Alan Kelly
Ceist:91. Deputy Alan Kelly asked the Minister for Health when disability day services will be fully reintroduced for all those who need it; and if he will make a statement on the matter. [23655/20]
Amharc ar fhreagraDisability Services Provision
Ceisteanna (91)
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.
Most day services have now resumed services, with the remainder expected to reopen this week. Service providers have been working to get day services ready to reopen safely, and in line with public health guidance. Service providers have been 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.
Covid-19 Tests
Ceisteanna (92)
Éamon Ó Cuív
Ceist:92. Deputy Éamon Ó Cuív asked the Minister for Health his plans to introduce regular testing for Covid-19 of home care workers in view of the vulnerability of the clients they are caring for through age or disability or both; and if he will make a statement on the matter. [23658/20]
Amharc ar fhreagraFreagraí scríofa
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. The HSE's overall testing approach continues to evolve in accordance with the epidemiology of COVID-19 in Ireland.
I have been informed that where healthcare workers, including home support workers, require a test, they are prioritised and there is no delay in scheduling a test appointment.
You will appreciate that testing is only one element of a comprehensive strategic response to COVID-19. Testing for COVID-19 only provides a point-in-time result. It confers no guarantee that the individual with a 'not detected' result is not incubating the infection or the level of virus is below detectable levels at the time of the test.
Targeted, risk-based testing can yield important data to inform control measures but does not constitute a control measure in and of itself. A comprehensive response to the COVID-19 pandemic must therefore include a strong focus on infection prevention and control and additional measures such as prompt identification and exclusion from work of symptomatic healthcare workers for example.
Appropriate infection prevention and control practice across the home care sector will therefore continue to be an important protection for clients and health care workers from COVID-19.
Health Services Data
Ceisteanna (93)
Gary Gannon
Ceist:93. Deputy Gary Gannon asked the Minister for Health the number of persons here diagnosed with chronic lymphocytic leukaemia. [23679/20]
Amharc ar fhreagraFreagraí scríofa
The National Cancer Registry of Ireland report that between 2014 and 2016, there were 219 cases of chronic lymphocytic leukaemia diagnosed annually and estimate that between 2017 – 2019, there were 240 cases per year.
Question No. 94 answered with Question No. 76.
Hospital Services
Ceisteanna (95)
Gino Kenny
Ceist:95. Deputy Gino Kenny asked the Minister for Health his plans to increase capacity in hospitals permanently; his further plans to increase the current 45 ICU beds in view of the worrying recent increase in the number of Covid-19 infections and in anticipation of another wave of the virus; and if he will make a statement on the matter. [23677/20]
Amharc ar fhreagraFreagraí scríofa
The Programme for Government, Our Shared Future, commits to continuing investment in our health care services in line with the recommendations of the Health Service Capacity Review and the commitments in Project Ireland 2040.
The Health Service Capacity Review 2018 found that the net requirement in combination with health system reform is for an additional 2,590 hospital beds by 2031 (2,100 inpatient, 300 day case and 190 critical care). The Review identified an immediate requirement for 1,290 beds to address overcrowding and to ensure hospitals operated at 85% occupancy in line with other OECD countries. The National Development Plan provides for the addition of the full 2,590 beds by 2027.
The Department of Health is working with the HSE to increase acute capacity in hospitals throughout the country. In the context of the current COVID-19 Pandemic response, the HSE advised on 22 June 2020 that an additional 324 acute beds have opened since March, bringing the current total of acute beds in the system to 11,597 excluding critical care capacity. It should be noted that this is the total current bed capacity. However, beds are unavailable when they are temporarily closed for reasons such as infection control, maintenance/refurbishment, or staffing shortages.
In addition, the National Treatment Purchase Fund (NTPF) agreed to support the marginal costs of funding additional beds for three months to the end of March 2020 at a cost of €5.8 million. The HSE confirmed 197 of those beds had opened as planned. A further extension of this agreement has been approved until the 31st December 2020 at an estimated cost of €12 million.
