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Tuesday, 13 Oct 2020

Written Answers Nos. 463-480

Addiction Treatment Services

Ceisteanna (463)

Louise O'Reilly

Ceist:

463. Deputy Louise O'Reilly asked the Minister for Health the status of the work of the working group to consider alternative approaches to the possession of drugs for personal use; and if he will make a statement on the matter. [29705/20]

Amharc ar fhreagra

Freagraí scríofa

The report of the Working Group to consider the approaches taken in other jurisdictions to the possession of small quantities of drugs for personal use was submitted to the Ministers for Health and for Justice and Equality at the end of April 2019.

The Ministers, having considered the recommendations in the report, prepared a proposal which was agreed at Cabinet in July 2019 to introduce a health-led approach. This approach will connect people who use drugs with health services and a pathway to recovery, avoiding a criminal conviction, which can have far-reaching consequences for people, particularly younger people.

The Programme for Government commits to implementing the Health Diversion Programme as an important step in developing a public health-led approach to drug use. A review of the Programme will take place following the first full year of the programme’s implementation, to ensure that it is meeting all of its aims.

An implementation, monitoring and evaluation group, chaired by the Department of Health, is implement the Health Diversion Programme. The Group is currently examining proposals to commence implementation of the Health Diversion Programme on an administrative basis in a number of locations throughout the country ahead of a nationwide roll out of the programme.

I am committed to a health-led approach for possession of drugs for personal use. It is important that we treat drug use as a health issue and give people who use drugs the opportunity to avoid a criminal conviction. I look forward to the commencement of the health diversion programme in 2021.

Medical Cards

Ceisteanna (464)

Kieran O'Donnell

Ceist:

464. Deputy Kieran O'Donnell asked the Minister for Health the steps he is taking to ensure the required funding is provided for the increase in thresholds for medical cards as agreed in the Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 and as announced in budget 2020. [29709/20]

Amharc ar fhreagra

Freagraí 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.

In recent days the Government has approved the necessary funding required to implement this measure and the new increased income limits will take effect from November 1st 2020.

Officials in my Department are therefore now making the necessary arrangements to commence the relevant section of the Act and are engaging with the HSE's National Medical Card unit to ensure all operational arrangements are in place for implementation of this measure.

Health Services Staff

Ceisteanna (465)

Róisín Shortall

Ceist:

465. Deputy Róisín Shortall asked the Minister for Health the number of approved posts for adult and paediatric audiologists; the number of posts filled; the number of posts vacant by community healthcare organisation, CHO, area, in tabular form; and if he will make a statement on the matter. [29723/20]

Amharc ar fhreagra

Freagraí scríofa

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

Addiction Treatment Services

Ceisteanna (466)

Róisín Shortall

Ceist:

466. Deputy Róisín Shortall asked the Minister for Health his plans for improving access to treatment for persons with gambling addictions; if he will consider the results of a study of the nine community healthcare organisation, CHO, regions (details supplied); and if he will make a statement on the matter. [29724/20]

Amharc ar fhreagra

Freagraí scríofa

The Department of Justice and Equality has responsibility for gambling regulation. In March 2019, the Government published the Inter-Departmental Working Group Report on Future Licensing and Regulation of Gambling. This report refers to the introduction of a modern licensing approach to all gambling activities, including enhanced protection of consumers and vulnerable individuals.

The report addresses the social impact of gambling, including the issue of problem gambling. It notes the social and health impacts of problem gambling and acknowledges that problem gambling can lead to social breakdown, with devastating financial losses and alienation of family and friends. Problem gambling can be associated with a range of harms including higher risk of psychiatric disorders, alcohol and drug misuse, physical and mental health issues, separation and divorce, unemployment and insolvency

The 2014/15 Drug Prevalence Survey provides the first comprehensive set of data on the extent of gambling in Ireland. The results indicate that 64.5% of the population report some form of gambling in the 12 months prior to the survey, with 41.4% gambling on a monthly basis, or more often. The survey further found that prevalence of problem gambling in the general population was 0.8%.

The survey is being repeated for 2018/2019 under the auspices of the Health Research Board (HRB).

The Inter-Departmental Working Group recommended that:

- funding be made available for research, training, and community interventions into treatment of gambling addiction.

- funding of public education and awareness raising programmes and the production of relevant information materials be supported.

- assistance be given in the provision of additional services to treat gambling addiction.

In order to meet these objectives, the Group recommended that a Social Fund, managed by the gambling regulatory authority should be established.

The Health Service Executive has r esponsibility for the provision of addiction treatment services.

