Written Answers Nos. 771-790
771. Deputy Dara Calleary asked the Minister for Health when training services for patients with mental health challenges will be reopened; the reason for the delay in reopening these vital centres; and if an urgent intervention will be made on the matter [26321/20]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
772. Deputy Cathal Crowe asked the Minister for Health if provision will be made for those forced to travel long distances for Covid-19 tests, such as persons in west County Clare who are being called to a testing centre in Limerick, an hour and a half from their homes. [26322/20]
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.
773. Deputy Michael Fitzmaurice asked the Minister for Health when the anomaly of inferior terms and conditions offered to consultants in public health in comparison to the conditions of hospital consultants will be addressed; and if he will make a statement on the matter. [26323/20]
Amharc ar fhreagraConsultant status for public health specialists as recommended in the Crowe Horwath Report on the Specialty is an immediate priority. It is also consistent with the role envisaged for the specialists in Sláintecare and Professor Scally’s Report on the National Screening Service ('CervicalCheck') under a new public health framework.
I, my Department and the HSE are committed to the early introduction of a new framework for public healthcare, as provided for in the Programme for Government, and to the framework incorporating consultant status for public health specialists. While finalisation of the future framework was paused in the context of Covid-19, addressing the pandemic has accelerated the implementation of many of the Crowe Horwath recommendations.
The specialty is already working - and leading out - the operationalisation of a very different operational model in response to the pandemic from that which was previously in place; the role of the public health doctor has transitioned very rapidly from one of leading small confined teams, to now leading and directing the activities of a very broad range of organisations and large multidisciplinary teams and the workforce has been diversified to a level not previously envisaged. This reform will continue when the Pandemic Framework, currently the immediate priority for the HSE, is finalised.
Teams are now in place in my Department and the HSE working on a related business case for submission to the Department of Public Expenditure and Reform seeking consultant status and remuneration and this will be completed and submitted as soon as possible. We will also continue to engage with the IMO over the coming weeks. There is an amount of work to be completed and we are committed to progressing this as a priority.
774. Deputy Bríd Smith asked the Minister for Health the impact of level 3 Covid-10 restrictions and possible further restrictions on businesses (details supplied) in the Dublin area; and the guidance available to owners and operators of such facilities [26325/20]
Amharc ar fhreagra801. Deputy Niall Collins asked the Minister for Health the category of activity a business (details supplied) falls into regarding the Covid-19 restrictions; if he will provide specific advice on the way to operate within the guidelines; and if he will make a statement on the matter. [26437/20]
Amharc ar fhreagra809. Deputy Jennifer Murnane O'Connor asked the Minister for Health if community swimming pools and leisure centres will be permitted to hold swimming classes for children in primary schools; and if he will make a statement on the matter. [26447/20]
Amharc ar fhreagra991. Deputy Niall Collins asked the Minister for Health his views on matters raised in correspondence (details supplied); the person or body the group should contact for assistance in organising the event; and if he will make a statement on the matter. [27327/20]
Amharc ar fhreagraI propose to take Questions Nos. 774, 801, 809 and 991 together.
I can assure the Deputies that the public health advice relating to Covid-19 and it's impact is kept under continuing review by the NPHET and the Government.
As the Deputies are aware, the Resilience and Recovery 2020-2021: Plan for Living with COVID-19 was published by the Government on 15 September. This Framework sets out Ireland's approach to managing and living with COVID-19 in a range of areas over the next 6 - 9 months.
The Plan sets out five levels of response, each with a number of measures designed to help us all lower COVID-19 transmission and setting out what is permitted at that moment in time. It aims to allow society and businesses to be able to operate as normally as possible, while continuing to suppress the virus. The Plan is framed to account for periods during which there is a low incidence of the disease, with isolated clusters and low community transmission, through to situations where there is a high or rapidly increasing incidence, widespread community transmission and the pandemic is escalating rapidly in Ireland and globally. It recognises the need for society and business to be allowed to continue as normally as possible and is designed so that either national or county level restrictions can be applied.
Each level outlines what is permitted for social or family gatherings, organised indoor and outdoor gatherings, work and public transport, bars, hotels and restaurants, exercise activities and religious services.
As I am sure the Deputies can appreciate, COVID-19 spreads when individuals and groups come into close contact with one another, enabling the virus to move from one person to another. COVID-19 is infectious in a person with no symptoms, or for the period of time before they develop symptoms. For this reason, we are all asked to be extra careful when socialising and working with others. For now, we must act like we have the virus to protect those around us from infection.
