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Gnáthamharc

Tuesday, 7 Jul 2020

Written Answers Nos. 781-800

Cancer Services

Ceisteanna (781)

Maurice Quinlivan

Ceist:

781. Deputy Maurice Quinlivan asked the Minister for Health the plans in place to reduce the delays in emergency endoscopy and colonoscopy tests for those showing symptoms of colon cancer. [14201/20]

Amharc ar fhreagra

Freagraí scríofa

As the issue raised is a service delivery matter, I have asked the Health Service Executive to respond directly to the Deputy.

Mental Health Services

Ceisteanna (782)

Alan Kelly

Ceist:

782. Deputy Alan Kelly asked the Minister for Health the funding that has been made available to mental health services for additional costs incurred to date due to the Covid-19 crisis; the additional funding being made available for mental health services to return to providing services; the proportion of the overall additional HSE spend on Covid-19 for mental health; his views on whether mental health services will achieve a balanced budget in 2020 by absorbing the additional costs associated with Covid-19; the reason St. James’s Hospital has not yet implemented the national clinical programme for self-harm in view of the fact that the homeless are a particularly vulnerable group; and if the HSE will reinstate the funding which was withdrawn at the end of 2019 for the multidisciplinary mental health team for the homeless in south central areas of Dublin in view of the expected post-Covid-19 mental health wave. [14202/20]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy as soon as possible.

Home Help Service

Ceisteanna (783)

Cathal Crowe

Ceist:

783. Deputy Cathal Crowe asked the Minister for Health if measures will be put in place to maintain financial support for the homecare sector in view of the fact the latest HSE pay policy came to an end on 31 May 2020. [14203/20]

Amharc ar fhreagra

Freagraí scríofa

Standard PPE will continue to be the responsibility of private providers for non-COVID-19 clients. However, HSE will provide appropriate additional PPE supplies to Home Support Providers in relation to clients confirmed to have COVID-19 on the clear understanding that the individual service provider will deliver appropriate Infection Protection and Control training to its staff. As the Deputy's question is an operational matter it has been referred to the HSE for direct reply.

Question No. 784 answered with Question No. 751.

Hospital Appointments Status

Ceisteanna (785)

Pa Daly

Ceist:

785. Deputy Pa Daly asked the Minister for Health the steps he will take to expedite overdue spinal surgery for a child (details supplied). [14211/20]

Amharc ar fhreagra

Freagraí scríofa

In response to the Covid-19 pandemic the HSE had to take measures to pause all non-urgent elective scheduled care activity with effect from the end March 2020. 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 National Public Health Emergency Team (NPHET) and in accordance with the World Health Organisation, and the National Action Plan. The decision to delay appointments and admissions is not undertaken lightly and when such a decision is made, it is based on the safe delivery of care to all patients.

On 5 May 2020, NPHET agreed that its recommendation of 27 March, in regard to the pausing of all non-urgent 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. Children’s Health Ireland (CHI) is now re-establishing services on an incremental basis.

To ensure services are re-introduced in a safe, clinically-aligned and prioritised way, the HSE launched its Strategic Framework for ‘Service Continuity in a Covid Environment’ on 24 June. Its implementation will ensure service resumption is done in an integrated way. This will involve a phased approach to ensure community services are strengthened. The Framework will also consolidate new ways of working and build on international knowledge. The HSE is currently developing a Service Continuity Roadmap for the resumption of services across the health system.

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.

My Department has been made aware of the specific patient query raised and has been advised by CHI that they are in direct contact with the family of the patient concerned.

Hospital Appointments Status

Ceisteanna (786)

Niamh Smyth

Ceist:

786. Deputy Niamh Smyth asked the Minister for Health if a hospital appointment will be expedited for a person (details supplied); and if he will make a statement on the matter. [14218/20]

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.

Medical Cards

Ceisteanna (787)

Emer Higgins

Ceist:

787. Deputy Emer Higgins asked the Minister for Health when the increased thresholds for the over-70s announced in budget 2020 will come into effect; and if he will make a statement on the matter. [14219/20]

Amharc ar fhreagra

Freagraí scríofa

On 25th June, the Government gave approval for the publication of the Health (General Practitioner Service and Alteration of Criteria for Eligibility) Bill 2020. This Bill provides, amongst other things, for the necessary legislative amendments to increase the weekly gross medical card income limits for those aged 70 and over. The Bill was published on July 1st, 2020 and arrangements are now being made for its passage through the Houses of the Oireachtas.

