Thursday, 10 Dec 2020

Written Answers Nos. 401-428

Mental Health Services

Ceisteanna (401)

James Lawless

Ceist:

401. Deputy James Lawless asked the Minister for Health the reason there are no primary care psychologists in north County Kildare; and if he will make a statement on the matter. [42547/20]

Freagraí scríofa

Minister for Health

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 (402)

Catherine Connolly

Ceist:

402. Deputy Catherine Connolly asked the Minister for Health the steps sanctioned by him arising from the publication of the options appraisal for the model four hospital at Merlin Park, Galway; the status of the delivery of the hospital; and if he will make a statement on the matter. [42550/20]

Freagraí scríofa

Minister for Health

An options appraisal for a Model 4 hospital in Galway was completed late last year.

Since then, the Elective Hospitals Oversight Group has completed a Catchment Area Analysis in Dublin, Cork and Galway, within a national capacity context.  The Group is now working on the development of  high-level facilities spatial briefs, which will be considered in the context of the Sláintecare vision for the provision of health services.

Meanwhile, developments continue at University Hospital Galway and construction of a new radiotherapy centre has commenced.

Mental Health Policy

Ceisteanna (403)

Catherine Connolly

Ceist:

403. Deputy Catherine Connolly asked the Minister for Health the status of the national implementation and monitoring committee envisaged under Sharing the Vision; the membership of the committee; the terms of reference of the committee; and if he will make a statement on the matter. [42551/20]

Freagraí scríofa

Minister of State at the Department of Health

The National Implementation and Monitoring Committee structure (NIMC), is collectively responsible for driving and overseeing the long-term implementation and roll out of the recommendations of the national mental health policy Sharing the Vision – A Mental Health Policy for Everyone.

The NIMC comprises a Steering Committee and a Specialist Group Panel. The purpose of both will be to drive reconfiguration, monitor progress against outcomes and deliver on the commitments set out in the Policy. 

The NIMC Specialist Group Panel will provide specialist input at various points in the implementation of the Policy, including through membership of specific themed specialist groups, as envisaged in the Policy.

The NIMC will work with partners to evaluate performance, check overall progress and gather information on examples of good practice as informed by national and international research.

The NIMC Terms of Reference will be finalised at the first meeting of the NIMC Steering Committee. It is expected that these will include further details with regards to the roles of the NIMC Steering Committee and the NIMC Specialist Group Panel, as well as other implementation structures and processes.

In November, I announced the appointment of Mr John Saunders as independent Chair of the NIMC Steering Committee. Additionally, members have been appointed to the NIMC Steering Group and the NIMC Specialist Group Panel. The first meeting of the NIMC Steering Group will be held on Friday 11 December. The full list of membership of the NIMC Steering Committee and Specialist Group Panel is attached for the Deputy’s consideration.

NIMC Steering Committee Membership

Ms Fiona Coyle

Ms Aisling Culhane

Ms Kerry Cuskelly

Mr Maurice Dillon

Dr Joseph Duffy

Mr Daniel Flynn

Dr Siobhan MacHale

Mr Dave Maguire

Mr John Meehan

Dr Amir Niazi

Dr Brian Osborne

Mr Ian Power

Mr Jim Ryan

Mr Michael Ryan

Dr Anne Marie Waldron

Tbc

NIMC Specialist Group Panel Membership  

Ms Julie Ahern

Ms Clare Austick

Mr Alan Breathnach

Ms Catherine Brogan

Mr Kevin Burn

Ms Margaret Casey

Mr John Church

Ms Catherine Cocoman

Ms Martina Colville

Mr Tim Conlon

Dr Sarah Craig

Ms Denise Cronin

Dr Maeve Doyle

Mr John Dunne

Ms Paula Fagan

Ms Treasa Fox

Mr Paul Geraghty

Ms Moninne Griffith

Ms Claire Guilfoyle

Mr Brendan Harold

Mr Padraig Heverin

Mr Brian Holohan

Mr Bernard Joyce

Dr Lynsey Kavanagh

Ms Michele Kerrigan

Ms Vanessa Lacey

Ms Sharon Lane

Mr Dominic Layden

Mr Brendan Lennon

Mr Thomas McCann

Dr Gerry McCarney

Ms Sandra McDonagh

Ms Helen McDonald

Ms Deirdre McHugh

Mr Stephen McMahon

Mr Jim Meaney

Mr Brian Miles

Ms Lisa Molloy

Mr Niall Mulligan

Ms Tonya Myles

Ms Colette Nolan

Dr Chris Noone

Ms Stephanie O’Connor

Dr Donal O’Hanlon

Mr Steve Pitman

Mr Mark Smyth

Ms Maeve Sweeney

Dr Rosalyn Tamming

Ms Rachael Treanor

Dr Eamonn Waters

Ms Monica Whyte

Respite Care Services

Ceisteanna (404)

