Written Answers Nos. 240-260
240. Deputy Peter Burke asked the Minister for Health if the reason a HSE employee (details supplied) who submitted a job evaluation application over two and a half years ago has not had the application acknowledged or processed despite repeated queries will be examined; if his Department will provide an explanation for the delays in administrative processing; and if he will make a statement on the matter. [13783/21]
Amharc ar fhreagraI have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
241. Deputy Louise O'Reilly asked the Minister for Health the reason optometrists have been left off the priority vaccination list despite engaging in patient facing work daily; and when they can expect to receive the vaccination. [13797/21]
Amharc ar fhreagraThe 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.
Vaccination of those aged 70 and older (in the following order: 85 and older, 80-84, 75-79, and 70-74) 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 will be vaccinated in Group 2. This includes HCWs working in public, private, and voluntary settings. Other HCWs, not in direct patient contact, will now be vaccinated in Group 6.
242. Deputy Paul Donnelly asked the Minister for Health if he will report on concerns in relation to Covid-19-related stillbirths; and if there needs to be an elevated warning to pregnant women. [13810/21]
Amharc ar fhreagraGiven the role of the HSE’s National Women & Infants Health Programme in relation to the dissemination of clinical advice and guidelines to maternity services across the country, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
243. Deputy Richard Boyd Barrett asked the Minister for Health the body that is responsible for enforcing restrictions in the construction or other sectors; and if he will make a statement on the matter. [13818/21]
Amharc ar fhreagraAs you will be aware, the 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 23rd February, 2021, the Government published it's updated plan for managing Covid-19 - COVID-19 Resilience & Recovery 2021: The Path Ahead. This three part plan reviews the learnings from our experience to date, considers the enormous impacts our efforts to manage and suppress the disease have had on our economy and on our society and sets out a cautious and measured approach to the easing of restrictions over the coming months.
Details of the public health measures currently in place for construction can be found at:- https://www.gov.ie/en/publication/2dc71-level-5/#construction. Information on essential services and essential retail is available here:- https://www.gov.ie/en/publication/c9158-essential-services/ and here:- https://www.gov.ie/en/publication/60ecc-essential-retail-outlets-for-level-5/.
The Health and Safety Authority (HSA) is the lead agency in relation to the assessment of compliance with the Work Safely Protocol in workplaces. In addition to the HSA, a number of inspectorates from across Government are carrying out Work Safely Protocol inspections in support of the HSA. These include inspectors from the Department of Agriculture, Food and the Marine, Department of Education, Sea Fisheries Protection Authority, Tusla and the Workplace Relations Commission. These additional inspectors are supporting the HSA in carrying out checks on compliance with the Protocol as part of their normal duties, bringing the number of inspectors carrying out Protocol compliance inspections to around 700. Information on the Work Safely Protocol is available online here:- https://www.gov.ie/en/publication/bb7fd-work-safely-protocol/.
Between the 18th of May 2020, when initial restrictions were lifted, and the week ending the 26th February 2021, 27,443 inspections assessing compliance with the guidance provided by the COVID-19 Work Safely Protocol have been carried out by the various inspectorate bodies from across Government.
Inspectors have observed and reported a generally high level of compliance with the recommended measures to limit the spread of COVID-19 in a workplace.
You may wish to note that responsibility for the enforcement of current public health regulations rests with the Garda Commissioner.
An Garda Síochána continue to use the 'Four E's' approach in line with their strong tradition of community policing and policing by consent. This sees Garda members Engage with, Encourage and Educate members of the public on public health advice and regulations, with Enforcement used only as a last resort.
The Regulations in effect providing for the current public health restrictions are the Health Act 1947 (Section 31A - Temporary Restrictions) (Covid-19) (No. 10) Regulations 2020 (S.I. No. 701 of 2020) as amended by S.I. No. 4 of 2021, S.I. No. 29 and S.I. No. 95 of 2021.
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/
245. Deputy Michael McNamara asked the Minister for Health if the additional intern jobs created in 2020 which allowed every graduating doctor the chance to stay and work in Ireland are being discontinued in respect of the 2021 cohort of interns as a result of which the vast majority of international graduating doctors will be forced to leave Ireland to work as doctors. [13827/21]
Amharc ar fhreagraAt the height of COVID, in 2020 intern numbers were increased to deal with health service pressures. This increase was an emergency measure in direct response to the COVID-19 Pandemic. It was not planned, and it was never intended to be sustained on an annual basis.
