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Tuesday, 14 Jul 2020

Written Answers Nos. 1273-1297

Child and Adolescent Mental Health Services

Ceisteanna (1273)

Johnny Mythen

Ceist:

1273. Deputy Johnny Mythen asked the Minister for Health his plans to provide a Jigsaw youth mental health service for County Wexford; and if he will make a statement on the matter. [15872/20]

Amharc ar fhreagra

Freagraí scríofa

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

Hospital Consultant Contracts

Ceisteanna (1274)

Róisín Shortall

Ceist:

1274. Deputy Róisín Shortall asked the Minister for Health the number of retired consultants that were re-employed in the health service in the past year; the amount paid in respect of their salaries in the past year; the percentage of those employed under different contracts in tabular form; if each type of contract permits a split between public and private work; if so, the percentage allowed in each case; and if he will make a statement on the matter. [15873/20]

Amharc ar fhreagra

Freagraí scríofa

I have asked the HSE to reply directly to the Deputy with the data sought.

Covid-19 Pandemic

Ceisteanna (1275, 1282)

Róisín Shortall

Ceist:

1275. Deputy Róisín Shortall asked the Minister for Health if he has considered the recommendation by the Irish Human Rights and Equality Commission that his Department should undertake a participative consultation process with it regarding the "Ethical Framework for Decision-Making in a Pandemic" document; and if he will make a statement on the matter. [15874/20]

Amharc ar fhreagra

Mary Lou McDonald

Ceist:

1282. Deputy Mary Lou McDonald asked the Minister for Health if a participative consultation process will be undertaken with those most likely to be impacted by the guidance of his Department on prioritisation in access to critical care in the context of Covid-19, which explicitly engages human rights and equality expertise as recommended by the Irish Human Rights and Equality Commission. [15923/20]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 1275 and 1282 together.

The fields of human rights and healthcare ethics are distinct albeit they are inter-related. Human rights principles, in common with normative ethical principles are rooted in values of respect for persons, dignity, justice and equality.

Respect for human rights and dignity of persons is an integral part of the public health response to the COVID-19 pandemic. In recognition of this, the Pandemic Ethics Advisory Group (PEAG) was established as an expert subgroup of the NPHET. The PEAG is multidisciplinary in composition and includes members from a broad range of relevant fields, including ethics, medicine, law and patient advocacy.

The subgroup has developed a broad range of national ethical guidance throughout the course of the Covid-19 pandemic with a view to supporting healthcare workers, managers and policy makers as they navigate their way through the ethical challenges and difficult decisions they are called upon to make during this challenging time. The Ethical Framework for Decision Making in a Pandemic and the supporting documents produced by PEAG clearly articulate the importance of fairness, inclusiveness, proportionality, and non-discrimination, all of which are enshrined Human Rights principles.

Given the volatility of the public health emergency and the urgent need for relevant guidance to be produced to address it, it was not feasible or appropriate to the circumstances to conduct an extensive consultation process when developing these guidance documents. However, they were reviewed by senior medical experts from a number of professional bodies including; the Joint Faculty of the Intensive Care Society of Ireland, the Royal College of Physicians in Ireland, the College of Anaesthesiologists of Ireland, and the HSE’s National Clinical Programmes.

The pandemic continues to evolve and the Ethics Guidance documents will be kept under review. Consideration will be given to the appropriateness of broader consultation as part of this process.

Speech and Language Therapy

Ceisteanna (1276)

Sorca Clarke

Ceist:

1276. Deputy Sorca Clarke asked the Minister for Health the timeline for the reopening of HSE speech and language therapy sessions. [15884/20]

Amharc ar fhreagra

Freagraí scríofa

As the Deputy's question relates to a service matter, it has been referred to the HSE for direct reply.

HSE Agency Staff

Ceisteanna (1277)

Sorca Clarke

Ceist:

1277. Deputy Sorca Clarke asked the Minister for Health the reason agency nurses being interviewed for permanent posts within the HSE are being offered zero-hour contracts and in cases in which they refuse, are faced with going through the interview process again for a 39 hour contract post. [15885/20]

Amharc ar fhreagra

Freagraí scríofa

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

Covid-19 Tests

Ceisteanna (1278)

Róisín Shortall

Ceist:

1278. Deputy Róisín Shortall asked the Minister for Health his views on reports that some private hospitals plan to charge patients up to €250 for a Covid-19 test before they can undergo a procedure in the hospital; if clarity will be obtained from private hospitals in respect of the matter in view of the substantial funds received by such hospitals from the State during the Covid-19 emergency period; and if he will make a statement on the matter. [15888/20]

Amharc ar fhreagra

Freagraí scríofa

As the Deputy will be aware, I do not have any responsibility for private hospitals, including in relation to charges that they apply.

