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Thursday, 10 Sep 2020

Written Answers Nos. 219-238

General Practitioner Services

Ceisteanna (219)

Alan Kelly

Ceist:

219. Deputy Alan Kelly asked the Minister for Health his plans to introduce free general practitioner care for children under eight as announced in Budget 2020 (details supplied); and if he will make a statement on the matter. [23105/20]

Amharc ar fhreagra

Freagraí scríofa

The Government is committed to increasing access to GP care without charges for children, an important healthcare measure that will remove a potentially prohibitive cost barrier to accessing GP care and will help to improve children’s health as they develop.

The Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 was signed into law in August. This Act provides, amongst other things, for the phased expansion of GP care without fees to all children aged 12 years and under. The initial stage of this phased expansion will be the provision of GP care without fees to all children aged between 6 and 8.

The appropriate date for commencing the expansion remains under consideration in light of COVID-19 and the additional pressures the expansion might place on general practice in that context and in anticipation of the usual increase in demand for healthcare services over the winter period. This date will be determined in consultation with the IMO. It is important to ensure that any additional pressures placed on general practice will not limit its capacity to meet the needs of all patients in the community.

Traveller Community

Ceisteanna (220)

Mary Lou McDonald

Ceist:

220. Deputy Mary Lou McDonald asked the Minister for Health the new resources being provided to ensure that Traveller primary healthcare projects return to work safely business plans can be implemented [23106/20]

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.

Respite Care Services

Ceisteanna (221)

Niall Collins

Ceist:

221. Deputy Niall Collins asked the Minister for Health when respite care will resume at a unit for a child (details supplied); when the child will be able to attend; and if he will make a statement on the matter. [23111/20]

Amharc ar fhreagra

Freagraí scríofa

The 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.

Respite Care Services

Ceisteanna (222)

Jackie Cahill

Ceist:

222. Deputy Jackie Cahill asked the Minister for Health when the adult day service in Stafford Street, Nenagh, County Tipperary (details supplied) will reopen and return to its normal schedule. [23112/20]

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 8th 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 began to gradually resume during the month of August and will continue to do so throughout early September. Service providers are 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 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, and the latest update, a video message from the Head of Strategy and Planning HSE Disability Services, is available at the above link.

An information portal that contains the dates on which the 966 disability day service locations will reopen around the country is now available. Service users and families can access this information on www.hse.ie/newdirections

It has been recognised that additional costs may arise for service providers in providing safe services. To date, Government has approved COVID 19 Pandemic Health service funding of €2bn. The aim of this funding is to support investment necessary to address COVID 19, to mitigate risk of the spread of COVID 19 and to facilitate the provision of health and social care services against the backdrop of COVID 19. The HSE is in the process of reviewing and validating business cases from disability services providers for additional funding to support the reopening of services.

As the Deputy's question also pertains to a service matter, I have asked the Health Service Executive to reply to the Deputy directly, as soon as possible.

Mobility Allowance

Ceisteanna (223)

Cathal Crowe

Ceist:

223. Deputy Cathal Crowe asked the Minister for Health the status of the review being undertaken of the mobility allowance; when details of a new scheme will be announced; and if he will make a statement on the matter. [23114/20]

Amharc ar fhreagra

Freagraí scríofa

At the whole of Government level, the National Disability Inclusion Strategy 2017-2021 sets the overall framework for the equal participation of people with disabilities in society. Monitoring of the implementation of the Strategy is being overseen by the National Disability Inclusion Strategy Steering Group which comprises key Government Departments, the National Disability Authority and the Disability Stakeholders Group.

Under the Strategy , the Department of Transport, Tourism and Sport has responsibility for the continued development of accessibility and availability of accessible public transport and is committed to the continued development of accessible public transport in recognition of the importance of such services to the lives of people with disabilities.

