Seán Sherlock
Ceist:301. Deputy Sean Sherlock asked the Minister for Health if matters raised (details supplied) in respect of fees paid to general practitioners will be examined. [10781/21]
Amharc ar fhreagraGeneral Practitioner Services
Ceisteanna (301)
Freagraí scríofa
The fees payable to GPs and pharmacists for the administration of vaccines against Covid-19 were set following consultation with the Irish Medical Organisation and the Irish Pharmacy Union. Where fees are paid to GPs, these are intended to include the full costs of scheduling and administering the vaccine and must cover not only GP pay, but also the additional payments to practice nurses and practice administrators who will be involved in providing vaccinations outside of normal clinic hours, as well as the additional costs of cleaning surgeries.
GPs and pharmacists are being asked to provide a proactive vaccination service which will require dedicated vaccination clinics while also maintaining regular services. They are also being asked to undertake administrative functions with regard to patient identification and consent. As with other types of vaccinations, the fees reflect the amount of time required, administrative complexity, and the level of post-vaccination care likely required. Furthermore, as Ireland has a blend of public and private GP-care provision, the fees have been agreed in consideration that GPs will be providing this service to both private and public patients on an equal basis without charge.
Vaccination Programme
Ceisteanna (302)
Éamon Ó Cuív
Ceist:302. Deputy Éamon Ó Cuív asked the Minister for Health if it is planned to recruit dentists as part of the Covid-19 vaccine teams in view of their qualifications and their experience and particularly to allow for the more rapid roll-out of the vaccine in rural areas; if so, when they will be recruited and mobilised; and if he will make a statement on the matter. [10802/21]
Amharc ar fhreagraFreagraí scríofa
The HSE are building and deploying its workforce in order to be prepared for the requirements associated with rolling out the COVID-19 vaccine programme.
The vaccine rollout is being conducted on a 7-day week basis and to date, more than 7,400 staff have received training to operate as vaccinators. To support the expanded immunisation programme the HSE launched a vaccinator recruitment campaign last week.
GPs, Pharmacists, doctors, nurses, paramedics, and many healthcare professionals, will have a role to play in the vaccination programme.
In addition, on Tuesday 23 February 2021, I signed the Medicinal Products (Prescription and Control of Supply) (Amendment) (No. 4) Regulations 2021. The purpose of these amending Regulations is to add registered optometrists and registered dentists to the list of professionals who may supply and administer Covid-19 vaccinations.
Alcohol Pricing
Ceisteanna (303)
Éamon Ó Cuív
Ceist:303. Deputy Éamon Ó Cuív asked the Minister for Health if he plans to commission a study on the possible effect the introduction of a minimum price for alcohol in this jurisdiction would have on cross-Border trade, given that no decision has been made by the Northern Ireland authorities to introduce a similar measure and the fact that the law providing this was passed by the Houses of the Oireachtas; and if he will make a statement on the matter. [10804/21]
Amharc ar fhreagraFreagraí scríofa
The current public health measures in place restrict the distance which we can all travel other than for essential reasons and therefore directly impact discretionary cross-border travel for purchases such as alcohol. On that basis this would not be an appropriate time to commission research to examine the potential impact of the introduction of minimum unit pricing on cross-border trade.
European Council Meetings
Ceisteanna (304)
Denis Naughten
Ceist:304. Deputy Denis Naughten asked the Minister for Health the number of formal and informal Council of the European Union meetings that have been held since 27 June 2020 under the remit of his Department; and the number of formal and informal meetings, respectively, held virtually. [10818/21]
Amharc ar fhreagraFreagraí scríofa
Since 27 June 2020, six meetings of Health Ministers have been organised by the Presidency of the Council of the European Union within the Employment, Social Policy, Health and Consumer Affairs Council (EPSCO) configuration. This includes a VC to replace the formal EPSCO Council meeting (2 December 2020), an informal EPSCO Council meeting (16 July 2020), and four informal meetings of Health Ministers (4 September 2020, 2 October 2020, 30 October 2020, and 13 January 2021). All six meetings were held virtually and were attended by Ireland at ministerial level.
