Written Answers Nos. 76-100
76. Deputy Christopher O'Sullivan asked the Minister for Justice if a national services development plan will commence in 2020; the role an organisation (details supplied) and its 38 front-line member services will play in developing a comprehensive national response to domestic abuse and coercive control; and if she will make a statement on the matter. [41721/20]
Amharc ar fhreagraTackling domestic abuse, which includes coercive control, and providing infrastructure that addresses victims needs comprehensively, is the collective aim of the Government and is a priority for me as Minister for Justice.
As the Deputy may be aware the Programme for Government commits to an audit of how responsibility for Domestic, Sexual and Gender based Violence (DSGBV) is segmented across different government agencies. The audit will be undertaken by an external consultant with meaningful involvement from relevant NGOs and service providers, as well as input from Departments and agencies.
The terms of reference for the audit have been finalised, and a procurement process to engage an independent person to undertake the audit has commenced with details available on my Department's website (www.justice.ie). It is intended that the audit will be completed within 3 months of commissioning and the findings will be presented to Government before the end of March 2021 in line with the PfG commitment.
The Deputy may also be aware that, over the last decade, work in this area has been conducted through successive DSGBV strategies. My Department coordinates the Second National Strategy on Domestic, Sexual and Gender-based Violence 2016-2021, which is a whole-of-Government approach to delivering on the many actions necessary to address these matters fully.
The Strategy includes input from relevant community and voluntary groups as well as other stakeholders across the sector. This is achieved through a Monitoring Committee composed of stakeholders from all sectors working together in partnership; as well as ongoing cooperation between the Department and frontline services and industry partners. The Monitoring Committee and the NGOs represented on it are key partners for my Department in our work to tackle DSGBV and will be a primary focus of our consultations in the audit process. I can confirm for the Deputy that the organisation referred to is a member of the Monitoring Committee.
Overall, the Strategy aims to considerably strengthen the law and structures in Ireland targeting domestic, sexual and gender-based violence and considerable progress has been made in addressing these issues through the Strategy.
Without prejudice to the outcome of the audit, a review of the outstanding actions has been conducted to inform the forthcoming 3rd National Strategy on DSGBV, to be developed and agreed by Government before the end of 2021.
As part of our national response to domestic abuse, in 2020, my Department committed almost €1.9 million to support services for victims of crime, including victims of sexual and gender based violence. These services provide important information and support to victims of crime, including emotional support, court accompaniment, accompaniment to Garda interviews and to sexual assault treatment units, counselling and referral to other services. I have secured €4.104 million under Budget 2021 to continue supporting victims of crime. I have also secured just over €3 million for raising awareness of domestic, sexual and gender based violence. These figures reflect the additional €2.3 million provided in Budget 2021 to support the implementation of the O'Malley review which will support vulnerable victims, including victims of domestic, sexual and gender based violence.
‘Supporting a Victims Journey’ will be implemented as a priority and it includes the provision of specific training for all of the key personnel a victim comes into contact with during the course of their journey throughout the criminal justice system. Such personnel includes the Gardaí, the DPP, the judiciary and the legal profession. Engagement on development of training programmes for serving Gardaí, the legal professions and members of the judiciary who are participating in sexual offences investigations and trials has already started, and I expect this training will be further rolled out in 2021.
The Deputy may also be interested to know that the rollout of the Divisional Protective Services Units (DPSU) within An Garda Síochána is now complete nationwide with DPSUs in every Garda division across the country. The completion of the rollout of DPSUs means that specially trained officers are available nationwide who will be responsible for engagement with, and interviewing of, vulnerable victims. This will ensure that when vulnerable victims of crimes such as domestic abuse and sexual violence present to Gardaí, they are met with a consistently high standard of specialist professional and expert assistance.
89. Deputy Niamh Smyth asked the Minister for Health the disability day services that have not reopened since Covid-19; when it is planned to open services fully; and if he will make a statement on the matter. [40647/20]
Amharc ar fhreagraAll day service locations with the exception of those being utilised as COVID-19 Isolation or testing centres have reopened since August.
