Written Answers Nos. 309-328
309. Deputy Carol Nolan asked the Minister for Health the amount allocated to the health service since the start of the Covid-19 pandemic for building additional hospital capacity in beds, ICU beds and staff recruitment; when the funds were allocated; and if he will make a statement on the matter. [7780/21]
Amharc ar fhreagraIn developing the National Action Plan on Covid-19 the pre-existing capacity constraints within the Irish Hospital system were well recognised. Ireland has the highest acute bed occupancy in Europe at 93%, one of the lowest levels of critical care beds per 1,000 of the population in Europe at 3.3 and has one of the lowest numbers of specialist doctors per 1,000 of the population at 1.4. Due to these issues there was a significant risk that Ireland’s hospital system would become overwhelmed very quickly.
Recognising this risk there were several measures identified in the action plan to address the critical capacity issues in the system: Expansion and repurposing of existing bed capacity to deliver more acute care, obtaining additional temporary capacity outside of the public system as required, and redirecting services from the hospital system to the primary care/community system where possible.
In 2020 €190m was allocated to the enhancement of existing capacity in the public hospital system through repurposing and expansion, a further €330m was provided to acquire the full capacity of the private system in the initial response to the pandemic and subsequent access for non COVID urgent patients to maintain acute/critical care capacity in the public hospitals. Recognising the urgent staffing demands arising from the increased acuity of patients in the public hospitals an additional €75m was provided for to recruit medical interns and student nurses.
In 2021 an additional €313m has been allocated to the further expansion of hospital capacity, along with establishment of the Access to Care fund with an allocation of €210m which will also provide additional capacity across the public and private sector.
310. Deputy Carol Nolan asked the Minister for Health the achievements in the ten months since the start of the Covid-19 pandemic in terms of additional hospital beds and staff that are actually operational; and if he will make a statement on the matter. [7781/21]
Amharc ar fhreagraSignificant progress has been made in the ten months since the start of the COVID 19 pandemic in relation to the funding and provision of additional hospital beds. The Programme for Government, Our Shared Future, commits to continuing investment in our health care services in line with the recommendations of the Health Service Capacity Review and the commitments in Project Ireland 2040.
The Health Service Capacity Review 2018 found that the net requirement in combination with health system reform is for an additional 2,590 hospital beds by 2031 (2,100 inpatient, 300 day case and 190 critical care). The National Development Plan provides for the addition of the full 2,590 beds by 2027.
The Department of Health is working with the HSE to increase acute capacity in hospitals throughout the country to meet this and other health demands. Government allocated €236 million revenue and €40 million capital expenditure as part of Budget 2021 to fund additional acute beds on a permanent basis. This funding will provide, by the end of 2021, an additional 1,146 acute beds (excluding critical care beds). As part of this, over 400 beds, opened in 2019/2020 on a temporary basis, will remain open on a permanent basis.
In addition, a proportion of these 1,146 beds are being provided as part of the HSE’s Winter Plan 2020/21. The Winter Plan aims to provide additional health service capacity across a range of services. Initiatives comprise additional acute and community beds to increase acute capacity, help reduce admissions and facilitate egress. The HSE has reported that 388 of these beds had opened by 27th January. This represents a significant step towards achieving the recommendations in the 2018 Health Service Capacity Review.
I have asked the Health Service Executive to respond to the Deputy directly as soon as possible with further information in relation to the staffing of these beds.
311. Deputy Carol Nolan asked the Minister for Health the number of ICU beds that existed in public hospitals in February 2020; the number that currently exist; and if he will make a statement on the matter. [7782/21]
Amharc ar fhreagraSignificant additional critical care capacity has been put in place in response to the Covid-19 pandemic, with funding for 40 additional adult critical care beds provided in March 2020 . The HSE has advised that between 280 and 285 permanent adult critical care beds are now fully staffed and open, with the precise number on any given day fluctuating due to staffing or other operational factors. This compares to a baseline figure of 255 beds available in January 2020. However, as is currently the case in the context of the demands of Covid, the number of critical care beds can surge beyond the baseline of 280-285 as part of an emergency response.