Furthermore the HSE has indicated additional surge capacity of general acute beds of 1,633 in the event of a rise in Covid cases.
In relation to critical care capacity, the Health Service Capacity Review 2018 recommended that it be increased to 430 beds by 2031 (an additional 190 critical care beds). 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.
The future opening of additional acute and critical care bed capacity will be considered in the context of the Estimates discussions for the years concerned and on the priorities in the HSE's National Service Plans for those years.
Vaccination Programme
Ceisteanna (96)
Alan Kelly
Ceist:96. Deputy Alan Kelly asked the Minister for Health the way in which he plans to increase the uptake for the flu vaccine the 2020-21 winter season; if his Department has prepared analysis into the costing of providing the flu vaccine to all citizens; and if he will make a statement on the matter. [23652/20]
Amharc ar fhreagraFreagraí scríofa
In previous years, the seasonal influenza vaccination was made available without charge to Medical or GP Visit card holders in one of the HSE-defined at-risk groups, while others in the at-risk groups were provided the vaccine without charge and typically paid an administration fee to have the vaccine delivered. Research indicates that the requirement to pay a charge results in lower uptake rates among those in the at-risk groups who do not hold Medical or GP Visit cards.
Given the potential for the winter flu season in 2020/2021 to coincide with a resurgence of COVID, and the importance of minimising hospital attendance, the Government is expanding the provision of vaccination without charge to all of those in the at-risk groups, including healthcare workers, and to all children aged from 2 to 12 years.
It is proposed to administer the vaccines via GPs and pharmacists, as in previous years. Given the importance of significantly increasing the level of uptake of the vaccine for the coming winter, resources will be provided to GPs and pharmacists not only to deliver the vaccination to the expanded groups, but to actively seek relevant patients and deliver vaccinations in a programmatic way, such as through dedicated flu vaccination clinics.
The expanded programme will ensure that those most vulnerable to the effects of influenza will have access to vaccination without charges. By providing vaccination to those most at-risk, and those most likely to require hospitalisation if they contract influenza, it is anticipated that the programme will see a reduction in the number of influenza-related hospital admissions, as well as a reduction in the overall spread of influenza in the community.
The total influenza vaccination programme in 2020 is expected to cost approximately €77 million, with approximately €61.5 million of that cost associated with the expansion of the programme. It is not possible to estimate the cost of expanding the influenza programme to provide vaccine administration without charge to the entire population, as the calculation would depend on too many variables such as the type and quantity of vaccine to be procured as well as the rate of vaccine uptake.
Question No. 97 answered with Question No. 76.
Covid-19 Tests
Ceisteanna (98)
Joan Collins
Ceist:98. Deputy Joan Collins asked the Minister for Health if weekly Covid-19 testing will be extended to categories (details supplied) that are essential to the running of the country; if he will report on the plan for track and trace; and the persons that will be targeted in view of the fact prompt test and trace results will be crucial. [23683/20]
Amharc ar fhreagraFreagraí scríofa
A comprehensive, reliable and responsive testing and tracing operation is central to our public health strategy for containing and slowing the spread of COVID-19 and the HSE has worked intensively over the last number of months to put this in place.
Ireland is pursuing a robust testing strategy under the guidance of NPHET. NPHET will continue to consider and review, based on public health risk assessments, how best to target testing to hunt the virus in populations where it’s most likely and where it will do most harm. There are a number of targeted testing programmes in place currently. This includes the testing of all close contacts on two separate occasions and a number of serial testing programmes to protect high risk groups. This includes:
- Serial testing of all staff in nursing homes which has been in place since the end of June. All staff are tested on a fortnightly basis.
- Serial testing of staff in the food processing sector. This commenced in Kildare, Laois and Offaly on Friday 21st August and has expanded to food production facilities on a national scale.
- Planning is also under way for serial testing in Direct Provision Centres on a fortnightly basis and this testing will commence shortly.