There are currently 7 day service locations nationally that are being used for COVID-19 isolation or testing centres: one in CHO1; two in CHO2; one in CHO3 and three in CHO9.
Service users that usually received their supports from these locations are now either receiving supports at another location or receiving outreach or home-based supports. A further location will resume as a day service location in the coming weeks as an alternative COVID-19 test facility has been procured.
Day services re-opened at 39% capacity throughout August and early September. For the duration of the COVID-19 emergency day service capacity is reduced, this is due to the physical limitations of the buildings available, the lack of mainstream community activities, and the continued restrictions imposed by social distancing guidance. Many people with disabilities have underlying health conditions, and as the threat of COVID-19 remains, unfortunately so too does the need for these restrictions.
In September, Minister Donnelly and I announced that €7.5 million is being made available in 2020 to increase disability day services by one day a week for 14,940 adults. I also secured funding under the Budget to maintain this increase in 2021.
The funding will be used to augment staffing levels so that adults that currently live at home with their families will receive an average of an additional day of service at a day service location over and above what they have been receiving since day services resumed in August. Chief Officers were asked to immediately progress plans with the service provider sector to expedite the recruitment of the staff in this regard.
90. Deputy Peadar Tóibín asked the Minister for Health the nature of the correspondence his Department has received from organisations, charities, volunteer groups and NGOs which warn of an increase in mental health issues and suicide rates since the start of the Covid-19 pandemic. [42445/20]
Amharc ar fhreagraOver the last few months, correspondence has been received by the Department of Health in relation to the impact of Covid-19 on mental health. Some correspondents have expressed concern over a potential increase in self-harm, suicide and increased anxiety in the general population.
While early information suggests that there has not been a significant increase in self-harm and suicide figures, this is an area that the Department of Health will continue to monitor. It should be noted that the most recent year for which we have confirmed suicide figures is 2016, as coroners' reports and late registrations must be included. Provisional figures for 2019 are available.
I am aware, however, that traffic to online counselling sites has increased.
This is the case, for example, with MyMind, which is a HSE partner NGO providing online counselling sessions. Funding of €2.2m has been provided for 2020 to ensure that we can meet this increased demand through MyMind and a number of other providers.
It is important to promote the availability of these services. In this regard, the HSE has, since October, conducted an awareness campaign, through radio advertisements, directing people who need services to yourmentalhealth.ie and the mental health information telephone line 1800 111 888.
I recognise that the Covid pandemic may increase anxiety levels among the general population. The Government campaigns, “In this Together” and “Keep Well”, which encourage and offer practical advice on keeping our physical and mental health well, have helped to deal with this issue. In this regard, the results of the recent Amarach tracker survey, which measures emotional well-being, showed slight improvement in terms of anxiety, from 40% in October to 31% at end-November.
We do not yet fully understand the impact of Covid-19 on mental health, the extent of subsequent supports that may be required and how this will affect longer term demand for services. However, the HSE already has a range of proactive responses for any rise in service need. The Department and HSE continue to plan for any surge in demand as it arises and as services return to normal provision and capacity, subject to public health advice.
91. Deputy Louise O'Reilly asked the Minister for Health the reason it is being claimed that student nurses and midwives are supernumerary in view of the fact they are working on the frontline. [42437/20]
Amharc ar fhreagraClinical placements for nursing and midwifery students represent the practice experience of the undergraduate programme. Students on placements are learning through participation in practice and care delivery, under the supervision of qualified staff. They develop the practical knowledge, clinical skills and professional values required to meet the education standards for qualification and to become a registered practitioner.
This is the same in many European countries that have graduate nursing programmes.
Both Nursing and Midwifery are graduate professions must achieve academic, clinical and professional learning requirements to meet educational standards, as set by the Nursing and Midwifery Board of Ireland.
