Tuesday, 20 Oct 2020

Medical Waste Disposal

Ceisteanna (564)

Denis Naughten

Ceist:

564. Deputy Denis Naughten asked the Minister for Health the options available to families for disposal of medical waste; and if he will make a statement on the matter. [30948/20]

Amharc ar fhreagra

Freagraí scríofa

I have no function in relation to the disposal of municipal medical waste. The Deputy may wish to note that the Department of Communications, Climate Action and Environment is responsible for national waste management policy, and has recently published a new National Waste Action Plan for a Circular Economy (2020 – 2025). I also understand that waste management planning is the responsibility of local authorities under Part II of the Waste Management Act, 1996.

Covid-19 Pandemic

Ceisteanna (565)

Róisín Shortall

Ceist:

565. Deputy Róisín Shortall asked the Minister for Health if he will respond to matters raised in correspondence (details supplied); and if he will make a statement on the matter. [30950/20]

Amharc ar fhreagra

Freagraí scríofa

Minister of State at the Department of Health

I replied to this correspondence on 19 October. With regard to progressing implementation an Implementation Framework has been established in order to ensure a priority focus on key short-term public health and protective measures for nursing home residents over the coming months, with a particular emphasis on winter and ongoing preparedness against COVID-19. As part of this framework, an Implementation Oversight Team and a Reference Group has been established, of which SAGE advocacy is a member. As part of this structured process, progress on these recommendations is provided to these groups. It is my expectation that my officials will provide myself and Minister Donnelly with a first progress report shortly. It is our intention that these will be published on an ongoing basis.

Medical Cards

Ceisteanna (566)

Róisín Shortall

Ceist:

566. Deputy Róisín Shortall asked the Minister for Health if consideration has been given to reintroducing automatic renewal of medical cards in view of the rising cases of Covid-19 and increased restrictions nationwide. [30952/20]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

Eligibility reviews were temporarily suspended by the HSE Primary Care and Eligibility Reimbursement Service (PCERS) during the initial phase of the COVID-19 pandemic. Cards that were due to expire during March and August 2020 were automatically extended for up to one year and will be re-assessed on a planned basis. This temporary measure was taken in the initial phase of the Covid-19 pandemic in order to preserve necessary resources for emergency HSE Covid-19 responses and to also ensure continued eligibility for individuals during that unprecedented time in the health service.

While the HSE PCERS have resumed eligibility reviews, it is important to note that where any medical or GP visit card holders has a review process initiated, he/she will continue to retain their eligibility for the duration of the review process. It is noted that every effort is made by the HSE, within the framework of the legislation, to provide an eligibility assessment process that is responsive and sensitive to people’s needs, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services and to that end, the HSE may exercise discretion and grant a medical card where an applicant exceeds his or her income threshold.

Speech and Language Therapy

Ceisteanna (567)

Seán Sherlock

Ceist:

567. Deputy Sean Sherlock asked the Minister for Health when a person (details supplied) will receive speech and language therapy. [30957/20]

Amharc ar fhreagra

Freagraí scríofa

Minister of State at the Department of Health

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.

Hospital Staff

Ceisteanna (568)

John Lahart

Ceist:

568. Deputy John Lahart asked the Minister for Health the number of staff trained and assigned to perform colonoscopies that were working in public hospitals from 2016 to 2019 and to date in 2020, in tabular form; and if he will make a statement on the matter. [30971/20]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

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

Hospital Waiting Lists

Ceisteanna (569)

Maurice Quinlivan

Ceist:

569. Deputy Maurice Quinlivan asked the Minister for Health the position regarding the wait time in excess of two years for obtaining an MRI scan at University Hospital Limerick for a person (details supplied); and if he will make a statement on the matter. [30981/20]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

It 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.

Maternity Services

Ceisteanna (570)

Jennifer Whitmore

Ceist:

570. Deputy Jennifer Whitmore asked the Minister for Health the provision made in budget 2021 to roll out specialist perinatal mental health services as outlined in the national model of care, including provision of full staff teams and clinical space for the six specialist perinatal mental health hubs in the maternity hospitals in Galway, Limerick, Cork, the Rotunda, the national maternity hospital and the Coombe and for the development of a national mother and baby unit in view of the recent findings in the national maternity experience survey. [30984/20]

Amharc ar fhreagra

Freagraí scríofa

Minister of State at the Department of Health

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

Disabilities Assessments

Ceisteanna (571)

Jennifer Whitmore

Ceist:

571. Deputy Jennifer Whitmore asked the Minister for Health if he will provide a breakdown of the €2 million allocated to County Wicklow as publicly announced from the €7.8 million in funding provided to address waiting times for children awaiting assessment of needs; and if he will make a statement on the matter. [30991/20]

Amharc ar fhreagra

Freagraí scríofa

Minister of State at the Department of Health

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.

