Written Answers Nos. 221-239
221. Deputy Alan Kelly asked the Minister for Health when cancer screening services will resume by cancer type and region of country; if screening will resume sooner in areas of the country with lower incidence of Covid-19; and if he will make a statement on the matter. [17571/20]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
222. Deputy Alan Kelly asked the Minister for Health when his Department will complete its review of its resourcing [17572/20]
Amharc ar fhreagraAny changes made to the Finance function in my Department will be considered as part of the wider restructuring review of the Department of Health, which is currently underway.
223. Deputy Emer Higgins asked the Minister for Health if he will make lidocaine patches available on the medical card to patients with cancer in need of pain relief; and if he will make a statement on the matter. [17580/20]
Amharc ar fhreagraThe Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drug schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
Following a review, the HSE introduced a new system for the reimbursement of the lidocaine 5% medicated plaster (Versatis), which is licensed only for the localised relief of post-shingles pain in adults.
Patients are reviewed by the Medicines Management Programme (MMP) for reimbursement approval, on foot of an application by the patient’s clinician, through the HSE online system.
In exceptional circumstances, the product may be approved for supply for unlicensed uses.
If an application is refused, the clinician may make an appeal, making a clear clinical case for the patient to the MMP at mmp@hse.ie.
This process ensures the appropriate use of the patch and that post-shingles patients, and other patients as clinically appropriate, can continue to have this treatment.
224. Deputy Sean Sherlock asked the Minister for Health the options available for persons who cannot wear a face mask for medical reasons; and if must prove the medical reason [17581/20]
Amharc ar fhreagraI would like to assure the Deputy that my Department appreciates the challenges experienced by those with medical difficulties.
The National Public Health Emergency Team (NPHET) continues to examine all emerging evidence as it arises and has provided advice relating to face coverings on an ongoing basis.
NPHET advises the wearing of a non-medical face covering in a number of circumstances which include:
- when on public transport
- when in indoor public areas including retail outlets
- by people visiting the homes of those who are cocooning
- by people who are being visited in their homes by those who are cocooning
- all visitors to residential care facilities and
- in indoor work environments where it is difficult to maintain a two-metre distance
Individual judgement or preference should be used to consider the wearing of face coverings in other environments.
It is important to emphasise that the wearing of face coverings is an additional hygiene measure and should not take the place of good hand hygiene, respiratory etiquette and other personal protective public health measures. Face coverings should be used properly, in line with the guidance and hands should be washed hands before putting them on and taking them off.
On 15 June, the Government and the National Transport Authority launched a national communications campaign which outlines best practice for the use of face coverings in retail outlets, on public transport and in other public locations in which it is difficult to maintain social distancing or where this distance cannot be guaranteed, and are communicating to the public about:
- who should wear face coverings
- in what settings, and how to wear and remove face coverings correctly.
Guidance on how to make and safely use face coverings is available on gov.ie/facecoverings and the HSE website.
As the Deputy is aware, on Friday 10 July 2020, having consulted with the Minister for Transport, Tourism and Sport and the Minister for Justice and Equality, I signed the Health Act (Covid-19)(Face Coverings on Public Transport) Regulations 2020. The regulations provide that, from 13 July 2020, members of the public shall not, without reasonable excuse, travel by public transport without wearing a face covering.
Reasonable excuse includes where a person:
- cannot put one on, wear or remove a face covering because of any physical or mental illness, impairment or disability or without severe distress
- needs to communicate with another person who has difficulties communicating
- removes the face covering to provide emergency assistance or to provide care or assistance to a vulnerable person
- removes the face covering to avoid harm or injury, or the risk of harm or injury
- removes the face covering to take medication.
The Regulations do not apply to children under the age of 13 years. It is a matter for the person using the transport service to demonstrate that they have a reasonable excuse.
The Government has now also agreed to the mandatory wearing of face coverings in retail outlets, shops and shopping centres. Retail staff will also be obliged to wear a face covering unless there is a partition between them and members of the public or where there is a distance of 2 metres between them and members of the public. Work on the development of relevant Regulations has commenced and it is likely that similar “reasonable excuse“ provisions will apply .