Supernumerary status means that the student is in the clinical area but additional to the staffing numbers required for that area. Students work under supervision and alongside qualified staff who have undertaken specific training to support them in the clinical area. Students do not have responsibility for patient caseloads on supernumerary placements, though they can participate in the delivery of care.
The clinical experience required by student nurses and midwives is gained via the supervised care of patients.
Supernumerary status is critical for learning in complex environments. This places them on the frontline in a learning capacity.
During the 4th year Internship placement student nurses and midwives are no longer supernumerary. They remain under supervision and are considered equivalent to 0.5 WTE. This ensures a lighter patient case load for students and to avoid reducing the qualified nursing compliment, which has increased by 1,404 since last December.
92. Deputy David Cullinane asked the Minister for Health the number of persons waiting and wait times for scoliosis treatment and surgery; and if he will make a statement on the matter. [42337/20]
Amharc ar fhreagraI sincerely regret that children can experience a long waiting time for treatment for scoliosis, and I am conscious of the burden that this places on them and their families.
In response to the Covid-19 pandemic, Children’s Health Ireland had to take measures to defer most scheduled care activity between March and May of this year. This decision was in line with the advice issued by the National Public Health Emergency Team in accordance with the advice of the World Health Organisation.
Physical distancing measures and Infection Prevention and Control requirements have a material impact on the available physical space to deliver all hospital services.
Despite these challenges, by December the 4th, Children’s Health Ireland had carried out 304 scoliosis procedures, 150 of which were spinal fusions, 25 fewer than the same period last year. 154 other spinal procedures were carried out, 27 fewer than last year.
Children’s Health Ireland has advised my Department that as of 4th December, there were 120 patients on the spinal fusion waiting list, an increase of 21 compared to the start of the year. There were 74 patients on the waiting list for other spinal procedures, which is a decrease of 10 patients since the start of 2020.
Children’s Health Ireland is exploring initiatives to increase access to scoliosis services, such as transferring additional patients to the National Orthopaedic Hospital Cappagh for treatment. The National Treatment Purchase Fund is trying to source additional capacity in Private Hospitals.
Children's Health Ireland has also advised that a General Orthopaedic Surgeon, based at CHI Crumlin and Tallaght sites, took up post in Q3, 2020. This surgeon will help address waiting times for children for general orthopaedic outpatient appointments, including scoliosis.
93. Deputy Jennifer Carroll MacNeill asked the Minister for Health if his Department has plans for updated health promotion campaigns under the Healthy Ireland framework for 2021; and if he will make a statement on the matter. [41943/20]
Amharc ar fhreagraSince early 2018, Healthy Ireland national communications campaigns have highlighted key messages around eating well, being physically active and minding our mental wellbeing. The current campaign; ‘Keep Well’, promotes resilience and positive physical and mental health and wellbeing in the context of the current Covid-19 pandemic.
Sláintecare has provided €7m to support delivery of initiatives and support services, working with a range of partners including the HSE, Local Authorities, Children’s and Young People’s Services Committees, Sport Ireland, the Creative Ireland Programme, Libraries Ireland and Bord Bia.
The campaign is focussed on five main themes. These are:
- Keeping active and being outdoors. Physical activity can be really helpful in improving mood and reducing anxiety, in addition to keeping us all fit and healthy
- Staying connected with people safely, as addressing isolation, supporting volunteerism and initiatives that support person-to-person connection is vital to our wellbeing
- Switching off and being creative or learning something new, getting back to nature and finding ways to relax can also be really beneficial for general wellbeing.
- Eating well allows us to develop a better connection between the food we eat and how we feel and can positively impact our physical and mental health and wellbeing.
- Minding your mood . Under this theme, people will be equipped with information on where to go if they need support.
The Keep Well campaign will run until March 2021, after which Healthy Ireland campaigns will continue to support key Healthy Ireland outcomes; healthy eating, obesity reduction, increased levels of physical activity and positive mental health.
Future campaigns will, in addition, work with partners to support the wider determinants of health, the key themes in the forthcoming Healthy Ireland Strategy and the evolving national response to the Covid-19 pandemic.