Catherine Connolly

Ceist:

404. Deputy Catherine Connolly asked the Minister for Health when respite care services will be deemed as an essential service; when they will be fully restored to pre-Covid-19 levels; and if he will make a statement on the matter. [42552/20]

Freagraí scríofa

Minister of State at the Department of Health

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.

Disability Support Services

Ceisteanna (405)

Catherine Connolly

Ceist:

405. Deputy Catherine Connolly asked the Minister for Health the status of the reopening of day centres for adults with disabilities; the timeline for when day centres will fully reopen; and if he will make a statement on the matter. [42553/20]

Freagraí scríofa

Minister of State at the Department of Health

All 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.

Nursing Home Accommodation

Ceisteanna (406)

Catherine Connolly

Ceist:

406. Deputy Catherine Connolly asked the Minister for Health if nursing home residents will be allowed to be visited twice a week by two family members one at a time in all levels of the Living with Covid-19 plan; and if he will make a statement on the matter. [42554/20]

Freagraí scríofa

Minister of State at the Department of Health

The importance of continued social interaction of residents and their families cannot be overstated and every effort should be made, in line with public health advice, to ensure that these interactions continue.   The Plan for Living with COVID-19 Framework has been developed to help us to go about our daily lives as much as possible, with measures aimed at the key priorities of protecting health, strengthening employment, and supporting communities.  The system is communicated through a numbered system of alert Levels, from 1 to 5 with Level 1 being the lowest with the least amount of restrictive measures in place and Level 5 being the highest with the most restrictions in place.   

The Health Protection Surveillance Centre published updated guidance on visitations to long term residential care facilities on 30th November.  The new guidance which came into effect from the 7th December, aims to further support long-term residential care services, including nursing homes and residents in planning visits across all levels of the framework for restrictive measures in the government’s Plan for Living with COVID-19.

This new guidance outlines an updated definition for ‘critical and compassionate circumstances’, which now provides that, subject to risk assessment, residents may be facilitated to receive:

- up to one visit by one person per week under Levels 3 and 4 of the framework;

- up to one visit by one person per two weeks under Level 5.

It also notes that at all framework levels every practical effort should be made to accommodate an additional visit on compassionate grounds during the period of a major cultural or religious festival or celebration of particular significance to the resident, such as the Christmas/New Year period. 

Nursing home providers are ultimately responsible for the safe care of their residents. Under Regulation 11 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 it is the legal responsibility of each registered provider to make arrangements for a resident to receive visitors, having regard to any risks that may present for the resident or other residents.  I encourage all nursing homes to remain familiar with the latest public health advice and support, and to make every effort to continue to facilitate visitors in line with public health advice and to communicate with family and friends on an ongoing basis in order to support positive mental health and wellbeing.  I have communicated with the sector outlining the need for them to be flexible, innovative and to facilitate visiting arrangements, in line with public health advice.  

Notwithstanding this, it is also important to be cognisant of the wider epidemiological situation and the risks associated with same. On the 19th November, the European Centre for Disease Control published its latest risk assessment with regard to long-term care facilities across Europe. It highlights that the probability of COVID-19 introduction into a long-term care facility depends on the level of COVID-19 circulation in the community, with a higher risk associated with higher incidence rates in the community.  

This highlights the importance of suppressing the level of the virus in the community as one of the primary measures for protecting nursing homes. As citizens, we all have a responsibility in this regard and our actions across all of society can directly impact the outcomes for nursing home residents.

Health Services Provision

Ceisteanna (407)

Jennifer Carroll MacNeill

Ceist:

407. Deputy Jennifer Carroll MacNeill asked the Minister for Health the steps being taken to ensure the delivery of the National Traveller Health Action Plan. [35132/20]

Freagraí scríofa

Minister of State at the Department of Health

The National Traveller and Roma Inclusion Strategy (NTRIS) is the Government policy framework for addressing the health and other needs of Travellers. It contains over 30 health-related actions across four themes. The Dept of Health and the HSE are represented on the steering committee for NTRIS and report on a regular basis on the various health actions.