The number of people allowed to gather in different scenarios in the Government Framework are based on a review of international practice and the judgment of public health experts. It seeks to balance the risks of different types of gatherings against the desire to allow normal activities to proceed in so far as possible.
It is advised to socialise safely and within the capacity limits. These various limits in the Levels are all designed to reduce the number of households mixing with each other and cut down the virus’s chances of spreading into more homes.
The Deputies should note that the numbers should not be considered a target - they are the maximum recommended number. It’s always safer to meet less people, less often, for less time. If we do this, we have a better chance of keeping to the lower Levels in the Framework, and continuing to keep businesses, schools, and healthcare services open, while also protecting the most vulnerable.
Further information on the public health measures currently in place under the different Levels can be found at www.gov.ie/en/campaigns/resilience-recovery-2020-2021-plan-for-living-with-covid-19/.
775. Deputy Christopher O'Sullivan asked the Minister for Health when a person (details supplied) will receive an appointment; and if he will make a statement on the matter. [26328/20]
Amharc ar fhreagraIt is recognised that waiting times for scheduled appointments and procedures have been impacted as a direct result of the COVID-19 pandemic.
In response to the Covid-19 pandemic the HSE had to take measures to defer most scheduled care activity in March, April, and May of this year. 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 the National Public Health Emergency Team (NPHET) in accordance with the advice of the World Health Organisation.
The resumption of services from June onwards has allowed for increased activity, with the HSE utilising innovative methods including telemedicine to facilitate patient appointments. Patient safety remains at the forefront of service resumption. To ensure services are re-introduced in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols which has resulted in reduced capacity and activity
The HSE continues to optimise productivity through alternative work practices such the use of alternative settings including private hospitals, community facilities and alternative outpatient settings.
The National Treatment Purchase Fund has also recommenced arranging treatment in both private and public hospitals for clinically suitable patients who have been waiting for long periods on public hospital waiting lists.
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.
776. Deputy Mary Lou McDonald asked the Minister for Health the day services for persons with disabilities that remain closed; and the date that each centre is expected to reopen in tabular form. [26329/20]
Amharc ar fhreagra777. Deputy Mary Lou McDonald asked the Minister for Health the measures that will be put in place to address reduced capacity in reopened day services for persons with a disability which is as high as 60% for some services. [26330/20]
Amharc ar fhreagra778. Deputy Mary Lou McDonald asked the Minister for Health the amount that will be allocated to the reopening of day services for persons with a disability; if the expenditure will be ring-fenced for this purpose; and if the expenditure will remain separate from the HSE winter plan. [26331/20]
Amharc ar fhreagraI propose to take Questions Nos. 776 to 778, inclusive, together.
I was pleased to announce with Minister Donnelly this week that €10 million is being made available to support the resumption of day services and enhanced home support services for disability service users. As issues around the resumption of disability day services are COVID specific, funding was sought from the National Action Plan on COVID-19.
Of this €10 million, €7.5 million will increase disability day services by one day a week for over 14,000 adults. €2.5 million will provide 210 intensive support packages to enable children and young adults to remain at home and in their communities.
The additional funding will further support the resumption of day services, which began to gradually resume throughout August and September. However, it should be noted that capacity in day service locations will be reduced, in line with public health guidance. The HSE and service providers will keep this measure under review and as public health guidance evolves, capacity to provide supports will adapt accordingly. Both the HSE and service providers are committed to maximising the support that can be provided within these restrictions.
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 reopened around the country is available. This information can be accessed at www.hse.ie/newdirections
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.
779. Deputy Niall Collins asked the Minister for Health when the position of speech and language therapist will be filled at west Limerick children's services; and if he will make a statement on the matter. [26354/20]
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.
781. Deputy Pauline Tully asked the Minister for Health the additional funding required to clear the home support waiting list; and if he will make a statement on the matter. [26360/20]
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.
782. Deputy Thomas Gould asked the Minister for Health when the specific guidance will be published for those aged over 70 years of age under Covid-19 level 2 restrictions. [26362/20]
Amharc ar fhreagraAs the Deputy is aware, on Tuesday 15 September 2020 the Government published it's medium term plan Resilience and Recovery 2020-2021: Plan for Living with COVID-19 which frames Ireland's approach to managing and living with COVID-19 in a range of areas over the next 6 - 9 months.
The plan sets out five levels of response, each with a number of measures designed to help us all lower COVID-19 transmission, and setting out what is permitted at that moment in time. It aims to allow society and businesses to be able to operate as normally as possible, while continuing to suppress the virus. The plan is framed to account for periods during which there is a low incidence of the disease, with isolated clusters and low community transmission, through to situations where there is a high or rapidly increasing incidence, widespread community transmission and the pandemic is escalating rapidly in Ireland and globally. It recognises the need for society and business to be allowed to continue as normally as possible and is designed so that either national or county level restrictions can be applied.
