Written Answers Nos. 1010-1029
1010. Deputy David Cullinane asked the Minister for Health the estimated cost of recruiting and retaining one psychologist; the number needed to adequately staff health services and to identify the areas of need; and if he will make a statement on the matter. [21137/20]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1011. Deputy David Cullinane asked the Minister for Health the estimated cost of providing full medical cards to all persons with disabilities regardless of employed status or income; and if he will make a statement on the matter. [21138/20]
Amharc ar fhreagra1127. Deputy David Cullinane asked the Minister for Health the estimated cost of providing a medical card to all persons with disabilities regardless of employment or income; and if he will make a statement on the matter. [21416/20]
Amharc ar fhreagraI propose to take Questions Nos. 1011 and 1127 together.
Eligibility for a medical card remains primarily on the basis of financial assessment. The HSE's Expert Group on Medical Needs and Medical Card Eligibility examined the issue of awarding medical cards on the basis of illness or a disability and concluded that it was not feasible, desirable nor ethically justifiable to list medical conditions in priority order for medical card eligibility. The Expert Group also concluded that a persons means should remain the main qualifier for a medical card. This remains unchanged.
In relation to the cost of providing a permanent medical card to people with disabilities regardless of their work status, the data required to model this is not readily available and it is therefore not possible to provide an estimate of the cost of the proposal.
However, it should be noted that since 1st December 2018, the medical card earnings disregard for persons in receipt of Disability Allowance was increased from €120 to €427 per week and applies to the assessment process for both single persons and to family assessments. This measure gave effect to one of the key recommendations of the Make Work Pay for Persons with Disabilities Report and enables persons in receipt of the disability allowance to have a higher level of earnings and still retain their medical card.
1012. Deputy David Cullinane asked the Minister for Health the estimated cost of fully delivering on Time to Move on from Congregated Settings; and if he will make a statement on the matter. [21139/20]
Amharc ar fhreagraThe Report “Time to Move on from Congregated Settings – A Strategy for Community Inclusion” proposes a new model of support in the community moving people from Congregated settings to the community in line with Government policy. The Report identified around 4000 people (based on 2008 census) with disabilities in Ireland living in congregated settings, defined as a residential setting where people live with ten or more people.
This Government is committed to moving people with disabilities out of congregated settings, to enable them to live independently and to be included in the community. The objective is to reduce this figure by one-third by 2021 and ultimately, to eliminate all congregated settings.
Time to Move On from Congregated Settings is progressing and continues to demonstrate very positive results for service users who have transitioned to living in homes in community settings. Overall, the population in congregated settings at the year end will be 50% lower than those identified in the original report with less than 2,000 people remaining in congregated settings.
I want to emphasise that the appropriate supports and resources are being put in place to ensure that people are supported as they move out of residential centres. The model of care for individuals will be based on a person centred plan (PCP). The PCP may change over time in line with an individual’s needs and circumstances and the model of service delivery applicable at a particular time.
Any opportunity for residents to live in smaller settings in the community will come after considerable planning and discussion with those residents and their families. It will be on the basis that it will enhance their life, and anyone who moves will continue to access the services they require.
The HSE has prioritised the transition of a further 132 people from congregated settings in 2020 under its Service Plan.
As the HSE is responsible for leading out on the recommendations of "Time to Move on from Congregated Settings - A Strategy for Community Inclusion", I have asked the HSE to reply directly to the Deputy in relation to the question posed.
1013. Deputy Mark Ward asked the Minister for Health if his attention has been drawn to reports in the delay of the HSE homebirth services since March 2020; and if he will make a statement on the matter. [21143/20]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1014. Deputy Fergus O'Dowd asked the Minister for Health if the issues raised in correspondence from a person (details supplied) regarding the fair deal care for older persons living in the community or in sheltered housing will be addressed; and if he will make a statement on the matter. [21144/20]
Amharc ar fhreagraThe Nursing Homes Support Scheme (NHSS), commonly referred to as Fair Deal, is a system of financial support for people who require long term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term residential care is accessible and affordable for everyone and that people are cared for in the most appropriate settings. As the NHSS is governed by primary legislation, changes to the legislation would be required to action any amendments in relation to the scope of the support provided under the Scheme.
To enable people to continue to live at home for as long as possible, the Department is progressing the establishment of a new stand-alone statutory scheme for the financing and regulation of home support services. The new scheme will be designed to integrate effectively with the Nursing Home Support Scheme and other health supports, including nursing, therapies and other primary care services, and will support equitable access to services based on an assessment of need. It will also provide transparency about service allocation while ensuring that the scheme operates consistently and fairly across the country.