A Strategic Plan for Critical Care was noted by Government in December 2020 and aims to bring permanent adult critical care capacity in Ireland to 321 by the end of 2021 and to 446 in the long term in line with the recommendations of the Health Service Capacity Review.
A total of €52m was provided to advance the Critical Care Strategic Plan in Budget 2021. This will retain, on a permanent basis, the 40 adult critical care beds put in place on a temporary basis last year and add significant new build bed capacity, as well as allowing for the development of a workforce plan and education initiatives to grow the critical care workforce.
In relation to the specific queries raised by the Deputy, I have asked the HSE to respond directly to her to provide the details requested.
312. Deputy Carol Nolan asked the Minister for Health the length of time healthcare staff are off work waiting for a Covid-19 test result on average; the proportion of current staff shortages which are due to issues such as this; and if he will make a statement on the matter. [7783/21]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.
313. Deputy Mark Ward asked the Minister for Health the contingency plans in place to ensure that the over-70s receive vaccines in a prompt manner if Covid-19 vaccines are deemed not suitable for over-70s. [7784/21]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly.
314. Deputy Chris Andrews asked the Minister for Health the number of children nationwide and in the Dublin region who availed of early intervention from the HSE by category (details supplied); and if he will make a statement on the matter. [7806/21]
Amharc ar fhreagraThe Programme for Government, Our Shared Future, recognises the need to improve services for both children and adults with disabilities through better implementation and by working together across Government in a better way.
The Government commits to prioritising early diagnosis and access to services for children and ensuring that the most effective interventions are provided for each child, to guarantee the best outcomes.
As this is a service matter I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
315. Deputy Gary Gannon asked the Minister for Health his views on the practice of general practitioner clinics that are accepting new patients but are refusing to take new patients with general practitioner visit cards or medical cards; if the practice is compliant with HSE rules and regulations; and if he will make a statement on the matter. [7810/21]
Amharc ar fhreagraAlthough GPs will ordinarily accept new patients who hold a medical or GP visit card on to their GMS panel, a GP may choose not to accept such a patient. Where a GP chooses not to except a new patient who holds a medical or GP visit card, the HSE may request, in confidence, the reason for that decision.
Additionally, the GMS GP contract stipulates that the maximum number of medical card or GP visit card patients that a GP can have on his/her panel is 2,000, or 2,200 if the GP also holds an under 6 contract, except in exceptional circumstances where the HSE decides to apply a higher limit.
Where a patient who holds a medical or GP visit card experiences difficulty in finding a GP to accept him/her as a patient, the HSE has the power to assign that person to a GP's GMS patient list where the person has unsuccessfully applied to at least three GPs in the area who hold GMS contracts (or fewer GPs if there are fewer GPs in the area).
316. Deputy Róisín Shortall asked the Minister for Health the status of talks with public health doctors; if agreement has been reached to upgrade all existing public health specialists to consultant in line with all other specialties; if agreement has been reached on the necessary additional investment in this service; and when he expects this matter to be finalised. [7819/21]
Amharc ar fhreagraMy Department and the HSE have met with Irish Medical Organisation to discuss a pathway towards a reformed consultant led public health model in Ireland and related matters. I hope that engagement will continue over the coming weeks with a view to reaching agreement. We want to work with our public health specialists to ensure we have a public health model in place that best meets the future needs of the Irish people. It is also important that Public Health is seen as an attractive career option amongst medical practitioners in Ireland.
The Government is committed to investment in our public health framework and our public health workforce. Last September, I announcement plans to double the current workforce by recruiting an additional 255 permanent staff, at an annual cost of over €17m. This includes public health doctors, nurses, scientists, and support staff. This is not only a response to the current pandemic but is an investment in the future development of our Public Health function. Recruitment for these positions commenced immediately and is progressing well.
317. Deputy Róisín Shortall asked the Minister for Health the steps he is taking to address the issue of travellers from Dubai, Portugal and other locations using Dublin Airport as a back door into the UK; and if he will make a statement on the matter. [7821/21]
Amharc ar fhreagraMy Department has agreed a mechanism with our Northern Ireland counterpart whereby Ireland’s Passenger Locator Form system will be used to contact international passengers who travel through Ireland to Northern Ireland, to advise them of their requirement to fill in a UK passenger locator form and informing them of specific public health advice. This will commence this week.