A key health action in NTRIS (#73) is to develop and implement a detailed action plan to address the specific health needs of Travellers, using a social determinants approach. The lead role in developing the action plan rests with the HSE, in conjunction with Traveller organisations.

The Programme for Government also includes a commitment to implement a National Traveller Health Action plan.

The HSE has outlined a process, including establishing a steering group, which will lead to the completion of the plan. The HSE advise that the steering group hope to finalise a draft to give to the National Director shortly.

The Department of Health is fully committed to providing the leadership and resources to ensure the implementation of the plan.

Separately, Budget 2021 provides an allocation of €2.1m to enhance access to health services for socially excluded groups, including €270,000 to expand Traveller health units.

I welcome the additional funding for Traveller health in Budget 2021 as the first phase of the forthcoming HSE Traveller health action plan.

Hospital Appointments Status

Ceisteanna (408)

John McGuinness

Ceist:

408. Deputy John McGuinness asked the Minister for Health if he will request WUH to continue the pathway of care organised by the hospital for a person (details supplied); if the urgent procedure recommended by the specialist at Whitfield under this care plan will be expedited; and if he will make a statement on the matter. [42566/20]

Freagraí scríofa

Minister for Health

It 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.

Health Services Provision

Ceisteanna (409)

Michael McNamara

Ceist:

409. Deputy Michael McNamara asked the Minister for Health when the venesection clinic on the day service unit at Ennis General Hospital will reopen to the public; and if he will make a statement on the matter. [42567/20]

Freagraí scríofa

Minister for Health

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 (410, 411)

Réada Cronin

Ceist:

410. Deputy Réada Cronin asked the Minister for Health the medical and epidemiological or other data basis on which live music at weddings is prohibited in the current phase of Covid-19; and if he will make a statement on the matter. [42575/20]

Réada Cronin

Ceist:

411. Deputy Réada Cronin asked the Minister for Health the medical and epidemiological or other data basis on which dance classes unlike gyms have not been allowed open up in the current phase of Covid-19 though their owners have taken every precaution possible to keep their students safe; and if he will make a statement on the matter. [42577/20]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 410 and 411 together.

The Government appreciates that there are many aspects of normal life that have been altered by the emergence of COVID-19, and the response that has been required. It also recognises that these changes are difficult for many people. However, it is the case at present that many of the things which we have previously taken for granted are no longer accessible in the same way due to the risks that they pose and the ease with which this virus spreads in particular conditions.

The Government's medium-term Plan Resilience and Recovery 2020-2021: Plan for Living with COVID-19, sets out Ireland's approach to managing and living with COVID-19 in a range of areas over a period of 6 – 9 months.

The Plan aims to allow society and businesses to operate as normally as possible, while protecting our key priorities of supporting and maintaining health and social care services, keeping education and childcare services open and protecting the most vulnerable members of our communities.

The Plan consists of 5 levels. Each level sets out what is permitted for social or family gatherings, work and public transport, bars, hotels and restaurants, exercise activities and religious services, at that moment in time.  Each level contains a “basket” of measures which are intended, collectively, to contribute to lowering the risk of transmission of Covid-19 in alignment with the risk level at that time. The set of measures, individually, do not comprise a list of activities or places which are equally safe.  Instead, they are “baskets” of measures which are informed by public health understanding of the disease. 

As I'm sure you can appreciate, COVID-19 spreads when individuals and groups come into close contact with one another, enabling the virus to move from one person to another. COVID-19 is infectious in a person with no symptoms, or for the period of time before they develop symptoms. The various limits at all levels in the Government's Plan are designed to reduce the number of households mixing with each other and cut down the virus’s chances of spreading into more homes. It seeks to balance the risks of different types of gatherings against the desire to allow normal activities to proceed in so far as possible. 

The measures in place at each level reflect the prevailing disease situation and recognise that we can and must prioritise some activities over others.  

