Written Answers Nos. 271-290
271. Deputy Pauline Tully asked the Minister for Health the number of persons with disabilities who were entitled to day services in 2019; the number of persons who availed of day services in 2019; the number of persons with disabilities who were entitled to day services since they reopened in September 2020; the number of persons who availed of day services since they reopened in September 2020; and if he will make a statement on the matter. [27791/20]
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 this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
272. Deputy Pauline Tully asked the Minister for Health the number of persons who were entitled to respite services in 2019; the number of persons who availed of respite services in 2019; the number of persons who were entitled to respite services since they reopened in September 2020; the number of persons who availed of respite services since they reopened in September 2020; and if he will make a statement on the matter. [27792/20]
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 this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
273. Deputy Pauline Tully asked the Minister for Health the timeframe in which he plans to lift Covid-19 restrictions for trade fairs and exhibitors; and if he will make a statement on the matter. [27793/20]
Amharc ar fhreagraAs the Deputy is aware, Resilience and Recovery 2020-2021: Plan for Living with Covid-19 was published by the Government on 15 September, 2020. 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 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. The Framework was informed by expert advice and recommendations from the National Public Health Emergency Team (NPHET).
Resilience and Recovery 2020-2021: Plan for Living with Covid-19 specifically deals with the events and exhibition sector and the government will continue to work with the sector to progress the development of agreed protocols to enable the hosting of trade events in the near future. The Deputy may wish to note that my colleague Minister of State Robert Troy TD in the Department of Business, Enterprise and Innovation has met with sector representatives.
The Deputy may also wish to note that the number of people allowed to gather in different scenarios in the plan is 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 not possible to say what circumstances will apply in the future due to the nature of the virus that has caused this global pandemic and the concerns that remain about the very serious threats to health that can be caused by Covid-19. The measures in place and the public health advice have been adapted to the changing circumstances and this will continue to be the case for the foreseeable future.
274. Deputy Pauline Tully asked the Minister for Health the number of persons with a disability who have been provided with respite care by county and by month to date in 2020; and if he will make a statement on the matter. [27794/20]
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 this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
275. Deputy Alan Kelly asked the Minister for Health the date on which and the correspondence in which NPHET advised him that the lack of sick pay in some organisations and work settings was a concern with regard to the spread of Covid-19. [27797/20]
Amharc ar fhreagraIn his letter of 4th August 2020, the Acting Chief Medical Officer informed the Minister for Health of the NPHET's most recent advice to Government concerning the State's ongoing response to the COVID-19 pandemic. Among the specific measures mentioned, the NPHET advised that:
"Measures should be put in place to ensure that economic considerations and insecurity of employment are not a deterrent for people coming forward for testing in these groups" (Appendix 1, Section 3).
The Deputy is advised that the relevant letter has been published on the Department of Health's website:
https://www.gov.ie/en/collection/ba4aa0-letters-from-the-cmo-to-the-minister-for-health/#august
276. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full-year cost of permanently increasing and staffing fully and on a permanent basis the number of acute beds to obtain 85% occupancy in the hospital network. [27798/20]
Amharc ar fhreagraIn 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.
277. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full-year cost of permanently increasing and staffing fully and on a permanent basis to bring the level of ICU beds to 560 in the hospital network. [27799/20]
Amharc ar fhreagraThe cost of a critical care bed has several determining factors. The HSE has advised that a new critical care will typically cost between €1m and €1.5m, depending on a variety of factors, including design, construction, equipping and all other associated capital costs.
The HSE has advised that the average annual cost of running a critical care bed is €747k. However, it should be noted that this figure includes costs for both ICU and HDU beds, with the ICU beds the more expensive of the two. It should also be noted that the impacts of COVID-19 and the new recommendations on distance requirements on costs are yet to be determined.
My Department and the HSE are currently engaging in regard to critical care capacity requirements in the public hospital system. However, in order to provide the Deputy with more detail on costs associated with additional critical care beds, I have asked the HSE to respond directly to him as soon as possible.
278. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full-year cost of the current levels of nursing home care provided through the public health system. [27800/20]
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.
279. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full-year cost of the subsidies paid to private nursing homes. [27801/20]
Amharc ar fhreagra280. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full-year cost of the fair deal scheme. [27802/20]
Amharc ar fhreagraI propose to take Questions Nos. 279 and 280 together.
The 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 nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.