The new scheme will build on the HSE’s continual enhancement of existing service provision and on emerging good practice across the current system of health and social care delivery. Alongside the establishment of a scheme, a system of regulation will also be developed to ensure that all recipients of home support are provided with a standard, high-quality level of care.
Work is ongoing within the Department of Health to determine the optimal approach to the design of the statutory scheme and system of regulation within the broader context of the reform of Ireland’s healthcare system, as envisaged by Sláintecare. This work is being informed by stakeholder engagement, which will continue throughout the development of the scheme.
1015. Deputy Catherine Connolly asked the Minister for Health the projections for demand for winter 2020/2021; the plans being put in place to meet the demand; and if he will make a statement on the matter. [21173/20]
Amharc ar fhreagraAs a result of the significant impact of Covid-19 on routine health services, the health system is facing unprecedented challenges for the delivery of services. Resuming health and social care services and building health sector capacity and capability is a priority for the Government.
The HSE has developed a draft Plan which contains proposals for health service delivery for Winter 2020 to the end of 2021 and this is currently under review by my Department and the HSE.
The draft Plan has been formulated in the context of increasing demand for unscheduled care, the need to support continuity and resumption of elective services for non-Covid-19 healthcare, and the requirement to continue delivering essential healthcare in a Covid-19 context. The Plan comprises targeted initiatives to address population health needs which combine the need to shift care to home and ambulatory care environments, especially for high-risk cohorts such as elderly patients and those with chronic illnesses.
The Plan indicates the need for zero tolerance for overcrowding in care settings and acknowledges that this will require additional capacity in both acute and community care services. The various initiatives proposed in the Plan will aim to decrease acute hospital demand by enhancing community capacity, reduce unnecessary acute hospital admissions by enhancing alternative community care pathways, enable timely discharges from acute hospitals, and consequently reduce waiting times in hospital emergency departments.
The HSE is undertaking work to model and project expected demand for Winter 2020 and 2021 as part of this planning process, and these projections are expected to be included in the final Plan.
1016. Deputy Catherine Connolly asked the Minister for Health the likely additional demand for mental health services resulting from Covid-19 and the resultant lockdown; and if he will make a statement on the matter. [21174/20]
Amharc ar fhreagraProvision of mental health services during Covid-19, a planning Group (HSE, Department of Health, NGO sector) has been established to plan for additional current and/or anticipated needs as the crisis extends in duration. There are existing HSE guidelines, published in 2014, on ‘Psychosocial and Mental Health Needs following Major Emergencies’. These guidelines recognise that prior to, during and following national emergencies there would be a need to support certain members of the population with their emotional, cognitive, social and physical needs.
The HSE is continuing to provide all community services, in so far as possible, while following Covid-19 guidelines to ensure the protection of patients and staff. At present, there is a range of existing services which offer online text and telephone supports to people seeking mental health information and advice. These include Samaritans, Pieta House, MyMind, Turn2Me; Aware, Crisis Text Ireland, Shine, BeLongTo, LGBT Ireland, Jigsaw, Bodywhys and Childline. The YourMentalHealth.ie website provides a ‘one-stop-shop’ portal for people seeking information, supports and services, including information on accessing urgent help and a mental health text messaging support service is available 24 hours a day, 7 days each week to connect people with trained volunteers. NGOs currently funded by the HSE are being supported and encouraged to develop updated responses to the Covid-19 outbreak. Details of these services are listed on the HSE website, www.yourmentalhealth.ie , and information on available services is also provided through the free mental health telephone information line, 1800 111888.
In order to respond to the anticipated additional needs of the population during this crisis, additional online services are being delivered to support the population, including online counselling, expanded crisis textline support and online life skills training, building on existing pilot schemes and developments in digital mental health in recent years.
1017. Deputy Catherine Connolly asked the Minister for Health the number of persons on the waiting list for home care packages; and if he will make a statement on the matter. [21175/20]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1018. Deputy Catherine Connolly asked the Minister for Health when the planned report on implementing automatic renewal of medical cards for the terminally ill will be published; the estimated cost of same; and if he will make a statement on the matter. [21176/20]
Amharc ar fhreagra1090. Deputy David Cullinane asked the Minister for Health when the clinical advisory group into medical cards for the terminally ill will issue a final report; the number of times the group has met; his views on extending the medical card entitlement to terminally ill patients; and if he will make a statement on the matter. [21353/20]
Amharc ar fhreagra1091. Deputy David Cullinane asked the Minister for Health the estimated cost of extending a full medical card to all terminally ill patients; and if he will make a statement on the matter. [21354/20]
Amharc ar fhreagra1199. Deputy David Cullinane asked the Minister for Health the status of medical cards for persons with a terminal illness; the estimated cost of providing medical cards for persons with a terminal illness; and if he will make a statement on the matter. [21566/20]
Amharc ar fhreagraI propose to take Questions Nos. 1018, 1090, 1091 and 1199 together.
