Wednesday, 31 Mar 2021

General Practitioner Services

Ceisteanna (944)

Peadar Tóibín

Ceist:

944. Deputy Peadar Tóibín asked the Minister for Health the number of missed general practitioner appointments in 2020 and to date in 2021. [16650/21]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

General practitioners are private practitioners. Information on missed general practitioner appointments is not collected by my Department or the HSE.

Cancer Services

Ceisteanna (945)

Peadar Tóibín

Ceist:

945. Deputy Peadar Tóibín asked the Minister for Health the reason cancer treatment services will not resume in full until the end of 2021. [16651/21]

Amharc ar fhreagra

Freagraí scríofa

The National Action Plan on Covid-19 identified the continued provision of cancer care as a priority. Due to the ongoing need for physical distancing and related infection prevention and control measures, capacity across many cancer services has been reduced. However, cancer services are continuing to operate in line with guidance issued by the National Cancer Control Programme (NCCP).

The principles underpinning cancer care delivery during the pandemic remain key to efforts to mitigate the impact on services:

- continuation of diagnostic services, particularly patients referred to Rapid Access Clinics;

- continuation of treatment, considering the risk: benefit ratio for each individual patient;

- prioritising time-sensitive treatment across the cancer pathway;

- reviewing the location of the delivery of cancer services to optimise patient safety and infection control;

- minimising any non-essential face to face patient contact, e.g. through the use of virtual assessment and triage where appropriate;

- optimising the potential for providing cancer services in private hospitals; and

- adherence to national guidance for all services as laid out by NCCP and the HSE’s Chief Clinical Officer.

The total number of patients seen across all Rapid Access Clinics in 2020 (44,233) amounted to 88% of the 2019 figure (50,249). In regard to 2021, GP e-referrals to Rapid Access Clinics for weeks 2-10 this year stand at 112% of the activity in the corresponding weeks in 2020.

Medical Oncology services continue in all 26 hospitals and guidance has issued to clinicians regarding the provision of Systemic Anti-Cancer Therapy (SACT). This includes details on treating cancer patients with Covid-19, or with potential Covid-19. The number of patients receiving chemotherapy up end 2020 was approximately 88% of 2019 levels.

Radiation oncology services in the public hospitals are currently operating at >90% of 2019 activity levels. Radiation oncology units are accommodated in buildings that are largely separate from other hospital services, which may reassure patients who are nervous about presenting to hospitals in the current climate.

Urgent surgical oncology is being prioritised and there is an emphasis on maintaining safe patient pathways for this. Private hospitals have been key to ensuring that time-sensitive surgery continues. Surgery numbers in public hospitals in 2020 were 76% of the 2019 levels (this does not include public case surgeries undertaken in private hospitals).

Funding of €12m has been allocated this year for the restoration of cancer services to 95% of 2019 (pre-Covid) levels. This funding will support hospitals in addressing backlogs, extending clinic times, providing additional clinics, increasing diagnostic capacity and providing locum/temporary support. It will also support virtual clinics and more accurate triage, and facilitate infrastructure and minor equipment purchases to increase capacity across Rapid Access Clinics and surgical oncology, medical oncology and radiation oncology services.

In addition, as part of Budget 2021, an extra €20m has been allocated for the continued implementation of the National Cancer Strategy this year. This funding will facilitate developments across prevention, diagnosis, treatment and patient supports.

Cancer Services

Ceisteanna (946, 1061)

Peadar Tóibín

Ceist:

946. Deputy Peadar Tóibín asked the Minister for Health if his Department has carried out an assessment of the impact of Covid-19 upon cancer screening and cancer treatment in terms of missed diagnoses, advanced diagnoses, terminal cancer diagnoses, cancer deaths and treatment delays. [16652/21]

Amharc ar fhreagra

Peadar Tóibín

Ceist:

1061. Deputy Peadar Tóibín asked the Minister for Health if his Department has undertaken a study to investigate the impact of Covid-19 and lockdowns on the provision of cancer services. [17011/21]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 946 and 1061 together.