In 2020, the NHSS saw a further investment in its budget, to bring it to €1.07bn for the year. This significant investment will provide ongoing long-term residential care over the course of 2020 ensuring that the Scheme continues to deliver affordable and accessible nursing home care for our citizens with long-term care needs.
Separately, as part of package of support measures for nursing homes, my Department established a COVID-19 Temporary Assistance Payment Scheme (TAPS), which opened for applications on 17th April 2020. The core concept of the scheme is that the State will provide additional funding to those nursing homes that require it, to contribute towards costs associated with COVID-19 preparedness, mitigation and outbreak management. The scheme was originally devised to operate for a 3-month period to the end of June, this scheme was extended to the end of September. The scheme is now being further extended to the end of 2020 and for the first 6 months of 2021 (end June 2021).
As the Deputy's question regarding the estimated full-year cost of the current levels of nursing home care provided through the public health system relates to service matters I have arranged for his correspondence to be referred to the HSE for consideration and direct reply to him.
281. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full-year cost of subsidies paid to the private hospital network. [27803/20]
Amharc ar fhreagraIn anticipation of the projected surge in Covid-19 cases and the expected impact on the health care system a major part of the response was to urgently ramp up capacity for acute hospital care facilities. A critical element of the strategy was to put in place an arrangement with the private hospitals to use their facilities as part of the public system, to provide essential acute hospital services for the duration of the emergency. Following negotiations with the Private Hospitals Association an overarching agreement with the 18 private acute hospitals was agreed at the end of March. Under the agreement, the HSE secured 100% of the capacity of the private hospitals until the end of June. Initial indications are that the costs arising from this agreement will be in the region of €305 million euros (subject to verification).
Following termination of the agreement the Government mandated the HSE to seek to agree, with the private hospitals on a new arrangement which would provide the HSE with full access to private hospital capacity in the event of a surge of Covid-19 cases and separately with ongoing agreed access, in conjunction with the National Treatment Purchase Fund, to private hospital services to address the HSE's priority needs in providing both essential care and addressing elective care for public patients experiencing delays. The negotiations in the event of a surge are ongoing.
In August the HSE initiated a procurement process to secure access to additional acute services and diagnostic capacity from private providers which is required to address anticipated shortfalls over the next two years. Tenders have been received and are currently being evaluated by the HSE. In the meantime, the Department has approved a HSE temporary arrangement for the treatment of patients in private hospitals pending the finalisation of the national procurement process. Funding of up to €25 m has been sanctioned for this purpose.
282. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full-year cost of conducting 200,000 Covid-19 tests per week through the existing network of State-owned and operated medical laboratories. [27805/20]
Amharc ar fhreagraThe Resilience and Recovery 2020-2021 Plan for Living with COVID-19 recently launched by Government, commits the HSE to introducing a more accessible and sustainable testing service that will meet the demands coming into the Autumn/Winter months.
The HSE has recently been developing the future service model for testing and contact tracing. This model will aim to deliver a patient-centred, accessible, consistent, responsive and flexible service, with sufficient capacity to take us through the winter months and beyond. This plan includes recruitment of a permanent dedicated workforce for for Covid-19 Testing and contact tracing which has already commenced, and a range of other service improvements to be rolled out quickly. For example, the HSE is currently recruiting over 700 people to take swabs and over 500 contact tracing staff all around the country.
This future model is currently being finalised by the HSE and will be submitted to the Department, together with costings, in the near future.
283. Deputy Richard Boyd Barrett asked the Minister for Health if he has costed a move towards a Covid-19 saliva sample testing system; if so, the estimated full-year cost of conducting 35,000 tests per day via the system; and if he will make a statement on the matter. [27806/20]
Amharc ar fhreagraThe current standard of care in Ireland for the detection of SARS-CoV-2 (the virus that causes COVID-19) involves testing of clinician-collected combined nasopharyngeal-oropharyngeal specimens with reverse transcription polymerase chain reaction (RT-PCR).
RT-PCR is considered the 'gold standard' in diagnostics for the detection of SARS-CoV-2 ribonucleic acid (RNA) in the acute phase of infection.
As the current plan is to continue to test by PCR, any spend on alternative tests to PCR is likely to be in addition to, rather than instead of, PCR. Therefore, to date, cost estimates in respect of saliva sample testing have not been created.