People who present to the HSE for addiction treatment for gambling are offered the same range of interventions as those who present with a drug and alcohol addiction, or a mental health concern, including an initial assessment, a comprehensive assessment, and individual counselling.

Although some cases of problematic gambling have been provided with treatment, services have not been funded to develop a programme or intervention for problematic gambling.

To provide additional services for gambling addiction would result in significant capacity issues and lengthening of existing waiting lists for people with drug and alcohol problems.

The HSE also provides funding to a number of voluntary sector providers who treat gambling addiction, along with drug and alcohol addictions.

I support the recommendations of the working group report to address the social impact of gambling and to establish a social fund to support treatment services for gambling addiction.

Question No. 467 answered with Question No. 423.

Health Services Staff

Ceisteanna (468)

Kathleen Funchion

Ceist:

468. Deputy Kathleen Funchion asked the Minister for Health the number of occupational therapists, physiotherapists and speech and language therapists available for assessments and follow-up appointments for children in counties Carlow and Kilkenny; the wait time for assessments; and the wait time for follow-up services. [29729/20]

Amharc ar fhreagra

Freagraí 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, as soon as possible.

Mental Health Services

Ceisteanna (469)

Seán Sherlock

Ceist:

469. Deputy Sean Sherlock asked the Minister for Health the number of vacancies in mental health services for adults and children, respectively, by county, in tabular form. [29732/20]

Amharc ar fhreagra

Freagraí scríofa

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

Disability Services Funding

Ceisteanna (470)

Seán Sherlock

Ceist:

470. Deputy Sean Sherlock asked the Minister for Health the budget requested by each disability service to resume providing services for children and adults, in tabular form. [29733/20]

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.

Period Poverty

Ceisteanna (471)

Catherine Connolly

Ceist:

471. Deputy Catherine Connolly asked the Minister for Health when the report of the sub-committee on period poverty will be published; and if he will make a statement on the matter. [29753/20]

Amharc ar fhreagra

Freagraí scríofa

The National Strategy for Women and Girls (NSWG) Strategy Committee established a sub-committee on period poverty in 2019, chaired by the Department of Health.

In line with Oireachtas motions passed in early 2019, its remit includes establishing the extent of period poverty and population cohorts most at risk in Ireland and making recommendations with regard to education, stigma reduction, targeting of at-risk groups and mainstreaming period poverty mitigation measures across all relevant Government Departments and public bodies. Recent commitments in the Programme for Government 2020 are also being taken into account.

A report on the findings of the sub-Committee is in the final drafting stages. This work has been somewhat delayed due to the ongoing challenges imposed by the Covid-19 pandemic. The report will be submitted to the NSWG Strategy Committee for consideration, as soon as circumstances permit.

The NSWG Strategy Committee, is currently led by the Department of Justice and Equality, however, responsibility for the National Strategy for Women and Girls will shortly transfer to the Minister for Children and Youth Affairs.

Medicinal Products

Ceisteanna (472)

Jackie Cahill

Ceist:

472. Deputy Jackie Cahill asked the Minister for Health the status of a drug (details supplied); if it is reimbursed; and if he will make a statement on the matter. [29759/20]

Amharc ar fhreagra

Freagraí scríofa

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.

In line with the 2013 Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the reimbursement list.

Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.

In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact.

HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).

I am advised by the HSE that it has received two applications for the reimbursement of cannabidiol (Epidyolex®):

1. for use as adjunctive therapy of seizures associated with Lennox-Gastaut Syndrome in conjunction with clobazam, for patients two years of age and older.

In February 2020, the HSE commissioned the NCPE to complete a rapid review with respect to this indication. The NCPE recommended a full health technology assessment (HTA) to assess the clinical effectiveness and cost effectiveness of cannabidiol compared with the current standard of care. On 16 March 2020, the HSE commissioned a full pharmacoeconomic assessment for this indication.

2. for use as adjunctive therapy of seizures associated with Dravet Syndrome in conjunction with clobazam, for patients two years of age and older.

In February 2020, the HSE commissioned the NCPE to complete a rapid review with respect to this indication. The NCPE recommended a full HTA to assess the clinical effectiveness and cost effectiveness of cannabidiol compared with the current standard of care. On 16 March 2020, the HSE commissioned a full pharmacoeconomic assessment for this indication.

In July 2020, applicant submissions were received by the NCPE for both of the above indications. These applications will be assessed by the HSE in line with the 2013 Health Act.