I would like to draw your attention to the CSO website for access to a range of data relating to Covid-19 including data on confirmed COVID-19 cases linked to outbreak location. This is available on the CSO Covid-19 Information Hub at www.cso.ie/en/releasesandpublications/ep/p-covid19/covid-19informationhub/ and, in particular, at:-  https://www.cso.ie/en/releasesandpublications/br/b-cdc/covid-19deathsandcasesseries17/

A range of data on the epidemiology of Covid-19 in Ireland, including data on trends in transmission, is also published in the daily report by the Health Protection Surveillance Centre (HPSC) available at: www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/casesinireland/epidemiologyofcovid-19inireland, while a daily report on the last 14 days in cases available at: www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/casesinireland/epidemiologyofcovid-19inireland.

Healthcare Policy

Ceisteanna (412)

Pauline Tully

Ceist:

412. Deputy Pauline Tully asked the Minister for Health his plans to implement the recommendations of the Oireachtas Joint Committee on Health Report on Foetal Anti-Convulsant Syndrome published in May 2018; and if he will make a statement on the matter. [42611/20]

Freagraí scríofa

Minister for Health

Valproate-containing medicines (also known as sodium valproate or valproic acid) are approved in Ireland under the brand name Epilim, for the treatment of epilepsy and bipolar disorder. Based on the totality of available scientific data on this drug, it is known that children exposed in utero are at a high risk of serious developmental disorders (in up to 30-40% of cases) and congenital malformations (in approximately 10% of cases). 

To prevent exposure during pregnancy, there is a robust regulatory framework for the licensed use of Epilim in women of childbearing potential. This regulatory framework was strengthened following participation by the Health Products Regulatory Authority (HPRA) in two EU-wide reviews in 2014 and 2017.

After the European Medicines Agency (EMA) issued new recommendations on the use of sodium valproate in early 2018, the HPRA collaborated with national stakeholders, including patient representatives and healthcare professionals, to implement the new valproate risk-minimisation measures in Ireland. These measures included changes to the product information for patients and healthcare professionals; a visual warning on the packaging of valproate medicines; updated educational materials to reflect the new measures and provide age-appropriate advice; and a patient alert card to be attached to the packaging so that pharmacists can go through it with the patient when valproate is dispensed.

To support the actions taken by the HPRA, the Pharmaceutical Society of Ireland directed pharmacists that they must inform women of child-bearing age of the potential risk of abnormal pregnancy outcomes when supplying any medicine containing valproate. This includes providing counselling and including a Package Leaflet and Alert Card with each supply of these medicines.

To address the more operational aspects of this issue, a HSE Valproate Response Project was established in May 2018 under the remit of the HSE Office of the Chief Clinical Officer. The Project Team was able to provide expert support to individuals and families with concerns about previous exposure to valproate and the possible impact on their children. The HSE team has also worked to improve the structures in place to support families affected by foetal valproate syndrome. A specialist dedicated genetics clinic has been established in Our Lady’s Hospital, Crumlin, to support diagnosis, and the HSE is working to improve access to genetic testing.

The HSE’s medium- to long-term response to the valproate issue is focused on the establishment of a Programme for Women’s Health in Epilepsy within one of the Regional Epilepsy Centres, which will coordinate this national response. This means that all women taking valproate will have yearly follow-up, sign a valproate agreement form, be kept up-to-date with developments and signposted to other services, including the diagnostic service for those potentially exposed during pregnancy.

 I have recently committed to holding an inquiry into the historical licensing and use of sodium valproate in Ireland, and have asked officials in my department to examine a number of different options for the structure of this inquiry.

Paediatric Services

Ceisteanna (413)

Malcolm Noonan

Ceist:

413. Deputy Malcolm Noonan asked the Minister for Health if his attention has been drawn to the severe shortage of paediatric rheumatologists; and if he will make a statement on the matter. [42626/20]

Freagraí scríofa

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Disability Services Provision

Ceisteanna (414)

Malcolm Noonan

Ceist:

414. Deputy Malcolm Noonan asked the Minister for Health if his attention has been drawn to an information leaflet compiled by parents of children with Down’s arthropathy; and his plans distribute it to general practitioner surgeries and other health professionals to facilitate prompt referrals. [42627/20]

Awaiting reply from Department.

