Written Answers Nos. 988-1006
988. Deputy Niamh Smyth asked the Minister for Health when freelance Irish sign language interpreters (details supplied) can receive the Covid-19 vaccine; and if he will make a statement on the matter. [16750/21]
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.
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.
On the 30th of March, the Government approved a further update to the COVID-19 Vaccination Allocation Strategy. Based on clinical, scientific and ethical frameworks produced by the National Immunisation Advisory Committee and my Department, following the vaccination of those most at risk, future groups will be vaccinated by age, in cohorts of 10 years (i.e., 64-55; 54-45, etc.).
The move to an age-based model better supports the programme objectives by:
- protecting those at highest risk of severe disease first, which benefits everyone most;
- facilitating planning and execution of the programme across the entire country;
- improving transparency and fairness.
Further details are available here:
https://www.gov.ie/en/press-release/93f8f-minister-donnelly-announces-update-to-irelands-vaccination-prioritisation-list/
989. Deputy Denis Naughten asked the Minister for Health when an assessment (details supplied) will be completed; the status of same; and if he will make a statement on the matter. [16754/21]
Amharc ar fhreagraThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. In line with the 2013 Health Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the reimbursement list. Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact. HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).
The HSE received an application on 22 November 2018 for the reimbursement of Burosumab (Crysvita) for the treatment of X-linked hypophosphataemia (XLH) with radiographic evidence of bone disease in children 1 year of age and older and adolescents with growing skeletons.
In February 2021, the HSE Drugs Group considered the reimbursement application for Burosumab and recommended that this medicine be approved for reimbursement for this indication. In doing so, the Drugs Group reviewed the NCPE's HTA report which was completed in March 2020, the subsequent outputs of commercial negotiations, the conclusions of the Rare Disease Technology Review Committee, and the patient group submissions received during the assessment process.
The final decision-making authority in the HSE is the HSE Executive Management Team (EMT). The HSE EMT decides on the basis of all the demands with which it is faced (across all services) whether it can fund a new medicine, or new uses of an existing medicine, from the resources that have been provided to it in line with the 2013 Health Act.
The HSE has advised that, on 9 of March 2021, the HSE EMT supported hospital pricing approval for Burosumab. The applicant company has been notified of the proposed decision and a formal approval letter will now be progressed by the HSE.
The final decision with respect to the reimbursement of Burosumab will be formalised by the HSE in accordance with 2013 Health Act.
990. Deputy Emer Higgins asked the Minister for Health if members of An Garda Síochána will be prioritised for the Covid-19 vaccine; and if he will make a statement on the matter. [16756/21]
Amharc ar fhreagra1035. Deputy Holly Cairns asked the Minister for Health if he will prioritise members of An Garda Síochána to receive Covid-19 vaccinations as front-line workers; and if he will make a statement on the matter. [16951/21]
Amharc ar fhreagraI propose to take Questions Nos. 990 and 1035 together.
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.
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.
On the 30th of March, the Government approved a further update to the COVID-19 Vaccination Allocation Strategy. Based on clinical, scientific and ethical frameworks produced by the National Immunisation Advisory Committee and my Department, following the vaccination of those most at risk, future groups will be vaccinated by age, in cohorts of 10 years (i.e., 64-55; 54-45, etc.).
The move to an age-based model better supports the programme objectives by:
- protecting those at highest risk of severe disease first, which benefits everyone most;
- facilitating planning and execution of the programme across the entire country;
- improving transparency and fairness.
Further details are available here:
https://www.gov.ie/en/press-release/93f8f-minister-donnelly-announces-update-to-irelands-vaccination-prioritisation-list/
991. Deputy Alan Kelly asked the Minister for Health if he will consider including spina bifida and hydrocephalus in category 4 on the vaccine priority list given that it is associated with kidney disease, neurological complications, respiratory complications and obesity which in their own may not be considered as high risk but put together constitute a very high risk to the individual if infected by Covid-19. [16762/21]
Amharc ar fhreagraOn the 23rd of February 2021, 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 follow ing link:
https://www.gov.ie/en/press-release/b44b2-minister-donnelly-announces-update-to-vaccine-allocation-strategy/
The next cohort to be vaccinated (Cohort 4) are those aged 16-69 and at very high risk of severe illness and death. Vaccination of this group began in March.
It is important to emphasise that vaccination is only one part of our response to the prevention of COVID-19 infection. People who are vaccinated need to continue with all the public health measures that have been proven to reduce the risk of infection, i.e., limiting our social contacts, physical distancing, wearing a mask, hand hygiene, cough etiquette and avoiding non-essential travel until a sufficiently large proportion of the population are immune.
