Written Answers Nos. 141-160
141. Deputy James Lawless asked the Minister for Health the number of homecare support hours being provided in County Kildare in 2021; the way this compares to 2020; the number of persons currently waiting for homecare in the county to date; and if he will make a statement on the matter. [37668/21]
Amharc ar fhreagraAs this Parliamentary Question relates to an operational issue, it is a matter for the HSE. However, members of the Oireachtas are advised that the HSE is currently unable to access the information to answer Parliamentary Questions due to the recent cyber-attack, which has required a temporary shut-down of HSE IT systems. The disruption to service is ongoing, and the HSE is working hard to restore its IT capacity and resume normal services. Members of the Oireachtas will be advised as soon as the HSE is again in a position to provide responses to PQs and are encouraged to resubmit their Parliamentary Questions at that point.
142. Deputy David Cullinane asked the Minister for Health his plans to modernise and integrate the IT infrastructure of the HSE and his Department; and if he will make a statement on the matter. [37544/21]
Amharc ar fhreagraIn the context of planned ICT modernisation and integration, it is appropriate to respond to the Deputy's question with regard to the continued response to the ransomware attack.
The Department of Health and the Health Service Executive continue to engage cyber security specialists to forensically examine and restore health system functionality. The Department of Health continues to liaise closely with the National Cyber Security Centre, the Office of the Government Chief Information Officer, security partners and with colleagues across the Public Service to ensure that best practice is followed as it relates to all aspects of cyber security.
With regard to the Health Service Executive, in the wake of the recent ransomware attack, the HSE has deployed additional security toolsets and capabilities and applied recommendations from external consultants engaged following the ransomware attack. The HSE continues to engage with the National Cyber Security Centre and, with the support of my department, will continue to invest strategically in technical infrastructure, cyber defences and the resources necessary to protect the systems and data that are vital to the safe operation of the health system.
The HSE has deployed additional expertise, resources and technology to provide enhanced monitoring of systems and networks. This is considered an interim measure as they procure a permanent Security Operations Centre to provide security and threat incidence monitoring and response including:
- monitoring and alerting on portals and software;
- monitoring and incident management of all devices on the network to ensure that all devices are compliant with rules/policies;
- threat incident response including triage, close and/or escalation.
Improved security measures have already been put in place within the Department of Health ICT systems. A complete security review of the ICT infrastructure is currently being finalised and specialised software has been installed to mitigate against malicious software, and to provide early warning notifications of same. The system is fully monitored, providing for a rapid response to any notified incidents.
Inevitably, some planned health systems integration activities will require to be re-evaluated and re-planned in the aftermath of the ransomware attack. Health systems cyber security and disaster recovery protocols will be informed by learnings from the recent criminal ransomware cyberattack. In keeping with procedures on any critical incident, post incident review findings and recommendations will inform the process of continuous improvement. When further planning health ICT systems modernisation and activities, both the Department of Health and the Health Service Executive will be informed by recommendations made by the National Cyber Security Centre and post-incident reporting.
143. Deputy Violet-Anne Wynne asked the Minister for Health if he will report on the reinstatement of ShannonDoc services in County Clare, specifically in Ennistymon, Kilrush, Killaloe and Shannon, areas geographically challenged in their own right (details supplied). [23060/21]
Amharc ar fhreagraAs this Parliamentary Question relates to an operational issue, it is a matter for the HSE. However, members of the Oireachtas are advised that the HSE is currently unable to access the information to answer Parliamentary Questions due to the recent cyber-attack, which has required a temporary shut-down of HSE IT systems. The disruption to service is on-going, and the HSE is working hard to restore its IT capacity and resume normal services. Members of the Oireachtas will be advised as soon as the HSE is again in a position to provide responses to PQs and are encouraged to resubmit their Parliamentary Questions at that point.
145. Deputy Kathleen Funchion asked the Minister for Health his plans to address the serious deficiencies in the provision of women’s health across a range of services; and if he will make a statement on the matter. [28446/21]
Amharc ar fhreagraGovernment Commitment
Progressing women’s health is a priority for me and for this government.
We made a strong commitment to Promoting Women’s Health in the Programme for Government and are fully committed to the development and improvement of Women’s Health services and to working with women and girls to improve their health across the whole life cycle.
Women’s Health
We know that gender is a key determinant of your health and wellbeing. Today in Ireland, 86% - almost 9 in 10 women - feel that their own health is good or very good, so our starting point is incredibly strong.
But we also know that women have specific physical, mental and social health needs which services can struggle to meet. We know that women can have poorer health outcomes relating to certain conditions including some chronic diseases, cancers, and mental health conditions.
We know that women in minority or disadvantaged groups can face particular health inequalities.
