Written Answers Nos. 721-741
721. Deputy James Browne asked the Minister for Health the status of the resumption of adult disability day services; the date on which services will recommence; if all those that were availing of them will be able to do so; and if he will make a statement on the matter. [13972/20]
Amharc ar fhreagraAs part of the overall effort to contain the spread of COVID-19 and in line with public health advice, day service locations have been closed since March. However priority service users have been identified in each CHO, and individualised supports continue to be provided to many people in alternative models particularly for these individuals with higher support needs, through alternative means such as via online support and/or regular telephone contact with families. Health and social care responses to the current public health emergency are under continuing review, including specific measures such as these to support vulnerable people.
The resumption of adult day services is currently being considered by my Department and the HSE as part of broader planning to prepare for the resumption of non-COVID-19 community and social care services in the current environment, and in line with public health guidance. My Department and the HSE has established a Joint Working Group to develop a plan for Community Capacity.
The HSE is finalising plans to re-establish vital non-COVID 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. A national group for the resumption of day services representative of service users and families, service providers and the HSE is working together to prepare for the resumption of day service supports in line with COVID-19 guidance. The Framework for the Resumption of Adult Disability Day Services and Action Plan for resumption of services have been completed. The national group are currently developing guidance to support the day service sector to reopen within the parameters of public health advice.
Community Healthcare Organisations are working with service providers to ascertain the current level of service provision and innovative practises that have developed over the last number of months. The collation and analysis of this data will provide a current national picture which will enable the resumption group to address the challenges of reopening day service locations.
The resumption group plan to have completed the above strands of work by the end of June following which a timeframe for the phased reopening of adult day services will be planned in cooperation with HSE disability services and service providers. In the meantime, service providers continue to contact day service users regarding their support needs and are providing those supports in different ways. Some supports continue to be provided in a number of ways, for example by telephone, online communication and responses to address emergency needs.
The HSE and disability service providers, where identified, will continue to communicate with school leavers and their families to plan and organise for a transition to day services in line with public health guidance.
The safety of service users and staff is of critical importance therefore the attendance at locations will be determined by public health guidance, which may result in some reduction of capacity.
An information leaflet for service users and their families was developed by the national group and distributed widely to all stakeholders on June 9th.
It is expected that a clearer picture will emerge before end of June as to when day services are likely to be reinstated and how the service will be delivered taking account of Public Health Guidance and COVID-19 restrictions.
The Framework for Resumption of Adult Disability Day Services and the information leaflet “What’s Happening” is available on the New Directions website: www.hse.ie/newdirections.
722. Deputy Michael Healy-Rae asked the Minister for Health the number of abortions carried out here in 2019; the provision of the legislation which each of these abortions were carried out under; and if he will make a statement on the matter. [13976/20]
Amharc ar fhreagraThe first Annual Report on the Health (Regulation of Termination of Pregnancy) Act 2018, was laid before the Houses of the Oireachtas as required under section 20 of the Act, on 30 June 2020. The report covers the period from 1 January 2019 until 31 December 2019.
The Annual Report shows that in total 6666 medical procedures were carried out under the Act in 2019. Twenty-one (21) procedures were carried out due to a risk to life or health under the grounds set out in section 9 of the Act; three (3) due to a risk to life or health in an emergency situation under section 10; one hundred (100) due to a condition likely to lead to the death of the foetus; and six thousand five hundred and forty-two (6542) in early pregnancy under the grounds set out in section 12 of the Act.
723. Deputy Michael McNamara asked the Minister for Health when a person (details supplied) in County Clare will receive a date to be assessed by a respiratory consultant at University Hospital Limerick; and if he will make a statement on the matter. [13981/20]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In response to the Covid-19 pandemic the HSE had to take measures to defer all non-urgent elective scheduled care activity, including outpatient clinics. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by the World Health Organisation, and the National Action Plan published on 16 March. The trajectory of the disease means there is now an opportunity for increasing the provision of non-covid care including more routine care.
