Written Answers Nos. 822-841
822. Deputy David Cullinane asked the Minister for Health the current status and plans for advancing the support for Irish survivors of thalidomide Bill; the legislative timeline; and if he will make a statement on the matter. [36876/20]
Amharc ar fhreagraThe Deputy will appreciate that there are a number of cases concerning thalidomide before the High Court at present and it is not possible to comment on matters that are sub judice.
Following an Irish Government Decision in January 1975, the Government granted an ex-gratia sum equivalent to 4 times the German lump-sum and an ex-gratia monthly allowance for life equal to the German monthly allowance, to each of the Irish children found to have thalidomide related injuries. There are currently 29 Irish people in receipt of ex-gratia monthly payments from my Department.
The German monthly payments are made by the Contergan Foundation, which is established under German legislation. From 1 August 2013, the Foundation substantially increased its monthly payments to thalidomide survivors, including Irish survivors. Both the German payments and the Irish ex-gratia payments made to the survivors are exempt from tax, including DIRT and are not reckonable as means for the purpose of Social Welfare payments. The rate of payment is related to the survivors' level of thalidomide related injury.
In addition to the initial lump sum and monthly payments for life, the supports provided to each Irish survivor include a medical card on an administrative basis regardless of means, provision of appliances, artificial limbs, equipment, housing adaptations and access to a full range of primary care, hospital and personal social services. There is a designated senior manager in the Health Service Executive who liaises with Irish thalidomide survivors in relation to meeting their ongoing health and personal social service needs.
It is important to note that the German Contergan Foundation, which is established under German legislation, has confirmed that since 2013 it is accepting applications from individuals for compensation for thalidomide related injury. It is open to any Irish person to apply to the Foundation for assessment of their disability as being attributable to thalidomide. Any Irish person who establishes that their injury is attributable to thalidomide will be offered appropriate supports by the Irish Government, commensurate with those currently provided to Irish thalidomide survivors.
Work is underway in the Department to bring forward Heads of a Bill to provide on a statutory basis for health and personal social services for Irish survivors of thalidomide.
823. Deputy David Cullinane asked the Minister for Health the current status and plans for advancing the Nursing Home Support Scheme (Amendment) Bill 2016 to give effect to the fair deal review; the legislative timeline; and if he will make a statement on the matter. [36877/20]
Amharc ar fhreagraThe Nursing Homes Support Scheme, (NHSS) commonly referred to as Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.
The proposed policy change to the NHSS, to cap contributions based on farm and business assets at 3 years where a family successor commits to working the productive asset, has been approved by Government. The Department developed draft Heads of Bill while considering a number of complex ancillary policy and operational matters which may need to be addressed in the proposed legislation.
The stated policy objective of the general scheme of the Bill is to introduce further safeguards in the NHSS to further protect the viability and sustainability of family farms and businesses that will be passed down to the next generation of the family to continue to work them as productive assets to provide for them their livelihood.
The amendment of the scheme will bring certainty to the duration for which a contribution to the cost of care under NHSS will be levied against family farms and businesses. This in turn will support the viability of farms and businesses by increasing the likelihood of access to financing & promoting investment, which will encourage orderly succession planning with family members, encourage young farmers to remain farming and potentially encourage family members that had changed occupation or emigrated to return to the family farm.
The General Scheme of Bill for the Amendment to the NHSS was approved by Government on 11 June 2019 and subsequently published. The changes to the Scheme will come into effect as soon as the legislative process is successfully complete. The General Scheme was sent to the relevant Joint Committee and the Department participated in pre-legislative scrutiny on 13 November 2019. The Pre-legislative scrutiny Report has yet to be approved by the Committee on Health. Engagement with the Office of the Attorney General began in early 2020 to progress the legislative development process.
Further progress on the development of the Bill has been impacted by the COVID-19 pandemic with focus entirely on responding to the challenges presented by COVID-19. The response to the COVID-19 pandemic has been and continues to be a national and public health priority.
Work on the legislative process with the Office of the Attorney General regarding this Bill has recently resumed.
This piece of legislation is a priority for the government and will be progressed as soon as possible, to support Farm Families and Businesses.