An arrangement was agreed with the private hospitals earlier in the year to use their facilities as part of the public system on a temporary basis, to provide essential services in anticipation of additional demand on public hospital services. Under the arrangement, all patients in private hospitals were treated as public patients while the agreement was in place. On review, the Government decided that the existing arrangement should not be extended beyond the end of June, and on 1st July 2020 all private hospitals reverted to private activity. The Department of Health does not have a role in the operational functions of private hospitals.

More broadly in relation to testing, the HSE has developed guidance for the management of planned hospital admissions for non-COVID care which sets out advisory testing strategies for hospital patients. This guidance seeks to provide an advisory framework for mitigating risks associated with the delivery of non-COVID care while COVID-19 continues to be prevalent, and testing provides one of a number of measures that can be taken to reduce risk.

As with any procedure or test, there will be a cost. I am not in a position to comment on what the actual cost may be in private hospitals, however, I understand that the costs arising from testing for COVID-19 in public hospitals is much lower than the upper charges quoted by the Deputy.

In addition, I can confirm that the NTPF have advised my Department that no patient is liable for any charge from a private hospital for services arranged by the NTPF.

Obesity Strategy

Ceisteanna (1279)

Holly Cairns

Ceist:

1279. Deputy Holly Cairns asked the Minister for Health when an initial progress report on each recommendation in the Obesity Policy and Action Plan 2016-2025 will be issued by the obesity policy implementation oversight group. [15891/20]

Amharc ar fhreagra

Freagraí scríofa

‘A Healthy Weight for Ireland’, the Government’s Obesity Policy and Action Plan (OPAP), was launched in September 2016 under the auspices of the Healthy Ireland agenda. It covers a ten year period up to 2025 and aims to reverse obesity trends, prevent health complications and reduce the overall burden for individuals, families, the health system, and the wider society and economy. It must be emphasised that every sector of our society has a role in reducing the burden of obesity and the OPAP clearly acknowledges this.

An Obesity Policy Implementation Oversight Group (OPIOG) was established in October 2017 and the progress report on each recommendation in the OPAP is currently being finalised under the aegis of the OPIOG. The progress report is at an advanced stage, but its completion was delayed due to the impact of the COVID-19 crisis on Departmental business. However, it is now hoped to have it completed in the coming weeks and published shortly thereafter.

Covid-19 Pandemic

Ceisteanna (1280)

Holly Cairns

Ceist:

1280. Deputy Holly Cairns asked the Minister for Health the number of persons that will be able to attend weddings in September 2020 under the revised Roadmap for Reopening Society and Business guidelines. [15893/20]

Amharc ar fhreagra

Freagraí scríofa

As the Deputy is aware, on 19 June 2020, the then 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/.

Gatherings of 50 people (indoor) and 100 people (outdoor) are permissible in line with the public health guidance on mass gatherings, which is also available on the Government website at https://www.gov.ie/pdf/?file=https://assets.gov.ie/77452/39d51b02-5633-4e2f-a070-4551a3521081.pdf#page=6. The limits will increase to 100 (indoors) and 500 (outdoors) in phase 4. This will be subject to continued progressive improvements in the health indicators identified in the Framework for Future Decision-Making described in the Roadmap.

As the Deputy will be aware, religious buildings and places of worship may also now be reopened, in line with public health guidelines. The Government has exempted places of worship from the regulations restricting numbers on mass gatherings. The exemption applies to places of worship only and not to any gatherings that may take place after the religious ceremony such as wedding receptions.

Detailed Covid-19 Guidance has been developed for religious services. The Cabinet Committee reviewed the guidance, which state that an assessment should be carried out for each premises to determine how many can attend within the requirements of social distancing.