The data required to model the cost of the provision of medical cards to all patients suffering from a terminal illness is not readily available. The cost would be dependent on a number of factors including,the number of additional applications made to the HSE, the timescale within which these are made and the number of applicants who are deemed eligible.
However, it should be noted that the HSE has a system in place for the provision of medical cards for persons who are terminally ill and are receiving end of life treatment i.e. persons with a prognosis of less than 12 months. These medical cards are issued within 24 hours of receipt of the required medical report and a completed application form from a healthcare professional. Once these cards are awarded they are not reassessed by the HSE.
1019. Deputy Catherine Connolly asked the Minister for Health when the report on the difference in funding between private and public nursing homes due to be published in 2019 will be published; and if he will make a statement on the matter. [21177/20]
Amharc ar fhreagraA Value for Money (VFM) Review on Nursing Home Care Costs is being undertaken by my Department. The purpose of the VFM Review is to identify, quantify and analyse the reasons for any cost differential between public and private nursing homes and, following analysis, to make recommendations for improving the value for money obtained by the Health sector.
It was anticipated that this Review would be completed by end December 2019. However, due to a lack of comparable private sector data, the Chair decided to pause the Review until data collection issues could be overcome. Following a meeting between the Chair, members of the Review Team and Nursing Homes Ireland in March 2020, it was agreed that Nursing Homes Ireland would supply data to address the gaps in the Review. In the days following this meeting, the Department had to pause all non-essential work, including the VFM Review, in order to focus resources on the response to the COVID-19 pandemic.
In recent weeks work on the Review has restarted. The final draft of the Review is expected to be presented to the Irish Government Economic and Evaluation Service (IGEES) shortly for a robust assessment of data and methodology. Following the IGEES assessment the Final Report will be presented to the Steering Committee for agreement. Once the Steering Committee signs off on the Review, the Report will be laid before the Oireachtas in line with the procedures set out in the Public Spending Code.
1020. Deputy Catherine Connolly asked the Minister for Health the estimated cost to of extending the remit of the Public Services Ombudsman to cover all nursing homes; and if he will make a statement on the matter. [21178/20]
Amharc ar fhreagraPolicy in relation to the assignment of functions under the Ombudsman Act 1980 is a matter for the Department of Public Expenditure and Reform, in consultation with other relevant Departments as appropriate.
This Department has made enquiries with the Department of Public Expenditure and Reform, which advises that the Ombudsman can currently examine complaints about the HSE and agencies delivering health and personal social services on behalf of the HSE and that, since August 2015, the Ombudsman’s remit was extended to enable him to deal with complaints relating to the administrative actions of private nursing homes.
The Department of Public Expenditure and Reform has further informed this Department that it is advised by the Office of the Ombudsman that a very small number of private nursing homes may be outside of the Ombudsman’s remit as they have no Fair Deal residents in their care and that there would be no cost implications should those nursing homes happen to come within the Ombudsman’s remit in the future.
1021. Deputy Danny Healy-Rae asked the Minister for Health if the 'flu vaccine will be made available to all schoolgoing children free of charge; if so, if it will be made available before they return to school; and if he will make a statement on the matter. [21188/20]
Amharc ar fhreagraTo mitigate as much as possible the pressure on the health services that would result from a coincidence of the winter flu season and a resurgence of COVID-19, there will be an expanded provision of seasonal influenza vaccine this year. All of those in the at-risk groups aged from 6 months up, including healthcare workers, will be able to access the vaccination without charges. All children aged from 2 to 12 years inclusive will also have access to vaccination without charges.
The Quadrivalent Influenza Vaccine (QIV) will be made available to all persons in an at-risk group from 6 months up, while the Live Attenuated Influenza Vaccine (LAIV), which is delivered via nasal drops rather than by injection, will be made available to all children aged from 2 to 12 years old inclusive.