Dental Services

Ceisteanna (788)

Jackie Cahill

Ceist:

788. Deputy Jackie Cahill asked the Minister for Health when children’s dental services will be restored to St. Mary’s Hospital, Thurles, County Tipperary, after being relocated to Nenagh Hospital, Nenagh, County Tipperary; and if he will make a statement on the matter. [14224/20]

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.

Nursing and Midwifery Board of Ireland

Ceisteanna (789)

Catherine Connolly

Ceist:

789. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Questions Nos. 549 to 561, inclusive, and 674 to 677, inclusive, of 11 June 2019, the reason the persons involved that acted in contravention of the Protected Disclosures Act 2014 were not called to account under the Code of Practice for the Governance of State Bodies 2016, the Safety, Health and Welfare at Work Act 2005 and the Code of Professional Conduct and Ethics for Registered Nurses and Midwives 2014; and if he will make a statement on the matter. [14225/20]

Amharc ar fhreagra

Freagraí scríofa

The questions referred to relate to the details, and the handling of, a protected disclosure submitted to my Department in September 2014, raising matters of concern within the Nursing and Midwifery Board of Ireland (NMBI). As part of his comprehensive response on 11 June , 2019, my predecessor , Minister Harris, noted that two reports had been commissioned by the Board of the NMBI. Crowe Horwath was engaged to carry out an Organisational Review and BDO was engaged to carry out a review of Remuneration and Contract Management of Non-Permanent Employees. The relevant reports were submitted in late 2015 with recommendations that were accepted in full by the Board. Minister Harris further noted that, in view of the reports commissioned, the findings of same, and the steps taken by the NMBI to implement the recommendations of the reports, he was satisfied that significant action has been taken on foot of the complaints made. These complaints were an important input to the enhancement of governance in the NMBI.

The Deputy's current question to me focuses on three areas. Firstly, in relation to the Code of Practice for the Governance of State Bodies which was introduced in August 2016. This Code is not designed to provide specific accountability mechanisms in relation to individuals. Instead, it gives a framework for good governance practice and it is the responsibility of the body itself to comply with the Code. The role of the supervising Department is to monitor such compliance using the available mechanisms to obtain the necessary assurances. Secondly, the impact of certain conduct on the health and well- being of staff within the NMBI was one of the issues which had been raised. While the initial complaint did not characterise the matters as falling within the provisions of the Safety, Health and Welfare at Work Act, 2005, health and welfare issues were dealt with in the subsequent review under the Protected Disclosure Act 2014. Thirdly, I note that complaints under the Code of Professional Conduct and Ethics for Registered Nurses and Midwives can be made to the NMBI by members of the public, patients, relatives of patients, employers, other healthcare staff or the Board of the NMBI if they have a concern about the behaviour, conduct, practice or health of a registered nurse or a registered midwife.

In dealing with the matters raised, the Department ensured that a proper investigation was carried out and that any issues which had arisen were rectified and measures put in place to prevent a reoccurrence.

Covid-19 Pandemic

Ceisteanna (790)

Robert Troy

Ceist:

790. Deputy Robert Troy asked the Minister for Health if an urgent investigation will be conducted into the alleged neglect of nursing home residents during the Covid-19 restrictions; if specific direction was given to nursing homes on the way in which the additional funding allocated to nursing homes was to be spent; and if such funding was for additional PPE. [14227/20]

Amharc ar fhreagra

Freagraí scríofa

Since 2009 the Health Information and Quality Authority, HIQA, is the statutory independent regulator in place for the nursing home sector, whether a HSE managed or a private nursing home. The Authority, established under the Health Act 2007, has significant and wide-ranging powers up to and including withdrawing the registration of a nursing home facility, which means that it can no longer operate as a service provider.

This responsibility is underpinned by a comprehensive quality framework comprising of Registration Regulations, Care and Welfare Regulations and National Quality Standards.