The Minister for Health asked officials and the HSE to review options to increase the number of medical intern places for 2021.The review will include consideration of current training capacity, and the continued pressures faced by COVID-19 and the ongoing recruitment of senior medical staff.
The Minister is expecting an interim proposal this week. The HSE will also undertake a full review the number of intern posts in a planned and targeted manner for July 2022 to ensure any increases in intern posts is aligned with projected workforce planning requirements, postgraduate training positions, the overall objective of delivering high quality training programmes and having appropriate focused career development opportunities to build the medical workforce and continue to deliver safe care.
As we are coming out of the third wave of COVID and facing increased waiting lists and other challenges there is a focus is on continued recruitment to ensure we have senior doctors to deal with the continued demands. As part of the planned investment by the HSE in additional staffing, services and infrastructure the HSE will be investing in additional medical staffing in 2021. For example:
- Increased the number of approved postgraduate training places by 106 places for July 2021
- Introduced up to 54 new Senior Fellowship posts for July 2021
- Consultant Appointments Approval Committee has approved 91 new consultant posts since August 2020
Further increases are underway and planned as part of the HSE National Service Plan 2021.
These additional consultants and other senior decision makers will support the delivery of shorter waiting times, the reduction of inappropriate hospital admissions, improved patient flow, and earlier discharge of patients to the community.
246. Deputy Chris Andrews asked the Minister for Health the reason the Royal Victoria Eye and Ear Hospital is refusing patients such as a person (details supplied) an appointment until 14 days prior to receiving their Covid-19 vaccination; if this is normal practice; and the reason for same. [13828/21]
Amharc ar fhreagraIt is recognised that waiting times for scheduled appointments and procedures have been impacted in the last year as a direct result of the COVID-19 pandemic.
The HSE is currently recommending that only critical time dependent elective procedures are undertaken at this time due to the on-going and significant increased demand for bed capacity related to Covid-19.
This decision was made arising from the rapid increase in Covid-19 admissions and to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work.
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.
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.
247. Deputy Róisín Shortall asked the Minister for Health if his Department has undertaken a review of expectations for the number of NCHDs who will be working in the health service in 2022 and the coming years given reports that the 300 new NCHD posts created at the start of the pandemic will be cut and that a further 300 NCHDs are considering leaving the health service due to concerns regarding working conditions and the work environment; the steps he is taking to address both of these issues which would seriously negatively impact staffing levels in the health service; and if he will make a statement on the matter. [13829/21]
Amharc ar fhreagraAt the height of COVID, in 2020 intern numbers were increased to deal with health service pressures. This increase was an emergency measure in direct response to the COVID-19 Pandemic. It was not planned, and it was never intended to be sustained on an annual basis.
The Minister for Health asked officials and the HSE to review options to increase the number of medical intern places for 2021.The review will include consideration of current training capacity, and the continued pressures faced by COVID-19 and the ongoing recruitment of senior medical staff.
The Minister is expecting an interim proposal this week. The HSE will also undertake a full review the number of intern posts in a planned and targeted manner for July 2022 to ensure any increases in intern posts is aligned with projected workforce planning requirements, postgraduate training positions, the overall objective of delivering high quality training programmes and having appropriate focused career development opportunities to build the medical workforce and continue to deliver safe care.
As we are coming out of the third wave of COVID and facing increased waiting lists and other challenges there is a focus is on continued recruitment to ensure we have senior doctors to deal with the continued demands. As part of the planned investment by the HSE in additional staffing, services and infrastructure the HSE will be investing in additional medical staffing in 2021. For example:
- Increased the number of approved postgraduate training places by 106 places for July 2021
- Introduced up to 54 new Senior Fellowship posts for July 2021
- Consultant Appointments Approval Committee has approved 91 new consultant posts since August 2020
Further increases are underway and planned as part of the HSE National Service Plan 2021.
These additional consultants and other senior decision makers will support the delivery of shorter waiting times, the reduction of inappropriate hospital admissions, improved patient flow, and earlier discharge of patients to the community.
The HSE’s National Service Plan 2021 provides the projected medical/dental staffing for December 2021, based on projected employment figures. NCHDs are included as part of the overall medical/dental staffing requirements.
The planned investment in additional staffing, services, and infrastructure in the 2021 National Service Plan, will allow demonstrable progress to be made towards addressing the particular capacity gaps in both acute and community services, identified in the Health Service Capacity Review 2018.
