Seán Sherlock
Ceist:1386. Deputy Sean Sherlock asked the Minister for Health when respite services will resume for a person (details supplied); and if he will make a statement on the matter. [33498/20]
Amharc ar fhreagraRespite Care Services
Ceisteanna (1386)
Freagraí scríofa
The 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.
Question No. 1387 answered with Question No. 1111.
Question No. 1388 answered with Question No. 1114.
Hospital Data
Ceisteanna (1389)
Matt Shanahan
Ceist:1389. Deputy Matt Shanahan asked the Minister for Health the location of additional and existing critical care beds, acute beds, subacute beds and community beds provided for in Budget 2021; the administrative process and computational method of allocating the additional beds in tabular form; if the estimates capacity will be at a sufficient level to meet a surge in need which may arise; and if he will make a statement on the matter. [33584/20]
Amharc ar fhreagraFreagraí scríofa
The Programme for Government, Our Shared Future, commits to continuing investment in our health care services in line with the recommendations of the Health Service Capacity Review and the commitments in Project Ireland 2040.
The Health Service Capacity Review 2018 found that the net requirement in combination with health system reform is for an additional 2,590 hospital beds by 2031 (2,100 inpatient, 300 day case and 190 critical care). The National Development Plan provides for the addition of the full 2,590 beds by 2027.
This winter is expected to be particularly challenging due to the presence of Covid-19 and the uncertainty around the level of Covid-19 and non-Covid-19 healthcare demands. The Department of Health is working with the HSE to increase acute capacity in hospitals throughout the country to meet this and other health demands. Government allocated €236 million revenue and €40 million capital expenditure as part of Budget 2021 to fund additional acute beds on a permanent basis. This funding will provide, by the end of 2021, an additional 1,146 acute beds.
A proportion of these beds will be funded as part of the HSE’s Winter Plan 2020/21. The Winter Plan aims to provide additional health service capacity across a range of services. Initiatives comprise additional acute and community beds to increase acute capacity, help reduce admissions and facilitate egress.
With regard to critical care beds, at the start of the year, permanent adult critical care capacity in Ireland stood at 255 beds, according to the National Office of Clinical Audit. This included 204 Level 3 ICU beds and 51 Level 2 HDU beds. As part of the initial response to the pandemic, funding was provided for an additional 40 adult critical care beds in March 2020 as well as two paediatric beds. The HSE has advised that between 280 and 285 critical care beds are currently open, with the number open any given day subject to fluctuation in respect of available staff and other operational considerations.
Where necessary, the number of critical care beds can surge beyond the baseline of 280-285 as part of an emergency response. However, it is essential to understand that the use of surge capacity for critical care is necessarily tied to a reduction of services in other areas of the hospital. Moreover, the clinical advice is clear that the greater the reliance on surge ICU capacity, the greater the clinical risk with potential impact on patient outcomes.
Our critical care units have coped well so far, largely due to the fact that the curve was flattened successfully in early stages. As a result, our outcomes for Covid patients in ICU have compared well with other jurisdictions including the UK.
Budget 2021 will allocate funding totalling €52m in 2021 to critical care. This will retain, on a permanent basis, the 42 critical care beds put in place on a temporary basis this year and add significant new capacity. Funded adult critical care beds will increase to 321 by end 2021, an increase of 66 over the baseline number of 255 funded beds in 2020. Funding for 2021 will also include money to allow for the development of a workforce plan as well as education initiatives to grow the critical care workforce.”
In relation to community capacity, a home first approach is being taken founded on a community model of care that puts in place end to end care pathways to deliver care to people at or near home. This will include an integrated a mix of services delivered through Community Health Networks working closely with integrated older person teams, frailty teams, utilisation of new rehabilitation beds and enhanced home care with a new 5 million hours for 2021. The intermediate care beds are intended to enable people to avoid going into acute hospitals or when admitted to acute hospitals to enable to go home more quickly following a period of rehabilitation. These repurposed and additional beds will be located within the 9 Community Healthcare Organisations.
This represents a significant step towards achieving the recommendations in the 2018 Health Service Capacity Review which found that an additional 2,100 inpatient acute beds were required, in a reform scenario, by 2031.
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.