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.
724. Deputy John McGuinness asked the Minister for Health if residents of nursing homes were given the option of availing of the 'flu vaccine in 2019; his plans on same for 2020; if his Department or another health agency under his remit issued advice in this regard to nursing homes; and if he will make a statement on the matter. [13995/20]
Amharc ar fhreagraThe seasonal influenza vaccine is available free of charge to those most at risk of developing serious complications from influenza infection. These 'at-risk' groups include all people aged 65 years and older and residents of long-stay residential facilities, including nursing homes.
Vaccines are supplied by the HSE to GPs, retail pharmacies and occupational health departments, as well as community nursing homes and hospitals. Influenza vaccine is administered to residents of nursing homes by their GP or the medical officer in the nursing home.
The HSE's National Immunisation Office (NIO) prepares for influenza season, annually, by communicating with GPs and pharmacists and other healthcare workers, including services for older people, and voluntary organisations representing older people and those affected by long-term medical conditions. Information materials are disseminated about the season’s influenza vaccine and the importance of vaccinating all those who are at-risk, particularly people aged 65 years and older and residents of long-stay residential facilities, including nursing homes. At the start and during each influenza season, a media campaign is run to encourage people to get the vaccine.
The Health Protection Surveillance Centre of the HSE publishes a report of Influenza Vaccine uptake in Acute Hospitals and Long-term/Residential Care Facilities in Ireland for each influenza season. The report for the 2018/2019 influenza season, which is the most recent report available, is available on the HPSC website at the following link:
https://www.hpsc.ie/a-z/respiratory/influenza/seasonalinfluenza/influenzaandresidentsoflongtermcarefacilities/Seasonal%20Influenza%20Vaccine%20Uptake-2018-2019.pdf
Influenza vaccine uptake for long stay residents of long-term care facilities included in the report was 89%, exceeding the World Health Organization target of 75% for at-risk groups.
725. Deputy John McGuinness asked the Minister for Health if his Department will approve visiting guidance for nursing homes; the name of the organisation that is drawing up the guidelines; the title of the person managing the process; the reason there was no response to HIQA when this issue was queried after two weeks or more; and if he will make a statement on the matter. [13996/20]
Amharc ar fhreagraIn line with the Government's Roadmap for the re-opening of Society and Business, the National Public Health Emergency Team has agreed that a phased approach to the recommencement of visiting to long term residential centres would be appropriate at this time. The advice is that a co-ordinated and standard national approach to the recommencement of visiting is taken.
In light of the above , and on the basis that the COVID-19 disease status in the country remains in its current stable condition , the NPHET recommended that from 15th of June, the phased resumption of indoor visiting of residents in residential care facilities may commence in accordance with guidance issued by the Health Protection Surveillance Centre. The guidance which is published and available on the HPSC's website advises that indoor visiting in residential care facilities where there is no ongoing COVID-19 outbreak will be permissible from 15th of June in circumstances where certain criteria are followed. During an ongoing outbreak of COVID-19 within a residential care facility, the guidance advises that all but essential visiting is suspended in the interests of protecting residents, visitors and staff.
I am aware of how difficult the restrictions on visiting have been for both nursing home residents and their families. Therefore this phased approach is much welcomed as it will both facilitate visits to loved ones across the country , whilst also keeping some of our most vulnerable members of society protected during this challenging time.
726. Deputy John McGuinness asked the Minister for Health the date on which a primary medical certificate was issued to a person (details supplied); the date on which they were notified of the decision; the number of times their case was reviewed; the outcome of each review; the dates on which they were notified of a change of decision regarding the certificate; and if he will make a statement on the matter. [13999/20]
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 supports required to meet their needs and plan their lives.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for investigation and direct reply to the Deputy.
727. Deputy Colm Burke asked the Minister for Health if all public orthodontic services will reopen; and if he will make a statement on the matter. [14000/20]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for attention and direct reply to the Deputy.