Departmental Expenditure

Ceisteanna (572)

Alan Kelly

Ceist:

572. Deputy Alan Kelly asked the Minister for Health the amount a company (details supplied) is being paid per month for Covid-19 related services from March to September 2020. [30992/20]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

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 Tests

Ceisteanna (573)

Alan Kelly

Ceist:

573. Deputy Alan Kelly asked the Minister for Health the amount a company (details supplied) is being paid per month per Covid-19 test from March to September 2020. [30993/20]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

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 (574)

Niall Collins

Ceist:

574. Deputy Niall Collins asked the Minister for Health if he will consider a submission (details supplied); and if he will make a statement on the matter. [31001/20]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

There are a range of issues raised in the correspondence forwarded by the Deputy. In relation to testing, the HSE has adopted PCR as the gold standard test for diagnosing Covid-19 cases, consistent with international best practice. While it is acknowledged that PCR testing does not offer 100% sensitivity or specificity, it is still regarded internationally as the most effective test currently available. In addition, the Department, the HSE and the NPHET are giving detailed and active consideration to alternative diagnostic approaches, including rapid antigen testing. HIQA recently completed a rapid Health Technology Assessment (HTA) in this regard and its findings will be used to inform the national testing strategy.

In relation to data, while it is possible to distinguish if Covid-19 was determined to be a factor in the cause of death at present, it is not currently possible to break down cases with Covid-19 in hospitals by primary reason for hospitalisation. Work is however underway to enable collection of such data so that in future it should be possible to determine the number of hospital discharges where COVID-19 was the primary reason for the episode of care.

More broadly, as the Deputy will be aware, the Government has published a strategy ‘Resilience and Recovery 2020-2021: Plan for Living with COVID-19’ which sets out Ireland’s approach to managing the pandemic for the next 6-9 months. The Plan includes a five-level framework of public health restrictive measures to respond to different stages of prevalence of the virus. However, the Strategy recognises that simple measures taken by everyone are the best defence against this disease and that no single measure works, what matters is the combination.

We are at present in a very concerning position with a rapid deterioration over the last number of weeks in the incidence and severity of disease and Government is therefore considering all available options for bringing the disease back under control.

Hospital Charges

Ceisteanna (575)

Neale Richmond

Ceist:

575. Deputy Neale Richmond asked the Minister for Health if he has considered reducing or waiving accident and emergency fees for pensioners (details supplied); and if he will make a statement on the matter. [31002/20]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

The Health (Out-Patient Charges) Regulations 2019 provides that, subject to certain exemptions, a charge shall be made for out-patient services provided at designated centres including an emergency department (€100) and a minor injury unit (€75). These exemptions include a person with a medical card, a person who has a letter of referral from a registered medical practitioner and a person whose attendance results in admission as an in-patient.

There are no plans at present to amend the provisions in relation to the application of these charges.

Vaccination Programme

Ceisteanna (576)

Brendan Griffin

Ceist:

576. Deputy Brendan Griffin asked the Minister for Health the position in relation to flu vaccines; the number of vaccines available for administration immediately; the timeline for future deliveries; if every person who needs the vaccine can receive it in a timely manner; and if he will make a statement on the matter. [31003/20]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

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. Vaccines will be administered via GPs and pharmacists, as in previous years.

The HSE has placed orders for 1.35 million doses of the Quadrivalent Influenza Vaccine (QIV) for the forthcoming winter. This vaccine will be made available to all persons in an at-risk group from 6 months up. The HSE has also ordered 600,000 doses of the Live Attenuated Influenza Vaccine (LAIV), which is delivered via nasal drops rather than by injection and will be made available to all children aged from 2 to 12 years old inclusive.

Following a delay in the delivery of the first batch of vaccines, the first deliveries of the QIV influenza vaccines to all sites (GPs, pharmacists, nursing homes etc.) started on 17th September, with deliveries continuing to all sites every two weeks.

By the end of the second cycle of deliveries, in the week ending 9 October, approximately 800,000 doses of influenza vaccine were delivered to over 3,000 sites across the country. This represents an increase of 25% in quantities of vaccine delivered when compared with 2019. To date all sites have received 75% of the quantity used last season, and the allowance for the third delivery which began from 15th October will increase this to 90%. Further stocks will be available for the fourth round of deliveries.

The HSE is satisfied that sufficient vaccine has been ordered to vaccinate all those in the HSE defined at-risk groups and all shipments will have arrived into Ireland before the end of October. The current distribution process to GP, pharmacists, hospitals and nursing homes will ensure an equitable distribution of the vaccine to all target groups for vaccination around the country.

Deliveries of the children’s flu vaccine started on the 28th of September, and all of the total order of 600,000 doses is expected by mid-October, as planned.

Those not covered by the publicly funded influenza vaccination programme can avail of influenza vaccination from GPs and pharmacists on a private basis. It is understood that stocks of vaccine for private administration are now being distributed. The Health Products Regulatory Authority Shortages Framework has not been informed of any influenza vaccine shortages affecting the Irish market.