Recent developments which will impact on policy options regarding the provision of transport supports for people with a disability include the following:

- The ongoing progress by the Department of Transport, Tourism and Sport in providing accessible public transport nationally and that Department's public consultation launched on 14 November last, to review active travel and public transport policy, including accessible public transport;

- The Cost of Disability Study currently underway which was commissioned by the Department of Employment Affairs and Social Protection as part of Budget 2019. The research, when complete, will inform policy direction in relation to the provision of adequate supports to meet the needs of people with disabilities, including transport costs; and

- The Working Group established under Action 104 of the National Disability Inclusion Strategy by the Department of Justice and Equality which states that:- 'We will lead a review of transport supports encompassing all Government funded transport and mobility schemes for people with disabilities, to enhance the options for transport to work or employment supports for people with disabilities and will develop proposals for development of a coordinated plan for such provision. This plan will have regard to making the most efficient use of available transport resources.”

Other transport supports available to persons with disabilities in the State include the Disabled Drivers and Disabled Passengers scheme, operated by the Revenue Commissioners; the Free Travel Scheme operated by the Department of Employment Affairs and Social Protection; and CLÁR funding, approved by the then Minister for Rural and Community Development, to voluntary organisations providing transport for people with significant mobility issues.

By way of background, two schemes, the Mobility Allowance and Motorised Transport Grant, were put in place in 1979 and 1968 respectively, for operation by the Health Service Executive (HSE) at a time when there was limited availability of accessible public transport. The Government decided to close these administrative schemes in 2013, on foot of the reports of the Ombudsman in 2011 and 2012 regarding the legal status of both Schemes in the context of the Equal Status Acts. The recommendations of the 2013 Project Group which was established to review how to meet the transport needs of people with disabilities, informed the considerations of the 2013 Inter-Departmental Group chaired by the Department of An Taoiseach.

In 2013, the Government also decided to continue payment of the monthly Mobility Allowance on an interim basis, to those who were in receipt of the Mobility Allowance at the time that the Scheme closed. Of the 4,700 individuals in receipt of the Mobility Allowance (€9 million per annum) when the Scheme closed in 2013, there were 3,831 people in receipt of the interim payments at July 2019.

Hospital Services

Ceisteanna (224)

Alan Kelly

Ceist:

224. Deputy Alan Kelly asked the Minister for Health the plans the HSE has submitted to him to increase ICU capacity; and the number of ICU beds he expects to be available in acute care by the end of 202. [23122/20]

Amharc ar fhreagra

Freagraí scríofa

The Health Service Capacity Review 2018 recommended that Ireland’s critical care capacity be increased to 430 beds by 2031. In early 2020, baseline permanent adult critical care capacity in Ireland was reported by the National Office of Clinical Audit (NOCA) to be 255 beds. Funding for a further 40 adult critical care beds, and two paediatric critical care beds, was provided as part of the response to Covid-19 in March 2020. Surge ICU capacity supports the provision of critical care as required. Daily situational reports published by the HSE during recent months have reported potential critical care beds including surge as in the region of 430, with the number open on any given day subject to fluctuation in respect of available staff.

My Department and the HSE have been engaging in regard to critical care capacity requirements in the public hospital system and consideration is ongoing.

Health Services

Ceisteanna (225)

Holly Cairns

Ceist:

225. Deputy Holly Cairns asked the Minister for Health the number of DNRs signed in the healthcare system by month between 1 January 2015 and 1 July 2020, in tabular form. [23156/20]

Amharc ar fhreagra

Freagraí scríofa

I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Covid-19 Pandemic

Ceisteanna (226)

Holly Cairns

Ceist:

226. Deputy Holly Cairns asked the Minister for Health the estimated impact of the redeployment of HSE therapists to work as Covid-19 testers and contact tracers on waiting lists and the opening of clinics. [23157/20]

Amharc ar fhreagra

Freagraí scríofa

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

Disability Services Provision

Ceisteanna (227)

Holly Cairns

Ceist:

227. Deputy Holly Cairns asked the Minister for Health when the full range of disability services will be resumed. [23158/20]

Amharc ar fhreagra

Freagraí scríofa

The 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.