824. Deputy Steven Matthews asked the Minister for Health if his attention has been drawn to the closure of a centre (details supplied); and the alternative arrangements that will be made available in the immediate term to provide assurances to those who rely on this service. [36889/20]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
825. Deputy James Lawless asked the Minister for Health the Covid-19 testing protocols for hospital medical staff; the average waiting times for hospital staff to receive their results after they have been tested; if the testing of hospital medical staff is undertaken exclusively in the hospitals they work in or by an outside agency; if in-house testing in the hospitals of medical staff is quicker than those conducted by an outside agency; and if he will make a statement on the matter. [36896/20]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
826. Deputy Catherine Murphy asked the Minister for Health the way in which his Department’s annual amount for contingent liability is set; the factors considered when setting contingent liability; if forecasting is undertaken regarding setting future amounts; the contingent liability figure for his Department for 2020; and if the contingency provision has been utilised to date in 2020. [36906/20]
Amharc ar fhreagraThe State Claims Agency (SCA) has a statutory remit to manage personal injury claims on behalf of delegated state authorities, including the HSE. In this regard, the SCA arranges for an annual actuarial report to be produced that projects the value of future claims. This information feeds into the Department’s estimates process to identify possible liability for the Department and the HSE in any given year. The SCA assists the Governance and Performance division of the Department with a number of other claims relating to Medical Defence Union Refusals that involve legal proceedings which may generate liabilities, depending on the outcome of the litigation. Because these proceedings have yet to be heard disclosure would prejudice the Exchequer position and/or future negotiations with third parties.
Where there are any uncertainties, the Government Accounting Unit in the Department of Public Expenditure and Reform are consulted for guidance. Supporting documentation (including correspondence) outlining why the contingent liability has been entered into is retained for review either internally or by third parties, such as the staff of the Office of the Comptroller and Auditor General.
827. Deputy James Lawless asked the Minister for Health the number of Covid-19 tests undertaken in the past two weeks in the Punchestown testing centre, County Kildare; the average waiting times for the results to be returned to the persons tested; and if he will make a statement on the matter. [36915/20]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible
828. Deputy Joe O'Brien asked the Minister for Health his plans to introduce a salary scheme to compensate student nurses who while on placement carry out a standard 35-hour week; and if he will make a statement on the matter. [36918/20]
Amharc ar fhreagraI recognise the importance of student nurses and midwives completing their essential clinical placements in a safe environment and also recognise the potential hardship that might arise for students on placement due to COVID 19 such as, maintaining part time employment, increased travel and additional accommodation costs.
Student nurses and midwives are not paid for clinical placements in years 1-3 of their studies and this supernumerary status is critical for learning in complex environments. Financial supports for non-intern student nurses and midwives are governed by Circular 9/2004, that provides:
- an accommodation allowance up to €50.79 per week to be paid where it is necessary for a student to obtain accommodation away from their normal place of residence;
- a refund of travel expenses.
Both are paid as refunds on production of receipts.
In the immediate term my Department is reviewing a number of supports that apply to this year’s 1st, 2nd and 3rd year students on clinical placements, taking into account the impact of the COVID-19 pandemic on such placements.
Concerning 4th year nursing and midwifery students, the HSE continues to fund the internship employment of these students who are on rostered work placements. It is very important that the training element is protected for students. This includes those scheduled to commence in the coming weeks and those due to commence rostered work placement in 2021. These 4th year student nurses and midwives on rostered work placement are paid at the approved rate, that is €22,229 on an annual basis for psychiatric nursing specialism and €21,749 for all other nursing disciplines. This rate of pay is determined by HSE circular 005/2016 and is updated in accordance with the consolidated pay scales issued on 01st October, 2020 by my Department.
Separately, and for the longer term, my Department is also reviewing the accommodation and travel allowances for students on clinical placements that should apply from the academic year commencing Autumn 2021 and onwards. This review is expected to conclude at the end of this month, and I look forward to examining the outcome of this review in due course.
829. Deputy Pauline Tully asked the Minister for Health the progress of the personalised budgets demonstration projects pilot; the number of disabled persons who have signed up in phase 1 and phase 2; the projected timeline for the completion of the demonstration projects; and if he will make a statement on the matter. [36922/20]
Amharc ar fhreagra841. Deputy Pauline Tully asked the Minister for Health the progress of the personalised budgets demonstration projects pilot; the number of disabled persons who have signed up in phase 1 and 2; the timeframe for the completion of the demonstrations projects; and if he will make a statement on the matter. [36992/20]
Amharc ar fhreagraI propose to take Questions Nos. 829 and 841 together.