Covid-19 Pandemic
Ceisteanna (1390)
Christopher O'Sullivan
Ceist:1390. Deputy Christopher O'Sullivan asked the Minister for Health if maternity visitation restrictions can be eased to make room for social bubble, social and household exclusive support network; and if he will make a statement on the matter. [33590/20]
Amharc ar fhreagraFreagraí 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 (1391)
Richard Boyd Barrett
Ceist:1391. Deputy Richard Boyd Barrett asked the Minister for Health if he will provide a full list of regulations to allow for fines for the breaking of Covid-19 restrictions; and if he will make a statement on the matter. [33603/20]
Amharc ar fhreagraFreagraí scríofa
My Department is working closely with the Department of Justice to draft and finalise regulations around the introduction of fixed penalty notices. 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. In addition, they are published on the Department's website.
Covid-19 Pandemic
Ceisteanna (1392)
Richard Boyd Barrett
Ceist:1392. Deputy Richard Boyd Barrett asked the Minister for Health if a school (details supplied) that teaches music to students with intellectual disabilities is allowed to stay open under level 5 restrictions; and if he will make a statement on the matter. [33605/20]
Amharc ar fhreagraFreagraí scríofa
Officials in this Department were unable to establish the exact nature of the service in the Deputy's question. Clarification was sought from the Deputy's office, but in the absence of this, it has not been possible to advise whether the service in question can remain open. In the context of Level 5 of the Government's Resilience & Recovery Framework (2020-2021): Plan for Living with COVID-19, all services deemed essential must adhere to public health guidance and infection prevention and control precautions.
A full list of essential services at level 5 of the Governments Resilience & Recovery Framework (2020-2021) including health and social work services are available at: https://www.gov.ie/en/publication/754c1-stakeholder-guidance-regarding-level-5-of-the-plan-for-living-with-covid-19/#essential-retail-and-essential-services
In relation to health services, Health Service Executive (HSE) regards the provision of disability health services as essential to maintaining a response to people with a disability under Level 5 of this plan. All disability services must follow public health guidance in this area, including the prevention and management of COVID-19 related infection. The HSE and its funded disability partners will continue to provide therapeutic supports in line with public health guidance and direction and having regard to the availability of staffing resources.
Covid-19 Pandemic
Ceisteanna (1393)
Richard Boyd Barrett
Ceist:1393. Deputy Richard Boyd Barrett asked the Minister for Health if court ordered parental access which requires travel and household visiting is not impacted under level 5 regulations and that such arrangements must be continued; and if he will make a statement on the matter. [33606/20]
Amharc ar fhreagraFreagraí scríofa
On Tuesday 15 September the Government published ‘Resilience and Recovery 2020-2021: Plan for Living with COVID-19’. This Plan outlines our medium-term strategy for COVID-19 and sets out a Framework of 5 Levels which outline the broad measures which will apply depending on the level of the virus at any given time. The Plan is designed to help everyone – individuals, families, organisations and sectors – to better understand, anticipate and prepare for the measures that might be introduced to contain transmission of the virus. Restrictions on domestic travel apply at Levels 3, 4 and 5 of the Plan. No restrictions on travel apply at Level 1 and 2 of the Plan.
At all levels of the Framework, and in all regulations which give effect to measures agreed by Government, provision is made to ensure that parents can continue to access their children. The regulations make clear that it is permitted to travel across county borders (Levels 3 and 4) and further than 5km (Level 5) for these purposes. Travel is permitted for parents of a child; guardian of a child; and a person who has a right of access to a child.
Those who share parenting or custody arrangements are now also permitted to form a support bubble should they wish to and further details on support bubbles is available here: https://www.gov.ie/en/publication/3516d-support-bubbles/
Dental Services
Ceisteanna (1394)
Alan Dillon
Ceist:1394. Deputy Alan Dillon asked the Minister for Health his plans to alleviate the waiting times being imposed on children and their parents when availing of State-provided orthodontic care; his plans to tackle the waiting list; and if he will make a statement on the matter. [33610/20]
Amharc ar fhreagraFreagraí 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 (1395)
Richard Boyd Barrett
Ceist:1395. Deputy Richard Boyd Barrett asked the Minister for Health the details of his negotiations with the private hospital sector to ensure a permanent increase in the capacity across the health service; and if he will make a statement on the matter. [33226/20]
Amharc ar fhreagraFreagraí scríofa
In March, in anticipation of the projected surge in Covid-19 cases and the expected impact on the health care system, a critical part of the response was to urgently ramp up capacity for acute hospital care facilities. An important 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.