992. Deputy Alan Kelly asked the Minister for Health the person or body responsible for determining eligibility on category 4 of the vaccine list given that there currently is no clear database, for example, on obesity, respiratory complications and so on; and if he will make a statement on the matter. [16763/21]
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.
993. Deputy Alan Kelly asked the Minister for Health the status of Sláintecare workstream 1 in relation to providing co-ordinated care, in the right place and at the right time, with a specific emphasis on prevention of health deterioration for individuals living with spina bifida and hydrocephalus; and if he will make a statement on the matter. [16764/21]
Amharc ar fhreagra1238. Deputy Róisín Shortall asked the Minister for Health the status of the implementation of Sláintecare workstream 1 in relation to measures (details supplied). [17629/21]
Amharc ar fhreagraI propose to take Questions Nos. 993 and 1238 together.
Workstream 1 of Sláintecare refers to Service Redesign and Supporting Infrastructure. It focuses on providing the right care, in the right place, at the right time, where the patient/service user is paramount and strong emphasis is placed on prevention and public health.
Significant progress has been made in implementing this workstream. The development of an interagency multi-annual 5-year plan to integrate all five Capacity-Access workstreams (namely Healthy Living, Enhanced Community Care & Capacity, Enhanced Acute Care & Capacity, Scheduled Care and Unscheduled Care) is underway having been impacted by the re-assignment of key service and clinical staff to COVID-19. This work has now been factored into the development of the National Service Plan 2021 and the Slaintecare Implementation Strategy and Action Plan 2021-2023 currently being finalised.The 2021 Budget funding of €1.235 billion provides the opportunity for delivering Sláintecare at pace, and is intended to be the first major step towards achieving the appropriate capacity of the health service in terms of both beds and community-based services as set out in the Health Service Capacity Review, 2018.
Key areas of progress also include the development of the Healthy Ireland (HI) Strategic Action Plan which is currently undergoing review and approvals process. It sets out Healthy Ireland’s strategic actions for the next phase of the HI Framework (2021 -2025), aligned with the Programme for Government ambitions. The Sláintecare Healthy Communities Programme, an area-based approach to improving health and wellbeing at community level with a particular focus on areas of deprivation, is progressing well, with wide-ranging stakeholder engagement underway and targeted health and wellbeing services identified. Other elements that have progressed include the publication of healthy eating guidelines for young children and the “Keep Well” campaign to support resilience in individuals and communities, in line with the Government plans for COVID-19 Resilience and Recovery, focused on keeping active, staying connected, switching off, eating well and minding your mood, including significant investment of resources to support implementation of a range of initiatives under these themes, in partnership with a wide group of stakeholders.
An Enhanced Community Care Model including the development of a Community Healthcare Network multidisciplinary model through a learning site approach, Integrated Care Hubs for Older People and People with Chronic Diseases to provide specialist care in a community setting, building on the GP Agreement and the National Clinical Programmes for each of the four major chronic diseases (diabetes, asthma, COPD and heart failure) was also rolled out.
The value of eHealth, ICT and health information systems was demonstrated throughout the pandemic. Through rapid development and deployment of systems and technology, several thousand staff were set up to work remotely where they could continue to support frontline healthcare workers, telehealth solutions were deployed for GPs and outpatient clinics, paper prescriptions were replaced with electronic copies thus reducing non-essential contact with GPS and practice staff, ICU systems were deployed and upgraded, patient assessment hubs and other Covid facilities were fitted out and connected, the Covid Care Tracker used by contact tracing teams to record data on patients referred for test was developed and deployed. The Covid Tracker App was developed and became the first such app that worked across borders. Since December, the national covid vaccination system was developed an deployed and mass vaccination sites and other facilities have been connected to the health network and fitted out with kit to support vaccination teams.
Investment in EHRs continues. Building on the successful deployment of an EHR at St James Hospital in 2018 and Maternity & Newborn EHR systems in our larger Maternity Hospitals, the National Childrens Hospital are in the final stage of selecting their preferred product and the deployment of these complex systems will represent and multi annual exercise in preparation for commissioning of the site. In the meantime the National Forensics Hospital and National Rehabilitation Hospital are deploying EPR systems with other sites taking a more stepwise approach to deploying modular components of EHRs.
The Sláintecare Integration/Innovation Fund continued to support initiatives testing and scaling how services can be delivered and that support the delivery of integrated care and the shift to community care in new and innovative ways, helping to reduce and prevent hospital visits.
Full details of progress made in 2019 can be found in the Sláintecare Action Plan Year-end Report 2019. A report on implementation in 2020 is being finalised and will be published shortly.