Paediatric Services

Ceisteanna (415)

Malcolm Noonan

Ceist:

415. Deputy Malcolm Noonan asked the Minister for Health if his attention has been drawn to the lengthy waiting lists for children with Down’s arthropathy to see paediatric rheumatologists, either privately or publicly; the outcome of a meeting held on 18 December 2019 between the rheumatology department of Crumlin Children’s Hospital and an organisation (details supplied) on this issue; and if he will make a statement on the matter. [42628/20]

Freagraí scríofa

Minister for Health

I sincerely regret that children can experience a long waiting time for Rheumatology treatment, and I am conscious of the burden that this places on them and their families.

Children’s Health Ireland (CHI) has advised my Department that during the initial phases of COVID-19, all face to face hospital outpatient reviews and most of the planned diagnostic tests, including MRI, were deferred in response to the pandemic.  CHI at Crumlin have recommenced the majority of outpatient and diagnostic services, albeit at reduced numbers, due to public health guidelines on social distancing.  Currently, Consultant Rheumatologists are seeing a number of patients in the outpatient suite including urgent patients and those who were deferred during the early phases of COVID-19. 

CHI has further advised that there is an active recruitment campaign for an additional Rheumatology Consultant underway. This addition to the medical staff will allow for an increased number of patients to be seen, diagnosed and treatment initiated, as part of the comprehensive Rheumatology service.

In relation to the provision of MRI services, the demand for specialist imaging has increased over recent years due to increased activity and acuity in CHI, as well as an increasing trend to utilise imaging in diagnosis and treatment.  CHI have advised that, uniquely to Paediatrics, younger children and children up to 18 years old with complex needs may be unable to remain still in an MRI for the lengthy periods required to complete the scan, resulting in the requirement for a General Anaesthetic (GA) to be delivered by a Paediatric Anaesthesiologist.  This limits the ability for these scans to be performed outside of CHI hospitals. CHI have confirmed to my Department that each request for an MRI scan is carefully examined by Consultant Radiologists who must prioritise, based on clinical urgency, each case in terms of access to the scanner. 

CHI has advised that patients with Down Syndrome who present to Rheumatology services with suspicion of arthritis are clinically assessed and diagnosed by the clinical team. A cohort of these patients will require an MRI scan based on the individualised clinical examination and recommendation.  

In relation to the specific query raised by the Deputy regarding a meeting between the Rheumatology Department at CHI Crumlin and the organisation referred to in the details supplied, I have asked the Health Service Executive to respond to the Deputy directly.

Home Help Service

Ceisteanna (416)

Emer Higgins

Ceist:

416. Deputy Emer Higgins asked the Minister for Health the procedures and quality checks in place to monitor the care carried out by home help organisations contracted to carry out home caring work in the homes of persons; if there is a feedback mechanism for receivers of this care; and if he will make a statement on the matter. [42630/20]

Freagraí scríofa

Minister of State at the Department of Health

As this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Covid-19 Pandemic

Ceisteanna (417)

Pearse Doherty

Ceist:

417. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) will commence employment as a Covid-19 swabber with the HSE at Letterkenny University Hospital; and if he will make a statement on the matter. [42631/20]

Freagraí scríofa

Minister for Health

I have asked the HSE to respond to the Deputy directly on this matter.

Dental Services

Ceisteanna (418)

Michael Creed

Ceist:

418. Deputy Michael Creed asked the Minister for Health his plans to address lengthy public orthodontic waiting lists at a location (details supplied). [42641/20]

Freagraí scríofa

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Hospital Waiting Lists

Ceisteanna (419)

Matt Shanahan

Ceist:

419. Deputy Matt Shanahan asked the Minister for Health the waiting lists and duration on the list for procedures (details supplied) in University Hospital Waterford in tabular form; and if he will make a statement on the matter. [42644/20]

Freagraí scríofa

Minister for Health

It 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.

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 information requested by the Deputy in relation to Angiogram, Cataract, Endoscopy, Tonsillectomy, Hip and Knee Replacements (reported as small volume procedures) is provided in the attached table. Also attached is the waiting list for CT and MRI for Q3 2020.

In terms of the CT and MRI data, the HSE advises that a pilot project commenced in 2016 by HSE Acute Hospitals Division to progress the collection of national radiology waiting list data. The project has been supported by the Radiology Clinical Care Programme and has involved key stakeholders across the system including the National Integrated Medical Imaging System (NIMIS) Team, Hospital Groups, and the support of the National Treatment Purchase Fund (NTPF) for data collection and data management expertise.