There are currently 32 participants in the various stages of Phase 1 of the Personalised Budget Pilot Demonstration. This means that the pilot is running behind schedule. This is due to the COVID-19 pandemic, which as I'm sure the Deputy is aware, resulted in the closure of disability services. The current Level 5 restrictions are also severely impacting with the Health Service Executive's (HSE) ability to meet with individuals and progress.
The Department of Health, HSE and National Disability Authority (NDA) recommended that a sample size of 180 Personalised Budget packages would be sufficient to demonstrate the models of Personalised Budgets, as set out in the report - Towards Personalised Budgets for People with a Disability in Ireland. In that regard there are many variables that need to be considered for testing within this sample size:
- Types of Disability - Intellectual Disability, Physical and Sensory Disability, Autism
- Complexity of Need - High, Medium and Low
- Models of Personalised Budget - Person Managed Fund, Co Managed with Service Provider, Broker Managed Fund
- Levels of Governance
- Elements of Disability Services - Personal Assistance and Home Support, School Leavers, Other Day Services, Respite and Residential
- Community Health Organisation delivery systems - 9 CHOs
Up to 180 adults with a disability will participate in the Personalised Budget Pilot Demonstration over two phases (2 x 90). The launch of Phase 2 of the pilot commenced on 27th July with a call for Expressions of Interest. The Expressions of Interest application deadline for Phase 2 closed on 7th September, with the HSE receiving 136 applications. As there was a pause in processing applications, due to COVID-19, applications are still being processed.
Applications were welcomed from adults with a disability that are currently in receipt of HSE funded services; provided either directly by the HSE or through the non-statutory sector (including day services, residential services, respite services, rehabilitative training or personal assistance) and young people leaving school in 2020 that have a commitment to a funded day service.
830. Deputy Niamh Smyth asked the Minister for Health if he will review correspondence (details supplied); if he will clarify the matter; and if he will make a statement on the matter. [36947/20]
Amharc ar fhreagraAs the Deputy is aware, the situation regarding COVID-19 has been, and continues to be, an evolving situation. COVID-19 is still having a major impact both here in Ireland and elsewhere.
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. It will be possible for different regions and counties to be at different levels, depending on prevailing epidemiological situation. The Plan is designed to help everyone – individuals, organisations and sectors – to better understand, anticipate and prepare for the measures that might be introduced to contain transmission of the virus. The intention is that Departments and sectors will provide guidance for specific sectors and activities in line with the 5 level framework.
At Level 5 of the Plan, only essential retail outlets and essential services are allowed to open to the public. The list of essential services that can remain open during Level 5 includes therapy services provided by a member of a designated profession within the meaning of section 3 of the Health and Social Care Professionals Act 2005 (No. 27 of 2005). There are seventeen professions designated under the 2005 Act, which are encompassed in the list of essential services. These are: Dietitians, Dispensing Opticians, Medical Scientists, Occupational Therapists, Optometrists, Physiotherapists (which includes Physical Therapists), Radiographers, Radiation Therapists, Social Workers, Speech and Language Therapists, Clinical Biochemists, Counsellors, Orthoptists, Podiatrists, Psychologists, Psychotherapists and Social Care Workers.
The public health advice relating to Covid-19 is kept under continuing review by the National Public Health Emergency Team (NPHET), and it provides advice to Government in line with the current epidemiological position. The latest public health advice on these matters is available at the links below and is updated on a regular basis:
https://www.gov.ie/en/organisation/department-of-health/
https://www2.hse.ie/coronavirus/
https://www.gov.ie/en/
831. Deputy John Lahart asked the Minister for Health if the national services development plan will commence in 2020; if so, if it will be led by an organisation (details supplied); if the plan will be evidence-based; and if he will make a statement on the matter. [36949/20]
Amharc ar fhreagraThe question raised by the Deputy regarding the national service development plan does not appear to be relevant to the Department of Health. The organisation referred to by the Deputy is not funded by the Department. The Deputy may wish to note that this organisation is funded in the main by TUSLA, which falls under the auspices of the Department of Children.
If the Deputy could provide some further detail regarding the above issues, I will consider it further.