94. Deputy Sorca Clarke asked the Minister for Health if his attention has been drawn to the plight of parents of children with Down’s syndrome who have been without services since March 2020; if his Department will allocate additional resources to deal with the backlog; and if he will make a statement on the matter. [40784/20]
Amharc ar fhreagraBoth the Government and I, as Minister of State for Disabilities recognise the critical need and importance of supports for all children with disabilities and their families. The impact of Covid-19 on people’s lives has and still continues to be very significant.
Some services continued during the pandemic with staff including Speech and Language Therapists working with children with disabilities and their families remotely and using technology in new and effective ways. I will acknowledge that this may not have been suitable for some children as the Deputy brought to my attention during last week’s Topical Issue on services in Longford and Westmeath.
Having had discussions with the HSE, I can assure the Deputy that our collective aim is to fully restore services and this must be in a safe way and to pre- Covid-19 levels as soon as possible. The HSE has recently commenced a recruitment campaign for staff to support contact tracing and community testing facilities for Covid-19. The recruitment of Community Contact Tracers and Swabbing staff will allow the return of Occupational Therapists, Speech and Language therapists and other clinical staff who had been redeployed to these duties to their substantive roles as soon as possible.
With regard to the allocation of additional resources, I was pleased to have secured an additional €100 million in Budget 2021, including funding for additional therapy posts for children’s disability teams. Substantial funding of €7.8m was also recently provided to clear the AON backlog.
95. Deputy Mark Ward asked the Minister for Health the number of parents that have put in a complaint that their child did not receive an assessment of needs in a timely manner; the number upheld in each of the years 2016 to 2019 and to date in 2020; and if he will make a statement on the matter. [42162/20]
Amharc ar fhreagraI acknowledge that there are significant delays in the Assessment of Need process and that this places significant strain on families and children with disabilities waiting on assessments.
It has been a priority for me, as Minister for Disabilities and for this Government to reduce the waiting times for Assessment of Need and improve compliance with the time frames set out in Part 2 of the Disability Act 2005.
Under Section 14. —(1)(b) of the Disability Act 2005, parents are entitled to make a complaint if their child did not receive an Assessment of Needs in a timely manner.
HSE have advised me that in the year 2016, 1100 complaints were received, of which 876 were upheld, in the year 2017, 722 were received of which 507 were upheld, in the year 2018, 725 complaints were received of which 665 were upheld and in the year 2019, 1153 complaints were received of which 1036 were upheld.
So far this year, 992 complaints have been received by the HSE. Of these, 691 investigations have been completed with 634 complaints being upheld to date.
These figures demonstrate that while there is an adequate complaints process in place, clearly the Assessment process needs reform to deliver more timely assessments and subsequent interventions for children with disabilities.
I recently secured €7.8million additional funding specifically to address overdue Assessments of Need and support the HSE and its funded service providers to meet the legislative timelines for the Assessment of Need process.
This money was allocated to each CHO area based on their number of overdue Assessments as of 30th June 2020. All HSE areas have plans in place to eliminate the Assessment backlog as soon as possible which will increase access and reduce waiting times for assessment and interventions.
96. Deputy Emer Higgins asked the Minister for Health his views on the recent advice given to older persons to take vitamin D daily; if such advice applies to other age groups; if, the supplement will be subsidised for at-risk groups in the context of public health and health promotion; and if he will make a statement on the matter. [41875/20]
Amharc ar fhreagraVitamin D is essential for bone and muscle health in people aged 65 and older. A recent Food Safety Authority of Ireland report found that older people do not get sufficient vitamin D from their diet or the effect of sunlight on their skin. To help counteract this, the Department of Health recommends that people aged 65 and older take a vitamin D supplement every day to ensure that they get the essential amount of vitamin D they need.
The recommended daily amount of vitamin D supplement is 15 micrograms. This can be taken as a multi-vitamin supplement, a calcium and vitamin D supplement or a vitamin D only supplement.
