Written Answers Nos. 882-898
882. Deputy Fergus O'Dowd asked the Minister for Health if he will address concerns raised in correspondence (details supplied) in relation to rough shooting; and if he will make a statement on the matter. [38513/20]
Amharc ar fhreagraAs you will be aware, Ireland has moved to level 5 of the Government’s medium-term strategy for dealing with COVID-19, Resilience and Recovery 2020-2021: Plan for Living with COVID-19. This Plan sets out Ireland's approach to managing and living with COVID-19 in a range of areas over the next 6 - 9 months.
The Plan sets out five levels of response, each with a number of measures designed to help us all lower COVID-19 transmission and setting out what is permitted at that moment in time. It aims to allow society and businesses to be able to operate as normally as possible, while continuing to suppress the virus. Each level outlines what is permitted for social or family gatherings, work and public transport, bars, hotels and restaurants, exercise activities and religious services.
At level 5 of the Plan, people are asked to stay at home, with certain exceptions, and must exercise within 5 km of home. Exercise and sporting amenities have been closed in order to reduce the person-to-person contacts which allow the virus to spread. No matches or other sporting events may be held with the exception of professional elite sports and senior inter-county Gaelic games and horse and greyhound racing, which may continue behind closed doors. All other training activities should be individual only. It is possible to meet with 1 other household in an outdoor setting which is not a home or garden, such as a park, including for the purpose of exercise.
I would like to clarify that I have no function in relation to rough shooting, responsibility for which lies with the Minister for Housing, Local Government and Heritage.
883. Deputy Kathleen Funchion asked the Minister for Health if IVF is available through the public hospital system for a medical card patient. [38517/20]
Amharc ar fhreagraA commitment to introduce the model of care for infertility, which was developed by officials in my Department in conjunction with the HSE’s National Women & Infants Health Programme, is included in the Programme for Government, “Our Shared Future”. This model of care will ensure that infertility issues will be addressed through the public health system at the lowest level of clinical intervention necessary. It will comprise three stages, starting in primary care (i.e., GPs) and extending into secondary care (i.e., Regional Fertility Hubs) and then, where necessary, tertiary care (i.e., IVF and other advanced assisted human reproduction (AHR) treatments). Structured referral pathways will be put in place and patients will be referred onwards for further investigations or treatment as required and as clinically appropriate. It is intended that, in line with available resources, this model of care for infertility will be rolled out on a phased basis over the course of the coming years.
Phase One of the roll-out of the model of care has commenced and involves the establishment, at secondary care level, of Regional Fertility Hubs in maternity networks. which will facilitate the management of a significant proportion of patients presenting with infertility issues.
Phase Two of the roll-out will see the introduction of tertiary infertility services, including IVF, in the public health system. Phase Two will not commence until such time as infertility services at secondary level have been developed across the country and the AHR legislation is commenced. Drafting of the AHR legislation is ongoing, in conjunction with the Office of the Attorney General.
It should be noted that while AHR treatment is not currently funded by the Irish public health service, a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Arrangements administered by the HSE. Medicines covered by the High Tech Arrangements must be prescribed by a consultant/specialist and authorised for supply to the client’s nominated community pharmacy by the High Tech Hub managed by the Primary Care Reimbursement Service. The cost of the medicines is then covered, as appropriate, under the client’s eligibility, i.e., Medical Card or Drugs Payment Scheme. Given the costs associated with certain fertility medicines, I am aware that these schemes can have a material impact on the total cost of AHR treatment for individuals who avail of them.
In addition, there is other support available in that patients who access IVF treatment privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme.
Overall, the implementation of the model of care will help to ensure the provision of safe, effective and accessible infertility services at all levels of the public health system as part of the full range of services available in obstetrics and gynaecology.