728. Deputy Fergus O'Dowd asked the Minister for Health the position regarding the availability of Spinraza to children with spinal muscular atrophy type I, II or III on an exceptional and individualised basis; his plans to facilitate broader provision of the scheme; and if he will make a statement on the matter. [14012/20]
Amharc ar fhreagraThe HSE has statutory responsibility for medicine pricing and reimbursement decisions, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
On 11 June 2019, the HSE Leadership Team approved access to the drug Nusinersen (Spinraza) for children with Spinal Muscular Atrophy (SMA) Type I, II or III on an exceptional and individualised basis.
The HSE decision process in relation to Spinraza involved a full Health Technology Assessment followed by detailed consideration by the HSE expert groups on new drug therapies, including the Technology Review Group for Rare Diseases and the Drugs Committee. Evidence of the clinical effectiveness of this new drug therapy was also reviewed.
The recommendation is to approve access for children with genetically confirmed SMA Type I, II or III, in accordance with the controlled access criteria recommended by the Rare Diseases Technology Review Committee. The rare diseases committee recommendation was clearly targeted at the youngest and most severely affected SMA patients, and this group is the clear priority for the HSE. The actual patient assessment and approval process will be the means for determining access on an individual case by case basis.
To date, the total number of patients deemed eligible to receive Spinraza is thirty five. Children's Health Ireland (CHI) has confirmed that 18 patients are currently receiving Spinraza. Due to Covid-19, a number of patients who were due to commence treatment have been put on hold.
Individual applications for each patient are prioritised based on clinical need and a treatment plan and a date for administering the drug is agreed with their treating clinician.
The actual delivery of this drug to approved patients in a safe and sustainable way requires very specific and quite complex service arrangements to be put in place in CHI across all sites.
CHI has confirmed that in order to support the SMA service arrangements, a clinical nurse specialist has been appointed who will liaise with families and is the first point of contact for care for patients. A physiotherapist has also been appointed to support these patients ongoing care.
CHI is in continuous engagement process with families regarding their child's individual plan for the administration of Spinraza.
729. Deputy Anne Rabbitte asked the Minister for Health the number of persons on the waiting list for orthodontic work in County Galway by waiting periods of zero to six months and one to two, three to four, four to five and over five years, respectively in tabular form; and if he will make a statement on the matter. [14016/20]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for attention and direct reply to the Deputy.
730. Deputy Anne Rabbitte asked the Minister for Health the reason teenagers are being left to stand outside while waiting to be seen in the CAMHS unit at Merlin Park Hospital, Galway; if a temporary structure could be put in place to help facilitate socially distanced queuing that is less exposed; the protocol in place for persons left waiting at the unit; and if he will make a statement on the matter. [14019/20]
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.
731. Deputy Sean Sherlock asked the Minister for Health the costings carried out on the Programme for Government; and if he will provide documents on those costings. [14032/20]
Amharc ar fhreagraMy Department was not involved in any costings carried out in relation to the Programme for Government.
732. Deputy Anne Rabbitte asked the Minister for Health if there is a dedicated dementia unit in St. Brendan’s, Loughrea, County Galway; if so, if the unit is accepting new patients; if not, when it will be accepting new patients; and if he will make a statement on the matter. [14040/20]
Amharc ar fhreagraAs 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.
733. Deputy Anne Rabbitte asked the Minister for Health the position of a person (details supplied) on the waiting list for St. Brendan’s, Loughrea, County Galway; the length of time they will be waiting to be admitted; if they can be admitted to the dementia unit at St. Brendan’s as a matter of urgency due to a diagnosis of severe dementia; and if he will make a statement on the matter. [14041/20]
Amharc ar fhreagraAs 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.