HIQA in discharging its duties determines, through examination of all information available to it, including site inspections, whether a nursing homes meets the regulations in order to achieve and maintain its registration status.

Should a nursing home be deemed to be non-compliant with the Regulations and the National Quality Standards, it may either fail to achieve or lose its registration status. In addition, the Chief Inspector has wide discretion in deciding whether to impose conditions of Registration on nursing homes.

During the response to COVID-19, Nursing homes continue to be regulated by HIQA, who under the Health Act 2007 have the legal authority to examine the operation of any facility under their remit.

Any individual cases of concern should be brought to the attention of HIQA and the relevant HSE Safeguarding and Protection Team.

In relation to the COVID-19 Temporary Assistance Payment Scheme for Nursing Homes, where a nursing home applies for an assistance payment through the Scheme, the nursing home may only claim for those additional allowable costs, as set out in the Scheme details. Additional Costs are costs incurred by the Nursing Home which would not have been incurred were it not for the impact of the COVID-19 Pandemic. Allowable Costs are costs that may be included in an application for support under the Scheme. The nursing home must submit a Statement of Additional Allowable Costs in support of an application to the Scheme and, therefore, vouch that all amounts claimed are in relation to those allowable costs arising as a result of the impact of COVID-19.

Applications to the Scheme are made to the National Treatment Purchase Fund (NTPF) in the first instance where an assessment of the application is carried out to determine the payment amount in accordance with the Scheme Rules and subsequently advises the HSE of the proposed payment amount for each Nursing Home. The HSE undertakes a final validation and makes a decision on the application.

The NTPF and/or the HSE will carry out formal audits of claims made retrospectively on a risk and/or sample basis - they will be supported in this work by professional auditors. It will be necessary for the Nursing Home to be able to provide vouched evidence of COVID-19 expenditure as any expenditure that is not vouched will be recoverable.

In some cases, where an outbreak has been experienced and a claim is made under the outbreak assistance component of the Scheme, the claim requires independently certified verification.

Covid-19 Pandemic

Ceisteanna (791)

Robert Troy

Ceist:

791. Deputy Robert Troy asked the Minister for Health if direction will be given to nursing homes on when residents are allowed to leave the nursing home for day visits. [14228/20]

Amharc ar fhreagra

Freagraí scríofa

It is recognised that the impact of COVID-19 on society in general and particularly older people living in nursing homes has been considerable. Residential settings are people’s homes as well as places where health and social care are provided. The introduction of physical distancing, isolation and restricted contact with family and loved ones has changed the usual dynamic of social interaction. During these times there has been a particular emphasis on retaining a holistic view of the well-being of residents, remaining person-centred, being cognisant of their rights as citizens, and being vigilant that in seeking to shield them from infection that these rights are not infringed upon in to an extent, or in a manner, that is disproportionate.As the disease is becoming more suppressed in the community the National Public Health Emergency has advised that the gradual reintroduction of usual activities while taking public health precautions should commence. This advice is reflected in the latest Cocooning and visiting guidance. Detail of this guidance is set out by the Health Protection Surveillance Centre at: https://www.hpsc.ieFamilies are encouraged to talk to the staff at the person’s nursing homes, to make arrangements for visits and other activities that can be facilitated within the current public health guidance. While it is appropriate in line with the public health cocooning guidance for activities outside the home to commence it is important to balance the risk involved in prolonged periods of time outside the home. These risks will continue to be reviewed in line with the disease progression and guidelines will be updated. The Department of Health is very much aware of how difficult the current restrictions on visiting are for residents and their families, and we very much hope that this can be safely facilitated soon.

Hospital Appointments Status

Ceisteanna (792)

Niamh Smyth

Ceist:

792. Deputy Niamh Smyth asked the Minister for Health when an operation will take place for a person (details supplied). [14239/20]

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.

Abortion Services Provision

Ceisteanna (793)

Carol Nolan

Ceist:

793. Deputy Carol Nolan asked the Minister for Health the amount paid to general practitioners for the provision of termination of pregnancy services in 2019; and if he will make a statement on the matter. [14240/20]

Amharc ar fhreagra

Freagraí scríofa

The first Annual Report on the Health (Regulation of Termination of Pregnancy) Act 2018, which was laid before the Houses of the Oireachtas on 30 June, shows that during the period 1 January to 31 December 2019, 6,542 medical procedures were carried out in early pregnancy under the grounds set out in section 12 of the Act.