Women’s health outcomes and experiences are also affected by their roles in the family and society and their wider circumstances – for example more than 60% of unpaid carers are women which means they often access services on behalf of others.
We know that women often don’t feel listened to within our health service and this has to change.
Recent Progress
There has been recent progress in the area of women’s health including:
- the implementation of the National Maternity Strategy,
- implementation of the Sexual Health Strategy,
- establishment of a National Mesh Specialist Centre,
- improvements in screening services,
- improvements to sexual assault services, introduction of termination of pregnancy services,
- the rollout of the Maternal & Newborn-Clinical Management System, and
- the development of new models of care for ambulatory gynaecology and infertility.
Women’s Health Taskforce
The Women’s Health Taskforce was established in September 2019 to improve both health outcomes and experiences of healthcare for women and girls.
The members of the Taskforce meet regularly, with its twelfth meeting held earlier this month. Regular updates are provided through a dedicated webpage on the Department of Health’s website at gov.ie.
The Women’s Health Taskforce continues to work with the National Women’s Council of Ireland and the European Institute of Women’s Health to prioritise different issues each year with the aim of improving women’s health outcomes and experiences of healthcare.
Critical to this work is the process of listening to women - the Taskforce has so far listened to, engaged with and worked with more than 1,000 women and hundreds of organisations representing women and girls across the country.
Based on this information, the Taskforce has developed proposals to improve supports for gynaecological health, mental health, physical activity, and menopause all of which are rolling out this year and next year.
Through action like this forum, we can better address women’s whole health and help ensure that action on women’s health looks beyond reproductive health to make a real difference to women’s lives.
Work is ongoing to identify priorities for the year ahead, aligned to Sláintecare, and I expect to bring these to Government for approval this Autumn.
Budget 2021
I’m pleased to say that Budget 2021 provides a very significant investment to deliver on this commitment. This includes:
- funding of €12m to ensure a renewed impetus to the implementation of the National Maternity Strategy and the new model of maternity care, and to improve gynaecology services.
- funding of €10m to screening services including Breast Check and Cervical Check,
- and building on the work of the Women’s Health Taskforce, a €5m Women’s Health Fund to improve women’s health outcomes and experiences of healthcare.
Through the Women’s Health Fund, the significant funding provided for maternity, gynaecology and fertility services, as well as the €10m investment in screening services including BreastCheck and CervicalCheck, Budget 2021 has reiterated this Government’s commitment to the further development and improvement of Women’s Health services and to working with women and girls to improve their health across the whole life cycle.
Women’s Health Fund
Budget 2021 has provided a dedicated €5million Women’s Health Fund to implement a programme of actions arising from the work of the Taskforce.
The first two proposals funded under the Women’s Health Fund are:
- Two community-based Ambulatory Gynaecology Services in Tallaght University Hospital and University Maternity Hospital Limerick.
- Expansion of the endometriosis service at Tallaght University Hospital (TUH) to deliver a specialist endometriosis centre for the management and treatment of all forms of endometriosis.
In 2021, the Fund will deliver:
- a national awareness to provide a trusted source of information and help normalise discussions about women’s health,
- increased supports in the areas of gynaecology, menopause, mental health and physical activity, and
- further actions under priority areas to be decided in 2021.
Engagement is ongoing with Dept. of Health and HSE stakeholders to finalise further activities to be implemented under the Women’s Health Fund in 2021.
Impact of COVID19 on women and girls
The Government recognises the significant physical, mental and social health challenges that women and girls in particular have faced due to the COVID19 pandemic and response.
These include particular impacts relating to:
- the high prevalence of women as frontline workers in health and retail sectors and within domestic and caring job roles;
- impacts on health services that are important to women’s health specifically, such as restrictions on birth partners in labour; and
- wider issues such as the rise in domestic violence.
However, there have also been some positive service developments such as a new model of remote consultation for Termination of Pregnancy Services which will be continued.
Budget 2021 is supplemented by broader investment which will directly address some of the impacts of COVID19, including:
- €38m for new mental health services and
- €1.7 billion to protect health care workers, vulnerable groups and public from the impacts of COVID-19, and
- the recent launch of the “Keep Well” campaign which that which aims to support people and communities to mind their physical and mental health over the coming months including a new, free, online mental health and wellbeing programme called Minding Your Wellbeing.
