Written Answers Nos. 88-109
91. Deputy Michael McNamara asked the Minister for Health the provisions in place to guarantee parliamentary oversight of existing and future regulations made pursuant to the Health Act 1947, as amended, in the event that the emergency provisions contained therein are extended beyond 9 November 2020. [32284/20]
Amharc ar fhreagraSection 31A of the Health Act 1947 (as inserted by section 10 of the Health (Preservation and Protection and other Emergency Measures in the Public Interest) Act 2020) provides for the power of the Minister for Health to make regulations for preventing, limiting, minimising or slowing the spread of Covid-19. Subsection (3) of the Act provides that before making such regulations, the Minister for Health shall consult with any other Minister that he considers appropriate, having regard to that Minister’s functions.
There are a number of regulations currently in operation under Section 31A. The latest are the Health Act 1947 (Section 31A - Temporary Restrictions) (Covid-19) (No. 8) Regulations 2020 (S.I. No. 448 of 2020). As part of the making of these Regulations, I consulted the Minister for Transport, the Minister for Business, Enterprise and Innovation, the Minister for Finance, the Minister for Justice and Equality, and the Minister for Tourism, Culture, Arts, Gaeltacht, Sport and Media in accordance with subsection (3) of section 31A of the Act.
In relation to parliamentary oversight, section 5(5) of the Health Act 1947 provides that every regulation made by the Minister for Health under the Act is laid before each House of the Oireachtas as soon as possible after it is made. If either House passes a resolution to annul the regulation within the following 21 days after having been laid, the regulation will be annulled.
The latest regulations, Number 8 regulations, were laid before the Houses of the Oireachtas and notice of them was published in Iris Oifigiúil on the 23rd of October 2020. I can confirm that any future Regulations that relate to public health measures to minimise the spread of Covid-19 will be made in compliance with these provisions of the Health Act 1947, as enacted by the Oireachtas.
93. Deputy Pauline Tully asked the Minister for Health the position regarding commitments by successive Governments to close all institutional settings by 2018; his views on the adequacy of the measures taken by successive Governments to meet the yearly targets as set out in the report, Time to Move on from Congregated Settings; the actions he will take to accelerate the deinstitutionalisation process; the timetable for the completion of this process; and if he will make a statement on the matter. [29747/20]
Amharc ar fhreagraAlmost nine years ago, the Time to Move on from Congregated Settings Report identified approximately 4,000 people with disabilities living in congregated type settings. The 2011 Report expected that decongregation could happen at a much faster pace than was actually possible.
Since 2014, the Transforming Lives Programme provides the framework for implementation and for putting policy into practice across key reports, including Time to Move on from Congregated Settings in respect of residential centres,
Today less than 2,000 people live in congregated settings.
The Programme for Government – ‘Our Shared Future’ includes a commitment to continue with moving people out of old style congregated settings, into new homes within the community, with the necessary supports.
66 people have completed their transition so far this year, however, it is likely that the impact of COVID-19 will be reflected in the year-end total.
Today, people are being supported to live lives of their choice out in the community. Several congregated settings have closed fully and many more have closed specific units within the centres.
Thoughtful planning, capacity building work with stakeholders and sharing the learning across services is enabling meaningful person-centred planning and transitions that are sustainable.
While the pace of change has been slow in some services, there is momentum and progress is being made.
Budget 2021 provides for an unprecedented level of investment in disability services, with the investment of €100m for new initiatives in 2021. The increased level of funding in 2021 will enable us to build on initiatives currently underway, including the decongregation programme, with a renewed focus on assisting people to move out of congregated settings to homes in the community.
94. Deputy Jim O'Callaghan asked the Minister for Health the details of the access to care fund announced in Budget 2021; and if he will make a statement on the matter. [33465/20]
Amharc ar fhreagraThe Government’s commitment to maintaining and improving access to care can be seen through the allocation of funding in the Winter Plan as well as in Budget 2021. An additional €240 million has been provided in Budget 2021 for an Access to Care Fund, €210 m of which will be allocated as required to the HSE and €30 m to the National Treatment Purchase Fund for the provision of treatment in both private and public hospitals in order to address capacity issues in acute hospitals and waiting lists. This funding means that those patients who require urgent and time critical care are seen as a matter of priority, while at the same time providing the much-needed capacity to provide routine care for patients on waiting lists.
My Department continues to engage with the HSE on the development of the National Service Plan, which will set out further details of how the €210 million allocation for the fund will be utilised. It is envisaged that some of this funding will be used to procure additional capacity in private hospitals. It is also envisaged that it can be used for Public hospitals. This will help to make up for the impact of the Covid-19 pandemic on capacity in the public sector. The impact of this funding will be monitored by my Department.