Health Information and Quality Authority

Ceisteanna (228)

Holly Cairns

Ceist:

228. Deputy Holly Cairns asked the Minister for Health his views on the annual overview report by HIQA on the inspection and regulation of disability services in 2019; and if he will make a statement on the matter. [23159/20]

Amharc ar fhreagra

Freagraí scríofa

I welcome the publication of HIQA's Annual Overview Report on the Inspection and Regulation of Disability Services in 2019. The report illustrates the significant progress made by providers since HIQA commenced independent regulation of designated residential centres for adults and children with disabilities in Ireland in 2013. It also demonstrates that HIQA, as the independent regulatory authority charged with ensuring high quality and safe care for people using our health and social care services, has had a recognised positive impact on the lives of people with a disability who avail of our residential services. In 2018, all disability residential services were approved as designated centres, meaning that each of these centres has met the required standards for registration.

It is heartening to note that most residents told HIQA inspectors that they were happy in their homes, but we know that there is more to do to ensure that people with a disability can live 'ordinary lives in ordinary places' in line with the Transforming Lives disability reform programme. To this end, the Government is committed to continuing with the successful de-congregation programme and completing a further move of more people with disabilities from congregated settings to homes in the community, with the necessary supports, as outlined in the Programme for Government.

Disability Services Provision

Ceisteanna (229)

Seán Sherlock

Ceist:

229. Deputy Sean Sherlock asked the Minister for Health when a person (details supplied) will resume residency. [23174/20]

Amharc ar fhreagra

Freagraí scríofa

The 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.

Hospital Services

Ceisteanna (230)

Michael Healy-Rae

Ceist:

230. Deputy Michael Healy-Rae asked the Minister for Health if he will address the issue of a lack of sonographer services in University Hospital Kerry (details supplied); and if he will make a statement on the matter. [23183/20]

Amharc ar fhreagra

Freagraí scríofa

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

Vaccination Programme

Ceisteanna (231)

Denis Naughten

Ceist:

231. Deputy Denis Naughten asked the Minister for Health the status of plans to introduce a no-fault vaccination compensation scheme for severe adverse reactions to State-promoted vaccination programmes; and if he will make a statement on the matter. [23185/20]

Amharc ar fhreagra

Freagraí scríofa

In June 2018, the Government agreed to the establishment of an Expert Group to review the law of torts and the current systems for the management of clinical negligence claims chaired by High Court Justice Charles Meenan.

The Expert Group examined the system from the perspective of the person who has made the claim to explore if there is a better way to deal effectively yet more sensitively with certain cases. In this process the Group also looked at the impact of tort legislation on the overall patient safety culture and open disclosure. Judge Meenan submitted the final report of the Expert Group on the Reform of the Law of Torts and the Current System for Managing Clinical Negligence Claims on 17 January 2020. One of the report’s recommendations is that a compensation scheme be established to deal with certain vaccine damage claims.

On foot of a request from my Department, the Health Research Board carried out an evidence review on vaccine injury redress programmes in other jurisdictions and this was completed in March 2019.

The Expert Group’s report, in addition to the HRB's evidence review, and consultation with other Government Departments and relevant State agencies will inform the development of a proposal regarding the establishment of any compensation scheme.

Hospital Waiting Lists

Ceisteanna (232)

Denis Naughten

Ceist:

232. Deputy Denis Naughten asked the Minister for Health the waiting times for cataract surgery in each hospital in which such surgery takes place; and if he will make a statement on the matter. [23190/20]

Amharc ar fhreagra

Freagraí scríofa

Reducing waiting time for patients for hospital operations and procedures is a key priority for Government. In recent years, my Department has worked with the HSE and the National Treatment Purchase Fund (NTPF) and made considerable improvements to access for patients waiting for high volume procedures including cataracts. At the end of July 2017, the number of people waiting for a cataract procedure was 10,024. As of the end of July 2020, there were 5,525 patients waiting for a cataract procedure. Of these, 1,107 are waiting over 9 months which represents a reduction of 74% when compared to July 2017, when there were 4,249 waiting over 9 months.

A key development in improving access to Ophthalmology services was the opening of a stand-alone high-volume consultant-led cataract theatre by the University of Limerick Hospital Group in Nenagh Hospital in 2018, with the intention that it would facilitate patients from surrounding geographical areas to avail of their treatment there.

In 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.