Discussions with Northern Irish authorities to establish a data sharing agreement which will enable the sharing of data collected from Irish Passenger Locator Forms, in relation to travellers transiting to Northern Ireland from outside the common travel area, to support their public health efforts are at an advanced stage.
Continuing close consideration is being given by Government to policy on travel measures.
318. Deputy Róisín Shortall asked the Minister for Health if he will report on preparations for the introduction of mandatory hotel quarantine; the estimated number being planned for; the body or agency which will oversee the procurement of accommodation, transport, security and so on; the timescale to which he is working for the necessary legislation; and if he will make a statement on the matter. [7824/21]
Amharc ar fhreagraA mandatory home quarantine regime for all travellers arriving from overseas, including international passengers arriving via Northern Ireland, has come into force in order to mitigate risks posed by variants of concern.
The operationalisation of designated quarantine facilities is being advanced on a cross-departmental basis as a matter of priority, including the drafting of primary legislation to provide for these facilities.
My Department is leading a group from across government and agencies to progress policy and legislation and the operational requirements for designated quarantine facilities.
This work is supported by officials from across a number of Departments including Foreign Affairs, Transport, Justice, Public Expenditure and Reform, as well as Children, Equality, Disability, Integration and Youth. This group is working urgently to establish the scope of services required to put these facilities in place, including the necessary procurement and legislative basis.
319. Deputy Bernard J. Durkan asked the Minister for Health the progress to date in the determination of an application for a medical card in the case of a person (details supplied); if a medical card will be considered on discretionary grounds given the health circumstances in this instance; and if he will make a statement on the matter. [7828/21]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.
320. Deputy Bernard J. Durkan asked the Minister for Health when all front-line health staff in County Kildare received and will receive the Covid-19 vaccine; and if he will make a statement on the matter. [7829/21]
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.
321. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he can offer support or draw attention to the needs of epilepsy sufferers as set out by an organisation (details supplied); and if he will make a statement on the matter. [7830/21]
Amharc ar fhreagraBrainwave – the Irish Epilepsy Association (Epilepsy Ireland)
This project is a Sláintecare funded initiative. The purpose of the project is to develop a Pathway of Community Care Supports for people with Epilepsy in Ireland.
Context: The cumulative incidence of epilepsy is about 68/100,000 giving approx. 2,000 new diagnoses each year. Of the 40,000 PWE in Ireland, about 70% are well controlled on medication, with 12-15,000 people in regular contact with secondary/tertiary services. PWE often experience mental health problems & the condition has significant implications for social, vocational & occupational aspirations.
This innovative project demonstrates how a joint approach between staff based in hospital, primary care and the community can work together, to support people with Epilepsy with the management of their condition. The project has is delivering the service virtually due to COVID 19 and provides one-to one appointments, where necessary.
The project is delivering:
- Joint education programmes to 120 People with Epilepsy with follow up one-to-one appointments.
- Conducting research interviews with GPs and people with Epilepsy to gather their views on the concept and content of a patient held “checklist”.
- Training on engagement with Patients With Epilepsy for GPs, using the checklist.
To date, participants are reporting positive outcomes from the intervention:
Outcome: Of those whose evaluations have been analysed - 88% of participants reported an increase in their knowledge about their condition
Outcome: Of those whose evaluations have been analysed - 94% rated their confidence in dealing with their epilepsy as improved.
322. Deputy Róisín Shortall asked the Minister for Health if the National Immunisation Advisory Committee has recommenced its deliberations regarding the BCG immunisation programme; and when his Department expects submission of the final paper. [7831/21]
Amharc ar fhreagraThe HSE were requested, in 2019, to undertake an updated review of the epidemiology of TB in Ireland, considering the public health impact of having no BCG vaccination since April 2015. The review was completed and the National TB Advisory Committee (NTBAC) met to consider its findings on 16 December 2019.
My Department has been informed that the view of the Committee was that universal BCG vaccination should not be implemented at this time. The Committee agreed that the decision on whether a selective BCG vaccination programme targeting at risk groups or no BCG vaccination programme should be recommended, was outside the scope of the NTBAC and should be considered by the NIAC.