This Government’s continued commitment to improving waiting times can be further seen through the allocation of the additional €30 million Access to Care funding to the National Treatment Purchase Fund. This brings the total NTPF budget for 2021 to €130 million, which will be used to source appointments and treatment for long-waiting patients, and will also be used to support access to diagnostic scans and fund additional HSE beds.
95. Deputy Paul Murphy asked the Minister for Health the action he will take to ensure that persons who suffered narcolepsy after receiving the pandemrix vaccine will receive appropriate compensation without the need for expensive court cases [33177/20]
Amharc ar fhreagraThe State Claims Agency (SCA) has a statutory remit to manage personal injury claims on behalf of Delegated State Authorities including the Health Service Executive. The management of cases taken by persons who allege they developed Narcolepsy and/or Cataplexy as a result of receiving the H1N1 vaccine, Pandemrix, is delegated to SCA and, as such, the Government has no role in determining how these cases are conducted. I understand that it is the Agency’s preference to resolve claims using mediation where possible.
Separately, an Expert Group was established by the Government in June 2018, chaired by Mr Justice Charles Meenan, to examine the law in relation to personal injuries arising in the healthcare context and to explore alternative mechanisms by which claims could be managed more effectively, particularly from the perspective of the person on whose behalf a claim has been made. A report from this Expert Group was received by the Minister for Health and the Minister for Justice earlier this year, and I am considering how best to act on this report - I intend to bring forward a number of reforms that are recommended.
96. Deputy Paul Donnelly asked the Minister for Health if provisions have been made to accommodate service providers such as drug taskforces, community groups and so on in local authority buildings due to the reduced capacity of community centres due to Covid-19 social distancing. [24336/20]
Amharc ar fhreagraRestrictions on social interaction, the requirement for self-isolation and the restructuring of services, are particularly difficult for those accessing drug and alcohol services and supports.
In line with the Government plan for living with Covid-19, the Department of Health is developing a 'Framework for the Restoration of Drug and Alcohol Services', in a planned and appropriate manner in line with public health advice.
The Department has established a working group of drug and alcohol service providers to identify issues on which guidance and supports are required.
It is anticipated that the Framework will be completed in early November.
I recently met with representatives of drug and alcohol task forces to discuss continued support for their work in identifying and responding to local needs.
I have approved additional funding to support the resumption of drug and alcohol services including the adaptation of services, premises, online meetings, and personal protective equipment.
Under the scheme, the 24 Drug and Alcohol Task Forces can apply for one-off funding to meet Covid-19 related costs relating to drug and alcohol services in their area. It is intended that the fund will be allocated through the HSE, who will in turn allocate it to the Task Forces following consideration of applications.
I will announce the details of this additional funding shortly.
98. Deputy Matt Shanahan asked the Minister for Health the basis on which a service (details supplied) was discontinued; the person that authorised the removal and cessation of this contract with a company; the plans being put in place to replace this lost service in order to begin to reduce the climbing angiogram waiting list; and if he will make a statement on the matter. [30664/20]
Amharc ar fhreagraThe Herity Report recommended that the operating hours of the existing cath lab at University Hospital Waterford be extended to meet the needs of its effective catchment population. Pending the recruitment required to extend the opening hours, a mobile cath lab providing diagnostic services, was deployed at the hospital in October 2017.
The HSE has advised that, due to Covid-19 restrictions, the staff of the UK based company providing the mobile service could no longer travel to University Hospital Waterford and as a result, the contract for this service was terminated.
The HSE has confirmed that it is expected that a diagnostic angiogram service will commence in UPMC Whitfield this month and that University Hospital Waterford is also working with its Consultant Cardiologists to progress Saturday sessions in UPMC Whitfield. The HSE has further advised that University Hospital Waterford is finalising arrangements to outsource 200 patients for diagnostic angiograms to other facilities.
In addition, the HSE has advised that, as per the Herity Report, the existing cath lab opening hours at University Hospital Waterford will be extended to provide an 8am to 8pm service, three days per week, before the end of this year and that this will incrementally increase to seven days per week in Q1 2021.
It is expected that these measures will have the cumulative effect of reducing the waiting list for diagnostic cardiac services at University Hospital Waterford.
The Deputy might also wish to note that the National Treatment Purchase Fund is reviewing strategies to maximise activity, including increased use of private hospitals, funding weekend and evening work in public hospitals and funding hybrid services where public and private hospitals contribute to the treatment of patients.