The Cabinet Committee decided that where the size of the premises allows for a capacity of greater than 50 this may be permitted only where:

- Social distancing guidelines are adhered to

- The premises can be subdivided into distinct sections (cordoned or marked appropriately) of not more than 50 persons in each section

- There is a minimum of 4m between sections

- Each section has its own entrance/exit route

- There are separate arrangements for elements of the service involving close contact, e.g. the distribution of Holy Communion

- Strictly no movement of people between sections before, during or after the service

- The premises is well-ventilated.

Account must also be taken regarding the risk of congregation by people outside before and after any services, having regard to outdoor overall limits on mass gatherings and arrangements for staggered exiting after ceremonies.

The use of face coverings is strongly recommended for such indoor settings.

Covid-19 Pandemic

Ceisteanna (1281)

Jennifer Whitmore

Ceist:

1281. Deputy Jennifer Whitmore asked the Minister for Health the initiatives, including transnational initiatives, Ireland is involved in for the development of a vaccine or treatment for Covid-19; if the initiatives are based on a principle of free or affordable global access; if Ireland is participating in the people’s vaccine initiative from UNAIDS; and if he will make a statement on the matter. [15915/20]

Amharc ar fhreagra

Freagraí scríofa

The World Health Organization (WHO) has stated that the availability of a safe and effective vaccine for COVID-19 is well-recognized as an additional tool to contribute to the control of the pandemic, while simultaneously recognising that the challenges and efforts needed to rapidly develop, evaluate and produce this at scale are enormous.

On 24 April, the World Health Organization (WHO) hosted the launch of the Access to COVID-19 Tools (ACT) Accelerator, a new global collaboration to accelerate development, production, and equitable access to COVID-19 diagnostics, therapeutics, and vaccines. Within the Accelerator, Gavi, CEPI, and WHO together with multinational and developing country vaccine manufacturers are working on the COVAX (vaccine) Pillar to develop the COVAX Facility.

The Facility provides governments with the opportunity to benefit from a large portfolio of COVID-19 candidate vaccines using a range of technology platforms, produced by more manufacturers across the world, with a bigger market to provide security of demand – often with greater scope than governments or regional groups can support on their own. Even where governments already have access to a portfolio of candidate vaccines, it acts as an insurance policy through economies of scale and portfolio diversification.

Ireland has signed an expression of Interest letter indicating interest in participating in the Covax Facility, and accordingly in procuring vaccines from the Facility for the country.

In addition, to ensure that Europeans have access to a vaccine in a timely and fair manner, the European Commission proposes to conclude a number of advance purchase agreements with vaccine manufacturers. The contracts with companies would take the form of Advance Purchase Agreements (APAs) and would be concluded through a procurement process run by the Commission on behalf of all participating Member States. The related funding would come from the Emergency Support Instrument (ESI). The budgetary authorities, the European Parliament and the Council, have made EUR 2.7 billion available under the ESI. The Commission stands ready to commit the large majority of those funds to APA-related activities.

This process will respect the principle of subsidiarity and Member States competences as the central procurement action would only conclude the APAs with all relevant conditions, whereas the actual purchase and subsequent use of the vaccines product under the resulting framework contract would remain under the responsibility of the individual Member States.

A Steering Board has been established to run the procurement centrally and efficiently. The SB is chaired by the Commission and includes senior officials from all interested Member States to assist and provide guidance throughout the evaluation process. Ireland is represented on the Steering Board. For full transparency, the Commission proposes to report regularly to the Integrated Crisis Political Response (IPCR) on overall progress more generally.

Question No. 1282 answered with Question No. 1275.

Disability Support Services

Ceisteanna (1283)

Mary Lou McDonald

Ceist:

1283. Deputy Mary Lou McDonald asked the Minister for Health the progress made regarding day services for persons with disabilities further to the publication of a HSE document, entitled the Framework for the Resumption of Adult Disability Day Services; the way in which and when day services for persons with disabilities will open under the framework; the transport solutions that will be provided for persons accessing services under the framework; if school leavers with a disability will be provided for under the framework; and if he will make a statement on the matter. [15924/20]

Amharc ar fhreagra

Freagraí scríofa

As part of the overall effort to contain the spread of COVID-19 and in line with public health advice, day service locations closed in March.

Since then, HSE Disability Services have been working to develop national guidance on the part of the disability sector to direct how all day services can be delivered. The Guidance to support the Framework for the Resumption of Adult Disability Day Services was published by the HSE on 9 July 2020.