In terms of disability services, HSE Disability Services provide personal and social supports based on the needs of the individual, rather than the provision of services based on a specific diagnosis or condition. Services for people with disabilities include day and respite services, adult day services, residential services.
The HSE also provides a range of assisted living services including Personal Assistant and Home Support Services to support individuals to maximise their capacity to live full and independent lives. PA and Home Support Services are provided either directly by the HSE or through a range of voluntary service providers. The majority of specialised disability provision (80%) is delivered through non-statutory sector service providers.
Services are accessed through an application process or through referrals from public health nurses or other community-based staff. Individuals' needs are evaluated against the criteria for prioritisation for the particular services and then decisions are made in relation to the allocation of resources. Resource allocation is determined by the needs of the individual, compliance with prioritisation criteria, and the level of resources available. As with every service there is not a limitless resource available for the provision of home support services and while the resources available are substantial, they are finite. In this context, services are discretionary and the number of hours granted is determined by other support services already provided to the person/family.
994. Deputy Alan Kelly asked the Minister for Health if he will take measures to ensure that all adults have access to a multidisciplinary team in the treatment of spina bifida and hydrocephalus; if he will remedy the lack of co-ordinated care for persons with these conditions who are transitioning from adolescence to adulthood by providing complex needs nurse specialists and administration staff to co-ordinate care across disciplines; and if he will make a statement on the matter. [16765/21]
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.
995. Deputy Alan Kelly asked the Minister for Health the way in which his Department plans to meet the needs of persons with spina bifida and hydrocephalus in order that they can live independently with access to adequate supports, for example, occupational therapy and neuropsychology services, instead of persons ending up in nursing homes from the age of 30; and if he will make a statement on the matter. [16766/21]
Amharc ar fhreagraThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives.
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
996. Deputy Alan Kelly asked the Minister for Health if a needs-based approach in allocating personal assistant hours to support persons with spina bifida and hydrocephalus will be made available; and if he will make a statement on the matter. [16767/21]
Amharc ar fhreagraA Personal Assistant (PA) is someone employed by a person with a disability to enable them to live a more independent life. The PA provides assistance, at the discretion and direction of the person with the disability, thus promoting choice, and control for the person with the disability to live independently. This may include for example, assisting with personal care, household chores, supporting you during study or work, playing sports, pursuing hobbies, socialising or anything that the PA and service user may agree.
Personal Assistance Services are accessed through an application process or through referrals from public health nurses or other community based staff. Individuals' needs are evaluated against the criteria for prioritisation for the particular services and then decisions are made in relation to the allocation of resources.
Resource allocation is determined by the needs of the individual, compliance with prioritisation criteria, and the level of resources available. It is important to note that the level of service delivered is varied to ensure that each client’s needs are reflected. Therefore there is no average agreed number of PA hours per person. PA and Home Support Services are provided either directly by the HSE or through a range of voluntary service providers. The majority of specialised disability provision (80%) is delivered through non-statutory sector service providers.
997. Deputy Alan Kelly asked the Minister for Health if he will provide mental health services with a specific focus on understanding that hydrocephalus is akin to acquired brain injury and needs special support; and if he will make a statement on the matter. [16768/21]
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.
998. Deputy Alan Kelly asked the Minister for Health the status of the disability services for children and young persons in relation to children with spina bifida and hydrocephalus on accessing health services within their local area and equity of services received in CHI, Temple Street and CHI, Crumlin; and if he will make a statement on the matter. [16769/21]
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.
999. Deputy Alan Kelly asked the Minister for Health the status of the national model of care for paediatric services in relation to transitioning plans for adolescents with spina bifida and hydrocephalus; and if he will make a statement on the matter. [16770/21]
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.
1000. Deputy Alan Kelly asked the Minister for Health the way in which he plans to tackle the current waiting list of children awaiting surgery for scoliosis; and if he will make a statement on the matter. [16771/21]
Amharc ar fhreagraI sincerely regret that children can experience a long waiting time for treatment for scoliosis, and I am conscious of the burden that this places on them and their families. This Government’s priority is to improve waiting times for all patients accessing hospital treatment across all specialties, including Scoliosis.
It is recognised that waiting times for scheduled appointments and procedures have been impacted as a direct result of the COVID-19 pandemic, and as a result of the deferral of elective scheduled care activity in March, April and May of 2020, and since 2nd January 2021.
It is of note that key social distancing measures and Infection Prevention and Control requirements, such as two-metre distancing, have a material impact on the available physical space to deliver all hospital services, including scoliosis procedures, and this has had a significant impact on both available capacity and operational activity levels.