Older people who are currently taking a vitamin D supplement that has been prescribed by a doctor or nurse and that contains more than 15 micrograms can continue to take the supplement prescribed.
Vitamin D supplements are available for medical card holders under the Primary Care Reimbursement Service.
Vitamin D supplements are also recommended for infants who are breastfed up to 1 year of age and for 1 to 4 year old children in the extended winter months, from Halloween to St Patrick’s Day.
97. Deputy Brendan Griffin asked the Minister for Health the position regarding the provision of respite services for persons with disabilities and their families in County Kerry; if services will be restored to pre-Covid-19 levels; and if he will make a statement on the matter. [42432/20]
Amharc ar fhreagraSince March this year, the presence and threat of Covid-19 in Ireland has resulted in significant challenges for service providers, families and most importantly, people with disabilities.
Services such as respite were either suspended or delivered in alternative ways following public health guidance.
Since July, short-stay residential and emergency/residential respite have begun to re-open with further services due to resume between now and February.
All disability services must follow public health guidance in this area, including the prevention and management of Covid related infection.
The HSE is acutely aware that the Covid pandemic and associated reduction and cancellation of services has resulted in significant stress for families and individuals with disabilities across the country including Cork Kerry Community Healthcare.
HSE continue to engage with service providers to ensure that the maximum possible service level is resumed and maintained, based on prioritising those with the greatest needs.
I am aware that Deputy Griffin recently enquired about the Abhaile Respite Service in Listowel, run by St John of God Services. I am pleased to inform the Deputy that this service will revert to respite from next Monday, 14th December 2020.
HSE Disability Services have provided me with a comprehensive update on respite services across their CHO area, which I will arrange to be forwarded on to the Deputy today.
The Programme for Government is committed to providing additional respite places, throughout the country, for adults and children with a disability.
Funding is being made available in 2021 to support additional respite services for people with a disability and their families. This includes the developing of nine additional respite houses around the country.
98. Deputy Thomas Pringle asked the Minister for Health the assessment he is undertaking on reports that there were failed medical abortions in Ireland which resulted in the pregnant person being forced to travel to the UK for healthcare in 2020; and if he will make a statement on the matter. [41106/20]
Amharc ar fhreagra122. Deputy Thomas Pringle asked the Minister for Health if a person presents in time for an abortion and the medication fails, will a doctor prescribing additional medication be deemed to be continuing the first in time procedure; if the abortion will still be legal under section 12 if the pregnancy by then exceeds 12 weeks; and if he will make a statement on the matter. [41104/20]
Amharc ar fhreagra186. Deputy Thomas Pringle asked the Minister for Health if a person presenting with health risks associated with a failed abortion legally can be treated under section 9, serious risk to health grounds or section 10, emergency grounds, as appropriate; and if he will make a statement on the matter. [41105/20]
Amharc ar fhreagraI propose to take Questions Nos. 98, 122 and 186 together.
Section 12 of the Health (Regulation of Termination of Pregnancy) Act 2018 states that a termination of pregnancy may be carried out by a medical practitioner where, having examined the woman, he or she is of the reasonable opinion formed in good faith that the pregnancy has not exceeded 12 weeks of pregnancy. The medical practitioner must certify this opinion and three days must elapse between certification and the procedure being carried out.
As the Deputy has pointed out, sections 9 and 10 of the Health (Regulation of Termination of Pregnancy) Act 2018 set out other grounds on which termination of pregnancy is permitted in this country. Section 9 requires that two medical practitioners, having examined the pregnant woman, are of the reasonable opinion formed in good faith that there is a risk to the life, or of serious harm to the health, of the pregnant woman; the foetus has not reached viability; and it is appropriate to carry out the termination of pregnancy in order to avert the risk concerned. One of the two medical practitioners must be an obstetrician; and the other must be an appropriate medical practitioner, and both must certify their opinions in order for the termination to be carried out.