146. Deputy Jennifer Whitmore asked the Minister for Health the efforts he has carried out to ensure universal application of the lifting of restrictions for partners attending the birth of their child in maternity hospitals is in fact applied to all hospitals across the country; and if he will make a statement on the matter. [37586/21]
Amharc ar fhreagraAs this Parliamentary Question relates to an operational issue, it is a matter for the HSE. However, members of the Oireachtas are advised that the HSE is currently unable to access the information to answer Parliamentary Questions due to the recent cyber-attack, which has required a temporary shut-down of HSE IT systems. The disruption to service is on-going, and the HSE is working hard to restore its IT capacity and resume normal services. Members of the Oireachtas will be advised as soon as the HSE is again in a position to provide responses to PQs and are encouraged to resubmit their Parliamentary Questions at that point.
147. Deputy Michael Moynihan asked the Minister for Health the action being taken to reduce waiting times for essential therapies such as speech and language, occupational therapy and physiotherapy; and if he will make a statement on the matter. [37505/21]
Amharc ar fhreagraBoth I and the HSE acknowledge the challenges in meeting the demand for children’s disability services and is acutely conscious of how this impacts on children and their families.
A number of service improvements are being introduced that, when implemented, will help improve access to services for children with disabilities and developmental delays. The overall programme of improvement is the ongoing roll out of Progressing Disability Services for Children and Young People. This requires the reorganisation of all current HSE and HSE funded children’s disability services into geographically-based Children's Disability Network Teams.
The Progressing Disabilities Programme is doing this by forming partnerships between all the disability organisations in an area and pooling their staff with expertise in the different types of disabilities to form the Network Teams. These teams will provide for all children with significant disability, regardless of their diagnosis, where they live or where they go to school.
The HSE is establishing a total of 91 Children’s Disability Networks across each of the nine CHOs comprised of specialist inter-disciplinary Children’s Disability Network Teams to work with children with complex disability needs. This reconfiguration of services under the Progressing Disability Services for Children & Young People programme is in line with Health Service Reform and the implementation of Community Healthcare Networks under Sláintecare.
In addition, 100 new posts have been allocated under the HSE National Service Plan 2021. Funding for these posts will facilitate each area to determine the discipline and grade required to address the gaps in their Children’s Disability Network Teams. The 2021 allocation of posts is being assigned to the CHO areas in two tranches of 50 posts and will further strengthen the capacity of Network Teams.
I trust this clarifies the position for the Deputy.
148. Deputy Jim O'Callaghan asked the Minister for Health the supports he is providing to reduce waiting times for inpatient and day case procedures and outpatient appointments in St. Vincent’s Hospital, Dublin; and if he will make a statement on the matter. [37681/21]
Amharc ar fhreagraIt is recognised that waiting times for scheduled appointments and procedures have been impacted in the last sixteen months as a direct result of the COVID-19 pandemic and more recently as a result of the ransomware attack.
While significant progress was made in reducing waiting times from June 2020 onwards, the surge in Covid-19 cases in the first quarter of 2021, and the resultant curtailment of acute hospital services, is reflected in the most recently available waiting list figures to 13th May 2021.
On 23 March 2021 the HSE published the “Safe Return to Health Services Plan”, outlining a three phased approach for the proposed restoration of services across Community Services, Acute Hospital Operations, Cancer Services and Screening Services. It sets target times for their safe return and details the conditions and challenges that will have to be met. However, the implementation of this plan has been suspended pending the resolution of the recent ransomware attack, which had a significant impact on acute hospitals.
The HSE has been working since 14th May last to recover the effects of the cyber attack on its systems. The HSE advise that at present most systems are operational and services are returning to normal activity. There is a challenge in back entering data and there are still a number of areas of ongoing concern. The HSE was already seeking to recover from the Covid peak in the first quarter of this year and the ransomware attack has delayed this and had the effect of increasing access delays for services. My Department does not have full access to information on the impact of this ransomware attack on elective waiting lists but will provide an update as soon as one is available.
An additional €240 million has been provided in Budget 2021 for an access to care fund, €210m of which has been allocated to the HSE and a further €30m to the NTPF. This is to be used to fund additional capacity to address the shortfall arising as a result of infection control measures taken in the context of COVID-19, as well as addressing backlogs in waiting lists.
My Department, the HSE and the NTPF are currently working on a Multiannual Waiting List Plan to address waiting lists and bring them in line with Sláintecare targets over the coming years.
Due to the ongoing IT issues triggered by the HSE cyber-attack, the National Treatment Purchase Fund (NTPF) has been unable to receive weekly national hospital waiting list data or downloads. The latest published waiting list information was collated by the NTPF on 13th May 2021.
In relation to the particular query raised by the Deputy, the NTPF has advised that as of 7 July 2021, funding has been approved for 273 In patient and Day Case procedures and 9,245 Outpatient appointments through insourcing initiatives at St. Vincent’s University Hospital, Dublin.