Primary Care Centres

Ceisteanna (473)

Carol Nolan

Ceist:

473. Deputy Carol Nolan asked the Minister for Health the status of the development of the primary care centre in Birr, County Offaly; and if he will make a statement on the matter. [29767/20]

Amharc ar fhreagra

Freagraí scríofa

As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.

Dental Services

Ceisteanna (474, 524)

Cormac Devlin

Ceist:

474. Deputy Cormac Devlin asked the Minister for Health if he will request increased funding in budget 2021 to ensure the oral hygiene and dental sector is supported in the form of enhanced subsidies for general medical services, GMS, and PRSI patients and increase tax reliefs for private patients; and if he will make a statement on the matter. [29790/20]

Amharc ar fhreagra

Brendan Griffin

Ceist:

524. Deputy Brendan Griffin asked the Minister for Health the measures he is seeking in budget 2021 to support dentistry here; and if he will make a statement on the matter. [30127/20]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 474 and 524 together.

The Dental Treatment Services Scheme provides dental treatments to medical card holders. Services are provided by independent practitioners who have contracts with the HSE. Services currently available annually, without prior approval of the local HSE Principal Dental Surgeon, include an examination, two fillings and emergency extractions. Other more complex care is also provided some of which requires prior approval by a Principal Dental Surgeon. Patients with special needs and high risk patients can avail of a broader range of treatments including a scale and polish on approval of the Principal Dental Surgeon.

Smile agus Sláinte, the National Oral Health Policy, published by my Department in April 2019, sets out the new model of care delivery for dental services. The timeframe for the delivery of the Policy, which will be rolled out incrementally, is up to 2026. As the Deputy will appreciate, I cannot comment at this stage on the outcome of the estimates process, or matters which will be the subject of national service planning in 2021.

The Dental Treatment Benefit Scheme comes under the remit of the Minister for Employment Affairs and Social Protection. Eligibility for this Scheme is based on a person's PRSI contributions. Tax reliefs come under the remit of the Minister for Finance.

Covid-19 Tests

Ceisteanna (475)

Éamon Ó Cuív

Ceist:

475. Deputy Éamon Ó Cuív asked the Minister for Health the reason a response has not issued from the HSE to Parliamentary Question No. 1241 of 8 September 2020; the protocols in place between his Department and the HSE to ensure timely replies to parliamentary questions referred to the HSE; and if he will make a statement on the matter. [29795/20]

Amharc ar fhreagra

Freagraí scríofa

Under Standing Order 42A, a question may be referred to a body and the referred body has ten working days to provide a response to the Deputy.

The HSE has been experiencing large volumes of Parliamentary Questions and Representations, particularly in relation to testing and tracing. Up to 6 October 3,469 PQs have ben referred for direct reply. I have been advised that the HSE is currently answering 82% of all PQs within the 10 working day deadline. Some PQs are complex and take additional time to gather and collate the information requested which may not be routinely available. In addition, I am advised that the HSE has received (to 6 October) 3,481 Representations directly through its Parliamentary Affairs Division. The HSE advise thay currently 82% of all Reps are being answered before/within deadlines. My Department and the HSE are committed to answer all questions in a timely manner. Officials in the Parliamentary Support Unit in my Department hold regular meetings with their counterparts in the HSE to discuss the management of parliamentary obligations.

Covid-19 Pandemic

Ceisteanna (476)

Thomas Gould

Ceist:

476. Deputy Thomas Gould asked the Minister for Health if documentation is required to prove that a person is travelling across county lines to provide an essential care service; and if so, the documentation required. [29815/20]

Amharc ar fhreagra

Freagraí scríofa

Regulation 5(1) of the Health Act 1947 (Section 31A – Temporary Restrictions) (Covid-19) (No. 6) Regulations 2020 (SI No 413 of 2020) provides that a person shall not travel from their county of residence to another county without a reasonable excuse. Regulation 5(2) of the same SI sets out a non-exhaustive list of reasonable excuses. The Regulations do not prescribe whether documentation is required or what type of documentation might be required to support any reasonable excuse.

Covid-19 Tests

Ceisteanna (477)

Aengus Ó Snodaigh

Ceist:

477. Deputy Aengus Ó Snodaigh asked the Minister for Health if he will address a matter regarding a Covid-19 test for persons (details supplied). [29843/20]

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.