Section 10 deals with emergency situations. It provides that a termination of pregnancy may be carried out by a medical practitioner who, having examined the pregnant woman, is of the reasonable opinion formed in good faith that there is an immediate risk to the life or of serious harm to the health of the pregnant woman, and it is immediately necessary to carry out the termination of pregnancy in order to avert that risk.
It would not be appropriate for me, as Minister for Health, to intervene in medical practice to suggest how medical practitioners treat their patients, or to dictate the practice of obstetrics. Medical practitioners are bound through professional regulatory mechanisms to operate in accordance with best medical practice.
Clinical guidelines for the provision of termination of pregnancy services, within the legal framework set out in the Health (Regulation of Termination of Pregnancy) Act 2018, have been developed by the relevant professional medical bodies.
There is regular ongoing engagement between the Department of Health and the HSE to facilitate the operation of the service and to resolve any issues that may arise.
99. Deputy Brian Stanley asked the Minister for Health when a child psychologist will be appointed to cover counties Laois and Offaly. [40396/20]
Amharc ar fhreagraThe provision of clinical posts including Psychology as well as other allied health professional posts required to meet current and projected need of children with disabilities is a priority for the HSE.
I have been advised by HSE Midlands Louth Meath team that there are a total of 4 Senior Psychologist posts in the Laois/Offaly area. One Senior Psychologist is currently on maternity Leave and the HSE Midlands Louth Meath team can confirm that the Senior Psychologist will return from Maternity Leave and resume their post on January 6th 2021.
There is a vacancy for 1 Senior Clinical Psychologist and the HSE advise that the recruitment process for this post is on-going. In addition, there are 4 Staff Grade Psychologist posts, all currently vacant where the HSE are currently in the recruitment process to fill one of these posts immediately and has plans to fill another two positions in the coming months.
In the meantime, in October 2020, the HSE recruited 2 agency Staff Grade Psychologists on fixed term contracts. These Psychologists will work on a team to eliminate the backlog for Assessments of Need in the area.
I acknowledge the strain that clinical staff shortages place on service providers and especially families and children with disabilities. I hope that the recruitment process will be successful and that the staff member returning from maternity leave will have a positive impact on service delivery, particularly access to early assessment and interventions for children with complex need.
100. Deputy Paul Murphy asked the Minister for Health when restrictions on partners attending at maternity hospitals will be lifted; and if he will make a statement on the matter. [42443/20]
Amharc ar fhreagraI acknowledge that the visitor restrictions introduced in maternity services, because of Covid-19, have given rise to concern and anxiety for women and families. However, the reality is that, while very regrettable, these restrictions have been necessary to protect the safety of patients and families, hospital staff and the operability of our maternity services.
To date, thankfully, no maternal deaths linked to Covid-19 have been recorded in Ireland. This coupled with the fact, that we have had a low incidence in pregnant women, suggests that the measures taken by maternity services to protect women, have been successful.
The Health Protection Surveillance Centre has issued guidance regarding attendance at acute hospitals during the pandemic, including attendance at maternity hospitals. The guidance advises that restrictions on partner visiting; accompanying persons in labour; or parents visiting neonatal intensive care units, should be based on a documented risk assessment that is regularly reviewed.
In that context, and in an attempt to ensure the greatest consistency of service across our maternity units, the HSE is now re-classifying partners as an ‘essential companion’ for the purpose of fetal anomaly or anatomy scans. I am advised that the HSE is currently finalising guidance for maternity hospitals in this matter; the expectation is that from next week, partners’ attendance at antenatal scanning will be facilitated, where possible., having regard to overall patient and staff safety.
However, it is important to emphasise that if a case of Covid-19 is linked to a maternity unit, Public Health teams will undertake a public health risk assessment, and it may be necessary to re-introduce restrictions. Of course, responses and recommendations for each maternity unit may differ, depending on the facilities and circumstances.
The Deputy will appreciate that, notwithstanding the relaxation of the restrictions in place, there will be a need to ensure that the safety of women, their partners and hospital staff is protected. Maternity services are a core, essential service and the focus must be to protect services to ensure we are able to continue to provide 24/7 care.