99. Deputy Alan Dillon asked the Minister for Health the way in which he plans to extend the opening hours for primary health centres to elevate demand for acute accident and emergency hospital settings and address the trolley crisis; and if he will make a statement on the matter. [33609/20]
Amharc ar fhreagraAs the Deputy will be aware, the HSE recently published its Winter Plan for 2020-2021 which set out a range of initiatives that, among other things, targeted acute and ED overcrowding. Amongst the key objectives of the plan are an improvement in patient experience times in Emergency Department settings and a reduction of 30% on the previous year’s trolley count.
Extended opening hours for Primary Care Centres were not viewed as being critical in reducing demand on Emergency Departments. This reflects the fact that although the centres are important in supporting the delivery of primary care therapy and other services in the community, they are not intended to serve as minor injury units or as an alternative to ED admission.
However, there are several initiatives being advanced in the Primary Care sector through the Winter Plan and Budget which will support hospital avoidance. This investment includes a total of €180m to develop new pathways of care for primary health services and a further €25m for structured GP access to diagnostics. This unprecedented funding for primary care reform will enable the recruitment of over 2,000 staff, with a particular focus on nursing and community therapists, and will allow capacity deficits in the sector to be addressed through the rollout of such initiatives as Community Healthcare Networks, community specialist teams for older people and for chronic disease management, and the nationwide expansion of Community Intervention Teams.
The additional investment secured in Budget 2021 will not only bolster our response to COVID-19 but will help to strategically develop capacity across the health system in line with Sláintecare to improve access to care and address the challenges identified by the Deputy.
100. Deputy Bríd Smith asked the Minister for Health the details of his discussions with the 221+ patient support group in relation to the CervicalCheck Tribunal; the steps he is taking to ensure the concerns of the group are dealt with; and if he will make a statement on the matter. [33547/20]
Amharc ar fhreagraConcerns in respect of the CervicalCheck Tribunal and how CervicalCheck cases would be dealt with were raised with me by the 221+ patient support group at a meeting on 2 September. I responded to the issues raised by the group at those meetings in my letter of 20 October, informing the group of the Tribunal’s establishment day, and in further letters of 27 and 28 October. Further meetings about the Tribunal and CervicalCheck cases were held with the 221+ group on Friday, 23 October 2020 and Monday, 26 October 2020, and I am engaged in ongoing constructive correspondence with the group.
Although the Tribunal was established on 27 October 2020, all further actions with regard to establishing the Tribunal, including the appointment of the members to properly constitute the Tribunal, have been paused as agreed pending the 221+ group’s consideration of my responses to their concerns.
I remain committed to addressing the 221+ group's concerns in respect of the Tribunal. The only practical impact of the establishment of the Tribunal on 27 October 2020 is that the nine-month period for making claims runs from that day, however this can be extended if necessary.
My Department will provide the Deputy with a briefing note setting out the issues raised by the 221+ group and my responses to those issues.
101. Deputy Niamh Smyth asked the Minister for Health the status of the provision of extra day services for persons with physical disabilities in counties Cavan, Monaghan and Meath; when services will resume to full operation following Covid-19; and if he will make a statement on the matter. [31082/20]
Amharc ar fhreagraThe HSE began planning for the resumption of adult disability day services in May, and services have now resumed nationwide. Public health guidance was specifically developed to underpin the safe resumption of services, and this guidance was published in July.
The guidance developed to support the resumption of adult day services has had to take account of social distancing rules which has meant that there is a reduced number of people in each service location. This means that, when day services re-opened they re-opened at approximately 40% capacity. However, the HSE is committed to maximising the support that can be provided within these restrictions.
The government will be investing an additional €100 million in new initiatives in 2021, bringing the total disabilities budget to around €2.2 billion. Regarding day services specifically, this additional investment will build the capacity of our adult disability services nationally, including services in Cavan, Monaghan and Meath, and will increase day services by one day a week, for those whose services were reduced due to COVID-19. It will also support around 1,700 young people who leave school and training programmes in 2021.
This is in addition to the €7.5 million being made available to support the resumption of day services which I announced in September.
The HSE gathered data at the end of September on the quantum of services currently being provided to individuals, and this will act as a baseline to track additional service levels.
102. Deputy Richard Boyd Barrett asked the Minister for Health his plans for investment in testing tracing infrastructure and public health tracing teams in the coming weeks to ensure that when Ireland emerges from the current level 5 there will be the resources necessary to track down any new outbreaks of the virus; and if he will make a statement on the matter. [33225/20]
Amharc ar fhreagraThe HSE has worked intensively over the last number of months to put in place a comprehensive testing and tracing operation. We now have standing capacity to test 120,000 people every week.