As I am sure the Deputy can appreciate, the evidence relating to the SARS-CoV-2 virus and the discussion around face coverings, masks and shields is constantly evolving. I can assure you that the public health advice relating to Covid-19 is kept under continuing review by the National Public Health Emergency Team (NPHET). The Expert Advisory Group (EAG) of the NPHET has also been proactively examining all relevant evidence relating to the virus and the issue of face coverings. The EAG has requested the Health Information and Quality Authority to prepare a revised and updated evidence synthesis on face coverings and I have been informed that this paper is expected to be finalised shortly.
The latest public health advice on face coverings is available at the following links and is updated on a regular basis:
https://www.gov.ie/facecoverings
https://www2.hse.ie/conditions/coronavirus/face-masks-disposable-gloves.html.
225. Deputy Robert Troy asked the Minister for Health if a diagnostic assessment for a pupil (details supplied) with the school age team will be expedited [17583/20]
Amharc ar fhreagraThe recently published Programme for Government document "Our Shared Future" recognises the need to improve services for both children and adults with disabilities through better implementation and by working together across Government in a better way.
The Government commits to prioritising early diagnosis and access to services for children and ensuring that the most effective interventions are provided for each child, to guarantee the best outcomes.
As the Deputy's question relates to a service issue, it has been referred to the HSE for direct reply.
226. Deputy Róisín Shortall asked the Minister for Health the average turnaround time between taking a Covid-19 test and receiving results in the hospital and in the community, respectively; the average time to complete contact tracing for a confirmed case of Covid-19; and if he will make a statement on the matter. [17589/20]
Amharc ar fhreagraA robust, real-time process of testing, isolation and contact tracing is central to our public health strategy for containing and slowing the spread of COVID-19, as advocated by WHO, EC and ECDC.
Turnaround times have improved rapidly thanks to process improvements and automation. In around 90% of cases the turnaround time from referral to completion of contact tracing is now 3 days or less and I would like to recognise the HSE’s hard work to achieve this target which it set itself in the testing and tracing Roadmap.
As of 20 July the average turnaround time from swab taken to laboratory result for the last 7 days is 32 hours in the community and 16 hours in hospitals. The average time to complete all contact tracing calls was 0.3 days.
The HSE publishes updates on testing and contact tracing including activity levels and turnaround times on a daily basis. These can be accessed here - https://www.hse.ie/eng/services/news/newsfeatures/covid19-updates.
227. Deputy Róisín Shortall asked the Minister for Health the number of persons that have been alerted through the new Covid-19 tracker app that they are a close contact of a confirmed case of Covid-19 [17591/20]
Amharc ar fhreagraAs this question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
228. Deputy Róisín Shortall asked the Minister for Health the daily testing capacity in each hospital and Covid-19 community testing centre, in tabular form; the total capacity; and if he will make a statement on the matter. [17592/20]
Amharc ar fhreagraAs the HSE has responsibility, the Executive has been asked to reply directly to the Deputy.
229. Deputy Róisín Shortall asked the Minister for Health his views on the testing strategy; and his further views on whether a greater number of potential asymptomatic carriers should be tested when there is spare testing capacity in the system. [17590/20]
Amharc ar fhreagraA robust, real-time process of testing, isolation and contact tracing is central to our public health strategy for containing and slowing the spread of COVID-19, as advocated by WHO, European Commission and ECDC. The HSE has developed a comprehensive, reliable and responsive testing and tracing operation which has standing capacity to undertake 15,000 tests per day/100,000 tests per week. Significant effort has also been made to ensure quick turnaround times. As of 20 July, 567,819 tests have been carried out with an 5.1% positivity rate overall. 50,860 tests have been completed in the last 7 days.
It is important to note that the recommendation in relation to 15,000 tests a day/100,000 tests a week was always in relation to the level of capacity that should be available on a continuous basis in case it is needed and was never intended as an activity target that should be met on a regular basis. While we are in a positive position of not needing this full capacity at present, it is critical that we have it available to us when it is needed. The testing and contact tracing operational and resource model has been designed to flex up and down as needed to match an increase in demand, it has been stressed tested at higher activity levels and is capable of responding quickly to changes in demand.
COVID-19 testing demand is influenced by a range of factors including prevalence of the virus, the case definition and overall testing strategy, and testing activity levels will fluctuate as these factors change as we have already seen over the last four months.