In developing the guidance document to guide providers, the HSE worked closely with service providers through representative organisations such as the National Federation of Voluntary Service Providers, Disability Federation of Ireland and the Not for Profit Association, in addition to Inclusion Ireland, who represent people with intellectual disabilities and their families.

The guidance document seeks to support the safe return of services in the context of ongoing public health guidance. It also recognises that the impact of public health guidance will result in services being provided at a reduced level and will require changes in how people are supported, increased use of technology where appropriate and more use of outreach supports.

Day services will gradually resume during the month of August. Service providers are already working to get day services ready to reopen safely, and in line with public health guidance. Service providers will be in touch with all families and service users during the month of July to discuss when they may expect the resumption of their service and what that service will consist of.

As services resume it will be necessary to identify how transport can continue to be provided in as safe a manner as possible and strictly within social distancing and other COVID-19 precautions. Transport providers will have to demonstrate that their transport services are safe and that all COVID-19 precautions have been established and observed. The guidance includes general guidelines and a risk assessment matrix on safe transport.

With regard to school leavers, the HSE are continuing to plan to meet the needs of all young people leaving school and people leaving Rehabilitation Programmes in 2020 that may require a HSE funded Adult Disability Day Service. Ring-fenced resources to facilitate this have been provided as part of the HSE's National Service Plan 2020. People that have left school and require a day service will be introduced to a new service during September, and school leavers referred to the HSE can continue to communicate with their contact person by telephone or email.

I want to acknowledge the many challenges experienced by individuals and their families over this difficult time. Families across the country have had their routines upended due to the impact of COVID-19 and I hope that this will be the first step towards returning to some sense of normalcy.

The Guidance to support the Framework for Resumption of Adult Disability Day Services is available on the New Directions website: www.hse.ie/newdirections. The HSE have also issued monthly communications updates for service users and their families, the latest leaflet “Adult Disability Day Services and COVID-19 - What’s Happening? July 2020” is available at the above link.

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Traveller Community

Ceisteanna (1284)

Mary Lou McDonald

Ceist:

1284. Deputy Mary Lou McDonald asked the Minister for Health the dates on which the Traveller health advisory committee met between 2010 and 2020 inclusive in tabular form; the date on which it will next meet; and if he will make a statement on the matter. [15925/20]

Amharc ar fhreagra

Freagraí scríofa

The Traveller Health Advisory Committee ceased in 2012, following a formal review which found that:

- the committee did not function well, with limited efficiency and effectiveness and with differing views its role and remit;

- there were concerns around its membership and composition;

- there were overlaps between the role and composition of the committee and the Traveller Health Advisory Forum (structure chaired by the HSE); and

- there were a number of other contentious issues, including the lack of a response to the findings of the All-Ireland Traveller Health Study.

The Department of Health is committed to addressing the serious health inequalities facing the Traveller community, informed by the All Ireland Traveller Health Survey which was published in 2010.

The Department has ongoing engagement with the Traveller community on ways to improve Traveller health. In 2018, the Department convened a roundtable with Traveller organisations to discuss Traveller health concerns. This was attended by officials from various policy units in the Department.

The Department is currently working with the HSE to develop a national Traveller health action plan. This is one of 35 actions in the National Traveller and Roma Inclusion Strategy to improve the health status of Travellers and Roma, covering the areas of improved access to health services, reductions in health inequalities, culturally appropriate delivery of health services and reductions in suicide and mental health.

The strategy is overseen by a steering committee including government departments and agencies, and Traveller representative organisations.

I am determined to publish and implement the national Traveller health action plan, which is a commitment in the Programme for Government. Together with the Minister for Health, I look forward to receiving the health action plan from the HSE and to support the implementation of the plan. I will consider the arrangements for engaging with the HSE and with Traveller organisations to implement the plan.

Medicinal Products

Ceisteanna (1285)

John Lahart

Ceist:

1285. Deputy John Lahart asked the Minister for Health his plans to make adjuvant immunotherapy, nivolumab and pembrolizumab available to public patients with stage 3 melanoma; and if he will make a statement on the matter. [15926/20]

Amharc ar fhreagra

Freagraí scríofa

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

In line with the 2013 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 licensed indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.

HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).