The NIAC has been asked to make recommendations to the HSE about the BCG immunisation programme. This work by the Committee was paused due to the COVID-19 pandemic.
The NIAC had resumed this work and had hoped to report its recommendations on this issue to the HSE before the end of the year. However, the NIAC have been fully engaged in the planning for the COVID-19 Vaccine rollout and thus have had to defer submission of a final paper regarding the BCG immunisation until Q2 of 2021.
The outcome of these processes, once finalised, will guide my Department regarding the future provision of BCG vaccination in Ireland.
323. Deputy Róisín Shortall asked the Minister for Health if the definition of a support bubble has changed (details supplied); and if he will make a statement on the matter. [7832/21]
Amharc ar fhreagraAs you will be aware, Ireland is currently at Level 5 of Resilience and Recovery 2020-2021: Plan for Living with COVID-19.
At Level 5, people are asked to stay at home as much as possible unless they have a "reasonable excuse" for leaving.
The Regulations providing for these measures are set out in S.I. No. 701 of 2020 and S.I. 29 of 2021. Regulation 4. of SI 701 sets out a non-exhaustive list of reasonable excuses for leaving one’s home. This non-exhaustive list includes at 4. (2) (w) in the case of a person who is part of a paired household, to travel to an event in a dwelling in accordance with Regulation 5.
Regulation 6. of SI 701 of 2020 sets out the meaning for paired households. Further clarification on support bubbles (paired households) is provided on gov.ie:- https://www.gov.ie/en/publication/3516d-support-bubbles/
Statutory Instruments relating to the Covid-19 pandemic are available here:- https://www.gov.ie/en/collection/1f150-view-statutory-instruments-related-to-the-covid-19-pandemic/
324. Deputy Róisín Shortall asked the Minister for Health the current advice of his Department on vitamin D regarding its role in strengthening the immune system in the context of Covid-19; and if he will make a statement on the matter. [7833/21]
Amharc ar fhreagraThe Deputy is advised that the existing guidance on vitamin D was updated in November 2020 and advises that adults aged 65 and older take a 15 microgram (600 IU) daily supplement for bone and muscle health.
An evidence synthesis paper on vitamin D and COVID-19 prepared for NPHET was discussed at its meeting of January 28. The NPHET agreed that efforts should be made to increase awareness of existing guidance; and that adults spending increased time indoors or are housebound or in long-term residential care or have dark skin pigmentation are also recommended to take a daily vitamin D supplement.
These recommendations for the use of vitamin D are being incorporated into wider messaging, and additionally are being communicated across the health service, including nursing homes and social care settings as necessary.
There is currently no plan for a campaign providing vitamin D supplements to certain groups. The NPHET agreed that at present there is insufficient high-quality evidence with respect to vitamin D in the prevention and treatment of COVID-19, and noted that ongoing developments, particularly Randomised Control Trials, in this area be monitored by the NPHET with guidance reviewed accordingly.
325. Deputy Róisín Shortall asked the Minister for Health the current advice of his Department on the role of ventilation in reducing the spread of Covid-19 in domestic settings, school settings and workplace settings; and if he will make a statement on the matter. [7834/21]
Amharc ar fhreagraThe NPHET keeps all issues in relation to COVID-19 under review, including modes of transmission and the role that ventilation can play in mitigating transmission. These matters were discussed most recently at its meeting of 21st January.
COVID-19 is a new disease, and the effect of ventilation on the transmissibility of SARS-CoV-2 (the virus that causes COVID-19) is still unclear, however there is evidence that COVID-19 outbreaks are more commonly associated with crowded indoor spaces, and that poor ventilation may increase the risk of transmission in such settings.