884. Deputy Holly Cairns asked the Minister for Health further to Parliamentary Question No. 214 of 17 September 2020, the number of officials engaged in actively listening to public views and concerns from the outset of the Covid-19 pandemic collating commentary on social and traditional media; the grade of each official; the way in which decision-making in his Department has been impacted by this process; and if he will make a statement on the matter. [38524/20]
Amharc ar fhreagraWHO Outbreak Communication Planning Guides state that: “Understanding the public’s risk perceptions, views and concerns is critical to effective communication and the broader emergency management function it supports. Without knowing how people understand and perceive a given risk and what their existing beliefs and practices are, decisions and required behaviour changes necessary to protect health may not occur and societal or economic disruption may be more severe.”
Similarly, ECDC guidance issued in March 2020 stated the following: “In addition to informing the population about mandated measures, people should be strongly encouraged to take action at a personal level as a means of protecting themselves and others.... A monitoring system should also be put in place to observe public perceptions and opinions of the social distancing measures that people are being subjected to.” This guidance is available to read on the EDCD's website.
While the reviewing and monitoring of printed press, broadcast media and social media is an everyday workstream in my Departments press office, as per the guidance I have outlined, the Department of Health has actively listened to public views and concerns from the outset of this pandemic. The Department is also conducting surveys among the general public through the Amárach survey, published regularly on the Department’s website.
There are currently 3 press officers and 3 executive officers involved in this workstream.
885. Deputy Sorca Clarke asked the Minister for Health the dental services currently available to medical card holders. [38544/20]
Amharc ar fhreagraThe Dental Treatment Services Scheme (DTSS) provides dental treatments to adult medical card holders. Services currently available annually, without prior approval of the local HSE Principal Dental Surgeon, include an examination, two fillings and emergency extractions.
Other more complex care is also provided some of which requires prior approval by a Principal Dental Surgeon. Patients with special needs and high risk patients can avail of a broader range of treatments including a scale and polish on approval of the Principal Dental Surgeon.
886. Deputy Sorca Clarke asked the Minister for Health the number of dentists by county in tabular form. [38545/20]
Amharc ar fhreagraMy Department does not routinely collate this information. The Dental Council, under the Dentists Act 1985, establishes and maintains a register of dentists. This register is published annually and is available from the Dental Council.
887. Deputy Sorca Clarke asked the Minister for Health the number of dentists who offer services to medical card holders, by county and in tabular form. [38546/20]
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.
888. Deputy Seán Haughey asked the Minister for Health if he will request the HSE to suspend the routine reviews of medical card eligibility during level 5 restrictions given difficulties medical card holders have had in assembling the necessary documentation during the pandemic; and if he will make a statement on the matter. [38556/20]
Amharc ar fhreagraIn accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. The Act obliges the HSE to assess whether a person is unable, without due hardship, to arrange general practitioner services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure. The HSE is also required to undertake periodic reviews of eligibility in order to ensure that a person continues to meet the qualifying criteria required to continue holding eligibility.
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. 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.
Furthermore, the HSE have also introduced a number of helpful operational measures since the onset of COVID-19 that have temporarily removed some of the requirements that would normally be expected for the completion of a medical card application.
889. Deputy Carol Nolan asked the Minister for Health if concerns regarding the failure to employ a specialist diabetic nurse for Mullingar Regional Hospital will be addressed; and if he will make a statement on the matter. [38558/20]
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.
890. Deputy Alan Farrell asked the Minister for Health if consideration will be given to requesting the retail and public transport sectors to allow specific shopping and travelling times for the older and vulnerable members of society when the current restrictions are lifted; and if he will make a statement on the matter. [38564/20]
Amharc ar fhreagraThe Deputy should note that the issue referred to in the question in relation to requesting the public transport sector to allow specific travelling times for the older and vulnerable members of society is a matter for the Minister for Transport. The issue in relation the retail sector allowing specific shopping times for the older and vulnerable members of society is a matter for the Minister for Enterprise, Trade and Employment.
891. Deputy Pa Daly asked the Minister for Health his views on general practitioners charging medical card holders for blood tests. [38569/20]
Amharc ar fhreagraPersons who are eligible for GP care without charge under the Health Act 1970 are not subject to any co-payments or other charges in respect of such services. There is no provision under the GMS GP contract for persons who hold a medical card or GP visit card to be charged for routine phlebotomy services provided by their GP which are required to either assist in the diagnosis of illness or the treatment of a condition and the HSE has advised GPs accordingly.