149. Deputy Bríd Smith asked the Minister for Health the plans and measures that will be put in place to support training, recruitment and retention of the healthcare professionals necessary to build capacity across the whole health service; and if he will make a statement on the matter. [37725/21]
Amharc ar fhreagraI wish to thank the Deputy for raising this important matter.
The Programme for Government commits the Department of Health to working with the education sectors, regulators, and professional bodies to improve the availability of health professionals and reform their training to support integrated care across the entire health service.
A Strategic Workforce Planning Unit has been established within my Department to pursue these key objectives. The unit engages on an ongoing basis with colleagues in the HSE, Department of Further Higher Education Research Innovation and Science and the Medical Council regarding medical education and training and additional student places on health-related courses.
Earlier this year, I was pleased to announce an additional 120 medical intern posts for July 2021 and funding for up to 92 additional postgraduate and fellowship trainees. This increase in the number of intern places was supported with accompanying increases in postgraduate training and fellowship places to ensure that doctors can avail of the next step in the training pathway following completion of an internship. The additional training places provide enhanced opportunities for doctors in Ireland and will ultimately support the delivery of shorter waiting times, the reduction of inappropriate hospital admissions, improved patient flow, and earlier discharge of patients to the community.
A significant expansion of the health and social care workforce is required to respond to the additional pressures caused by COVID-19 pandemic. Budget 2021 provided for the longer-term expansion of the health service in order to meet the needs of the population, and funded the retention of these COVID-related posts on a permanent basis plus an additional circa 3,216 whole-time equivalents, funding a total increase of approximately 15,838 positions. Healthcare workers are being hired from across the range of professions, and recruitment campaigns continue to go live through the HSE and its recruitment teams. At the end of the April, the health sector workforce has 128,999 WTE, which is an increase of 9,182 WTE since the end of December 2019, and an increase of 1,915 WTE since the end of December 2020.
The Sláintecare Reform Programme aims to address many of the challenges the health and social care system is facing, including through a stronger orientation towards primary and social care settings, community care provision through Community Health Networks and promoting integration of care.
The Sláintecare reform “Workstream 6 – Workforce Planning” programme, of the Slaintecare Implementation Strategy & Action Plan 2021-2023, is centred on having sufficient capacity in the workforce and the appropriate configuration of staff and skill-mix, which are integral to the delivery of safe and timely health and social care services. Ensuring, that sufficient professionals are trained, attracted, and retained in the areas where need is anticipated, will form a key part of the work of Workstream 6 – Workforce Planning programme.
150. Deputy Joan Collins asked the Minister for Health the number of permanent residential places in homes, healthcare facilities and any other settings; the number of these places for persons with mental health conditions; and the number that are vacant at this time. [37590/21]
Amharc ar fhreagraAs this Parliamentary Question relates to an operational issue, it is a matter for the HSE. However, members of the Oireachtas are advised that the HSE is currently unable to access the information to answer Parliamentary Questions due to the recent cyber-attack, which has required a temporary shut-down of HSE IT systems. The disruption to service is on-going, and the HSE is working hard to restore its IT capacity and resume normal services. Members of the Oireachtas will be advised as soon as the HSE is again in a position to provide responses to PQs and are encouraged to resubmit their Parliamentary Questions at that point.
152. Deputy Thomas Gould asked the Minister for Health if a framework for discussion has been drawn up for the citizens' assembly on drugs; and if this will be published. [13257/21]
Amharc ar fhreagraThe Programme for Government includes a commitment to convene a citizen’s assembly to consider matters relating to drug use. The timing of this, and other assemblies, over the lifetime of the Government has yet to be determined. One element critical to the success of assemblies has been the opportunity to meet in person. The restrictions experienced with Covid-19 have presented considerable difficulties in this regard, as meetings moved to being held online. The experiences and learning in this new way of working will inform how future citizen’s assemblies are conducted.
In 2019, the Government agreed to adopt a health-led approach to people who use drugs, following the publication of the report of the working group on alternative approaches to the possession of drugs for personal use, which was informed by 20,000 public responses. The approach will offer compassion, not punishment, to people who use drugs. The Programme for Government endorses this approach as an important step in developing a public health-led approach to drug use.
An implementation group chaired by the Department of Health is finalising plans for the commencement of the Health Diversion Programme in 2021. The aim of the programme is to connect people who use drugs with health services and provide a pathway to recovery, thereby avoiding a criminal conviction. Under the programme, An Garda Síochána will divert a person found in possession of drugs for personal use to the HSE for a health screening and brief intervention
As outlined in the Programme for Government, the programme will be reviewed after the first full year of implementation to ensure that it is meeting all of it aims and to make any necessary changes.