We are now able to conduct automatic testing of close contacts, serial testing in high risk environments and large-scale testing in outbreak situations. We are now proactively finding more cases than we would have previously.
As part of its ongoing process improvement, the HSE is currently running a nationwide recruitment campaign for swabbers and contact tracers, setting up temporary swabbing sites and making process improvements to the end-to-end test and trace system. Recruitment is a key focus. 500 additional contact tracers are being hired to provide standing capacity for contact tracing with 280 already in place and a further 60 - 70 being appointed on a weekly basis. A further 180 people have been appointed to date to carry out swabbing activities, whilst additional candidates are currently going through the compliance and interview process.
My Department continues to work with the HSE to improve turnaround times, consistency and our end-to-end testing pathway in general. This ensures the system is responsive to nature of the current and expected future demand for testing and tracing. Testing and contact tracing continues to be a key component of the Government’s response to the pandemic.
103. Deputy John Lahart asked the Minister for Health the funding being provided in Budget 2021 for Sharing the Vision, the new national mental health policy; and if he will make a statement on the matter. [33456/20]
Amharc ar fhreagraBudget 2021 saw an additional €50 million allocated to Mental Health Services, bringing the total 2021 mental health budget to €1.076 billion, the largest mental health budget on record. This emphasises the Government’s continued commitment to mental health and the priority it deserves in these unsettling times.
The additional allocation includes €23 million which will be used to used to commence implementation of many of the short-term recommendations of the Sharing the Vision mental health policy. This includes establishing the new structures required to implement the policy, and the expansion of the clinical care programmes in Dual Diagnosis, Early Intervention in psychosis, and Mental Health and Intellectual Disability. It will also fund additional mental health beds, enhanced Community Mental Health Teams, CAMHS Hubs/Teams, Adult Crisis Resolution Services, increased supports in employment, Peer Support Workers, Bereavement Co-ordinators, and Dialectical Behaviour Therapy.
Launched in June 2020, Sharing the Vision promotes equitable access to quality, safe mental health care for all citizens. The policy aim is that 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 intended to be implemented over a ten-year period.
A National Implementation and Monitoring Committee has been established to drive the policy's implementation and a chair and membership from a wide range of stakeholders will be selected in the coming weeks.
104. Deputy Pa Daly asked the Minister for Health his views on a standalone health board for County Kerry. [33306/20]
Amharc ar fhreagraA clear governance and accountability framework was identified as a key building block of Sláintecare by the Committee on the Future of Healthcare. As part of its recommendations in this area, the Committee called for the HSE to become a more strategic and patient-focused ‘national centre’ carrying out national level functions, and the establishment of regional bodies with responsibility for the planning and delivery of integrated care at a regional level. The new Programme for Government, Our Shared Future, recommits to this Sláintecare recommendation, stating “Enhanced governance and accountability in the health service is a key component of Sláintecare reform. The HSE Board is now in place and we must now bring forward detailed proposals on the six new regional health areas to deliver services for patients locally that are safe, high quality and fairly distributed.”
When the new Regional Health Areas geographies were announced last year, Kerry and Cork were incorporated as Area D. As agreed at that time, a business plan for the establishment of these health areas was expected to be brought to Government for its approval in 2020. The intention was that this plan would set out the high-level organisational design for the health system, including: the respective roles, functions, responsibilities and accountabilities of the Department of Health, HSE centre and new regional structures; the relationship between these entities; and the overall legal construct. Work was underway in the Department of Health and the HSE to develop these detailed proposals, in consultation with stakeholders. Understandably, this work was paused as a result of COVID-19. This programme of work will be given further consideration to take account of the Programme for Government commitment and any new considerations relating to COVID-19.
105. Deputy Bríd Smith asked the Minister for Health his plans to deal with a number of industrial relations disputes in the health service including those involving public health doctors and medical laboratory scientists; the steps he is taken to address these concerns; and if he will make a statement on the matter. [33548/20]
Amharc ar fhreagraSince March, the HSE, the Health sector Trade Unions and the Department have engaged, up to twice weekly and as required, on all matters pertaining to the evolving COVID-19 public health emergency. This engagement has been constructive in progressing industrial relations issues that have arisen since the beginning of the pandemic.
With regard to the public health doctors, my Department and the HSE are committed to the early introduction of a future model for public health medicine encompassing the establishment of Consultant in Public Health Medicine roles, as provided for in the Programme for Government.