The information that is currently being collected is presently being tested and validated at hospital, hospital group and national level and as such should not be used/reported without the context of the caveats set out below:

- Data is subject to inclusions and exclusions which are documented in the Data Profile Document. This document is available from Acute Operations and has been circulated to all Hospital Groups.

- Data contains urgent, routine and surveillance/planned activity which is currently not broken down in detail, as such this includes surveillance/planned activity which may not be exceeding planned date.

- Data is still undergoing validation at Hospital and Hospital Group level.

- Data does not take into account local nuances at site level (Site profile developed to support understanding of same).

- The purpose of this aggregate data is to provide a National Level overview of the number of patients waiting for modalities of CT, MRI and Ultrasound.

- This report is not intended to be used for the active management of hospital diagnostics waiting list, local reports and mechanisms should continue to be used for the management of diagnostics waiting lists at hospital level.

In relation to the specific query raised regarding waiting lists for Scheduled Percutaneous Coronary Intervention, Mammography Radiology, and Diabetic Vascular Screening, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Waiting Lists

Parliamentary Questions

Ceisteanna (420)

Matt Shanahan

Ceist:

420. Deputy Matt Shanahan asked the Minister for Health the location to which parliamentary questions to the HSE for operational services responses are referred; if his Department will mandate a correspondence return date for same; and if he will make a statement on the matter. [42645/20]

Freagraí scríofa

Minister for Health

Under Standing Order 51 (1), a question may be referred to a body and the referred body has ten working days to provide a response to the Deputy.

The HSE Parliamentary Affairs Division (PAD) processes Parliamentary Questions (PQs) referred by the Minister for Health for direct reply to the Oireachtas member.

Officials in the Parliamentary Support Unit in my Department hold regular meetings with their counterparts in the HSE to discuss the management of parliamentary obligations.

Health Services

Ceisteanna (421)

Niall Collins

Ceist:

421. Deputy Niall Collins asked the Minister for Health his views on a HSE response in relation to a referral for a person (details supplied) graded as urgent; and if he will make a statement on the matter. [42649/20]

Freagraí scríofa

Minister for Health

It 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.

Scheduled care activity was significantly impacted by this necessary decision with most routine elective care appointments and procedures deferred between March and May. As a result of the significant disruption in services, hospital waiting lists reached a peak in May. The resumption of services from June onwards has however allowed for increased activity.

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.

It is the responsibility of the treating Consultant to clinically prioritise patients on the waiting list. 

In addition, 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. 

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.

In relation to the particular query raised, as advised by the HSE in previous correspondence, if the patient's condition has deteriorated since their last referral, their GP should to forward an updated referral for the attention of their Consultant.

Occupational Therapy

Ceisteanna (422)

Seán Sherlock

Ceist:

422. Deputy Sean Sherlock asked the Minister for Health further to Parliamentary Questions Nos. 178 to 188, inclusive, of 18 November 2020, the cost per external contractor and the number of assessments carried out in each CHO in tabular form. [42685/20]

Freagraí scríofa

Minister of State at the Department of Health

The 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 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 (423, 426, 427, 428, 437, 450)

Joe O'Brien

Ceist:

423. Deputy Joe O'Brien asked the Minister for Health if he will consider permitting music at weddings given that unlike many other social events, they are held in a controlled manner under the Covid-19 restrictions; and if he will make a statement on the matter. [42689/20]

Mary Lou McDonald

Ceist:

426. Deputy Mary Lou McDonald asked the Minister for Health the reason for the decisions made regarding live music and dance at weddings under the current level 3 of the Living with Covid Plan. [42713/20]

Mary Lou McDonald

Ceist:

427. Deputy Mary Lou McDonald asked the Minister for Health if he has met with or plans to meet with representatives from the wedding business sector to hear their concerns regarding the restrictions contained in the Living with Covid Plan; and if he will make a statement on the matter. [42714/20]

Brendan Griffin

Ceist:

428. Deputy Brendan Griffin asked the Minister for Health his views on matters raised in correspondence by a person (details supplied) in respect of restrictions on wedding music; and if he will make a statement on the matter. [42718/20]

Pearse Doherty

Ceist:

437. Deputy Pearse Doherty asked the Minister for Health if DJ music is permitted at weddings in line with the latest level 3 Covid-19 restriction guidelines; and if he will make a statement on the matter. [42761/20]

Louise O'Reilly

Ceist:

450. Deputy Louise O'Reilly asked the Minister for Health the reason live music and dancing has been banned at weddings under level 3 restrictions under new Fáilte Ireland guidelines; and his role in contributing to the formulation of these guidelines. [42802/20]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 423, 426, 427, 428, 437 and 450 together.

