in directing how all funded agencies can deliver services on a medium to long-term basis. Plans have to comply with guidance as set out by the National Public Health Emergency Team as well as Public Health specialists in the HSE.

Question No. 569 answered with Question No. 461.

Hospital Appointments Status

Ceisteanna (570)

Cormac Devlin

Ceist:

570. Deputy Cormac Devlin asked the Minister for Health if the case of a person (details supplied) will be investigated in order to provide a satisfactory resolution; and if he will make a statement on the matter. [13677/20]

Amharc ar fhreagra

Freagraí scríofa

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.

In response to the Covid-19 pandemic the HSE had to take measures to defer all non-urgent elective scheduled care activity, including outpatient clinics. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by the World Health Organisation, and the National Action Plan published on 16 March. The trajectory of the disease means there is now an opportunity for increasing the provision of non-covid care including more routine care.  

My Department, the HSE and the National Treatment Purchase Fund are currently working together to estimate the impact of Covid 19 on Scheduled Care waiting lists, in order to be prepared to address any backlog or pent up demand. My Department continues to ensure that the resources available throughout our health system are best utilised at this unique and challenging time.

In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.

Covid-19 Pandemic

Ceisteanna (571)

Cormac Devlin

Ceist:

571. Deputy Cormac Devlin asked the Minister for Health when chiropody and podiatry services will resume under the Roadmap for Reopening Society and Business; and if he will make a statement on the matter. [13678/20]

Amharc ar fhreagra

Freagraí scríofa

The Health Act 1947 (Section 31A - Temporary Restrictions) (COVID-19) Regulations 2020 (SI No. 121 of 2020) were signed by the Minister for Health on 7 April 2020.

 

Schedule 2 of the Regulations sets out essential services that are exempted from the restrictions and therefore can continue to be provided. This includes (at 15(b)) podiatrists (also known as chiropodists) as these services are provided by a member of a designated profession within the meaning of section 3 of the Health and Social Care Professionals Act 2005 (No. 27 of 2005).

Health Services Provision

Ceisteanna (572)

Cormac Devlin

Ceist:

572. Deputy Cormac Devlin asked the Minister for Health if he will request the HSE to review the suite of services available to persons with Parkinson’s disease, in particular those with other conditions such as diabetes to ensure the latest occupational treatments and advice are available; and if he will make a statement on the matter. [13679/20]

Amharc ar fhreagra

Freagraí scríofa

As the issue raised are service delivery matters, I have asked the Health Service Executive to respond directly to the Deputy.

Question No. 573 answered with Question No. 559.

Dental Services

Ceisteanna (574)

Ruairí Ó Murchú

Ceist:

574. Deputy Ruairí Ó Murchú asked the Minister for Health further to Parliamentary Question No. 565 of 23 June 2020, the number of dentists that have given notice to withdraw from the dental treatment services scheme as of 24 June 2020; and if he will make a statement on the matter. [13710/20]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter it has been referred to the HSE for attention and direct reply to the Deputy.

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