Another health-led approach is the drug treatment court in Dublin and other parts of the country. Together with the health diversion programme, these initiatives align with the strategic priority in the EU Drugs Strategy to provide alternatives to coercive sanctions for people who use drugs. Ireland is committed to mainstream the implementation of effective measures that have a rehabilitative element and avoid a criminal sanction. To this end, Ireland will share comprehensive and in-depth data and exchange of best practices on alternatives to coercive sanctions with EU Member States.
The commencement of the Health Diversion Programme will demonstrate a health-led approach to drug use. I believe that a citizen's assembly could usefully considered the learnings from this programme and similar health-led initiatives in Ireland and internationally. It could also inform the development of new national drugs strategy, to replace the existing strategy when completed in 2025.
153. Deputy Verona Murphy asked the Minister for Health if the planned establishment of three new specialist eating disorder teams includes a team for CHO5; and if he will make a statement on the matter. [37687/21]
Amharc ar fhreagraEnhancement of specialist services for eating disorders, including improved access and shorter waiting lists, remains a key priority for me, the Government as a whole and the HSE.
In response to the growth in cases presenting to mental health services, €5.7 million has been allocated for the Eating Disorders National Clinical Programme since 2016. The Eating Disorders Model of Care was launched in 2018 and was developed in partnership with the College of Psychiatrists of Ireland and with Bodywhys, the national support group for people with eating disorders.
Under the National Eating Disorder Model of Care, there are plans to develop 2 mini eating disorder hubs in CHO5. It is anticipated that a CAMHS mini eating disorder hub will be developed in Waterford and an adult mini eating disorder hub in Kilkenny, both of which will link up with the larger eating disorder hub network. Importantly, adults with eating disorders can access treatment from local community mental health teams. There are currently 112 adult community mental health teams nationwide. Children and adolescents can similarly access treatment through the 72 CAMHS teams nationwide.
€1.77 million has been invested to date in eating disorder specialist posts, with 21.8 WTEs now in place. In addition, I secured the balance of €3.94 million for 2021 and this will enable further investment in specialist posts throughout this year. More specifically, it will allow for the establishment of 3 new specialist eating disorder teams and the completion of the 3 existing specialist teams. Premises are already under development for the expansion of the adult community team at the Mount Carmel site in Dublin, and this is expected to be completed by the end 2021. Recruitment is progressing well for all teams.
The funding allocated to date has seen real growth and improvement in our services. Despite the significant increase in referrals in 2020, there was a 43% increase in the number of eating disorder assessments completed compared to 2019, with twice as many people starting treatment.
As of last year, there are 3 specialist eating disorder teams in place. This means that we can treat over 90% of people with eating disorders in the community, avoiding more serious inpatient treatment.
Specialist outpatient treatment has been found to be the most effective and fastest way for most people with eating disorders to recover. Although there is good evidence that inpatient psychiatric care is not required for most people with eating disorders, it is recognised that a small number of people, mainly with restrictive eating disorders, may require inpatient care for short periods for structured refeeding and/or stabilisation.
There are currently 2 eating disorder specialist community teams based in CAMHS. One is the CHO4 Cork and Kerry Regional Eating Disorder Service CAREDS (operational since May 2019).The other is in Dublin based in CHO 7 Linn Dara Community Eating Disorder Service LDCEDS (operational since April 2018). Funding has been made available in 2021 to progress the recruitment of an additional CAMHS based eating disorder specialist community team in Community Healthcare West (Galway, Mayo and Roscommon, CHO2).
In circumstances where in-patient care is required, child and adolescent care is provided in all of the 4 Regional CAMHS Units across the country. Linn Dara in Dublin (8 beds) and Merlin Park in Galway (6 beds) have dedicated a number of specialist eating disorder beds, while the remaining 2 CAMHS units accept relevant admissions of children with eating disorders. There is national coordination of child and adolescent admissions, with transfer arrangements in place as required by individual clinical need.
There are plans for an eating disorder unit in the new National Children’s Hospital which will provide 8 additional beds. The HSE also funds individuals in private facilities. Decisions are made based on individual clinical need, as assessed by the local mental health team, and the prioritisation of available funding.
For adults, people who may require in-patient care for short periods of time are admitted to local general adult approved centres and attend generic inpatient treatment programmes. CHO6 has 3 dedicated beds for eating disorders based in St. Vincent’s University Hospital. The number of adult beds will increase, in line with the National Clinical Programme, including an additional 3 beds in St. Vincents, 5 beds in North Dublin, 5 beds in Galway and 5 beds in Cork. Timeframes for new beds will have to be established. These beds will be linked to eating disorder hubs. The funding available for 2021 will allow for the creation of 2 new adult eating disorder hubs in CHO4 and CHO9.