Covid-19 Pandemic

Ceisteanna (478, 489, 509, 512, 541, 544, 568)

Alan Farrell

Ceist:

478. Deputy Alan Farrell asked the Minister for Health if consideration will be given to allowing swimming lessons to continue under level 3 restrictions; and if he will make a statement on the matter. [29845/20]

Amharc ar fhreagra

Noel Grealish

Ceist:

489. Deputy Noel Grealish asked the Minister for Health the reason yoga studios cannot open under level 3 Covid-19 restrictions (details supplied); and if he will make a statement on the matter. [29921/20]

Amharc ar fhreagra

Neale Richmond

Ceist:

509. Deputy Neale Richmond asked the Minister for Health if consideration has been given to allowing children’s extracurricular activities to continue outside of school in a private play setting, be it dance or sporting classes, at level 3 with the children in pods; and if he will make a statement on the matter. [30068/20]

Amharc ar fhreagra

Niall Collins

Ceist:

512. Deputy Niall Collins asked the Minister for Health if he will respond to correspondence requesting guidance (details supplied); and if he will make a statement on the matter. [30074/20]

Amharc ar fhreagra

Neale Richmond

Ceist:

541. Deputy Neale Richmond asked the Minister for Health if he will address a matter regarding exercise practitioners (details supplied); and if he will make a statement on the matter. [30207/20]

Amharc ar fhreagra

Steven Matthews

Ceist:

544. Deputy Steven Matthews asked the Minister for Health if yoga studios are permitted to operate under level 3 restrictions; and if they are able to facilitate classes that adhere to all other advice with regard to social distancing and other guidelines. [30227/20]

Amharc ar fhreagra

Holly Cairns

Ceist:

568. Deputy Holly Cairns asked the Minister for Health if private dance and music schools are classified as education under the Plan for Living with Covid-19; and if he will make a statement on the matter. [30338/20]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 478, 489, 509, 512, 541, 544 and 568 together.

As the Deputy is aware, the Resilience and Recovery 2020-2021: Plan for Living with COVID-19 was published by the Government on 15 September, 2020. This Plan provides a framework setting out Ireland's approach to managing and living with COVID-19 in a range of areas over the next 6 - 9 months.

The framework 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 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.

The Plan reflects a careful consideration of the impact of the introduction of restrictions on employment and livelihoods, keeping as many businesses open as possible at different stages, while acknowledging that some businesses and services are critical. It acknowledges that sports, arts and other social activities are central to our well-being and that sports and arts are also the world of work for our many in our communities.

As I am sure the Deputy 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.

As the Deputy is aware, Ireland has moved from a short-term emergency response approach to a medium-term approach to managing risk and repairing the damage that COVID-19 has inflicted on society. All counties in Ireland are at Level 3 of the Plan for living with Covid-19 until 28th October. Further information on the public health measures in currently in place can be found at www.gov.ie/en/campaigns/resilience-recovery-2020-2021-plan-for-living-with-covid-19/.

The Deputy may wish to know that the Swim Ireland CEO and Chairman met recently with the Minster for Sport Jack Chambers T.D. to discuss a number of issues, including pool closures in a Level 3 environment.

Classes, including swimming, yoga, pilates, dance and sports are regarded as exercise and sporting events under the Plan and where possible, such classes can be held online.

Under Levels 3, 4 and 5 indoor training is only permitted on an individual basis, therefore exercise and sporting events, including classes, cannot take place. Under Level 2 restrictions, indoor dance classes, training and exercise can take place in pods of up to 6 people, once sufficient space is available and strict public health protocols are in place. Under Level 1 of the Framework, there is no specific capacity limit, with capacity guided by what can be accommodated safely in the venue while ensuring all protective measures are in place, including social distancing.

Further information on exercise and sporting events under the Plan is available at: www.gov.ie/en/publication/resilience-and-recovery-plan-for-living-with-covid-19-your-questions-answered/#exercise-and-sporting-events and n he Ireland Active website at https://irelandactive.ie/covid-19/.

Health Services Access

Ceisteanna (479)

Seán Sherlock

Ceist:

479. Deputy Sean Sherlock asked the Minister for Health when children (details supplied) will receive appointments for intervention. [29856/20]

Amharc ar fhreagra

Freagraí 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, as soon as possible.

Medical Cards

Ceisteanna (480)

Pearse Doherty

Ceist:

480. Deputy Pearse Doherty asked the Minister for Health the timeframe for the implementation of the commitment to raising the income threshold on medical cards for persons over 70 years of age; and if he will make a statement on the matter. [29861/20]

Amharc ar fhreagra

Freagraí 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.

In recent days the Government has approved the necessary funding required to implement this measure and the new increased income limits will take effect from November 1st 2020.

Officials in my Department are therefore now making the necessary arrangements to commence the relevant section of the Act and are engaging with the HSE's National Medical Card unit to ensure all operational arrangements are in place for implementation of this measure.

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