Hospital Funding
Ceisteanna (305)
Joe Carey
Ceist:305. Deputy Joe Carey asked the Minister for Health if the necessary funding will be made available to ensure no further time is lost in progressing the provision of urgently required acute beds for the mid-west region, given that planning permission has been granted for the development of a new 96-bed ward block at University Hospital Limerick; and if he will make a statement on the matter. [10833/21]
Amharc ar fhreagraFreagraí scríofa
As the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
National Cervical Screening Programme
Ceisteanna (306)
Claire Kerrane
Ceist:306. Deputy Claire Kerrane asked the Minister for Health if changes were made to the upper age limit in which women are invited for a smear test by CervicalCheck; the reason a person who turned 61 years of age before 30 March 2020 was not invited for further screening; and if he will make a statement on the matter. [10840/21]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
Vaccination Programme
Ceisteanna (307)
Emer Higgins
Ceist:307. Deputy Emer Higgins asked the Minister for Health if all pharmacy staff will be considered front-line healthcare workers and be prioritised for vaccination in order to be able to continue looking after patients. [10842/21]
Amharc ar fhreagraFreagraí scríofa
The COVID-19 Vaccine Allocation Strategy sets out a provisional list of groups for vaccination. The Strategy was developed by the National Immunisation Advisory Committee (NIAC) and my Department , endorsed by the National Public Health Emergency Team (NPHET), and approved by Government on 8 December 2020.
Vaccine allocation is a matter for my Department and further information is available here: https://www.gov.ie/en/publication/39038-provisional-vaccine-allocation-groups/.
The rollout of the COVID-19 vaccination programme is the responsibility of the HSE.
The aim of the COVID-19 vaccination programme is to ensure, over time, that vaccine will become available to vaccinate all of those for whom the vaccine is indicated. Given that there will be initially limited vaccines available, it will take some time for all to receive those vaccines and that has necessitated an allocation strategy to ensure that those most at risk of death and serious illness receive the vaccine first.
The priority is to first vaccinate and protect directly the most vulnerable amongst us, that is, those most likely to have a poor outcome if they contract the virus. The priority is to directly use vaccines to save lives and reduce serious illness, hence the focus on the over 65 year old cohort in long term residential care facilities, and healthcare workers in frontline services often caring for the most vulnerable.
The next group to be vaccinated are those aged 70 and older in the following order: 85 and older, 80-84, 75-79, and 70-74. Vaccination of this group began in February.
On the 23rd of February, I announced an update to Ireland’s COVID-19 Vaccine Allocation Strategy.
In comprising the initial Vaccine Allocation Strategy, the NIAC listed several conditions associated with increased risk of severe disease and death. In the intervening period, national and international evidence has become available which has enabled a more detailed analysis of underlying conditions that may increase the risk of developing severe disease or death.
The NIAC has now been able to more comprehensively identify those medical conditions and to distinguish between those which place a person at very high or high risk of severe disease if they contract the virus. Medical conditions and the magnitude of the risk they pose will continue to be monitored and periodically reviewed.
The NIAC continues to monitor data around this disease and indeed emerging data on effectiveness of vaccines on a rolling basis.
Further details are available at the following link:
https://www.gov.ie/en/press-release/b44b2-minister-donnelly-announces-update-to-vaccine-allocation-strategy/
Frontline healthcare workers (HCWs) in direct patient contact roles are being vaccinated in Group 2. This includes HCWs working in public, private, and voluntary settings. Other HCWs, not in direct patient contact, will be vaccinated in Group 6.
Covid-19 Pandemic
Ceisteanna (308)
Paul Kehoe
Ceist:308. Deputy Paul Kehoe asked the Minister for Health if a business (details supplied) can be categorised as essential work; and if he will make a statement on the matter. [10846/21]
Amharc ar fhreagraFreagraí scríofa
As you will be aware the current public health restrictions at level 5 of the Government's Framework Resilience and Recovery 2020-2021: Plan for Living with COVID-19 will remain in place until 5th April 2021, when a further review will be conducted. The Framework continues to provide an appropriate mechanism to guide decision-making, and it will continue to be supplemented by more detailed sectoral guidance in relation to measures that apply at each level of the Framework.