The HSE provides funding annually to Bodywhys to run the helpline which is delivered by a team of trained volunteers. They also provide a range of services (support groups, online groups, email and family programmes) for adults and young people with eating disorders, and their families. The HSE also supports Bodywhys to run the PiLaR (Peer Led Resilience) Programme, a 4-week online modular based programme for parents, friends and carers of a person with an eating disorder to build resilience and gain support in their role as a carer. Additionally, in March 2019 the HSE launched the first Self Care App which provides valuable information for those with or people caring for someone with an eating disorder.
People with eating disorders can additionally avail of our general mental health supports. The HSE provide a mental health text messaging support service, which is available 24 hours a day, 7 days each week to connect people with trained volunteers. Online counselling and supports are provided by Turn2Me, MyMind and other organisations. There are phone, text and email supports available through existing providers such as the Samaritans, Aware, Pieta and others. Furthermore, Jigsaw provides a variety of online, phone and text supports specifically to young people aged 12 to 25 years old.
If an individual is concerned about themselves or someone known to them, they should be directed to their GP in the first instance for primary care screening assessment and examination. Their GP may then make recommendations which may include, if clinically indicated, referral to the secondary care mental health services for full eating disorder assessment.
With the right support and intervention, people can and do recover from eating disorders. The Government and the Department, along with the HSE and its partners, are committed to providing and expanding high-quality treatment and support for all those affected by eating disorders.
154. Deputy Cathal Crowe asked the Minister for Health if HIQA stipulations that all elderly residents in care centres should have a personal space around their bed of 7.4 square metres will result in the loss of any beds at St. Josephs’ Hospital, Ennis. [28428/21]
Amharc ar fhreagraThe provision of residential care is part of a range of measures to offer a care system that reflects and responds to the varying needs of older people who require additional supports.
The safety and quality of care provided to persons living in nursing homes is of the greatest importance. To that end, the Department of Health continues to work closely with the Health Information and Quality Authority and nursing home providers to ensure that the highest standards continue to be met. The regulation referred to states that "On and from 1st January 2022, a bedroom in a designated centre which was carrying on the business of a designated centre on or before 1st July 2009 or a part of a designated centre where such business was carried on before that date shall have an area of not less than 7.4 square metres of floor space, which area shall include the space occupied by a bed".
This regulation means that providers must provide a minimum of 7.4 square metres per resident in a bedroom, rather than requiring 7.4 square metres between residents.
?The HSE's National Service Plan 2021 contains a number of measures designed to mitigate the risk of a temporary reduction of capacity in some nursing homes arising from both regulatory compliance pending the completion of the Community Nursing Unit capital infrastructure programme and from infection and prevention control measures in place arising from COVID-19. These include funding for an additional 1,250 community beds to reduce the number of older people in long stay residential care through purposing existing or developing additional rehabilitation and intermediate care beds, expanding reablement and outreach services and by significantly increasing home support hours.
With regards to the community nursing unit referred to by the Deputy, as this Parliamentary Question relates to an operational issue, it is a matter for the HSE. However, members of the Oireachtas are advised that the HSE is currently unable to access the information to answer Parliamentary Questions due to the recent cyber-attack, which has required a temporary shut-down of HSE IT systems. The disruption to service is on-going, and the HSE is working hard to restore its IT capacity and resume normal services. Members of the Oireachtas will be advised as soon as the HSE is again in a position to provide responses to PQs and are encouraged to resubmit their Parliamentary Questions at that point.
155. Deputy Thomas Gould asked the Minister for Health if consideration will be given to paying student travel allowances paid to students on placement from a student’s address given that colleges are teaching online and many students have not rented accommodation close to colleges in 2020. [43214/20]
Amharc ar fhreagraAs the Deputy is aware allowances are made available to support student nurses and midwives to attend their supernumerary placements on clinical sites. These placements have been continuing throughout the Pandemic and were only paused for a short time during the first and third waves. This occurred when the HSE required those staff who are normally assigned to support student education to be released to care for patients with COVID-19.
The payment of clinical placement allowances to student nurses and midwives while on supernumerary clinical placement is governed by Department of Health Circular 09/2004. This Circular provides for student nurses and midwives, in years 1-3 and the first semester of year 4, to receive a weekly accommodation allowance, currently of up to €50.79 per week should their placement be away from their normal place of residence. It also covers reimbursement of their vouched travel costs. Payment of allowances has been continuing during the Pandemic.