The National Action Plan on Covid-19 identified the continued provision of cancer care as a priority. Cancer services continue to operate in line with guidance issued by the HSE's National Cancer Control Programme (NCCP).

The NCCP is continuing to closely monitor trends in numbers coming forward to diagnostic services, and the level of attendances for appointments for treatment. The NCCP is focused on engaging with cancer services, and with hospital management, in the designated cancer centres (and beyond in the case of medical oncology) with a view to ensuring the continuation of services for cancer patients.

The number of people coming forward to their GPs, being referred to Cancer Rapid Access Clinics (RACs) and attending these clinics decreased significantly in mid-March to May 2020 due to the fears in regard to Covid, and the reaction of people to restrictions in place at that time.

These figures increased over time - the total number of patients seen across all RACs in 2020 (44,233) amounted to 88% of the 2019 figure (50,249) and GP e-referrals to RACs for weeks 2-10 this year stand at 112% of the activity in the corresponding weeks in 2020.

Medical and radiation and oncology services are continuing, utilising the safeguards of social distancing and infection prevention & control measures built up in the past year. The number of patients receiving chemotherapy up to end-2020 is at approximately 88% of 2019 activity, while radiation oncology is operating at >90% of 2019 activity.

BreastCheck, CervicalCheck and BowelScreen resumed their services last year and service continues, albeit at reduced capacity, during the current level 5 restrictions. The focus is on getting services resumed to achieve the maximum screening rates that are compatible with a safe and controlled follow-up treatment capacity in the health service. Throughout the pause in screening and the restart, those who were already scheduled for further assessment or treatment were prioritised, and follow-up clinics continued.

The safety of screening participants and staff continues to be the highest priority at this time. Safety precautions are in place throughout the National Screening Services to protect against the spread of Covid-19 and screening services have implemented advised safety measures to reduce the risk of infection. I’d like to take this opportunity to emphasise that screening is for healthy people who do not have symptoms.

An important message to everyone now is that, if you have any concerns about cancer please go to your GP, who will arrange appropriate follow-up care. Our cancer diagnostic and treatment services are open, and our healthcare staff will provide any necessary care.

Funding of €12m has been allocated this year for the restoration of cancer services to 95% of 2019 (pre-Covid) levels. This funding will support hospitals in addressing backlogs, extending clinic times, providing additional clinics, increasing diagnostic capacity and providing locum/temporary support. It will also support virtual clinics and more accurate triage, and facilitate infrastructure and minor equipment purchases to increase capacity across Rapid Access Clinics and surgical oncology, medical oncology and radiation oncology services.

In addition, as part of Budget 2021, an extra €20m has been allocated for the continued implementation of the National Cancer Strategy this year. This funding will facilitate developments across prevention, diagnosis, treatment and patient supports.

Hospital Car Parks

Ceisteanna (947)

Peadar Tóibín

Ceist:

947. Deputy Peadar Tóibín asked the Minister for Health the total receipts for hospital car parking charges in each of the years 2010 to 2020 and to date in 2021, nationally, by county and by hospital. [16653/21]

Amharc ar fhreagra

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 (948, 949, 950)

Neasa Hourigan

Ceist:

948. Deputy Neasa Hourigan asked the Minister for Health if the notification rate is a factor in the decision around which countries to include on the high-risk category 2 countries for inclusion on the quarantine list for entry into the State; and if he will make a statement on the matter. [16654/21]

Amharc ar fhreagra

Neasa Hourigan

Ceist:

949. Deputy Neasa Hourigan asked the Minister for Health if the test positivity rate is a factor in the decision around which countries to include on the high-risk category 2 countries for inclusion on the quarantine list for entry into the State; and if he will make a statement on the matter. [16655/21]

Amharc ar fhreagra

Neasa Hourigan

Ceist:

950. Deputy Neasa Hourigan asked the Minister for Health if the testing rate is a factor in the decision around which countries to include on the high-risk category 2 countries for inclusion on the quarantine list for entry into the State; and if he will make a statement on the matter. [16656/21]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 948 to 950, inclusive, together.