Despite the challenges resulting from the Covid-19 pandemic last year, by 31st December 2020 Children’s Health Ireland (CHI) had carried out 322 scoliosis procedures, a decrease in activity of 16% compared with 2019. By the end of February 2021, CHI had carried out a total of 76 scoliosis surgeries, an increase of 18 surgeries (31%) compared to the same period in 2020.
Children’s Health Ireland has advised that under the current HSE guidelines, they have reduced the number of procedures to urgent and those that are time sensitive. Children’s Health Ireland has advised that they are working with the National Orthopaedic Hospital Cappagh to expand orthopaedic capacity. This is expected to have a positive impact on orthopaedic long waiting patients, including reductions in waiting times for children with scoliosis. CHI is also running additional orthopaedic clinics in City West, using a new active clinical triage model, which is reducing the number of children waiting the longest for appointments.
Representatives of CHI, the Orthopaedic Spinal Team and the Advocacy Groups continue to meet as part of the Co-Design framework on a quarterly basis to work on providing solutions for patients in the spinal service.
1001. Deputy Ciarán Cannon asked the Minister for Health when he plans to fill the vacant paediatric pain consultant post at Children’s Health Ireland; and the waiting time for referrals to the service. [16774/21]
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.
1002. Deputy Brendan Howlin asked the Minister for Health if assistance will be provided in the case of a person (details supplied); and if he will make a statement on the matter. [16776/21]
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
1003. Deputy Neale Richmond asked the Minister for Health the reason vaccinators must register with third party agencies to work in vaccine hubs given they are already employed by the HSE; and if he will make a statement on the matter. [16777/21]
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.
1004. Deputy Neasa Hourigan asked the Minister for Health his plans to address the delays in access to mental health services for children and young persons; and if he will make a statement on the matter. [16786/21]
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.
1005. Deputy Neasa Hourigan asked the Minister for Health his plans to implement the recommendations of the report of the National Youth Mental Health Task Force; and if he will make a statement on the matter. [16787/21]
Amharc ar fhreagra1006. Deputy Neasa Hourigan asked the Minister for Health the status of the implementation of the youth mental health pathfinder initiative; and if he will make a statement on the matter. [16788/21]
Amharc ar fhreagraI propose to take Questions Nos. 1005 and 1006 together.
The National Youth Mental Health Task Force was established in response to an undertaking in the last Programme for Partnership Government. The Task Force report was published in December 2017 and it was suggested that the time-frame for full implementation should be three years. The report made recommendations in 10 different themed areas. It also identified lead agencies associated with each recommendation to develop and/or implement these as appropriate.
Since publication of the Task Force report, various recommendations have been incorporated into the service plans of lead agencies. The implementation of these recommendations has been ongoing since publication of the report and many major areas of priority have been delivered. In this regard, there have been several online support projects delivered to support online counselling, online CBT training and online signposting; schools have upskilled staff in mental health training and many disciplines have availed of mental health first aid training; early intervention projects such as perinatal training and family support projects have launched. Health and wellbeing projects have been supported and many NGOs have been supported to deliver local youth-specific mental health initiatives nationally through mental health funding, Sláintecare funding and Healthy Ireland community funding.
An update on the status of each recommendation is included in the attachment.
Implementation of a small number of recommendations was envisaged through a Pathfinder inter-departmental unit on youth mental health. In addition ’Sharing the Vision – a Mental Health Policy for Everyone’ advocates that access to mental health supports be based on individual need. This means that care plans should consider the needs of the whole individual regardless of age, gender or socio-economic profile. This will ensure that young people’s needs remain prioritised over the lifetime of the policy, taking over from where the Youth Mental Health Task Force Report ends.
The Department of Health and the HSE are now engaged in implementing Sharing the Vision and are committed to developing new youth mental health initiatives over the ten year lifetime of the policy.
The proposal to establish a cross-governmental youth mental health Pathfinder unit with participation from the Department of Health, the Department of Education and the Department of Children, Equality, Disability, Integration and Youth received Ministerial approval during the previous Government. Its establishment is a priority for me as Minister with special responsibility for mental health and is set out in the current Programme for Government.
The proposal is to formalise a new model for collaborative working within Government and place a Pathfinder unit on a statutory footing by utilising section 12 of the Public Service Management Act 1997. This section of the 1997 Act has never been used before. Various administrative, budgetary, governance and legal arrangements need to be developed and agreed to ensure a robust and workable model for the Pathfinder unit.
The Department of Health has engaged extensively with the Department of Public Expenditure and Reform, and continues to do so, with the objective of agreeing an implementation option that fully addresses the above issues. The demands on both departments as a result of the Covid-19 pandemic have presented challenges to progressing the proposals.