Ireland is now at level 3 of the Government's medium-term Plan Resilience and Recovery 2020-2021: Plan for Living with COVID-19, which sets out Ireland's approach to managing and living with COVID-19 in a range of areas over a period of 6 – 9 months.

The Plan aims to allow society and businesses to operate as normally as possible, while protecting our key priorities of supporting and maintaining health and social care services, keeping education and childcare services open and protecting the most vulnerable members of our communities.

The various limits at all levels in the Government's Plan are all designed to reduce the number of households mixing with each other and cut down the virus’s chances of spreading into more homes. It seeks to balance the risks of different types of gatherings against the desire to allow normal activities to proceed in so far as possible. 

As I'm sure you can appreciate, COVID-19 spreads when individuals and groups come into close contact with one another, enabling the virus to move from one person to another. COVID-19 is infectious in a person with no symptoms, or for the period of time before they develop symptoms.  In certain settings, such as weddings, higher noise levels due to music, can force people into close proximity, requiring them to raise their voices or shout to communicate thus increasing the risk of spreading virus to others. Dancing is not permitted given the close contact involved. Such activities present a higher risk of transmission of Covid-19.

Details of the public health measures in place for weddings at level 3 can be found at:- https://www.gov.ie/en/publication/ad569-level-3/

Guidance for religious services can be found at:- https://www.gov.ie/en/publication/7ba40-guidance-for-religious-services/ 

You may also wish to note that Fáilte Ireland has provided guidelines for the hospitality industry which includes guidance on weddings and is available at: - https://failtecdn.azureedge.net/failteireland/Guidelines-for-Re-opening-Hotels-and-Guesthouses.pdf

Departmental Expenditure

Ceisteanna (424)

Bríd Smith

Ceist:

424. Deputy Bríd Smith asked the Minister for Health if professional fees are paid by his Department on behalf of employees; if so, the total number involved; and the amount of each fee. [42703/20]

Freagraí scríofa

Minister for Health

Professional Fees are paid by staff members themselves and the reimbursed by the Department of Health, where appropriate. This occurs where staff in the Department require membership of a recognised body to enable them to discharge their functions within the Department. This can be areas such as medicine, human resources or finance. Staff must complete a claim form, with evidence of the payment of the membership fee. This is then reviewed and approved for payment by their line manager. This requires further approval by the learning and development unit before reimbursement is requested from the Accounts Unit.

In 2020 so far, there were 20 memberships reimbursed to staff in relation to medical bodies, mainly to the Royal College of Physicians Ireland but also to the Faculty of Public Health and Pharmaceutical Society of Ireland. This was on behalf of the practitioners currently working in the Department either on a permanent or secondment basis. These 20 memberships came to €8,439 in 2020 to date.

In 2020 so far, there were 7 memberships reimbursed to staff in relation to the Chartered Institute of Personnel and Development on behalf of staff working in human resources or learning and development. These 7 memberships came to €926 in 2020 to date.

In 2020 so far, there were 6 memberships reimbursed to staff in relation to various accountancy bodies on behalf of staff in the Department. These 6 memberships came to €3,093 in 2020 to date.

In 2020 so far, there were 3 memberships reimbursed to staff for miscellaneous other bodies, including the Law Society. These 3 memberships came to €264 in 2020 to date.

These individual membership reimbursements for 2020 come to €12,723

In 2020 so far the Department has paid 4 corporate membership fees to enable multiple staff to access resources. These were:

Irish Management Institute - €6,995

Institute of Public Administration (Governance Forum) - €4,500

Guidelines International - €2,995

Irish Institute of Training and Development - €625

Covid-19 Pandemic

Ceisteanna (425)

Seán Sherlock

Ceist:

425. Deputy Sean Sherlock asked the Minister for Health if there will be cold storage centres outside of Dublin for Covid-19 vaccines. [42712/20]

Freagraí scríofa

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Questions Nos. 426, 427 and 428 answered with Question No. 423.