734. Deputy Carol Nolan asked the Minister for Health the external consultancy organisation or provider which delivered diversity and inclusion training within his Department from 2018 to date; the costs associated with such services; and if he will make a statement on the matter. [14057/20]
Amharc ar fhreagraMy Department went to tender in July 2019 for the provision of Unconscious Bias Awareness training for staff in my Department. The successful tenderer was MASF consulting. Training was delivered in October and November 2019 and covered diversity and inclusion, equality legislation and unconscious bias awareness. The cost of this training was €7,499.
Table of Costs – 2018 to date
|
Training Provider |
Total Cost |
|
MASF Consulting |
€7,499 |
735. Deputy Carol Nolan asked the Minister for Health the expenditure his Department incurred in respect of external legal fees in each of the years from 2016 to date in tabular form; and if he will make a statement on the matter. [14074/20]
Amharc ar fhreagraThe Department of Health’s external legal costs for 2016 - 2020 (1 Jan-30 Jun) are set out in the table below:
|
2016 |
2017 |
2018 |
2019 |
2020 (1 Jan-30 Jun) |
|
|
Department of Health external legal costs |
€807,111.04 |
€160,585.94 |
€627,401.81 |
€655,186.18 |
€273,406.46 |
736. Deputy Louise O'Reilly asked the Minister for Health if he will provide advice or information to persons (details supplied) that are being denied the possibility to visit their family members in a nursing home in a safe, secure and socially distant manner in view of the fact they are residents in the home and have not received visitors for over four months; and if he will make a statement on the matter. [14086/20]
Amharc ar fhreagraIn line with the Government's Roadmap for the re-opening of Society and Business, the National Public Health Emergency Team (NPHET) has agreed that a phased approach to the recommencement of visiting to long term residential centres would be appropriate at this time. The advice is that a co-ordinated and standard national approach to the recommencement of visiting is taken.
In light of the above , and on the basis that the COVID-19 disease status in the country remains in its current stable condition , the NPHET recommended that from 15th of June, the phased resumption of indoor visiting of residents in residential care facilities may commence in accordance with guidance issued by the Health Protection Surveillance Centre (HPSC). The guidance which is published and available on the HPSC's website advises that indoor visiting in residential care facilities where there is no ongoing COVID-19 outbreak will be permissible from 15th of June in circumstances where certain criteria are followed. During an ongoing outbreak of COVID-19 within a residential care facility, the guidance advises that all but essential visiting is suspended in the interests of protecting residents, visitors and staff.
I am aware of how difficult the restrictions on visiting have been for both nursing home residents and their families. Therefore this phased approach is much welcomed as it will both facilitate visits to loved ones across the country, whilst also keeping some of our most vulnerable members of society protected during this challenging time.
737. Deputy Catherine Murphy asked the Minister for Health the status of his implementation of all aspects of the Sláintecare plan. [14101/20]
Amharc ar fhreagraSláintecare is the ten-year all-party Oireachtas policy setting out the vision to deliver a healthcare system for the population of Ireland. Sláintecare is about delivering a health and social care service that meets the needs of our population and attracts and retains the very best healthcare professionals, managers and staff. The plan is to deliver a universal health service that offers the right care, in the right place, at the right time, by the right team with a priority focus on keeping people well, developing primary and community services within a national policy context, and ensuring we have the right hospital capacity for the needs of our citizens.
Key recommendations of the Oireachtas Sláintecare report were to set up a Programme Implementation Office to oversee and enable the implementation of Sláintecare, to develop a detailed implementation plan for the reform programme and devise a detailed implementation programme project plan for each year of the plan, identifying key milestones which can be monitored across sectors. Following the publication of the all-party Oireachtas Sláintecare report, the Sláintecare Implementation Strategy was agreed by Government in August 2018 setting out an initial set of key actions for a three-year period. The Sláintecare Executive Director was appointed in September 2018, a small team was recruited from within the public sector to form the Sláintecare Programme Implementation Office during late 2018 and early 2019.