On 23 February the Government published COVID-19 Resilience & Recovery 2021: The Path Ahead which sets out how in-school education and childcare services will be reinstated in a phased manner from 1 March, with staggered return throughout March to be concluded after the Easter break on 12 April. Information on the revised plan is available here - https://www.gov.ie/en/publication/c4876-covid-19-resilience-and-recovery-2021-the-path-ahead/?referrer=http://www.gov.ie/ThePathAhead/
S.I. No. 701 of 2020 Health Act 1947 (Section 31A - Temporary Restrictions) (COVID-19) (No. 10) Regulations 2020 and S.I. No. 4 of 2021 Health Act 1947 (Section 31A - Temporary Restrictions) (COVID-19) (No. 10) (Amendment) Regulations 2021 (as amended by S.I. No. 29 of 2021) sets out the current public health restrictions at level 5.
Under the public health restrictions at level 5, all non-essential retail, and all non-essential services must remain closed. Information in relation to essential retail/essential services at level 5 is available at -https://www.gov.ie/en/publication/2dc71-level-5/#retail-and-services-for-example-hairdressers-beauticians-barbers
You are not restricted from purchasing any product at level 5, however you are restricted from physically going into non-essential retail outlets. This is to stop people making unnecessary journeys and congregating, in order to limit the spread of the virus. Under the current restrictions, click or phone and delivery from non-essential retail outlets is permitted.
For your assistance, Statutory Instruments related to the Covid-19 pandemic are available here - https://www.gov.ie/en/collection/1f150-view-statutory-instruments-related-to-the-covid-19-pandemic/
Vaccination Programme
Ceisteanna (309)
Denis Naughten
Ceist:309. Deputy Denis Naughten asked the Minister for Health if persons between 16 and 18 years of age who are medically vulnerable will be offered a vaccine (details supplied); if family carers will be offered vaccination in view of their prioritisation in the United Kingdom and other EU countries; and if he will make a statement on the matter. [10854/21]
Amharc ar fhreagraFreagraí scríofa
The COVID-19 Vaccine Allocation Strategy sets out a provisional list of groups for vaccination. The Strategy was developed by the National Immunisation Advisory Committee (NIAC) and my Department , endorsed by the National Public Health Emergency Team (NPHET), and approved by Government on 8 December 2020.
Vaccine allocation is a matter for my Department and further information is available here: https://www.gov.ie/en/publication/39038-provisional-vaccine-allocation-groups/.
The rollout of the COVID-19 vaccination programme is the responsibility of the HSE.
The aim of the COVID-19 vaccination programme is to ensure, over time, that vaccine will become available to vaccinate all of those for whom the vaccine is indicated. Given that there will be initially limited vaccines available, it will take some time for all to receive those vaccines and that has necessitated an allocation strategy to ensure that those most at risk of death and serious illness receive the vaccine first.
The priority is to first vaccinate and protect directly the most vulnerable amongst us, that is, those most likely to have a poor outcome if they contract the virus. The priority is to directly use vaccines to save lives and reduce serious illness, hence the focus on the over 65 year old cohort in long term residential care facilities, and healthcare workers in frontline services often caring for the most vulnerable.
The next group to be vaccinated are those aged 70 and older in the following order: 85 and older, 80-84, 75-79, and 70-74. Vaccination of this group began in February.
On the 23rd of February, I announced an update to Ireland’s COVID-19 Vaccine Allocation Strategy.
In comprising the initial Vaccine Allocation Strategy, the NIAC listed several conditions associated with increased risk of severe disease and death. In the intervening period, national and international evidence has become available which has enabled a more detailed analysis of underlying conditions that may increase the risk of developing severe disease or death.
The NIAC has now been able to more comprehensively identify those medical conditions and to distinguish between those which place a person at very high or high risk of severe disease if they contract the virus. Medical conditions and the magnitude of the risk they pose will continue to be monitored and periodically reviewed.
Those aged 16 or 17 years who are at high risk or very high risk and who have therefore been prioritised for vaccination should be given the Pfizer vaccine as this is the only vaccine authorised for use in this age group.