Consideration is ongoing in relation to the development and implementation of appropriate surveillance strategies for other healthcare worker.
It is important to note that while testing is an important component of our response to Covid-19, it is only one element of our response and it doesn't replace the range of protective measures that are necessary to prevent the transmission of this disease.
Disabilities Assessments
Ceisteanna (99)
Pádraig O'Sullivan
Ceist:99. Deputy Pádraig O'Sullivan asked the Minister for Health the steps being taken to reduce the waiting times for assessments of need under the Disability Act 2005 in the Cork north Lee local health area; and if he will make a statement on the matter. [23694/20]
Amharc ar fhreagraFreagraí scríofa
The 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.
Hospital Facilities
Ceisteanna (100)
Cormac Devlin
Ceist:100. Deputy Cormac Devlin asked the Minister for Health when funding will be given under the capital project in the National Development Plan 2018-2027 for phase II of the National Rehabilitation Hospital, Rochestown Avenue, Dún Laoghaire. [23659/20]
Amharc ar fhreagraFreagraí scríofa
Phase 1 of the redevelopment of National Rehabilitation Hospital was recently completed, commissioned and became operational in June of this year. Phase 1 included the provision of 120 new single bed en-suite rooms, in eight wards on four separate levels. Therapy spaces are provided in the individual wards. Included also are the new Sports Hall and Hydrotherapy facilities and a new entrance to the hospital off Rochestown Avenue.
Phase 2 provides for the relocation of all existing therapies and support facilities to a new modern development, to serve the new 120 bed hospital to minimise patients transferring long distances across the hospital for treatment, thereby maximising therapy impact. The Project Brief and Business Case for Phase 2 of the redevelopment are being currently being progressed and are expected to be finalised in 2020.
It is important to recognise that all capital development proposals must progress through a number of approval stages, in line with the Public Spending Code, including detailed appraisal, planning, design and procurement before a firm timeline or funding requirement can be established. The final decision to proceed with the construction of a project cannot be made until the tender process has been completed and the costings reviewed to ensure that the proposal delivers value for money and remains affordable, and that sufficient funding is available to fund the project to completion, including equipping and commissioning costs.
Care of the Elderly
Ceisteanna (101)
David Stanton
Ceist:101. Deputy David Stanton asked the Minister for Health the position regarding the opening and operation of day care centres for older persons; and if he will make a statement on the matter. [23692/20]
Amharc ar fhreagraFreagraí scríofa
We all know that community services such as day care play an important role in enabling older people to continue living in their communities and maintain their social connections. These services contribute to positive ageing and better overall health. However, the introduction of physical distancing, isolation and restricted contact with family and loved ones has changed the usual dynamic of social interaction.
The HSE continues to work closely with providers and community staff to identify where service is most required and has been undertaking risk assessments of local services. This is to ensure, insofar as possible, that Day Care services can resume in the context of COVID-19 and having regard for Public Health advice.
Day Care services will resume when it is safe to do so; when all infection prevention and control measures and the requirements of physical distancing can be maintained, so as to protect service users and staff and prevent any further spread of the virus. Some centres may not be suitable for reopening due to the constraints of their physical environment and it will be necessary to continue or expand alternative service delivery models developed during recent months.
I understand the impact that the continued delay in the re-opening of day centres is having on older people and the important role this service can play in their lives. I have asked the HSE to ensure that it continues to assess the risks and benefits of re-opening, as well as continuing to expand and explore alternative ways of delivering services to this vulnerable group. I am also continuing to meet with groups that work with and on behalf of older people to see how they can best be supported during this challenging time.