NPHET has since revised its recommendation on the pausing of all non-urgent health services, with a recommendation that the delivery of acute care be determined by appropriate clinical and operational decision making. Application of the essential risk mitigating steps set out in the guidance developed under the auspices of the NPHET Expert Advisory group will have operational implications, which will impact on throughput.

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.

As the system continues to deliver Covid-19 and non-Covid 19 care side-by-side over a more prolonged period, my Department and the HSE will continue to work closely together to protect essential non-Covid 19 acute care and progress the provision of more routine non Covid-19 care.

The data requested by the Deputy concerning the waiting times for cataract surgery in each hospital in which such surgery takes place, is outlined in the link provided below, provided to my Department by the NTPF.

Waiting list report

Health Services

Ceisteanna (233)

Denis Naughten

Ceist:

233. Deputy Denis Naughten asked the Minister for Health his plans to roll out the Sligo model of eye care; the reason for the delay; if alternatives to this model are being considered; and if he will make a statement on the matter. [23191/20]

Amharc ar fhreagra

Freagraí scríofa

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

Vaccination Programme

Ceisteanna (234)

David Cullinane

Ceist:

234. Deputy David Cullinane asked the Minister for Health his plans for expanding free access to the HPV vaccine; and if he will make a statement on the matter. [23193/20]

Amharc ar fhreagra

Freagraí scríofa

The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The committee's recommendations are based on the prevalence of the relevant disease in Ireland and international best practice in relation to immunisation. It makes recommendations on vaccination policy to my Department. The NIAC continues to revise recommendations to allow for the introduction of new vaccines in Ireland and to keep abreast of changes in the patterns of disease. Therefore, the immunisation schedule will continue to be amended over time.

In 2009, the NIAC recommended HPV (human papillomavirus) vaccination for all 12 to 13 year old girls to reduce their risk of developing cervical cancer when they are adults. In September 2010, the HPV vaccination programme was introduced for all girls in first year of secondary school.

The NIAC recommended that the HPV vaccine should also be given to boys. On foot of the NIAC’s recommendation, my Department asked the Health Information and Quality Authority (HIQA) to undertake a health technology assessment (HTA) to establish the clinical and cost-effectiveness of extending the current immunisation programme to include boys in the first year of secondary school.

The HIQA completed the HTA in December 2018, recommending that the HPV immunisation programme be extended to include boys. A policy decision was made to extend the HPV immunisation programme to include boys, starting in September 2019, with the introduction of a 9-valent HPV vaccine.

However, the HIQA report published in December 2018 did not recommend an HPV catch-up programme for older boys for the following reasons:

- vaccinating boys in the first year of secondary school provides the best possible protection against HPV infection;

- boys are already benefitting from the indirect herd protection provided by the girls' HPV vaccination programme which started in 2010.

The ages at which vaccines are recommended in the immunisation schedule are chosen by the NIAC in order to give each child the best possible protection against vaccine preventable diseases. As the HPV vaccine is preventative it is intended to be administered, if possible, before a person becomes sexually active, that is, before a person is first exposed to HPV infection.

Therefore, the gender-neutral HPV vaccination programme targets all girls and boys in first year of secondary school to provide maximum coverage. All vaccines administered through the School Immunisation Programme are provided free of charge.

My Department will continue to be guided by NIAC's recommendations on any emerging evidence on this issue in the future.

Motorised Transport Grant

Ceisteanna (235)

Verona Murphy

Ceist:

235. Deputy Verona Murphy asked the Minister for Health when a replacement scheme for the motorised transport grant will be approved; and if he will make a statement on the matter. [23198/20]

Amharc ar fhreagra

Freagraí scríofa

Two schemes, the Mobility Allowance and Motorised Transport Grant, were put in place in 1979 and 1968 respectively, for operation by the Health Service Executive (HSE) at a time when there was limited availability of accessible public transport. The Government decided to close these administrative schemes in 2013, on foot of the reports of the Ombudsman in 2011 and 2012 regarding the legal status of both Schemes in the context of the Equal Status Acts.