Covid-19 Pandemic

Ceisteanna (577)

Jim O'Callaghan

Ceist:

577. Deputy Jim O'Callaghan asked the Minister for Health the format that permitted nursing home visits will take during level 3 restrictions; and if he will make a statement on the matter. [31017/20]

Amharc ar fhreagra

Freagraí scríofa

Minister of State at the Department of Health

I am very much aware of how difficult the current situation is for families and their loved ones who are in long-term residential care. Continued social interaction is important and I fully appreciate the challenges that have been experienced in maintaining these interactions in a safe manner, especially with older people and those who are medically vulnerable. It is important that the right to have visitors is balanced with the need to ensure that visitations do not compromise overall resident care or adherence to requisite infection control procedures.

Residential settings are people’s homes as well as places where health and social care are provided. The introduction of physical distancing, isolation and restricted contact with family and loved ones has changed the usual dynamic of social interaction. During these times there has been a particular emphasis on retaining a holistic view of the wellbeing of residents, remaining person-centred, being cognisant of their rights as citizens, and being vigilant that in seeking to shield them from infection that these rights are not infringed upon to an extent, or in a manner, that is disproportionate.

The Plan for Living with COVID-19 Framework has been developed to help us to go about our daily lives as much as possible, with measures aimed at the key priorities of protecting health, strengthening employment, and supporting communities. A key aim of the Plan is to provide clarity on what restrictive measures are appropriate around the country based on the pattern and progress of COVID-19 in a particular area at a particular time.

The system is communicated through a numbered system of alert Levels (from 1 to 5) with Level 1 being the lowest with the least amount of restrictive measures in place and Level 5 being the highest with the most restrictions in place. Visits under the framework are; Level 1, open with protective measures in place, Level 2 open with enhanced protective measures and Levels 3 to 5 visits suspended, aside from critical and compassionate circumstances. These Levels are applied to each county based on the current COVID-19 situation therein.

In line with this Framework, new COVID-19 Guidance on Visitations to Residential Care Facilities has been developed by the Health Protection Surveillance Centre (HPSC), to support long-term residential care providers in the discharge of their responsibilities and to support residents, to the greatest extent possible, having regard for the challenging times in which we are living. This guidance is available on the HPSC website. Guidance documents are reviewed regularly.

The new guidance re-emphasises that in circumstances where visiting may need to be restricted or suspended in nursing homes for the protection of residents and staff, alternative arrangements such as “window visiting” is acceptable across all 5 levels of the framework of restrictive measures, providing a nursing home can safely facilitate them, and that arrangements should be in place to support virtual visiting (telephone or video-link) to the greatest extent possible. Crucially, the guidance also provides further clarity on visiting in critical and compassionate circumstances, which is a key issue for residents and families and the guidance should be referred to in making decisions with respect to visits.

At present Cavan, Donegal and Monaghan are at level 4 with the remaining counties at level 3. From midnight 21 October the country will move to level 5. In accordance with these levels and in order to reduce resident contacts, visiting in long-term residential care facilities nationwide is suspended except in critical and compassionate circumstances.

Nursing home providers are ultimately responsible for the safe care of their residents. Under Regulation 11 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 it is the legal responsibility of each registered provider to make arrangements for a resident to receive visitors, having regard to any risks that may present for the resident or other residents. I encourage all nursing home providers to maintain familiarity with the latest public health advice and support, to make every effort to continue to facilitate and ensure that nursing home residents receive visitors in critical and compassionate circumstances, in line with public health advice, and to communicate with family and friends on an ongoing basis in order to support positive mental health and wellbeing. It remains of critical importance that every nursing home provider takes steps and innovates to support ongoing communication between residents and their families and friends, even during periods of enhanced protective measures, while following public health advice.

Vaccination Programme

Ceisteanna (578)

Pearse Doherty

Ceist:

578. Deputy Pearse Doherty asked the Minister for Health if a person (details supplied) in County Donegal will receive the HPV vaccine; and if he will make a statement on the matter. [31042/20]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

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

Health Services Staff

Ceisteanna (579)

Pearse Doherty

Ceist:

579. Deputy Pearse Doherty asked the Minister for Health the date on which a CORU registration will be processed for a person (details supplied) in County Donegal; and if he will make a statement on the matter. [31043/20]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

In relation to the particular query raised, as this is an operational matter, I have asked CORU (the Health and Social Care Professional Council) to respond to the Deputy directly.

Hospital Waiting Lists

Ceisteanna (580)

Pa Daly

Ceist:

580. Deputy Pa Daly asked the Minister for Health if he will report on the waiting times for colonoscopies at a hospital (details supplied); and the number of persons waiting for three, six, nine months and so on, out to the end of the waiting list in three-month increments. [31064/20]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

It 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 non-urgent 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 urgent time-critical 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 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.

In relation to the particular query raised by the Deputy concerning colonoscopies, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Hospital Appointments Status

Ceisteanna (581)

Pádraig O'Sullivan

Ceist:

581. Deputy Pádraig 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. [31068/20]