The NIAC continues to monitor data around this disease and indeed emerging data on effectiveness of vaccines on a rolling basis.
Further details are available at the following link:
https://www.gov.ie/en/press-release/b44b2-minister-donnelly-announces-update-to-vaccine-allocation-strategy/
Family carers are a diverse group, therefore, each individual will be vaccinated in the group that is appropriate to them.
Covid-19 Tests
Ceisteanna (310, 315)
Michael McNamara
Ceist:310. Deputy Michael McNamara asked the Minister for Health the dates on which the PCR tests in which the three cases of the P1 Brazilian variant that were announced on 19 February 2021 were carried out; the dates on which it was notified to his Department and the National Public Health Emergency Team, NPHET, that the said variant was detected; and if he will make a statement on the matter. [10858/21]
Amharc ar fhreagraMichael McNamara
Ceist:315. Deputy Michael McNamara asked the Minister for Health the dates on which the PCR tests regarding the three cases of the P1 Brazilian variant that were announced on 19 February 2021 were carried out; the dates on which it was discovered by NPHET that the variant was detected; and if he will make a statement on the matter. [10864/21]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 310 and 315 together.
On 19 February 2021, the Health Protection Surveillance Centre was notified of three cases of a new variant of COVID-19 (‘P1’), first identified in Brazil. All of the cases identified are understood to be directly associated with recent travel from Brazil. All cases are being followed up by public health teams and enhanced public health measures have been put in place, in line with guidance. This was notified to my Department on the same date.
My Department cannot comment on the specific circumstances of the individual cases which have arisen in this case as to do so would breach the duty of confidentiality to the individuals.
Addiction Treatment Services
Ceisteanna (311)
Thomas Gould
Ceist:311. Deputy Thomas Gould asked the Minister for Health if an external report and the subsequent recommendations on the Keltoi facility is to be published; and the timeline for this publication. [10859/21]
Amharc ar fhreagraFreagraí scríofa
I am aware that the HSE has commissioned a report into the facility referred to by the Deputy and I understand that the report is the subject of ongoing discussions between staff and management.
As this is a service matter, I have asked the Health Service Executive to respond to the deputy.
Covid-19 Pandemic
Ceisteanna (312)
Réada Cronin
Ceist:312. Deputy Réada Cronin asked the Minister for Health his policy on vitamin D supplementation in the population; his policy on the strategic use of drugs such as HCQ and ivermectin in the treatment of Covid-19; and if he will make a statement on the matter. [10860/21]
Amharc ar fhreagraFreagraí scríofa
Vitamin D
With regard to Vitamin D supplementation in the population, the Deputy is advised that the existing guidance on vitamin D was updated in November 2020 and advises that adults aged 65 and older to 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 the NPHET was discussed at its meeting on 28th January 2021. 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.
The NPHET agreed that efforts should be made to increase awareness of existing guidance. Adults spending increased time indoors or those who 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.
The Department of Health has recently written to the HSE and Nursing Homes Ireland to encourage implementation of guidance on vitamin D in nursing homes.
The Government will continue to look to the NPHET to provide recommendations with regard to Vitamin D and COVID-19.
Hydroxychloroquine and Ivermectin
The Deputy is advised that, at the request of the NPHET, HIQA conducted a rapid evidence review to identify studies on the effectiveness of (i) pharmaceutical and (ii) non-pharmaceutical interventions, in the ambulatory setting, aimed at reducing progression to severe disease in individuals with confirmed or suspected COVID-19. This evidence review included a review of relevant studies in relation to Hydroxychloroquine and Ivermectin.
Low certainty or very low certainty evidence was identified in relation to a small number of interventions. However, HIQA noted the low quality of the evidence available including the high risk of bias, small sample sizes and short durations of follow-up different trials and advised that results from these studies should not be used to inform decision-making with respect to effectiveness. The HIQA’s overall finding was that there is currently insufficient evidence of either effectiveness or safety to support the use of any pharmaceutical intervention in the community setting to reduce the risk of progression to severe disease in patients who have been diagnosed with COVID-19 unless as part of an ongoing monitored clinical trial. Furthermore, no evidence was identified for the effectiveness or safety of any non-pharmaceutical intervention in the community setting.