The collection of nasopharyngeal swabs by healthcare workers involves an invasive technique that is uncomfortable for the patient, which is of particular concern for paediatric populations. A relative degree of skill is required by the provider, and due to risk of transmission, the procedure necessitates substantial personal protective equipment. Other issues include the potential for a shortage of swabs during large scale testing initiatives. Alternative specimens from the upper respiratory tract, such as saliva or nasal, may offer a means to mitigate these limitations.
In light of this, an Evidence Review to inform this consideration was published by the Health Information and Quality Authority (HIQA) on 21st August 2020. HIQA is currently in the process of updating this review in light of the ongoing developments in the field.
This issue continues to be under active consideration by the NPHET.
284. Deputy Richard Boyd Barrett asked the Minister for Health the manner in which the Covid-19 pen-and-paper tracking and tracing system is currently configured; the estimated full-year cost of operating the system; if there were reductions in the numbers of staff involved in the system following the introduction of the Covid-19 tracker application. [27807/20]
Amharc ar fhreagraThe HSE and the Department have worked intensively over the last number of months to put in place a comprehensive, reliable and responsive testing and tracing operation. We now have capacity in place to test 15,000 people a day (100,000 pw).
Rigorous contact tracing and automatic testing of close contacts, large-scale testing in outbreak situations and other serial testing programmes means we are finding more cases than we would have previously.
The testing and contact tracing operational and resource model has been designed to flex up and down as needed. The HSE has over recent weeks ramped up resources significantly, and will continue to do so, including optimising and maximising our laboratory testing capacity.
The current Testing pathway consists of a number of stages:
- On referral from a GP, an appointment is made for an individual at a Testing Centre,
- Swab is taken from the individual.
- Swab has then to be transferred to a Laboratory for testing.
- Result is recorded and advised to Centre.
- Individual is informed of result.
The HSE are constantly monitoring all stages of the process to increase efficiency of each of the individual components of the testing pathway and to reduce the turnaround times as much as possible.
Earlier this year, the HSE estimated maximum potential costs for testing and contact tracing for the full year of €414 million. This figure should be considered an estimate of the maximum costs as it is based on activity levels of 100,000 tests per week every week, and actual costs may be lower and reflective of actual activity levels earlier in the year.
The Government has to date approved just over €200 million to cover the costs of testing and contact tracing this year. The estimated expenditure on testing and contact tracing to 18 September was €120.96m.
The Covid Tracker App was introduced to complement the manual contact tracing system and integrate into it, and did not replace any element of it. Therefore, no reductions in staff resulted. In fact, in recent weeks the number of staff engaged daily in Contact Tracing has increased significantly to almost 300. Furthermore, the HSE is currently in the process of recruiting over 500 contact tracing staff all around the country.
285. Deputy Richard Boyd Barrett asked the Minister for Health the number of public health consultants in the employ of the public health service; and the estimated full-year cost of employing them. [27808/20]
Amharc ar fhreagraCurrently the public health services employ Public Health Specialists and Directors of Public Health. The most recent census data, returns for July 2020, include 57.7 Public Health Specialists and 18.6 Directors of Public Health (whole time equivalents).
Consultant status for the Specialty as recommended in the Crowe Horwath Report is an immediate priority. It is also consistent with the role envisaged for the Specialists in Slaintecare 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. 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. The full year cost will depend on the number of consultant posts in the finalised framework and the remuneration arrangements that will apply.
286. Deputy Seán Canney asked the Minister for Health the reason carer's allowance is taken into account as income in assessing the means for medical card applicants over 70 years of age; and if he will make a statement on the matter. [27823/20]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.
287. Deputy Brendan Smith asked the Minister for Health if he will address the need for additional investment in mental health services in budget 2021 (details supplied); and if he will make a statement on the matter. [27840/20]
Amharc ar fhreagraProtection of the vulnerable continues to be a Government priority, especially in these challenging times, and those with mental health issues are often among the most vulnerable in society.
Access to services is central to the Government’s commitments under Sláintecare and the new national mental health policy, Sharing the Vision, and the Programme for Government: Our Shared Future highlights these policies. The Government’s commitment to continued enhancement of mental health services is shown in ongoing increases in the mental health budget. Since 2012, €315 million has been added, bringing the mental health budget today to €1.026 billion, an increase of 44%.
Much has been achieved in mental health in recent years, but it is recognised that much remains to be done. Ireland has fundamentally robust legislation, policies and services that have been built up over time and which, overall, compare favourably internationally. More importantly, there are identified and widely agreed pathways to undertake further improvements in all these areas, including improved residential and community-based care for children and adults and psychiatry of later life.