The NCPE conducts health technology assessments (HTAs) for the HSE and makes recommendations on reimbursement to assist HSE decisions. The NCPE uses a decision framework to systematically assess whether a drug is cost-effective as a health intervention.

The HSE at all times ensures that the systems that it has in place are designed to provide equitable access to all medicines across all therapeutic areas, cancer and non-cancer, from the resources provided to it.

In 2019 and 2020, the Vhi decided to extend cover to a number of new cancer medicines. The decision by the Vhi applies only to private care to private Vhi patients in private hospitals. It has no impact on the availability and use of medicines in public hospitals, where there is no distinction between public and private patients.

A number of the medicines, or indications (which includes pembrolizumab and nivolumab), which the Vhi has now decided to cover, are in process with the HSE with a view to making them available in the public hospital system.

I am advised by the HSE that it has received pricing and reimbursement applications for the indications listed below:

- Nivolumab (Opdivo®) as monotherapy is indicated for the adjuvant treatment of adults with melanoma with involvement of lymph nodes or metastatic disease who have undergone complete resection.

- Pembrolizumab (Keytruda®) as monotherapy is indicated for the adjuvant treatment of adults with Stage III melanoma and lymph node involvement who have undergone complete resection.

The HSE has confirmed that health technology assessments have been completed by the NCPE for both these indications. These applications for reimbursement are now been assessed by the HSE in line with the 2013 Health Act.

Disability Services Provision

Ceisteanna (1286)

Denise Mitchell

Ceist:

1286. Deputy Denise Mitchell asked the Minister for Health when a service (details supplied) in Dublin 13 will reopen to service users. [15927/20]

Amharc ar fhreagra

Freagraí scríofa

As part of the overall effort to contain the spread of COVID-19 and in line with public health advice, day service locations closed in March.

Since then, HSE Disability Services have been working to develop national guidance on the part of the disability sector to direct how all day services can be delivered. The Guidance to support the Framework for the Resumption of Adult Disability Day Services was published by the HSE on 9 July 2020.

In developing the guidance document to guide providers, the HSE worked closely with service providers through representative organisations such as the National Federation of Voluntary Service Providers, Disability Federation of Ireland and the Not for Profit Association, in addition to Inclusion Ireland, who represent people with intellectual disabilities and their families.

The guidance document seeks to support the safe return of services in the context of ongoing public health guidance. It also recognises that the impact of public health guidance will result in services being provided at a reduced level and will require changes in how people are supported, increased use of technology where appropriate and more use of outreach supports.

Day services will gradually resume during the month of August. Service providers are already working to get day services ready to reopen safely, and in line with public health guidance. Service providers will be in touch with all families and service users during the month of July to discuss when they may expect the resumption of their service and what that service will consist of.

I want to acknowledge the many challenges experienced by individuals and their families over this difficult time. Families across the country have had their routines upended due to the impact of COVID-19 and I hope that this will be the first step towards returning to some sense of normalcy.

The Guidance to support the Framework for Resumption of Adult Disability Day Services is available on the New Directions website: www.hse.ie/newdirections. The HSE have also issued monthly communications updates for service users and their families, the latest leaflet “Adult Disability Day Services and COVID-19 - What’s Happening? July 2020” is available at the above link.

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Hospital Facilities

Ceisteanna (1287)

Denise Mitchell

Ceist:

1287. Deputy Denise Mitchell asked the Minister for Health the status of St. Michael's ward in Beaumont Hospital, Dublin 9. [15928/20]

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.

Rare Diseases Strategy

Ceisteanna (1288)

John Lahart

Ceist:

1288. Deputy John Lahart asked the Minister for Health when the proposed new national plan for rare diseases will be completed; if a consultation process will be run to allow input into this plan; and if he will make a statement on the matter. [15930/20]

Amharc ar fhreagra

Freagraí scríofa

A National Rare Disease Plan for Ireland (2014 – 2018) was launched by the Minister for Health in July 2014. This is a generic policy framework for rare diseases. The scope of the plan is broad given that there are approximately 8,000 rare diseases affecting millions of EU citizens; and consequently, there can be a dearth of expertise and knowledge about some rare diseases, simply because they are so rare.