The Deputy will recall that in October 2020, I appointed Professor Tom Collins to conduct a short-term review of these allowances in the context of the pandemic, acknowledging that students may have been experiencing challenges as a result of the public health restrictions in place. including while travelling to and from clinical placements, Professor Collins reported to me in December 2020. Following my acceptance of the key recommendation in the Collins report, a student nurse/midwife Pandemic Placement Grant (PPG) of €100 per week for each week spent on supernumerary placement was introduced with effect from the start of the current academic year, September 2020. The PPG is un-vouched and paid to every student nurse and midwife for every week of their supernumerary clinical placement. In addition to the PPG, students can continue to avail of the existing travel and accommodation allowances,
I also directed that a second longer-term review take place. This review will include an examination of the existing clinical placement allowances payable to student nurses and midwives on supernumerary clinical placement as well as pay for the final-year internship placement. Conducted by Mr Sean McHugh, this review has commenced its work and while the HSE cyberattack has delayed progress , I expect to receive the report by the end of July.
156. Deputy Richard Bruton asked the Minister for Health the way the locations will be chosen for a disadvantaged area in which a special health strategy will be implemented; the method which will be adopted in those areas to maximise the impact on health inequalities; and when the first such programme will be put in place. [28088/21]
Amharc ar fhreagraThe Sláintecare Healthy Communities Programme is a new initiative, led by Sláintecare and Healthy Ireland in the Department of Health, in partnership with cross-sectoral, national and local stakeholders.
The aim of the SHCP is to identify specific areas in which high risk factors to the health and wellbeing of the population are particularly prevalent due to deprivation, with a view to implementing targeted initiatives to tackle these challenges from within these communities. This will be achieved through partnership with a range of stakeholders and through the provision of dedicated services to build sustainable improvements in the health and wellbeing of those of all ages living in these communities through focusing on the determinants of health.
The criteria for the selection of areas for inclusion in the programme is based on the following:
- The Pobal Haase-Pratschke deprivation index relative score applied to Electoral District and on a Small Area basis with scores above -10
- Alignment with existing Social Inclusion Community Activation Programme (SICAP) Lot areas
- The areas to be selected will also need to be contiguous and part of existing natural communities
Local Authorities will be consulted on the areas selected to validate selection and to ensure that the programme can be operationalised within them.
€10m was provided in Budget 2021 to support health and wellbeing interventions using an area-based approach to target health inequalities in the selected areas. These health-specific interventions are targeting smoking, social prescribing, parenting, healthy eating and "making every contact count" programmes to support healthy behaviours.
It is expected that programme delivery will commence in quarter three of 2021.
157. Deputy John Lahart asked the Minister for Health if all persons in the 60 to 69 cohort that received a first dose of a vaccine (details supplied) will have received the second by 19 July 2021; and if he will make a statement on the matter. [37546/21]
Amharc ar fhreagraOn 4 June I announced a shorter interval between doses for the Vaxzevria® (AstraZeneca) vaccine. This follows updated recommendations from the National Immunisation Advisory Committee (NIAC), which have been endorsed by the Chief Medical Officer. The NIAC has concluded that those of any age (without any previous COVID-19 infection), who have received their first dose of Vaxzevria® should receive their second dose 8-12 weeks later.
The HSE recently received updated advice from the NIAC in relation to reducing the dosing interval for the administration of the AstraZeneca vaccine from 12 weeks to 8. Extensive planning has been required to put in place a programme that will now see the remaining, approximately 450,000 people, in receipt of the AstraZeneca vaccine fully immunised through the administration of this second dose and it is expected to be substantially completed by 19 July.
158. Deputy Mick Barry asked the Minister for Health if he will report on the progress in implementing the 2018 National Clinical Programme for Eating Disorders in particular its proposal to establish 16 specialist hubs in five years; and if he will make a statement on the matter. [37665/21]
Amharc ar fhreagraEnhancement of specialist services for eating disorders, including improved access and shorter waiting lists, remains a key priority for me, the Government as a whole and the HSE.
In response to the growth in cases presenting to mental health services, €5.7 million has been allocated for the Eating Disorders National Clinical Programme since 2016. The Eating Disorders Model of Care was launched in 2018 and was developed in partnership with the College of Psychiatrists of Ireland and with Bodywhys, the national support group for people with eating disorders.
€1.77 million has been invested to date in eating disorder specialist posts, with 21.8 WTEs now in place. In addition, I secured the balance of €3.94 million for 2021 and this will enable further investment in specialist posts throughout this year. More specifically, it will allow for the establishment of 3 new specialist eating disorder teams and the completion of the 3 existing specialist teams. Premises are already under development for the expansion of the adult community team at the Mount Carmel site in Dublin, and this is expected to be completed by the end 2021. Recruitment is progressing well for all teams.
The funding allocated to date has seen real growth and improvement in our services. Despite the significant increase in referrals in 2020, there was a 43% increase in the number of eating disorder assessments completed compared to 2019, with twice as many people starting treatment.