Sharing the Vision promotes equitable access to quality, safe mental health care for all citizens. Service users and their families, carers and supporters will have timely access to evidence-informed mental health services. Tailored measures will be put in place to ensure that individuals with complex mental health difficulties can avail of services across the State without discrimination. This builds on the intent of A Vision for Change and Sláintecare and is expected to be implemented as part of a ten-year plan.
Sharing the Vision recognises and plans for the increasing need for mental health services and demand for more holistic person-centred responses. The ten-year plan addresses population needs through a focus on the requirements of individuals. It promises early intervention, with a focus on prevention and positive mental health promotion. This focus advocates a mental health system that works in partnership with service users and their families to deliver a range of integrated services and supports.
Establishment of the National Monitoring and Implementation Committee (NIMC), to oversee Sharing the Vision, is well advanced. The NIMC will drive reconfiguration, monitor progress against outcomes and deliver on commitments in the new policy.
This year has been exceptional. The Covid-19 pandemic has caused significant stress, anxiety, worry and fear for many people throughout the world, from the disease itself and from impacts such as increased social isolation, disruption to daily life and uncertainty about employment and financial security.
The HSE has continued to provide all community services, as far as possible, while following Covid-19 guidelines to ensure protection for patients and staff. Acute inpatient and community residential facilities have remained open and patients have been provided with services throughout the pandemic, although with reduced numbers in some settings.
Covid-19 has rapidly accelerated online delivery of mental health services. The Department of Health, with the HSE, has launched a number of initiatives to promote mental health and wellbeing, including the national Crisis Text-Line in June. An additional €2.2m has been provided for a mental health promotion and well-being campaign, through enhanced online supports, and to support the HSE psychosocial strategy. This will enable implementation of integrated tele-health solutions and improve existing online interventions. Examples are the free counselling sessions offered by HSE partners MyMind and online peer support groups for frontline workers from Turn2me.
A key priority for Minister Butler and the Department is to update the 2001 Mental Health Act. The Act sets out the care and treatment of people (including children) with mental illness, including involuntary detention procedures and patient safeguards. The updating process is in line with expert advice, international best practice and human rights. The Department is finalising draft heads of a bill to amend the Act and hopes to finalise a draft bill by the end of 2020.
Another priority is the new forensic mental health facility at Portrane. This significant and modern facility is expected to open early next year. The new 170-bed hospital complex will replace the Central Mental Hospital Dundrum (103 beds) as a modernised National Forensic Mental Health Service. It will include a 120-bed central mental hospital, a 10-bed forensic child and adolescent unit and a 30-bed intensive care rehabilitation unit.
Funding will be sought in this year’s Estimates campaign to implement the short-term objectives of Sharing the Vision. This will, of course, be influenced by the availability of resources. However, the current budget of over €1 billion enables the HSE to maintain and develop its wide range of mental health and suicide prevention services. These span all specialties and ages, from mental health promotion and early intervention to acute inpatient care and clinical programmes such as self-harm and eating disorders. Improving access and reducing waiting lists, where possible, are key Government objectives, despite acknowledged recruitment difficulties and the greatly changed Covid-19 operational environment.
288. Deputy Martin Browne asked the Minister for Health the arrangements that were made while Covid-19 restrictions on travel were in place to accommodate persons using medicinal cannabis preparations under licence; the length of time such arrangements will continue; and his views on making such arrangements permanent. [27845/20]
Amharc ar fhreagraOn the 6th April, the Minister for Health announced an initiative to assist patients access to their medical cannabis products during the COVID-19 pandemic period. The Department of Health has so far organised a number of collections from the Netherlands for patients of clinicians in possession of a ministerial licence under the Misuse of Drugs Act owing to the COVID-19 travel restrictions and quarantine requirements and the initiative will continue while these are in place.
289. Deputy Louise O'Reilly asked the Minister for Health the amount his Department has paid to a company (details supplied) in 2020; and the projects the spend was for in tabular form. [27853/20]
Amharc ar fhreagraThere have been no payments to the company mentioned by the Deputy in 2020 up to and including 30 September. However, I can inform the Deputy that my Department is expecting an invoice of €2,500 ex VAT from the company in question.
290. Deputy Alan Kelly asked the Minister for Health the status of the clearing of the CervicalCheck backlog; and if he will make a statement on the matter. [27854/20]
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.