In the meantime, I can inform the Deputy that the Department of Health allocation in Budget 2021 includes €50,000 for on-line training programmes for health care professionals dealing with victims of domestic violence. The aim is to ensure that families experiencing, or at risk of experiencing domestic or sexual violence will be supported when they access health services. Further details will be set out in the HSE National Service Plan for 2021, which is to be submitted to the Minister for Health shortly.
832. Deputy Niamh Smyth asked the Minister for Health if he will review correspondence (details supplied); and if he will make a statement on the matter. [36950/20]
Amharc ar fhreagraAs the Deputy is aware, the situation regarding COVID-19 has been, and continues to be, an evolving situation. COVID-19 is still having a major impact both here in Ireland and elsewhere.
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. It will be possible for different regions and counties to be at different levels, depending on prevailing epidemiological situation. The Plan is designed to help everyone – individuals, organisations and sectors – to better understand, anticipate and prepare for the measures that might be introduced to contain transmission of the virus. The intention is that Departments and sectors will provide guidance for specific sectors and activities in line with the 5 level framework.
At Level 5 of the Plan, only essential retail outlets and essential services are allowed to open to the public. The list of essential services that can remain open during Level 5 includes therapy services provided by a member of a designated profession within the meaning of section 3 of the Health and Social Care Professionals Act 2005 (No. 27 of 2005). There are seventeen professions designated under the 2005 Act, which are encompassed in the list of essential services. These are: Dietitians, Dispensing Opticians, Medical Scientists, Occupational Therapists, Optometrists, Physiotherapists (which includes Physical Therapists), Radiographers, Radiation Therapists, Social Workers, Speech and Language Therapists, Clinical Biochemists, Counsellors, Orthoptists, Podiatrists, Psychologists, Psychotherapists and Social Care Workers.
The public health advice relating to Covid-19 is kept under continuing review by the National Public Health Emergency Team (NPHET), and it provides advice to Government in line with the current epidemiological position. The latest public health advice on these matters is available at the links below and is updated on a regular basis:
https://www.gov.ie/en/organisation/department-of-health/
https://www2.hse.ie/coronavirus/
https://www.gov.ie/en/
833. Deputy Jennifer Murnane O'Connor asked the Minister for Health the number of vacant public health nurse posts in each CHO in tabular form; and if he will make a statement on the matter. [36956/20]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.
834. Deputy Jennifer Murnane O'Connor asked the Minister for Health the number of persons on the waiting list to see a consultant cardiologist at St. Luke's Hospital, Kilkenny; the average waiting time to see a consultant; and if he will make a statement on the matter. [36957/20]
Amharc ar fhreagraIt 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 routine 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.
Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.
The HSE continues to optimise productivity through alternative work practices such as the use of alternative settings including private hospitals, community facilities and alternative outpatient settings.
In addition the National Treatment Purchase Fund (NTPF) is currently reviewing strategies to maximise activity and benefit for patients, to include, increased use of private hospitals, funding weekend and evening work in public hospitals, funding “see and treat” services where minor procedures are provided at the same time as outpatient consultations, funding hybrid services where public and private hospitals contribute to the treatment of patients, virtual clinics and clinical validation.
The St Luke’s Hospital outpatient cardiology waiting list is outlined in the attached document. The latest NTPF figures show that there are currently 343 patients on the St Luke’s Hospital OPD cardiology waiting list. Of these, 62% (211) are waiting 6 months or less and 82% (281) are waiting 12 months or less. The St Luke’s Hospital OPD cardiology waiting list has decreased by 12%, when compared to the same period last year. The NTPF have advised that the average wait time to see a consultant cardiologist at St Luke’s Hospital, Kilkenny is 177 days.
835. Deputy Thomas Pringle asked the Minister for Health if he will report on the delay in delivering the primary healthcare centre for Finglas, Dublin 11; and if he will make a statement on the matter. [36965/20]
Amharc ar fhreagraThe development of primary care is central to the Government's objective to deliver a high quality, integrated and cost-effective health care system.
Finglas has been identified as a high priority location for the development of a Primary Care Centre. Approval for a HSE direct-build Primary Care Centre was approved in 2012. Following the review of a number of sites in the area, a Dublin City Council owned property on Mellowes Road, Finglas was identified as the preferred site. Subject to planning permission, the commercial terms for the sale were agreed with the officials of Dublin City Council and approved by the HSE.