While prevalence is low at present, Ireland is currently pursuing a very robust testing strategy under the guidance of NPHET. The case definition is very broad, with a low threshold for referral in place in line with the ECDC guidance. There are also a number of targeted testing programmes in place which are aimed at potential asymptomatic carriers and populations/settings that are most vulnerable to the virus. This includes testing of all close contacts, weekly testing of nursing home staff and pre-testing of incoming hospital patients.
Close contacts are now being tested twice and contacted on a daily basis to monitor symptom development. Very few countries are proactively testing asymptomatic contacts in this manner. The vast majority of close contacts tested so far were asymptomatic. Data for 19 May - 12 July shows that of contacts with first test results confirmed, the overall positivity rate was 8%. Within that group, the positivity rate for symptomatic contacts was 16%, whilst it was 6% for asymptomatic contacts.
All staff in nursing homes are being tested weekly over the course of 4 weeks, at which point the programme will be reviewed. This programme is in recognition of the vulnerability of nursing homes to this virus and builds on the mass testing programme carried out in April/May.
Finally, 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, both inpatient and daycase.
NPHET will continue to consider how best to target testing capacity. Our testing strategy will continue to evolve and will be based on emerging evidence, public health risk assessments and will continue to be directed by Public Health advice.
230. Deputy Richard Bruton asked the Minister for Health if his attention has been drawn to the fact that private hospitals are seeking cash contributions over and above the insurance cover of patients to cover PPE costs; and if he will consider that seeking insurers and hospitals ensure that these costs are included in cover in order that patients are not prevented from receiving the needed treatments by unexpected cost barriers. [17594/20]
Amharc ar fhreagraAs Minister for Health, I do not have responsibility for private hospitals, including in relation to charges that they apply to patients. Neither do I have a role, in the commercial decisions taken by any health insurer regarding the treatments or services provided in their products, as long as insurers comply with minimum benefits and other regulations, health insurance providers are free to impose certain terms and conditions on their policies.
I am not in a position to comment on what the actual cost may be in private hospitals. It is paramount that healthcare settings implement effective Infection prevention and control measures in line with HPSC guidance to ensure the safety of staff and patients. Cost relating to Covid-19 should not be a barrier to accessing healthcare. 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.
231. Deputy James O'Connor asked the Minister for Health when services such as a service (details supplied) and early intervention services in County Cork will reopen; and if he will make a statement on the matter. [17596/20]
Amharc ar fhreagraThe recently published Programme for Government document "Our Shared Future" recognises the need to improve services for both children and adults with disabilities through better implementation and by working together across Government in a better way.
The Government commits to Prioritising early diagnosis and access to services for children and ensuring that the most effective interventions are provided for each child, to guarantee the best outcomes.
As the Deputy's question relates to a service issue, it has been referred to the HSE for direct reply.
232. Deputy Neale Richmond asked the Minister for Health the number of persons who have downloaded the Covid-19 tracker application; the average number of check-ins per day; and if he will make a statement on the matter. [17605/20]
Amharc ar fhreagraAs this question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
233. Deputy Neale Richmond asked the Minister for Health the number of persons who have downloaded the Covid-19 tracker application in each county; and if he will make a statement on the matter. [17606/20]
Amharc ar fhreagraAs this question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
234. Deputy Seán Haughey asked the Minister for Health if he will intervene with the private hospitals to prevent them from charging for temperature tests and PPE gear for inpatient and outpatient attendances; if private health insurance providers can be requested to cover these levies; and if he will make a statement on the matter. [17620/20]
Amharc ar fhreagraAs the Deputy will be aware, I do not have responsibility for private hospitals, including in relation to charges that they apply. Neither do I have a role, as Minister for Health, in the commercial decisions taken by any health insurer regarding the treatments or services provided in their products, provided that the regulatory obligations set out in Minimum Benefit regulations and other health insurance legislation are complied with.
I am not in a position to comment on what the actual cost may be in private hospitals. It is paramount that healthcare settings implement effective infection prevention and control measures in line with HPSC guidance to ensure the safety of staff and patients. Cost relating to Covid-19 should not be a barrier to accessing healthcare. 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.