248. Deputy Bernard J. Durkan asked the Minister for Health his plans to address the shortcomings in the mental health services with particular reference to north County Kildare and the need to provide for those seeking institutional care or specific treatment not currently readily available in Ireland and or local access to psychology services without waiting prolonged periods of time; and if he will make a statement on the matter. [13840/21]
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.
249. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he expects to improve the supports for children with special needs while requiring therapeutic or residential short-term or long-term assistance; and if he will make a statement on the matter. [13841/21]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
250. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the Sláintecare programme is being enacted; the progress to date in this regard; the targets achievable in the next 12 months; and if he will make a statement on the matter. [13845/21]
Amharc ar fhreagraIn 2017 the Oireachtas Committee on the Future of Healthcare set out, in the Sláintecare Oireachtas Report, their vision to deliver safe, quality health and social care services that meets the needs of our growing population, and attracts and retains the very best healthcare clinicians, managers, and staff. The vision of Sláintecare is to achieve a universal single-tier health and social care system, where everyone has equitable access to services based on need, and not ability to pay. Over time, citizens will have entitlement to a comprehensive range of primary, acute and social care services. The aim is to deliver a universal health service that offers the right care, in the right place, at the right time, at low or no cost.
Following the publication of the Oireachtas Sláintecare Report in 2017, the Sláintecare Implementation Strategy was agreed by Government in August 2018, setting out an initial set of key actions for a three-year period. Implementation of the Sláintecare vision has continued in line with the 2018 Sláintecare Implementation Strategy with regular updates on progress being reported to the Cabinet Committee on Health and the Joint Oireachtas Committee on Health.
Key progress on the Sláintecare reforms, to end 2020, is summarised below. At a glance:
- A strong message of the importance of prevention has been made through significant investment in the work of Healthy Ireland and the roll out of the “Keep Well” resilience campaign during COVID-19
- A conscious move to implementing more integrated care has been taken, resourcing more networks of care, through the establishment of community healthcare networks, as well as older persons and chronic disease management (CDM) hubs and a GP Structured CDM Programme, with funding now in place for an additional 7000 community staff
- Additional capacity has been made available to the health and social care system through investment in capital and eHealth infrastructure
- The Sláintecare Integration Innovation projects demonstrated new ways of delivering care that are now being mainstreamed, and
- Government made key foundational governance decisions to underpin the direction of travel for Sláintecare reform
The Programme for Government (2020), reaffirmed the commitment to the implementation of Sláintecare and pledged to accelerate the process, underpinned by the allocation in Budget 2021 of more than €1.235billion to advance the implementation of Sláintecare.
Two years into the reform process, key progress set out against the Oireachtas Report Principles, has been:
Engagement: Significant political and public engagement; the establishment of joint GP Forum; the establishment of the Staff Engagement Forum and Integration Fund Learning Network; Engagement with Community Voluntary Network and Dialogue Forum on Voluntary Bodies; and Cross governmental partnerships through Healthy Ireland.
Patient is Paramount: we have provided targeted funding to support Integration/Innovation Projects focussed on patient empowerment; funded Community Healthcare Networks to provide integrated services for people nearer to home; established Integrated Care Programmes for Older People and People with Chronic Diseases; provided ICT tablets to nursing homes and hospitals with restricted visiting regimes to support patients to stay connected to their families and friends; and established the Patient Safety Office
Timely Access:
- Sláintecare has been funded to the levels envisaged in the Health Capacity Review (2018), including for health and wellbeing, and enhanced community care
- The Elective hospitals Strategic Assessment Report (SAR) has been approved in line with the Public Spending Code
- We have established the Access to Care Fund to help reduce waiting lists
- Electronic Prescriptions are now universally available between from GPs and pharmacies
- Sláintecare has funded a 4th elective surgery theatre at Tallaght hospital
- We have fully funded the reduction of disability assessment of needs waiting lists.
Care provided free at the point of delivery:
- we have increased entitlement to GP care and reduction in prescription charges
- we have agreed the expansion of the GP contract to support chronic disease management
- we have made substantial investment in increased homecare packages and a Healthy Age-Friendly Homes scheme to help people stay well in their own homes for as long as possible
Workforce: we have seen a significant and step change funding to support implementation of Sláintecare in the 2021 Budget with investment in an additional 7000+ community acute staff; investment in additional 3600 hospital staff; and investment in additional 600 consultant posts
Public Money in Public Interest: Government has agreed to the introduction of a public only Sláintecare Consultant contract moving towards removing private care from public hospitals
Accountability: Significant Foundational Decisions made by Government include the establishment of the HSE Board, and the approval of the geographies for six new regional health areas, to enable more accountable, devolved care
Prevention and Public Health: We have made substantial investment in Healthy Ireland and in public health promotion, including
- the Obesity Policy and Action Plan, the National Physical Activity Plan and the Sexual Health Strategy, and Alcohol and Smoking prevention
- the Sláintecare Communications and Citizen Engagement Campaign
- the In This Together Campaign supporting the Government’s Resilience and Recovery Plan, and a new public engagement “Keep Well” campaign
An updated Sláintecare implementation Strategy 2021-2023 and 2021 Action Plan is expected to focus on 2 reform programmes.