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 urgent time-critical care and addressing elective care for public patients experiencing delays.
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. The process is due to be completed soon, and a panel put in place, following which each hospital will run mini competitions for the services they need. In the meantime, the Department has approved a temporary HSE arrangement for the treatment of patients in private hospitals pending the finalisation of the national procurement process.
The negotiations in the event of a surge are ongoing.
Disability Services Funding
Ceisteanna (1396)
Alan Kelly
Ceist:1396. Deputy Alan Kelly asked the Minister for Health the steps he is taking to ensure that the substantial deficits currently experienced by section 38 and 39 disability service providers are eliminated; the target date he is working towards for the elimination of these deficits; and if he will make a statement on the matter. [30662/20]
Amharc ar fhreagraFreagraí scríofa
Disability Services focus on enabling people with disabilities to achieve their full potential, living ordinary lives in ordinary places, as independently as possible while ensuring that the voices of service users and their families are heard, and that they are fully involved in planning and improving services to meet their needs.
My primary concern as Minister for Health is to ensure the continuity of these vital services in the interests of the wellbeing of the children, adolescents and adults who, along with their families, depend on these key services and supports.
Specialist disability services are provided by a range of organisations. In some cases, services are delivered directly by the Health Service Executive (HSE). However the majority of organisations providing services for people with a disability are funded by the HSE, on a contract for services basis, underpinned by Section 38 and 39 of the Health Act 2004. Service Level Agreements are set out between the HSE and the individual organisations. Section 38 and Section 39 disability service providers have independent boards, who govern the organisations concerned and any deficits accruing are the responsibility of these organisations.
Significant resources have been invested by the health sector in disability services over the past number of years. Budget 2021 provides for an unprecedented level of investment in disability services, with an investment of €100m for new initiatives in 2021. In addition to this, €20 million once off funding is being made available in 2020 for disability voluntary service providers engaged in the Transforming Lives Reform programme. Criteria for dispersing this funding is being finalised.
In the context of COVID-19, the HSE has provided significant supports to Section 38 and Section 39 organisations providing disability specialist services. Through the Community Healthcare Organisations (CHOs), the HSE is actively engaging with any Section 38 and Section 39 disability service providers who are experiencing financial challenges, including access to cash acceleration, where appropriate, to maintain continuity of service provision where cash flow issues arise. Organisations receiving funding from the HSE should raise any concerns in relation to financial issues that may have implications for continuity of service provision with the relevant Community Health Care Organisation (CHO) responsible for the service arrangements.
In addition, the Government has agreed to allocate substantial additional funding to the Health Vote to meet the costs associated with the implementation of the measures outlined in the National Action Plan in response to COVID-19. Specific action has been taken at my request and that of Minister Rabbitte, to relieve Disability service providers of the necessity to achieve a 1% efficiency target in 2020.
The HSE will continue to work in partnership with all service provider organisations to ensure the best level of service possible is provided to people with a disability, and their families, within the resources available. As the Deputy's question deals with organisations providing services to the HSE, I have arranged for the question to be referred to the HSE for direct reply to the Deputy.
Voluntary Sector
Ceisteanna (1397)
Alan Kelly
Ceist:1397. Deputy Alan Kelly asked the Minister for Health the steps he plans to take to ensure that the recommendations of the independent review group examining the role of voluntary organisations is fully implemented; the recommendations acted upon to date; his timeline for the completion of each of the actions contained in the recommendations; and if he will make a statement on the matter. [30663/20]
Amharc ar fhreagraFreagraí scríofa
The Report of the Independent Review Group established to examine the role of voluntary organisations in publicly funded health and social services, published in February 2019, highlighted the important contribution that voluntary organisations have made and continue to make in the delivery of health and social care services across the country.