I am aware that, nonetheless, some GPs are charging GMS patients for phlebotomy services in some circumstances. The GP chronic disease management programme which is being phased in from this year will involve the ongoing monitoring of patients’ condition and any blood tests required in this context will be covered by the fees payable for this care.
However, it remains a matter of concern to me that a GMS and GP visit card patient might be charged for blood tests which are clinically necessary and I have asked my officials to discuss with the HSE what further solutions to this issue may be possible. If a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for routine phlebotomy services by his or her GP, then that patient should report the matter to their HSE Local Health Office. The local management, upon being notified of potential inappropriate charging of GMS patients, carry out an investigation into each complaint and will, where appropriate, arrange for a refund of charges incorrectly applied by the GP.
892. Deputy Michael McNamara asked the Minister for Health when a person (details supplied) in County Clare will receive an orthodontic appointment at St. Camillus's Hospital, Limerick, following a referral on 9 October 2015; and if he will make a statement on the matter. [38571/20]
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.
893. Deputy Pa Daly asked the Minister for Health if he will report on the requisite qualifications for the role of medical officers hired for the purpose of reviewing an emergency medical card application, with additional information for medical officers reviewing oncology applicants; and if he will make a statement on the matter. [38572/20]
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.
894. Deputy Thomas Pringle asked the Minister for Health the treatment options available for lymphoedema patients at Letterkenny University Hospital; his plans to ensure patients attending Letterkenny University Hospital can access necessary and appropriate treatment for lymphoedema; and if he will make a statement on the matter. [38576/20]
Amharc ar fhreagra895. Deputy Thomas Pringle asked the Minister for Health the status of the implementation of the model of care report on lymphoedema and lipoedema treatment in Ireland; and if he will make a statement on the matter. [38577/20]
Amharc ar fhreagraI propose to take Questions Nos. 894 and 895 together.
The HSE has initiated implementation of the Model of Care for Lymphoedema and Lipoedema through two proof of concept services - one for a primary care specialist lymphoedema service in Laois/Offaly (Community Healthcare Organisation 8 area) and the other for early detection in acute services (Mater Hospital). The recruitment of staff is on-going in Laois/Offaly, though this has been challenging particularly in the context of the Covid-19 pandemic. The early detection initiative in the Mater is progressing.
As recommended in the Model of Care, National Lymphoedema Clinical Guidelines are currently being developed and are due to be completed in mid-2021. In addition, work is ongoing on a GP education eLearning module which will be finalised shortly.
Patients in Donegal are referred to lymphoedema services in the community in line with the Model of Care.
896. Deputy Thomas Pringle asked the Minister for Health the number and list of treatments being assessed by a HSE drugs group at its next meeting; and if he will make a statement on the matter. [38580/20]
Amharc ar fhreagraAs this is a service matter relating to an administrative process, I have asked the Health Service Executive to respond to the deputy directly as soon as possible.
897. Deputy Aengus Ó Snodaigh asked the Minister for Health his plans to carry out a full health audit of former members of all branches of the Defence Forces with a view to extending a full medical card to all retired Defence Forces members. [38583/20]
Amharc ar fhreagraUnder the provisions of the Health Act 1970 (as amended), eligibility for health services in Ireland is based primarily on residency and means. The Act provides that persons who are unable, without undue hardship, to arrange GP services for themselves and dependents can qualify for full eligibility (a medical card). The HSE awards medical cards in accordance with the Health Act and assesses applicants on the overall financial situation of the applicant and his or her spouse or dependent.
Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of any 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. Currently, more than 32% of the population hold eligibility for a medical card.
All persons who are ordinarily resident in the state can apply to the HSE to be determined whether eligible for a medical card.
898. Deputy Barry Cowen asked the Minister for Health the status of the case of a person (details supplied); and when the person can expect an appointment with the audiology department at Midland Regional Hospital, Tullamore. [38591/20]
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 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.
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 the use of alternative settings including private hospitals, community facilities and alternative outpatient settings.
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.