My Department and the HSE are working intensively to finalise this framework, having regard also to the immediate model required in response to the pandemic. Engagement with the Department of Public Expenditure and Reform will also be required. I note the decision of the IMO to ballot on industrial action in relation to consultant status for public health specialists.
In relation to medical scientists, officials from my Department and the HSE met with the Medical Laboratory Scientists Association (MLSA) on three occasions in recent months and I can confirm that my officials are engaging with the Department of Public Expenditure and Reform in relation to the matters raised by the MLSA.
106. Deputy Denis Naughten asked the Minister for Health when out-of-hours flu vaccination clinics will commence; and if he will make a statement on the matter. [33287/20]
Amharc ar fhreagraThe Government has expanded the provision of seasonal influenza vaccination without charge to all of those in the HSE-defined at-risk groups, including healthcare workers, and to all children aged from 2 to 12 years. Vaccines are being administered via GPs and pharmacists, as in previous years.
GP practices and pharmacists commenced their vaccination programmes in early October with regular, opportunistic vaccinations and, in addition, through dedicated vaccination clinics which aim to maximise the number of patients vaccinated in the safest way possible without interfering with the day-to-day running of practices or pharmacies. Clinics to administer the LAIV to children aged from 2 – 12 years old have also commenced. It is the responsibility of each GP and pharmacist to arrange their clinics as best meets their needs and the needs of their patients.
107. Deputy Paul McAuliffe asked the Minister for Health his plans for changes in legislation to ensure better enforcement and adherence to Covid-19 guidelines. [31134/20]
Amharc ar fhreagraIt is vital that people in Ireland adhere to public health guidance and advice in order to suppress the spread of Covid 19 and the vast majority of people in Ireland are doing just that. Unfortunately, however, enforcement is sometimes required but always as a last resort. In that respect, the Deputy will be aware that the Health (Amendment) Act 2020 was passed by the Oireachtas on 23 October last.
The Act provides for penal provisions under the Health Act 1947 to be prescribed as fixed penalty provisions meaning that persons alleged to have committed an offence under a fixed penalty provision may pay a fixed penalty in lieu of prosecution. It provides that on prosecution, different levels of penalties may apply to first, second and third and subsequent offences under the Act. Finally, it provides for provisions to be prescribed as dwelling event provisions meaning that if a Garda reasonably suspects a breach of such a provision, he or she may attend at the entrance to the private dwelling and direct persons to leave that private dwelling or the vicinity of that private dwelling.
The fixed penalty notice offences and the level of penalties to apply will be determined in regulations which my Department is working on, in consultation with the Minister for Justice.
108. Deputy Neale Richmond asked the Minister for Health the engagement he has had with his Northern Irish counterpart in relation to ICU capacity; if Covid-19 patients from Northern Ireland have been transferred to hospitals here; and if he will make a statement on the matter. [33470/20]
Amharc ar fhreagraA Memorandum of Understanding was formally agreed by the Chief Medical Officers of the Department of Health and the Department of Health in Northern Ireland on 7 April 2020. This built on the long-standing cooperation and collaboration between health authorities and across the health systems in Ireland North and South and strengthened that cooperation in relation to the public health response to COVID-19.
The Memorandum has formalised and underpinned the significant engagement between Ministers, Chief Medical Officers, Departments and other health agencies throughout this pandemic. It is facilitating greater co-operation and consistency of approach wherever possible on areas such as public health messaging, programmes of behavioural change, evidence base/modelling and contact-tracing.
In respect of ICU capacity specifically, senior clinicians have been engaging directly to ensure readiness for mutual support should the need arise, but it is important to emphasise that COVID measures introduced recently on both sides of the border are intended to “flatten the curve” and thus avoid the need for such arrangements.
109. Deputy Brian Stanley asked the Minister for Health the progress which has been made since June 2020 to put in place the refurbishment and new build project for the Abbeyleix Hospital [33284/20]
Amharc ar fhreagraAbbeyleix Community Nursing Unit is moving to become an integrated Hospital and Community Hub that will include 18 short stream intermediate care beds which will be operated by the Dublin Midlands Hospital Group. Side B of the unit has been reconfigured and refurbished to accommodate the Acute Hospital Services as an Intermediate Care Facility. Side A of the unit (10 bedded designated unit) is due to undergo refurbishment commencing mid-November to accommodate 10 single rooms ensuite and meet HIQA requirements. These works will be carried out in 2 phases over 32 weeks in total.