Many of the major recommendations of the plan have already been implemented including the establishment of a National Clinical Programme for Rare Diseases and a Rare Disease Office. Building on this progress to date, themes for inclusion in a roadmap for the coming period have been agreed with the Rare Disease Task Force, which comprises the main rare disease advocacy groups; Rare Disease Ireland, the Medical Research Charities Group (MRCP), and the Irish Platform for Patent Organisations, Science and Industry (IPPPOSI). The Rare Disease Plan is now firmly embedded in the work of the HSE Clinical Programme for Rare Diseases and the Rare Disease Office. This programme is now under the governance of the Office of the Chief Clinical Officer.

Meetings to ensure that the input and the voice of the patient is represented in the continuing work ongoing in relation to Rare Diseases take place at regular intervals with the Rare Disease Task Force, the HSE National Clinical Programme for Rare Diseases and the Rare Disease Office.

In addition, a number of key themes have been identified for future progress, including: Patient Awareness; European Reference Networks; Research & Registries; Access to Services; Access to Medicines; Diagnosis; Education & Training and Legislation & Policy.

Health Services Staff

Ceisteanna (1289)

Patrick Costello

Ceist:

1289. Deputy Patrick Costello asked the Minister for Health the number of full-time paediatric occupational therapists and speech and language therapists in CHO 7 in 2019 and to date in 2020; and the number of vacant posts in CHO 7 as of 1 July 2020. [15932/20]

Amharc ar fhreagra

Freagraí scríofa

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

Hospital Data

Ceisteanna (1290)

Patrick Costello

Ceist:

1290. Deputy Patrick Costello asked the Minister for Health the number of scoliosis surgeries carried out at Crumlin Children's Hospital in 2019 and to date in 2020, in tabular form. [15934/20]

Amharc ar fhreagra

Freagraí scríofa

Improving access to scheduled care is a key commitment of government. In recent years there has been increased investment in paediatric orthopaedics and scoliosis services, which has improved access to surgery and outpatient appointments. In 2018 Children’s Health Ireland (CHI; previously the Children’s Hospital Group) was provided with an additional €9 million in funding to address paediatric orthopaedic waiting lists, including the provision of scoliosis services. As a result of this additional funding since 2018, CHI advise that there have been many improvements in paediatric scoliosis services, with increased activity and improved waiting times to access appointments and procedures.

CHI had advised my Department that they continue to develop sustainable solutions to reduce waiting times for children attending their orthopaedic and scoliosis services. The additional investment from the HSE in recent years and the implementation of the Scoliosis 10 Point Action Plan has increased orthopaedic activity levels across CHI. In addition, CHI has also advised my Department that a General Orthopaedic Surgeon, based at CHI Crumlin and Tallaght sites, is due to commence in Q3, 2020. This post is for general orthopaedic and trauma surgery, to support waiting list activity, and will further support waiting times for children for general orthopaedic outpatient appointments, including scoliosis.

My Department continues to engage with both CHI and the HSE in relation to paediatric scoliosis services.

In relation to the particular query raised and the specific breakdown of information requested, I have asked the HSE to respond to the Deputy directly.

Home Help Service

Ceisteanna (1291)

Patrick Costello

Ceist:

1291. Deputy Patrick Costello asked the Minister for Health the estimated amount it would cost in 2021 to provide 35,000 extra intensive home care packages. [15935/20]

Amharc ar fhreagra

Freagraí scríofa

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

Question No. 1292 answered with Question No. 1261.

National Dementia Strategy

Ceisteanna (1293, 1294, 1295, 1296)

Gino Kenny

Ceist:

1293. Deputy Gino Kenny asked the Minister for Health his views on the health impact of the Covid-19 pandemic on persons living with dementia and their family carers; his further views on the lack of consideration and strategy in terms of addressing the unique needs of this group during the pandemic; if the omission of the group will be addressed by specifically including it in current and future discussions and debate in relation to Covid-19 and other public health strategies and policies; and if he will make a statement on the matter. [15944/20]

Amharc ar fhreagra

Gino Kenny

Ceist:

1294. Deputy Gino Kenny asked the Minister for Health his views on a recently published report (details supplied); his further views on the conclusion in the report that policy and practice needs to focus on the way in which persons living with dementia and their informal and formal carers can be optimally supported; his plans to address same; and if he will make a statement on the matter. [15945/20]

Amharc ar fhreagra

Gino Kenny

Ceist:

1295. Deputy Gino Kenny asked the Minister for Health if the concerns of health professionals and organisations working with persons with dementia and their families that dementia has not been included specifically in data collection related to Covid-19 mortality or in the public messaging being issued will be addressed; the way in which he will address the lack of emphasis placed on the complex needs of those impacted by dementia in the community and in residential settings; and if he will make a statement on the matter. [15946/20]

Amharc ar fhreagra

Gino Kenny

Ceist:

1296. Deputy Gino Kenny asked the Minister for Health his views on whether persons with dementia and their family carers have been rendered invisible during the Covid-19 crisis; the way in which he will ensure that dementia is given high priority in terms of public health policy, research into its impact and future planning with regard to Covid-19; if the issuing of guidelines for the reopening of services and supports for persons and their families will be prioritised; and if he will make a statement on the matter. [15947/20]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 1293 to 1296, inclusive, together.

My Department is aware of the report referred to by the Deputy, which will contribute to our learning on the impact of Covid-19 on people living with dementia and help to inform how we meet their needs as we plan for the resumption of services.

I would like to assure the Deputy that there has been a continued focus on meeting the needs of people living with dementia throughout the Covid-19 pandemic. Through the Dementia Understand Together Campaign, led by the HSE, and collaboration with other key stakeholders, 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. In addition, the Alzheimer Society of Ireland has played a key role in supporting people living with dementia in the home following the suspension of their day and respite services, through social and activity engagement calls, telephone support and family carer training.

The HSE has adapted its community services in order to provide a flexible response so that the needs of people with dementia continue to be met during the Covid-19 crisis. Primary care team support is operating nationwide, with referrals being made to community supports, including the Alzheimer Society of Ireland’s dementia adviser service and the local authority community response forums. While home visits have been necessarily restricted, the HSE uses prioritisation and screening measures to identify clients needing home visits.

As the Deputy will be aware, people with dementia living in residential settings experience specific challenges. 23 Covid response teams have been established across network of Community Health Care Organisations (CHO) and these teams have geriatrician input, ensuring that the needs of the person living with dementia are incorporated into the overall plan for each nursing home.

As part of the public health follow-up of confirmed cases of Covid-19, information is routinely collected by the Health Protection and Surveillance Centre (HPSC) on whether a case has certain medical conditions, including chronic neurological disease. While I appreciate that many health professionals and organisations working with people with dementia would like to have dementia explicitly included as an underlying condition, the HPSC has to limit the number of conditions on its surveillance forms for the sake of brevity, as the people being interviewed are either caring for a very ill person or are very ill themselves.

The HSE is currently engaged in detailed operational planning across the primary and community sector that will underpin the phased resumption of community services, including supports for people with dementia, over the period ahead. This work will align with the recently published document “Service Continuity in a COVID Environment – A Strategic Framework for Delivery” which is available on the HSE’s website at https://www.hse.ie/eng/services/news/newsfeatures/covid19-updates/service-continuity-in-a-covid-environment-a-strategic-framework-for-delivery.pdf.

Assisted Human Reproduction

Ceisteanna (1297)

Pat Buckley

Ceist:

1297. Deputy Pat Buckley asked the Minister for Health his plans to ensure that same sex couples that received IUI and or IVF abroad will have full recognition of their parentage on birth certificates registered here; and if he will make a statement on the matter. [15948/20]

Amharc ar fhreagra

Freagraí scríofa

Parts 2 and 3 of the Children and Family Relationships Act 2015 commenced on 4 May 2020.

This provides a legal framework for registering the births of children who are born in the State as a result of assisted human reproduction involving donated eggs or sperm or embryos. The Act applies to procedures where the woman who gives birth is also the intending mother of the child.

Commencement of Parts 2 and 3 of the 2015 Act entitles parents of children born in the State as a result of a donor-assisted reproduction procedure performed before the 4th of May to apply to the courts for legal recognition of their parental status.

The Deputy may wish to note that procedures which take place outside of a clinical setting or outside the State from May 4th, 2020 do not fall within the scope of the Act and regulations for parentage will not apply in these circumstances.

Surrogacy is not covered under this legislation. The forthcoming Assisted Human Reproduction Bill contains provisions for areas including domestic surrogacy and the subsequent assignment of parentage.

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