Payments to General Practitioners for the provision of termination of pregnancy services are made through the HSE’s Primary Care Reimbursement Service. I have therefore, asked the HSE to provide the information requested directly to the Deputy.

Abortion Services Provision

Ceisteanna (794)

Carol Nolan

Ceist:

794. Deputy Carol Nolan asked the Minister for Health the measures and supports in place to reduce the number of abortions from the recorded 6,666 abortions that took place in 2019; and if he will make a statement on the matter. [14241/20]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter I have referred the Deputy's question to the Health Service Executive for attention and direct reply to her.

Health Services Staff

Ceisteanna (795)

Noel Grealish

Ceist:

795. Deputy Noel Grealish asked the Minister for Health the number of posts vacant in CHO2; the number of vacant posts in the Saolta Hospital Group; the breakdown of the vacant posts; and if he will make a statement on the matter. [14250/20]

Amharc ar fhreagra

Freagraí scríofa

I have asked the HSE to respond to the Deputy directly on this matter.

Covid-19 Pandemic

Ceisteanna (796)

Catherine Connolly

Ceist:

796. Deputy Catherine Connolly asked the Minister for Health when the Covid-19 national guidelines will be published to enable the reopening of day services including Alzheimer’s day services in HSE community healthcare west; and if he will make a statement on the matter. [14252/20]

Amharc ar fhreagra

Freagraí scríofa

As the Deputy will be aware, day care and other community services play an important role in supporting 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 from the Covid-19 experience to date, 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.

Against this background, the HSE has recently published a strategic framework document, outlining its overall approach and phased resumption of services, taking into account the COVID-19 environment in which services will need to work. It will affect how services are delivered, as well as service capacity. It is envisaged that the framework will guide hospitals and community services, including day services, in developing their own local individual plans, on how services can resume, in the months ahead.

Medical Qualifications

Ceisteanna (797)

Peter Burke

Ceist:

797. Deputy Peter Burke asked the Minister for Health if his Department will review the fact that the counselling doctorate offered by Trinity College Dublin and fully recognised and accredited by an organisation (details supplied) does not provide payment to students unlike the doctorate in clinical psychology which is offered by the five main Irish universities; and if he will make a statement on the matter. [14257/20]

Amharc ar fhreagra

Freagraí scríofa

I have asked the HSE to respond to the Deputy directly on this matter.

Home Help Service

Ceisteanna (798)

Thomas Gould

Ceist:

798. Deputy Thomas Gould asked the Minister for Health if a pay agreement has been reached between the HSE and an organisation (details supplied) to continue providing financial support for the supply of PPE to the private homecare sector in view of the fact that the initial agreement expired on 31 May 2020. [14261/20]

Amharc ar fhreagra

Freagraí scríofa

Standard PPE will continue to be the responsibility of private providers for non-COVID-19 clients. However, HSE will provide appropriate additional PPE supplies to Home Support Providers in relation to clients confirmed to have COVID-19 on the clear understanding that the individual service provider will deliver appropriate Infection Protection and Control training to its staff.

However as this is a service matter I have referred this matter to the HSE for direct reply.

HSE Properties

Ceisteanna (799, 800, 807)

Thomas Gould

Ceist:

799. Deputy Thomas Gould asked the Minister for Health if consideration has been given to utilising the Sarsfield Court Hospital site in Glanmire, County Cork, for the new acute hospital in Cork included in the National Development Plan 2018-2027 [14268/20]

Amharc ar fhreagra

Thomas Gould

Ceist:

800. Deputy Thomas Gould asked the Minister for Health if consideration has been given to utilising the Our Lady’s Hospital, Guarranabraher, site for the new acute hospital in Cork included in the National Development Plan 2018-2027 [14269/20]

Amharc ar fhreagra

Thomas Gould

Ceist:

807. Deputy Thomas Gould asked the Minister for Health if community groups will be engaged with in consultation prior to a decision on the location of the proposed acute hospital in County Cork included in the National Development Plan 2018-2027 [14276/20]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 799, 800 and 807 together.

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.

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