The clear Government and public health advice is that everybody should avoid non-essential travel.

Medical Graduates

The Department of Further and Higher Education, Research, Innovation and Science have informed my Department that the figures relating to medical graduates for 2020 have not yet been compiled. Therefore, they are not included in the attached table. However, I have included the figures for 2015 so that the Deputy will have the last 5 years data.

It should be noted that each year the applicants for medical internships are a mixture of the CAO medical students, fee paying medical students and EEA applicants who undertook medical school outside of Ireland. Of the available intern posts approximately 680 places are offered to CAO applicants annually.

There are approximately 600 international, fee paying medical students in Ireland each year. It was never envisaged that an intern post would be made available for all medical students studying in Ireland. These students are made aware of this before taking up studies in Ireland. The number of intern places allocated each year are in accordance with HSE workforce and service requirements. The HSE does not set the annual intake into Medical Schools.

Minister for Health (Deputy Stephen Donnelly)

Inpatient and outpatient cardiology services are available at Portiuncula University Hospital. These are led by a Consultant Cardiologist who is shared with University Hospital Galway (0.75 WTE in Portiuncula).

An integrated hospital/primary care heart failure nursing service is in place and a Cardiac Rehabilitation service is available in the hospital. A number of cardiac diagnostics are available including Echo, Holter, Exercise Stress Tests and CT Coronary Angiography.

The cardiac service in Prortiuncula has received a Sláintecare Integration Fund grant of approximately €0.33m to develop community-based cardiac diagnostics (Echo & Holter), an integrated heart failure nursing service and a novel Heart Failure Virtual Clinic, where GPs can directly access Consultant Cardiologist specialist opinion. Through this initiative, community-based cardiac diagnostics are now available in four Primary Care Centres - Ballinasloe, Mountbellew, Portumna and Monksland.

Hospital Staff

Ceisteanna (961)

Alan Kelly

Ceist:

961. Deputy Alan Kelly asked the Minister for Health the number of full-time paediatric endocrinologists at Cork University Hospital; and if this number will be further increased. [16671/21]

Amharc ar fhreagra

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 (962)

David Cullinane

Ceist:

962. Deputy David Cullinane asked the Minister for Health the terms of agreements made with a group (details supplied) and any other agreements made under the provisions of the Health (Amendment) Act 2021; the cost of same per agreement or cost item; the maximum agreed cost; the terms of renewal; the terms of a break in contract; the length of each contract; and if he will make a statement on the matter. [16673/21]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health (Deputy Stephen Donnelly)

Given the necessity to establish the mandatory quarantine services in an expedited timeframe, an initial scoping exercise was conducted, involving a number of market operators. These initial proposals were reviewed based on the capability to deliver the broad suite of services involved, capacity to deliver in an expedited timescale, and the proposed cost models.

The contract was awarded to Tifco based on their capability to deliver the broad suite of services involved, their capacity to deliver in an expedited timescale, and their proposed cost model. The contractual arrangement and cost model agreed with the provider is commercially sensitive.

Speech and Language Therapy

Ceisteanna (963)

Seán Fleming

Ceist:

963. Deputy Sean Fleming asked the Minister for Health if the HSE will bring in staff on a contract basis with regard to the major issue of the lack of a speech and language therapist in the midland region especially to assist children who need this facility in view of the fact that due to operational reasons, the HSE cannot provide this facility through its own staff; and if he will make a statement on the matter. [16675/21]

Amharc ar fhreagra

Freagraí scríofa

Minister of State at the Department of Health (Deputy Anne Rabbitte)

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

General Practitioner Services

Ceisteanna (964)

Thomas Gould

Ceist:

964. Deputy Thomas Gould asked the Minister for Health the number of general practitioners who retired by county in each of the years 2015 to 2020 and to date in 2021, in tabular form. [16680/21]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

General practitioners are private practitioners, most of whom hold a GMS contract with the HSE to provide medical services on its behalf to medical card and GP visit card holders without charge. I have asked the HSE to reply directly to the Deputy in relation to the number of GMS GPs that have retired.