As confirmed by the HIQA’s COVID-19 Expert Advisory Group (https://www.hiqa.ie/sites/default/files/2021-02/Interventions-to-prevent-progression_Advice.pdf), evidence regarding the effectiveness of pharmaceutical treatments intended for systemic use, must be subject to the highest standards of rigour. Where a pharmaceutical intervention is recommended in the absence of appropriate supportive evidence, there is a significant potential for harm to the patient. Whereas this risk of harm may be justified in certain circumstances (e.g. the intervention poses minimal risk, or the setting involves patients with high potential to gain due to almost certain risk of severe adverse consequences in absence of any intervention) this is less likely to be the case in the setting of mild disease, where a great number of otherwise well patients would potentially receive the intervention.
The HIQA has also advised my Department that several international health technology assessment or guideline development organisations have specifically reviewed the evidence to date on ivermectin in COVID-19 and have cautioned or advised against the use of ivermectin outside the setting of clinical trials on the basis of the current evidence. The HIQA has also advised that the pharmaceutical company MSD (Merck, USA), which holds a license in the USA for the use of ivermectin as an antiparasitic agent, on 4th February 2021 published a statement including the following:
“It is important to note that, to-date, our analysis has identified:
- No scientific basis for a potential therapeutic effect against COVID-19 from pre-clinical studies;
- No meaningful evidence for clinical activity or clinical efficacy in patients with COVID-19 disease, and;
- A concerning lack of safety data in the majority of studies.
We do not believe that the data available support the safety and efficacy of ivermectin beyond the doses and populations indicated in the regulatory agency-approved prescribing information.”
I trust that the above information satisfactorily addresses your question.
Health Services Staff
Ceisteanna (313)
Réada Cronin
Ceist:313. Deputy Réada Cronin asked the Minister for Health the number of public health doctors and specialists who have been appointed since the outbreak of Covid-19; the number who will be appointed in 2021; the grade at which they will be appointed; and if he will make a statement on the matter. [10861/21]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.
Vaccination Programme
Ceisteanna (314)
Robert Troy
Ceist:314. Deputy Robert Troy asked the Minister for Health the current plans to administer vaccines to those who are aged over 85 years, are completely housebound and, therefore, cannot attend a doctor's surgery or a vaccination centre; and if the HSE is making provisions to administer vaccines in the home in such cases. [10863/21]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Question No. 315 answered with Question No. 310.
Health Services Funding
Ceisteanna (316)
John Lahart
Ceist:316. Deputy John Lahart asked the Minister for Health the status of the access to care fund and the HSE national treatment fund action plan for 2021 announced in budget 2021; and if he will make a statement on the matter. [10867/21]
Amharc ar fhreagraFreagraí scríofa
The annual Scheduled Care Access Plan sets out yearly activity targets for the HSE and the National Treatment Purchase Fund (NTPF), along with measures to improve care for patients waiting for Scheduled Care.
Each year the Access Plan focuses on reducing waiting times for identified high-volume procedures, as well as very long waiters. The 2018 and 2019 Access Plans resulted in positive improvements in Inpatient and Daycase (IPDC) waiting lists which saw a reduction of 18% from 2017 to 2019, and some broader trends in improvement for GI Scopes and Outpatient (OPD) lists. The 2020 Access Plan had not been finalised for publication by March 2020 when the COVID-19 pandemic forced the cancellation of routine elective scheduled care for a number of months.
In the context of addressing the impact of Covid-19 on scheduled care, the Government has allocated an additional €210m to the HSE for access to care, which includes funding to help address the shortfall in acute hospital capacity, due to measures introduced to deal with the Covid-19 pandemic, and address waiting lists. An additional €30m has also been given to the NTPF to help to address backlogs in waiting lists. This demonstrates the Government’s commitment to improving access to care including reducing waiting times for scheduled care.
The Department of Health, HSE and NTPF are working together to agree targets in relation to waiting list focused activity for 2021. It is expected that this work will conclude shortly.