Each level outlines what is permitted for social or family gatherings, work and public transport, bars, hotels and restaurants, exercise activities and religious services. Any measure included at any level in this plan is underpinned by expert advice and recommendations from the National Public Health Emergency Team (NPHET).
The Deputy may wish to note that under Level 2, those aged over 70 years and the medically vulnerable are advised to exercise judgement regarding the extent to which they engage with others and in activities outside home.
The Health Protection Surveillance Centre (HPSC) has published Guidance on cocooning to protect people over 70 years and those extremely medically vulnerable from COVID-19 which is available at: www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/vulnerablegroupsguidance/COVID-19%20Guidance%20for%20extremely%20medically%20vulnerable%20groups.pdf.
784. Deputy Bríd Smith asked the Minister for Health when the change to the presence on-site of a gerontologist and a registered nurse took place; the person or body responsible for the change in regulations relating to the care of the elderly in long-term residential care identified by the expert panel report on page 96; and if he will make a statement on the matter. [26368/20]
Amharc ar fhreagraThe Health Act, 2007 provides for an independent inspection and registration system for residential services. On 1 July 2009 Statutory responsibility was given to the Chief Inspector of Social Services, part of the Health Information and Quality Authority for inspecting and registering designated centres for older people. This responsibility was underpinned by a comprehensive quality framework comprising the Health Act 2007, the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2009, as amended, the Health Act 2007 (Registration of Designated Centres for Older People) Regulations 2009 and the National Quality Standards for Residential Care Settings for Older People in Ireland.
The Care and Welfare Regulations were first introduced in 2009, these regulations were extensively reviewed, and revised regulations were published in 2013 to improve the regulatory framework. The new regulations came into effect on 1 July 2014.
The 2013 Regulations retained the requirement for the person in charge to be a nurse with a minimum of three years’ experience in the area of nursing of older persons within the previous six years and that in certain circumstances the person in charge can be a registered doctor. The 2013 regulations also provided that from 1 July 2017 any registered nurse appointed to the role of person in charge of a designated centre for older people also needs at least three years’ experience in a management capacity in the health and social care area and a post-registration management qualification in health or a related field.
Under the Regulations the registered provider is required to ensure that the number and skill mix of staff is appropriate having regard to the needs of the residents, assessed in accordance with Regulation 5, and the size and layout of the designated centre concerned. The person in charge is required to ensure that there be at least one registered nurse on duty at all times, except in circumstances where the Chief Inspector is satisfied that no resident of the designated centre concerned has been assessed as requiring full time nursing care.
Under the Health Act 2007 the Health Information and Quality Authority sets standards on quality and safety. The National Standards set out what is expected in terms of the service provided to residents, with a focus on continuous development of safe and effective care. Since the publication of the first National Quality Standards for Residential Care Settings for Older People in Ireland in 2009, the Authority has devised a framework for developing standards which was developed following a review of international and national evidence, engagement with international and national experts and applying the Authority’s knowledge and experience of the Irish health and social care context. Delivering improvements within quality themes depends on services having capability and capacity in four key areas, one of which is in relation to a Responsive Workforce – planning, recruiting, managing and organising staff with the necessary numbers, skills and competencies to respond to the needs and preferences of people in residential services. The Standards are outcome-based. The standard statement describes the high-level outcome required to deliver quality residential services and residential respite services for people. Under each standard statement there are a list of features which give some examples of what the residential service may consider in order to meet the standard and achieve the required outcome.
The Standards provide that safe and effective recruitment practices are in place to recruit staff, staff have the required competencies to manage and deliver person-centred, effective and safe services to all residents, staff are supported and supervised to carry out their duties to protect and promote the care and welfare of all residents and that training is provided to staff to improve outcomes for all residents.
785. Deputy Joe McHugh asked the Minister for Health the possibility of funding for an organisation (details supplied) on a more sustainable basis through the HSE; and if he will make a statement on the matter. [26372/20]
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.
786. Deputy Colm Burke asked the Minister for Health if consideration will be given to delivering a carers guarantee to providing access to a core basket of supports including respite, home care and training to carers nationwide; and if he will make a statement on the matter. [26395/20]
Amharc ar fhreagraAs the Deputy will be aware, the Programme for Government commits to delivering a ‘Carers Guarantee’ that will provide a core basket of services to carers across the country, regardless of where they live. This commitment is consistent with the National Carers' Strategy, which seeks to support family carers to care with confidence through the provision of adequate information, training, services and supports.