The key finding in the Report is the need to strengthen the relationship between the State and the voluntary sector. To this end, a Dialogue Forum with Voluntary Organisations was established in December 2019 as recommended in the Report as a key mechanism for strengthening this relationship. The aim of the Forum is to build a stronger working relationship between the State and the voluntary healthcare sector for the benefit of patients and service users. The Forum will also facilitate regular dialogue with the voluntary sector on Sláintecare and other policy initiatives and will consider issues around governance more generally.
The Forum is independently chaired by Peter Cassells. Members of the Forum include the Department, the HSE, HIQA, the Mental Health Commission and the main representative bodies of voluntary providers of health and social care: The Wheel; Mental Health Reform; Disability Federation of Ireland; Not for Profit Association; National Federation of Voluntary Service Providers; Voluntary Healthcare Forum; Voluntary Hospices Group and National Community Care Network.
The Forum met twice in December and January, but further meetings scheduled for March 2020 and May 2020 were postponed due to the COVID-19 pandemic.
The Chair recently convened a sub-group of the Forum to act as a planning group to assist him in planning and, where appropriate, progressing the work of the Forum over the next three to four months. The Planning Group met online for the first time on 29 September 2020 and the Group will meet again in November and December. It is planned to recommence full Forum meetings in early 2021.
More generally, many of the Independent Review Group Report’s recommendations dovetail with the Sláintecare programme and are being considered in that context. In addition, some recommendations are being taken forward in the context of the Department of Rural and Community Development’s ‘Sustainable, Inclusive and Empowered Communities: A Five-Year Strategy to Support the Community and Voluntary Sector in Ireland 2019-2024’.
Child and Adolescent Mental Health Services
Ceisteanna (1398)
Paul McAuliffe
Ceist:1398. Deputy Paul McAuliffe asked the Minister for Health the status of the most recent CAMHS waiting lists; and if he will make a statement on the matter. [33448/20]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
Dental Services
Ceisteanna (1399)
Paul McAuliffe
Ceist:1399. Deputy Paul McAuliffe asked the Minister for Health the number of persons waiting for orthodontic procedures in CHO9; and if he will make a statement on the matter. [33449/20]
Amharc ar fhreagraFreagraí scríofa
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
Ceisteanna (1400)
Michael Healy-Rae
Ceist:1400. Deputy Michael Healy-Rae asked the Minister for Health when a registration number will issue to a person (details supplied); and if he will make a statement on the matter. [33623/20]
Amharc ar fhreagraFreagraí scríofa
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.
Nursing Staff
Ceisteanna (1401)
Richard Boyd Barrett
Ceist:1401. Deputy Richard Boyd Barrett asked the Minister for Health if student nurses on job placement in hospital and care settings are being paid by the HSE or another body; the rates of pay they are receiving and entitled to; if they will be given employee rights while in these roles; if so, the rights they will be entitled to; if these placements, payments and employee rights extend to the duration of any Covid-19 measures; and if he will make a statement on the matter. [33625/20]
Amharc ar fhreagraFreagraí scríofa
The HSE continues to fund the employment of 4th year student nurses and midwives who are on rostered work placements in hospital settings.
These 4th year student nurses and midwives on rostered work placement are paid at the approved rate as detailed on the HSE salary scale of €22,229 (annualised - psychiatric nursing specialism) and €21,749 (annualised - all other nursing specialisms).
This rate of pay has been determined by HSE circular 005/2016 and is updated in accordance with consolidated pay scales issued on 1 October 2020.
Other financial supports open to all eligible nursing students include:
- An accommodation allowance available for eligible nursing students which amounts up to €50.79 a week for the duration of the placement where it is necessary for the student to obtain accommodation away from his/her normal place of residence.
- A travel allowance is also available to eligible nursing students.
The 'Arrangements for Undergraduate Nursing/Midwifery Students Undertaking the Continuous Thirty Six Week Internship' , as detailed in HSE circular 030/2009, outline the rights and entitlements in place for 4th Year Student Nurses and Midwives that undertake this placement. It covers areas such as leave entitlements, incremental credit, superannuation and the terms and conditions of employment. These arrangements continue to be in force at the present time.
Concerning if these placements, payments and employee rights extend to the duration of any Covid-19 measures; I have referred this to the HSE to respond directly.
Question No. 1402 answered with Question No. 1099.
Question No. 1403 answered with Question No. 1099.