In 2013, the Government also decided to continue payment of the monthly Mobility Allowance on an interim basis, to those who were in receipt of the Mobility Allowance at the time that the Scheme closed. Of the 4,700 individuals in receipt of the Mobility Allowance (€9 million per annum) when the Scheme closed in 2013, there were 3,831 people in receipt of the interim payments at July 2019.

Other transport supports available to persons with disabilities in the State include the Disabled Drivers and Disabled Passengers scheme, operated by the Revenue Commissioners; the Free Travel Scheme operated by the Department of Employment Affairs and Social Protection; and CLÁR funding, approved by the then Minister for Rural and Community Development, to voluntary organisations providing transport for people with significant mobility issues.

At the whole of Government level, the National Disability Inclusion Strategy 2017-2021 sets the overall framework for the equal participation of people with disabilities in society. Monitoring of the implementation of the Strategy is being overseen by the National Disability Inclusion Strategy Steering Group which comprises key Government Departments, the National Disability Authority and the Disability Stakeholders Group.

Under the Strategy , the Department of Transport, Tourism and Sport has responsibility for the continued development of accessibility and availability of accessible public transport and is committed to the continued development of accessible public transport in recognition of the importance of such services to the lives of people with disabilities.

Recent developments which will impact on policy options regarding the provision of transport supports for people with a disability include the following:

- The ongoing progress by the Department of Transport, Tourism and Sport in providing accessible public transport nationally and that Department's public consultation launched on 14 November last, to review active travel and public transport policy, including accessible public transport;

- The Cost of Disability Study currently underway which was commissioned by the Department of Employment Affairs and Social Protection as part of Budget 2019. The research, when complete, will inform policy direction in relation to the provision of adequate supports to meet the needs of people with disabilities, including transport costs; and

- The Working Group established under Action 104 of the National Disability Inclusion Strategy by the Department of Justice and Equality which states that:- 'We will lead a review of transport supports encompassing all Government funded transport and mobility schemes for people with disabilities, to enhance the options for transport to work or employment supports for people with disabilities and will develop proposals for development of a coordinated plan for such provision. This plan will have regard to making the most efficient use of available transport resources.”

Air Ambulance Service

Ceisteanna (236)

Denis Naughten

Ceist:

236. Deputy Denis Naughten asked the Minister for Health if there has been an interruption to the air ambulance service based at Custume Barracks, Athlone, County Westmeath, to date in 2020; the number of missions tasked in each month to date in 2020; his plans to maintain the service during Covid-19 restrictions at Custume Barracks; and if he will make a statement on the matter. [23200/20]

Amharc ar fhreagra

Freagraí scríofa

The Emergency Aeromedical Service (EAS) based at Custume Barracks is a nationwide Helicopter Emergency Medical Service provided by the Irish Air Corps in conjunction with the National Ambulance Service (NAS) during daylight hours. The service is staffed by an Air Corps flight crew, an EMT and a NAS Advanced Paramedic.

The Air Corps was not in a position to accept EAS taskings from the National Ambulance Service for four days per month for a period of four months, from November 2019 to February 2020. During the days when the Air Corps did not accept taskings, the Irish Coast Guard provided reserve cover. Irish Community Rapid Response (ICRR), provided additional cover using a second helicopter based in Roscommon Hospital, and was tasked to 112/999 calls in the usual way, by the National Emergency Operations Centre within the National Ambulance Service. This is in line with current National Ambulance Service priorities, whereby the most appropriate and safe services are provided for patients and staff.

On the question of the number of number of EAS missions tasked to date this year, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.

Covid-19 Pandemic

Ceisteanna (237)

Sorca Clarke

Ceist:

237. Deputy Sorca Clarke asked the Minister for Health the number of persons presenting for Covid-19 testing in counties Longford and Westmeath that are not registered with a general practitioner. [23208/20]

Amharc ar fhreagra

Freagraí scríofa

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

HSE Staff

Ceisteanna (238)

Sorca Clarke

Ceist:

238. Deputy Sorca Clarke asked the Minister for Health the number of staff in the HSE employed through employment agencies; the cost of same; and if the number has changed since the outbreak of Covid-19. [23210/20]

Amharc ar fhreagra

Freagraí scríofa

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

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