235. Deputy Michael Creed asked the Minister for Health his plans to publicly communicate the contents of a report (details supplied); if so, the timeline for communicating same; and if he will make a statement on the matter. [17673/20]
Amharc ar fhreagra236. Deputy Michael Creed asked the Minister for Health if his Department will offer the opportunity for stakeholder consultation regarding the public communication of the contents of a report (details supplied); his views on whether stakeholder consultation is best practice prior to communicating policy; and if he will make a statement on the matter. [17674/20]
Amharc ar fhreagraI propose to take Questions Nos. 235 and 236 together.
The Food Safety Authority of Ireland (FSAI) published a report on 22 June 2020 entitled “Scientific Recommendations for Food-Based Dietary Guidelines for 1 to 5 Year-Olds in Ireland”. The report, which was commissioned by the Department of Health, arises from the work of the Scientific Committee of the FSAI and is based on the latest Irish research on the dietary habits of this age group and reflects international best practice on young child feeding in an Irish context. It is the first Irish scientific report to address the nutritional needs of toddlers and pre-school children.
The Scientific Recommendations for this age group were prioritised by the Department of Health to provide the evidence base for the Department’s next stage of the 'Healthy Food for Life' programme, which will include Healthy Eating Guidelines for 1 to 5 year olds, a Children’s Food Pyramid and a suite of resources including daily meal plans for 1, 2 3 and 4 year-olds.
These resources are currently being finalised by the Department of Health having been developed with the help of the technical working group of the Healthy Eating Subgroup of the Obesity Policy Implementation Oversight Group. These Healthy Eating Guidelines are expected to be launched later this year and an implementation plan for dissemination and training is currently being developed with key partners on the Healthy Eating Subgroup. These include the Department of Children and Youth Affairs, HSE, safefood and the Irish Nutrition and Dietetic Institute. Key messages on healthy eating in the recommendations of the FSAI’s scientific report will be communicated, in particular to the parents and carers of children in the relevant age group.
237. Deputy Michael Creed asked the Minister for Health when scoliosis surgery will resume in Our Lady’s Children’s Hospital, Crumlin; and if he will make a statement on the matter. [17675/20]
Amharc ar fhreagraIn response to the Covid-19 pandemic the HSE had to take measures to pause most 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 World Health Organization guidelines, 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. 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.
Children’s Health Ireland (CHI) has advised my Department that while much of the scoliosis activity was deferred in line with the National Action Plan on COVID-19, scoliosis surgeries have recommenced as part of the overall recovery of scheduled care activity across the hospital group, including CHI at Crumlin. CHI is exploring options to increase surgical capacity, including the use of Cappagh Hospital for clinically suitable scoliosis patients.
CHI has also advised 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.
238. Deputy Richard O'Donoghue asked the Minister for Health the position regarding funding for neurology services at University Hospital Limerick [17694/20]
Amharc ar fhreagraAs this is a service issue, I have asked the Health Service Executive to reply to you directly.
239. Deputy Róisín Shortall asked the Minister for Health if his Department oversees responsibility for reporting on the cost of the testing and tracing strategy; if so, the amount spent to date on tracing; the planned budget into the future; if not, the reason the matter does not fall under the remit of his Department; and if he will make a statement on the matter. [16875/20]
Amharc ar fhreagraResponsibility for overseeing reporting on costing of COVID-19 testing and contact tracing is the responsibility of the Minister for Health in the first instance. However, costs are overseen through the Health Budget Oversight Group, comprising representatives of the Department of Public Expenditure & Reform, the Department of Health and the HSE.
Government has to date sanctioned funding of €206 million in 2020 for testing and contact tracing. Estimated expenditure to 03/07/20 totals €46.9m, including €2.8 million on tracing.
The HSE has estimated maximum potential costs for testing and contact tracing for the full year of €414 million. This is the amount that would be required for expenditure should the entire capacity of 100,000 tests be utilised on a sustained basis throughout the year. The average weekly testing levels currently are at much lower levels.
Actual activity levels and associated expenditure associated with the implementation of COVID-19 testing and contact tracing will be monitored, tracked and reported by the Health Service Executive and overseen through the Health Budget Oversight Group.
The HSE will be submitting a strategic plan in August for the longer term requirement for testing and tracing and the costs for the remainder of the year will be further reviewed at that stage. Any additional funding requirement over what has already been sanctioned will be subject to further Government approval.