1. Improving Safe, Timely Access to Care & Promoting Health & Wellbeing will centre on integration, safety, prevention, shift of care to the right location, productivity, extra capacity and elimination of waiting lists, while
2. Addressing Health Inequalities will focus on moving towards Universal Healthcare.
I anticipate that the updated Strategy will be published shortly.
251. Deputy Sorca Clarke asked the Minister for Health when the contract will be signed for the vaccination centre in County Longford. [13855/21]
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.
252. Deputy Sorca Clarke asked the Minister for Health the number of senior nurses currently employed on a full-time permanent basis at Midlands Regional Hospital, Mullingar. [13859/21]
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.
253. Deputy Sorca Clarke asked the Minister for Health if the nurses employed at Midlands Regional Hospital, Mullingar are on full-time HSE contracts. [13860/21]
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.
254. Deputy Sorca Clarke asked the Minister for Health the number of trained emergency department nurses employed at Midlands Regional Hospital, Mullingar. [13861/21]
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.
255. Deputy Sorca Clarke asked the Minister for Health the ratio of consultants to nurses at Midlands Regional Hospital, Mullingar. [13862/21]
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.
256. Deputy Sorca Clarke asked the Minister for Health further to Parliamentary Question No. 670 of 20 January 2021, the number of the confirmed 75.5% vacant positions at Midlands Regional Hospital, Mullingar; the number of these positions per department that are currently advertised for recruitment; and the number of these positions that are currently filled by agency staff. [13863/21]
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.
257. Deputy Jackie Cahill asked the Minister for Agriculture, Food and the Marine the estimated number of vets needed for the additional certification process in relation to changes in export health certification of products of animal origin on 1 April 2021; and if he will make a statement on the matter. [13580/21]
Amharc ar fhreagra258. Deputy Jackie Cahill asked the Minister for Agriculture, Food and the Marine if all vets have received the required training in relation to changes in export health certification of products of animal origin on 1 April 2021; and if he will make a statement on the matter. [13581/21]
Amharc ar fhreagra259. Deputy Jackie Cahill asked the Minister for Agriculture, Food and the Marine the number of certificates that will be needed to be signed by vets in relation to changes in export health certification of products of animal origin on 1 April 2021; and if he will make a statement on the matter. [13582/21]
Amharc ar fhreagra260. Deputy Jackie Cahill asked the Minister for Agriculture, Food and the Marine his views on whether Ireland has the infrastructure to ensure that changes in export health certification does not disrupt the speedy delivery of products; and if he will make a statement on the matter. [13583/21]
Amharc ar fhreagraI propose to take Questions Nos. 257 to 260, inclusive, together.
The requirement for certification into and through GB falls to be determined by the UK. Under its Border Operating Model (BOM), the UK is progressively introducing new checks and controls on its trade with the EU on 1st January, 1st April and 1st July.
This requirement places new additional demands on industry and the State. My Department has examined data, including conducting surveys with industry on likely certification requirements. The actual number of veterinary health certificates and other certificates that will be needed from 1st April depends very much on exporters' business practice in response to UK import requirements and wider considerations. For example, business decisions on consolidation of consignments in Ireland and distribution in Great Britain, decisions regarding the continued use of the landbridge for consignments destined for the EU continental market as well as trade impacts arising post-Covid lockdown will all impact on likely certification requirements from 1st April.
Good progress is being made in the implementation of the key elements of my Department's work plan to meet UK import requirements on 1st April. Detailed business processes have been prepared, work on IT systems is on track, and the necessary staffing and training is being put in place to deliver on the certification requirements (this will involve contracted services, some additional recruitment of staff and the temporary reassignment of existing staff). On communications, officials in my Department will continue to engage intensively with industry over the coming weeks to ensure that these systems are in place to provide export health certification on the scale required.
I would urge all exporters to avail of the range of Government supports that are available, including training and grants. Further information on these and other supports is set out at Gov.ie/Brexit.