The planning permission was appealed to An Bord Pleanála where an inspector upheld the Dublin City Council decision. However in February 2015, An Bord Pleanála took the unexpected decision not to grant planning permission for the Finglas primary care centre due to the loss of informal open space.
Following this refusal, HSE Estates in conjunction with local Primary Care Services Teams identified an alternative site for a new Primary Care Centre in Finglas and initiated discussions with Dublin City Council in relation to purchasing this site on terms agreeable to both parties.
Feasibility studies on the site are still progressing. The HSE will be tendering for the services of a Design Team to progress the proposed project to completion in the near future subject to agreeable conclusion to the site purchase.
836. Deputy Sean Sherlock asked the Minister for Health if his attention has been drawn to a situation which has arisen in which doctors are not being reimbursed by the HSE for providing abortion services to migrants, international students and others resident here but who do not possess a PPSN; his plans to address the issue; and if he will make a statement on the matter. [36971/20]
Amharc ar fhreagraTermination services are available without charge to women resident in Ireland. The relevant fees for these services have been established and are paid to GPs who provide the service by the HSE. As the operation of payments is an operational matter, I have asked the HSE to reply directly to the Deputy in relation to this aspect of the question.
837. Deputy Sean Sherlock asked the Minister for Health if his Department has a referral policy for cases in which a doctor refuses to provide reproductive health services to patients due to conscientious objection; and if he will make a statement on the matter. [36972/20]
Amharc ar fhreagraConscientious objection is covered under Section 22 of the Health (Regulation of Termination of Pregnancy) Act 2018. This section states that where he/she has a conscientious objection, a medical practitioner, nurse or midwife shall not be obliged to carry out, or participate in the carrying out, a termination of pregnancy.
Section 22 (3) provides that where a doctor, nurse or midwife has a conscientious objection, he/she shall, as soon as may be, make any necessary arrangements for the transfer of the woman’s care to enable her to avail of termination of pregnancy.
The Act makes it clear that conscientious objection cannot be invoked in an emergency situation, when the risk to a pregnant woman’s life or health is immediate.
More generally, section 49 of the Medical Council’s Guide to Professional Conduct and Ethics for Registered Medical Practitioners (Amended) (8th Edition 2019) deals with conscientious objection. It sets out the referral procedure to be followed by medical practitioners where a procedure, lawful treatment or form of care conflicts with their sincerely held ethical or moral values.
838. Deputy Cathal Crowe asked the Minister for Health when a person (details supplied) will receive an assessment appointment for a primary medical certificate at a health centre in Limerick city. [36974/20]
Amharc ar fhreagraBy way of background, the Minister for Finance has responsibility for the Disabled Drivers and Passengers (Tax Concessions) Scheme, which is operated by the Revenue Commissioners. To qualify for the Scheme, an applicant must be in possession of a Primary Medical Certificate.
The extent of the involvement of Health Service Executive (HSE) personnel in the Scheme relates to making a professional clinical determination as to whether an individual applicant meets the specified medical criteria. This determination is undertaken by Senior Medical Officers for the relevant HSE Community Health Organisation, on behalf of the Department of Finance and the Revenue Commissioners.
Minister Donohoe has advised the Minister for Health, Donnelly that the immediate effect of a Supreme Court decision in June 2020 related to the Scheme, is that there is no firm legal basis on which to undertake assessments for Primary Medical Certificates. Minister Donohoe as requested that the Senior Medical Officers in the HSE do no recommence assessments for Primary Medical Certificates until the current legal position is clarified by the Department of Finance. Minister Donnelly requested the HSE to issue an immediate instruction to the relevant HSE personnel to that effect.
As the Deputy's question relates to a service matter, I have arranged for the question to be referred to the HSE for direct reply to the Deputy.
840. Deputy Róisín Shortall asked the Minister for Health the number of occupational therapists, speech and language therapists and psychologists who have been reassigned to the Covid-19 testing and tracing response by CHO in tabular form; the impact this has had on waiting lists for children waiting for assessments with occupational therapists, speech and language therapists and autism specialists; the timeline his Department is working towards to return all redeployed HSE staff to their original posts; and if he will make a statement on the matter. [36991/20]
Amharc ar fhreagraThe 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 question relates to a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