A detailed Action Plan for 2019 was developed for implementation, based on the Implementation Strategy and was published on the 13 March 2019. This 2019 Sláintecare Action Plan set out detailed timeframes for 138 projects that were to be progressed in 2019, as the first full year in the implementation of the Sláintecare vision, and firmly established a programmatic approach to the delivery of the Sláintecare strategy.
A progress report on the implementation of the 2019 Sláintecare Action Plan was approved by the Government in April 2020. Of the 138 projects for the period up to December 2019, 112 were on track, 24 have been progressed with minor challenges, and 2 with significant challenge. This work was carried out by many stakeholders, including from the Department of Health, the HSE, the voluntary and community bodies and key partners. It represents a concerted effort to deliver on the all-party vision and provided a strong foundation for moving forward into 2020, and beyond. During 2019, a series of important Sláintecare reform Government decisions were made, including the agreement:
1. on the geographies for the six new regional health areas which is a first major step towards restructuring our health services in line with recommendation in the Oireachtas Committee report, which is informing the development of a detailed business case for consideration by Government;
2. to support the findings of the Independent Review Group established to examine private activity in public hospitals with the decision and announcement that all future consultant appointments, from mid-2020, will be to the new Sláintecare Consultant contract for public only work;
3. on revised GP contractual arrangements in April 2019, which will see a €210 million investment (40% increase) in General Practice over the next four years of which €80 million will be available for the management of chronic diseases, like diabetes and COPD, through family doctors. This is expected to benefit more than 400,000 patients;
4. on the strengthening of the HSE with the formal appointment of the Health Service Executive (HSE) Board in June 2019 and the introduction of a new HSE Chief Executive Officer.
The 2019 Action Plan report setting out the progress against all the planned 138 projects can be found on the Department of Health website (link: https://www.gov.ie/en/publication/4c7594-delivering-slaintecare/#slaintecare-action-plan-year-end-report-2019 ).
The experience of the first full year of implementation of Sláintecare (2019) informed Sláintecare’s ongoing approach. The 2020 Action Plan was drafted by the Sláintecare Programme Implementation Office through the Sláintecare/HSE Joint Action Programme governance, and the Department of Health’s business planning process, in anticipation of a submission to the Minister and the incoming Government following the general election of February 8th, 2020. The COVID-19 pandemic resulted in major disruptions to routine health services. The response to the COVID-19 pandemic necessitated a singular and urgent focus on one priority, a highly focussed health and social care workforce, clear public messaging, societal engagement and real-time decision-making that facilitated rapid change and implementation. As has been noted in several quarters, many of the initiatives and changed ways of working that have been successfully and rapidly implemented over the past three months in response to the pandemic have been wholly aligned with the spirit of the Oireachtas Sláintecare Report. The implementation of Sláintecare now operates within a different context, but the principles of Sláintecare are even more relevant at this time.
Key programmes that have progressed during the first half of 2020 include developing a specification for the three elective hospitals in Dublin, Cork and Galway, to be procured as part of the National Development Plan, as well as determining the roll out of the Sláintecare Community Healthcare Networks and Specialist Hubs, to be staffed and geographically dispersed over one quarter of the country during 2021, with a view to covering the whole country by 2023.The draft Programme for Government was published on June 15th, 2020. It reaffirms the commitment to the implementation of Sláintecare and pledges to accelerate the process. A revised Sláintecare Action Plan 2020 – 2021 is being developed factoring in the learnings from COVID-19, the new context within which the health system operates and the agreed Programme for Government.
738. Deputy Catherine Murphy asked the Minister for Health his plans to continue with the regionalisation of the HSE into separate health boards. [14102/20]
Amharc ar fhreagraA clear governance and accountability framework was identified as a key building block of Sláintecare by the Committee on the Future of Healthcare. As part of its recommendations in this area, the Committee called for the HSE to become a more strategic and patient-focused ‘national centre’ carrying out national level functions, and the establishment of regional bodies with responsibility for the planning and delivery of integrated care at a regional level.