Covid-19 Pandemic
Ceisteanna (102)
Brendan Smith
Ceist:102. Deputy Brendan Smith asked the Minister for Health the engagement he is undertaking with his Northern Ireland counterpart to intensify an all-Ireland approach to tackling Covid-19; and if he will make a statement on the matter. [23689/20]
Amharc ar fhreagraFreagraí scríofa
There has been significant engagement between Irish and Northern Ireland health authorities throughout this pandemic. There has been, and will continue to be, engagement at official level at least weekly to discuss issues of common interest, and in particular policies on international travel and public health advice. These interactions, as appropriate, involve the Ministers for Health, Chief Medical Officers and other senior officials from the respective Departments of Health. Minister Swann and I have met on two occasions to date.
Maintaining strong North-South collaboration is important in these circumstances. Discussions continue to take place on fostering common approaches where possible.
A Memorandum of Understanding was formally agreed by the Chief Medical Officers of the Department of Health and the Department of Health in Northern Ireland in April to strengthen North South co-operation on the public health response to the COVID-19 pandemic.
Further, there have been regular Covid-19 trilateral coordination meetings between the Irish Government, the UK Government and the Northern Ireland Executive.
Health Screening Programmes
Ceisteanna (103)
Neale Richmond
Ceist:103. Deputy Neale Richmond asked the Minister for Health the status of prostate screening in view of the steep drop in referrals from general practitioners in spring 2020; and if he will make a statement on the matter. [23279/20]
Amharc ar fhreagraFreagraí scríofa
The National Cancer Strategy 2017-2026 does not recommend the introduction of a population based screening programme for prostate cancer as there was insufficient evidence in favour of such a programme. This position is consistent with the Recommendations adopted by the European Union which advocate the introduction of cancer screening programmes which have demonstrated their efficacy having regard to professional expertise and priority setting for healthcare resources. My Department, the HSE's National Cancer Control Programme (NCCP) and the National Cancer Screening Service will keep emerging international evidence under review including the results of randomised trials that are currently being conducted internationally.
The NCCP is working to enhance access to early diagnosis and multi-disciplinary decision-making for prostate cancer. In this regard, Rapid Access Prostate Cancer Diagnostic Clinics have been established in each of the eight designated cancer centres. Patients at higher risk are fast-tracked to these clinics, and those patients who receive a diagnosis of prostate cancer have immediate access to a multidisciplinary specialist cancer consultation regarding appropriate management.
A National Screening Advisory Committee (NSAC) was established in 2019. The Committee’s role is to undertake an independent assessment of the evidence for screening for a particular condition against internationally accepted criteria and make recommendations accordingly.
As part of its body of work the Committee will implement an agreed methodology for accepting applications to consider new, or revisions to, existing population-based screening programmes in Ireland.
The addition of any new population-based screening programmes will be incorporated as part of the Committee's work programme following a robust, methodologically sound and detailed analysis of the evidence in each and every case against internationally accepted screening criteria.
Updates in relation to screening will be posted on the NSAC website (https://www.gov.ie/en/campaigns/nsac/).
Furthermore, anyone who has concerns in relation to prostate cancer should contact their GP for appropriate referral.
Commencement of Legislation
Ceisteanna (104)
Thomas Gould
Ceist:104. Deputy Thomas Gould asked the Minister for Health when a commencement order will be given for the Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020. [23671/20]
Amharc ar fhreagraFreagraí scríofa
The Health (General Practitioner Service and Alteration of Criteria for Eligibility) Bill 2020, enacted on 2nd August 2020, provided for an increase to the gross medical card income limits for those aged 70 and over to €550 per week for a single person and to €1,050 per week for a couple.
Although it had been originally intended that this measure would be implemented from July this year, it was not possible to legislate for the necessary amendments to the 1970 Health Act to provide for this measure until there was a fully constituted Dáil and Seanad.
While the relevant section providing for the increased limits has not yet been commenced, I can assure the Deputy that the associated funding requirements and potential implementation date are being actively considered.
Cross-Border Health Initiatives
Ceisteanna (105)
Joan Collins
Ceist:105. Deputy Joan Collins asked the Minister for Health the reason the reimbursement for a cross-border directive operation has not been paid to a person (details supplied) a year after the payment was made by the patient. [23674/20]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.