In relation to my own role as Minister for Health, I am committed to listening to family carers and their representative organisations and working with my Government colleagues to ensure that we are providing the most appropriate supports to help sustain carers in their caring role. To this end, my colleague, the Minister for Health and Older People, held a roundtable with family carers on 15 September to hear about their experience as carers and how we can best support them in their caring role, in particular, given the challenges associated with the Covid-19 pandemic.
The Programme for Government also commits to reviewing and updating the National Carers' Strategy. This process will provide an opportunity to consider how best we can work towards providing a 'Carers Guarantee', bearing in mind that the needs of family carers encompass a wide range of areas and involve a number of Government departments.
787. Deputy Colm Burke asked the Minister for Health if consideration will be given to establishing an integrated statutory scheme for the provision of home and long-term care including the right to a carer needs assessment and 20 days' respite each year for all full-time family carers in line with the annual leave entitlement of paid workers; and if he will make a statement on the matter. [26396/20]
Amharc ar fhreagraEnabling people with care-needs to continue to live independently at home for as long as possible is a long-standing objective of the Government. To advance this, the Government is committed to establishing a new statutory scheme for the financing and regulation of home-support services, which the Department of Health is currently developing.
It is intended that the new scheme will provide equitable and transparent access to high-quality services based on a person’s assessed care-needs, and that it will operate consistently across the country. It 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 as well as supporting family and unpaid carers.
The national roll-out of interRAI as the single assessment tool (incorporating the assessment of carers’ needs) will be integral to the new scheme, underpinning the provision of one streamlined process for responding to the evolving care-needs of the individual, from entry-level home-support through to intensive care in a residential setting. The system of regulation will ensure public confidence in the services provided as well as safeguarding service-users.
As reflected by the National Carers' Strategy, the needs of family carers encompass a wide range of areas and involve a number of Government departments. In relation to my own role as Minister of State with responsibility for Mental Health and Older People, I am committed to listening to family carers and their representative organisations and working with my Government colleagues to ensure that we are providing the most appropriate supports to help sustain carers in their caring role. I held a roundtable with family carers on 15 September to hear about their experience as carers and how we can best support them in their caring role, in particular, given the challenges associated with the Covid-19 pandemic.
It should be noted that under the existing National Carers' Strategy, a range of measures have been introduced or extended by the Department of Health to support family carers in recent years. Since September 2018, free GP visit cards have been extended to persons in receipt of the Carer’s Allowance. The Programme for Government commits to further extending this service to recipients of the Carer's Support Grant.
In addition, the Winter Plan will provide a very substantial increase in the number of home care hours available. The new “Home First” approach, emphasises reablement and providing extensive home support packages for those with more complex needs, including people with dementia, who are also being supported through the recruitment of 10 additional dementia advisors.
788. Deputy Colm Burke asked the Minister for Health if consideration will be given to extending the carer general practitioner visit card to carers who are in receipt of the non-means tested carer’s support grant; and if he will make a statement on the matter. [26398/20]
Amharc ar fhreagraSince 1 September 2018 all those in receipt of either a full or half-rate Carer's Allowance or Carer's Benefit are automatically eligible for a GP visit card. It is noted that many persons in receipt of the Carer's Support Grant will qualify for a GP visit card as the Carer's Support Grant is paid automatically to persons in receipt of Carer's Allowance or Carer's Benefit.
789. Deputy Colm Burke asked the Minister for Health if consideration will be given to introducing the transport support scheme; and if he will make a statement on the matter. [26399/20]
Amharc ar fhreagraBy 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.
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.
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.
790. Deputy Colm Burke asked the Minister for Health if consideration will be given to providing additional funding for the National Treatment Purchase Fund to enable it to be extended so that the number of children and adults on waiting lists for essential healthcare services can be reduced in view of the withdrawal of services due to the Covid-19 pandemic; and if he will make a statement on the matter. [26400/20]
Amharc ar fhreagraImproving access to Scheduled Care and reducing waiting time for patients for hospital operations and procedures is a key priority for Government. The year-on-year increases to the National Treatment Purchase Fund (NTPF) since Budget 2017 reflect this priority and Budget 2020 saw the funding of the NTPF increase by €25million to €100million.
Furthermore, since 2017, the Department, HSE and NTPF have been collaborating to identify initiatives to improve waiting times for patients, and the NTPF works with the hospital system to provide additionality to improve access to inpatient/day case procedures and outpatient appointments.
Funding for the NTPF in 2021 will be considered as part of the upcoming Estimates process