The new Programme for Government, Our Shared Future, recommits to this core Sláintecare recommendation, stating “Enhanced governance and accountability in the health service is a key component of Sláintecare reform. The HSE Board is now in place and we must now bring forward detailed proposals on the six new regional health areas to deliver services for patients locally that are safe, high quality and fairly distributed.”
Work was underway in my Department and with the HSE to develop detailed proposals on Regional Health Areas but understandably this work was paused as a result of COVID-19. This programme of work will be given further consideration in the coming weeks to take account of the Programme for Government commitment and any new considerations relating to COVID-19.
It will be important that there is significant engagement with all key stakeholders across the health and social care sector to ensure that any structural changes do not unduly cause disruption and loss of focus on service delivery. This will be even more important now given the challenges facing the health service as a result of COVID-19.
739. Deputy Éamon Ó Cuív asked the Minister for Health when the HSE universal guidelines on bras, prostheses and wigs will be published; the funding to be allocated for the implementation of the guidelines; and if he will make a statement on the matter. [14103/20]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for attention and direct reply to the Deputy.
740. Deputy Martin Browne asked the Minister for Health the additional supports in place for communities affected by the increasing intimidation from drug dealers that has coincided with the significant increase in drugs seizures in County Tipperary; if a plan is in place to provide increased addiction treatment services in line with the increased Garda resources; and his views on the lack of co-ordination between the policing and addiction services sides of drug policy. [14106/20]
Amharc ar fhreagra741. Deputy Martin Browne asked the Minister for Health the measures he has taken to develop a more comprehensive approach to tackling the drug problem at a community level in view of the fact this necessitates close work between the Department of Justice and his Department; and the structures in place and the resources available to communities in this regard. [14107/20]
Amharc ar fhreagraI propose to take Questions Nos. 740 and 741 together.
Strengthening the resilience of, and building the capacity of communities to respond to the drug problem is a key objective of the national Drugs Strategy 'Reducing Harm Supporting Recovery'. The strategy is underpinned by an integrated whole of Government approach to resolving the drug problem based on a partnership approach between the statutory, community and voluntary sectors.
Drug and Alcohol Task Forces play a key role in assessing the extent and nature of the drug problem in local communities. They ensure that a coordinated partnership approach is taken across all sectors to address substance misuse based on identified needs and priorities in their areas including drug related intimidation and addiction. Memberships of the Task Forces include representatives from An Garda Síochána, the Community and Voluntary Sector as well as other key stakeholders. Mechanisms such as Local Policing Forums also help to build important relationships with communities.
There are a number of initiatives underway to deliver on the commitment in Reducing Harm Supporting Recovery to strengthen the effectiveness of the drug-related intimidation reporting programme in communities.
The National Drug-Related Intimidation Reporting Programme which was developed by the National Family Support Network and An Garda Síochána, provides a framework to allow reporting of an incident of intimidation to a nominated inspector.
An Garda Síochána and the National Family Support Network have concluded separate evaluations of the drug-related intimidation reporting programme and jointly agreed a number of actions to strengthen the programme, including external promotion of the programme through the media, external contacts and various forums.
In 2019 the Department provided additional funding of €1 million for the implementation of the National Drugs Strategy. Under this funding the Department has approved €190,000 over three years for the Drug Related Intimidation & Violence Engagement Project (DRIVE Project) which will support Drug and Alcohol Task Forces, Projects and the HSE to address the issue of Drug Related Intimidation at local and regional level.
Funding of up to €190,000 over three years has also been approved for the National Family Support Network to develop a national awareness campaign on the drug-related violence and intimidation reporting programme.
Families and communities affected by drug use need to have appropriate, accessible and timely services available to help them cope with the problems they are facing. It is important that we get the message out there that help is available, and that families and communities know where to go for help.