There is already a range of advice and guidance in place in relation to ventilation. The Health Protection Surveillance Centre has published Guidance on Non-Healthcare Building Ventilation during COVID-19 which provides an analysis of the current literature examining the association between ventilation and COVID-19. The Guidance provides recommendations, based on the literature, for commercial and public buildings, including with regard to mechanical ventilation. It also includes school specific guidance which recommends the use of indoor air quality meters which monitor the level of CO2 in classrooms that rely on natural ventilation. This guidance can be found at the following link: https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/educationguidance/Guidance%20on%20non%20HCbuilding%20ventilation%20during%20COVID-19.pdf
The HPSC has updated this guidance based on a recent HIQA rapid review of current public health guidance for community settings for COVID-19 and recent updates in similar international guidance. The guidance will be reviewed again, as required, following the findings of a new multisectoral group on ventilation which has been established by Professor Mark Ferguson at the request of the NPHET. The Group is chaired by Professor John Wegner and held its first meeting on 2 February 2021.
Additional guidance on ventilation in commercial spaces is available in the Work Safely Protocol (https://enterprise.gov.ie/en/Publications/Publication-files/Work-Safely-Protocol.pdf) and in NSAI guidance for the retail sector and shopping centres:
https://www.nsai.ie/images/uploads/general/NSAI-COVID19-Retail-Guidelines-13012021.pdf
https://www.nsai.ie/images/uploads/general/NSAI-COVID19-Shopping-Centre-Guidelines-13012021.pdf
There is also additional guidance on Gov.ie and on the HSE website which outlines the importance of ventilation in households. This can be found here:
https://www.gov.ie/en/publication/472f64-covid-19-coronavirus-guidance-and-advice/
https://www2.hse.ie/conditions/coronavirus/how-coronavirus-is-spread.html
326. Deputy Michael Healy-Rae asked the Minister for Agriculture, Food and the Marine the status of a farm payment for a person (details supplied); and if he will make a statement on the matter. [7484/21]
Amharc ar fhreagraThis person is fully up to date with all his payments due under the Organic Farming Scheme.
327. Deputy Richard Boyd Barrett asked the Minister for Agriculture, Food and the Marine the measures in place to ensure that all grants for struggling small to medium-sized farms are prioritised over larger and more profitable farms; and if he will make a statement on the matter. [7505/21]
Amharc ar fhreagraThere are a number of measures in place intended to ensure that payments and grants are prioritised to small and medium sized farms.
Within Pillar I of the Common Agricultural Policy (CAP), the Basic Payment Scheme (BPS) has a number of measures in place in this regard. Convergence is a mechanism whereby the value of payment entitlements move away from historic reference points towards the national average value for all farmers, large and small. The payment for Greening is linked to the value of payment entitlements, which has resulted in changes to Greening payments as the payment entitlements converged under BPS towards the national average value over the period 2015 - 2019.
The reduction of payments, also known as capping, means that any one farming enterprise cannot receive a BPS payment greater than €150,000. This is the most stringent capping limit available to Member States under the current regulations. Under the Young Farmers Scheme, these additional payments are made on the first 50 hectares held by a farmer and also under the National Reserve payment entitlement allocations or top-ups are made on the first 90 hectares only.
Within CAP Pillar II, payment rates per Hectare under the Areas of Natural Constrain Scheme (ANC) are frontloaded in favour of smaller farm sizes. Scheme details are available on the Department's website. In relation to on-farm investments, applications may be submitted by all eligible farmers. Approvals issue in accordance with the established ranking and selection criteria, full details of which are available on the Department’s website. Valid payment claims are generally approved for payment in the order in which they are submitted.
Negotiations on the new CAP Regulations are continuing at EU level. So far, these discussions have included issues such as further capping and convergence of payments and a small farmer scheme as well as new proposals for greater re-distribution of direct payments within CAP Pillar 1. The final shape of the new CAP will not be known until the negotiations are finalised.
328. Deputy Jackie Cahill asked the Minister for Agriculture, Food and the Marine if the loss of animals from TB by a farmer (details supplied) can be used as a stock rate reduction under force majeure with regard to BEAM; and if he will make a statement on the matter. [7530/21]
Amharc ar fhreagraThere may be certain circumstances where the removal of animals due to TB can be taken into account by the Department when calculating the nitrates reduction target that must be reached under the Beef Emergency Aid Scheme (BEAM). Each case will be looked at individually.
If the individual concerned wishes to have the nitrates reduction figure reviewed, he should write to the Beef Schemes Division of the Department setting out all the circumstances and the matter will be examined.