As a result of a delay in delivery of the Quadrivalent vaccine from the manufacturer, the start date for vaccinations of those in the at-risk groups is likely to be late September or early October, the same as in previous years.
Delivery of the nasal vaccine used to be used for children is not affected, and that is expected to be available in mid-October.
1022. Deputy Michael Healy-Rae 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. [21190/20]
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 Organisation guidelines, and the National Action Plan.
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. Further detail regarding the phases of service resumption are contained in the HSE’s ‘A Safe Return to Health Services’ document, published on their website on 22 July.
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 is a standardised approach used by the HSE to manage scheduled care treatment for in-patient, day case and planned procedures. It sets out the processes that hospitals are to implement to manage waiting lists and was developed in 2014 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.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1023. Deputy Barry Cowen asked the Minister for Health the status of the case of a person (details supplied); and when the person can expect an admission date to the National Rehabilitation Hospital, Dún Laoghaire, County Dublin. [21197/20]
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 the supports required to meet their needs and plan their lives.As the Deputy's question relates to an individual case, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
1024. Deputy Rose Conway-Walsh asked the Minister for Health the status of the private ambulance tender for the HSE framework; if there will be a new tendering process to allow private ambulances service providers currently outside of the HSE framework to apply; if so, when the tendering process will take place; and if he will make a statement on the matter. [21201/20]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1025. Deputy Thomas Pringle asked the Minister for Health the reason the HSE continues to refuse to pay Dublin City Council for the provision of the ambulance service in Swords, County Dublin, which stands at €12 million; and if he will make a statement on the matter. [21207/20]
Amharc ar fhreagraDublin Fire Brigade (DFB) provides emergency ambulance services in Dublin city and county by arrangement between Dublin City Council and the Health Service Executive (HSE). As the funding arrangement is an operational matter, I have asked the HSE to reply to you directly.
1026. Deputy Éamon Ó Cuív asked the Minister for Health when a person (details supplied) will be issued with an appointment for an assessment with the ASD services in counties Galway and Roscommon; the reason for the delay in issuing an appointment in view of the fact that they have been on the waiting list for a significant period of time and were due to be seen in July or August 2020; his plans to reduce the waiting times experienced by children and families waiting for ASD assessments; and if he will make a statement on the matter. [21209/20]
Amharc ar fhreagraThe Programme for Government, 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 this is a service matter, I have asked the Health Service Executive to respond to the deputy directly.
1027. Deputy David Cullinane asked the Minister for Health the extent of a facility for a patient on a public waiting list transferred to a private clinic to receive surgery recuperation, for example, three to four physiotherapies that they will receive; and if he will make a statement on the matter. [21230/20]
Amharc ar fhreagraMy Department contacted the Deputy to seek clarity in relation to the question submitted.
An agreement was reached with the Deputy that the question will be re-submitted at a later date when the Department will be happy to respond to the Deputy’s query.
1028. Deputy Pádraig O'Sullivan asked the Minister for Health if the decision to close Cara House on Redemption Road, Cork city, will be reviewed in view that there are significant shortages of respite care; and if he will make a statement on the matter. [21238/20]
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 the 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 (HSE) for direct reply to the Deputy.
1029. Deputy David Cullinane asked the Minister for Health the situation regarding pay for student nurses on work placement; the variations across placements or specialties; his plans in this regard; his further plans relating to pay for fourth year supernumerary placements for the variety of nursing specialties commencing in September 2020; the measures that will be in place to financially support nurses; and if he will make a statement on the matter. [21239/20]
Amharc ar fhreagraAll 4th year student nurses who are on rostered work placements are paid at the approved rate as detailed on the HSE payscale of €21,794 (annualised - psychiatric nursing specialism) and €21, 322 (annualised - all other nursing specialisms). I can confirm that these existing arrangements and paid rostered placements will be maintained for those entering 4th year in September 2020.
In addition to the above, the Department has provided supports to student nurses earlier this year to protect their education while clinical placements were affected by the COVID-19 pandemic. Clinical placements are expected to re-commence in September.
Work has also been undertaken to provide specific Infection and Prevention Control (IPC) guidance for the facilitation of clinical placements and movement between clinical areas. This also supports the students to work part time and move between organisations safely. The recent IPC guidance issued on 17 August 2020 to the Higher Institutes of Education (HEIs) and HSE service areas supports safe movement of students between clinical areas for placements. It also supports them working part-time in other areas and sectors (including, for example, in nursing homes).
Finally, there is a travel/accommodation allowance which amounts to €50.79 a week to support those students to access the clinical placements they require.