As of last year, there are 3 specialist eating disorder teams in place. This means that we can treat over 90% of people with eating disorders in the community, avoiding more serious inpatient treatment.
Specialist outpatient treatment has been found to be the most effective and fastest way for most people with eating disorders to recover. Although there is good evidence that inpatient psychiatric care is not required for most people with eating disorders, it is recognised that a small number of people, mainly with restrictive eating disorders, may require inpatient care for short periods for structured refeeding and/or stabilisation.
There are currently 2 eating disorder specialist community teams based in CAMHS. One is the CHO4 Cork and Kerry Regional Eating Disorder Service CAREDS (operational since May 2019).The other is in Dublin based in CHO 7 Linn Dara Community Eating Disorder Service LDCEDS (operational since April 2018). Funding has been made available in 2021 to progress the recruitment of an additional CAMHS based eating disorder specialist community team in Community Healthcare West (Galway, Mayo and Roscommon, CHO2).
In circumstances where in-patient care is required, child and adolescent care is provided in all of the 4 Regional CAMHS Units across the country. Linn Dara in Dublin (8 beds) and Merlin Park in Galway (6 beds) have dedicated a number of specialist eating disorder beds, while the remaining 2 CAMHS units accept relevant admissions of children with eating disorders. There is national coordination of child and adolescent admissions, with transfer arrangements in place as required by individual clinical need.
There are plans for an eating disorder unit in the new National Children’s Hospital which will provide 8 additional beds. The HSE also funds individuals in private facilities. Decisions are made based on individual clinical need, as assessed by the local mental health team, and the prioritisation of available funding.
For adults, people who may require in-patient care for short periods of time are admitted to local general adult approved centres and attend generic inpatient treatment programmes. CHO6 has 3 dedicated beds for eating disorders based in St. Vincent’s University Hospital. The number of adult beds will increase, in line with the National Clinical Programme, including an additional 3 beds in St. Vincents, 5 beds in North Dublin, 5 beds in Galway and 5 beds in Cork. Timeframes for new beds will have to be established. These beds will be linked to eating disorder hubs. The funding available for 2021 will allow for the creation of 2 new adult eating disorder hubs in CHO4 and CHO9.
The HSE provides funding annually to Bodywhys to run the helpline which is delivered by a team of trained volunteers. They also provide a range of services (support groups, online groups, email and family programmes) for adults and young people with eating disorders, and their families. The HSE also supports Bodywhys to run the PiLaR (Peer Led Resilience) Programme, a 4-week online modular based programme for parents, friends and carers of a person with an eating disorder to build resilience and gain support in their role as a carer. Additionally, in March 2019 the HSE launched the first Self Care App which provides valuable information for those with or people caring for someone with an eating disorder.
People with eating disorders can additionally avail of our general mental health supports. The HSE provide a mental health text messaging support service, which is available 24 hours a day, 7 days each week to connect people with trained volunteers. Online counselling and supports are provided by Turn2Me, MyMind and other organisations. There are phone, text and email supports available through existing providers such as the Samaritans, Aware, Pieta and others. Furthermore, Jigsaw provides a variety of online, phone and text supports specifically to young people aged 12 to 25 years old.
If an individual is concerned about themselves or someone known to them, they should be directed to their GP in the first instance for primary care screening assessment and examination. Their GP may then make recommendations which may include, if clinically indicated, referral to the secondary care mental health services for full eating disorder assessment.
With the right support and intervention, people can and do recover from eating disorders. The Government and the Department, along with the HSE and its partners, are committed to providing and expanding high-quality treatment and support for all those affected by eating disorders.
159. Deputy Peadar Tóibín asked the Minister for Health when cancer services will be restored to full pre-Covid-19 capacity in the State. [37676/21]
Amharc ar fhreagraThe National Action Plan on Covid-19 identified the continued provision of cancer care as a priority and cancer services continue to operate in line with guidance issued by the HSE's 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.
While the recent ransomware attack has had an impact on cancer services, every effort is being made to maintain cancer services at present, with a particular focus on urgent and time-sensitive cases.
Funding of €12m was allocated this year for the restoration of cancer services to 95% of 2019 (pre-Covid) levels. This funding is being used to:
- facilitate the expansion of capacity in diagnostic services in the context of Covid-19;
- support virtual clinics and more accurate triage;
- facilitate the better organisation of medical, radiation and surgical oncology in the context of increased organisational focus, social distancing and the provision of infection prevention & control measures;
- fund minor capital works to enable capacity restoration in medical oncology day wards; and
- support the continued provision of psycho-social supports to cancer patients and their families, including through the Together 4 Cancer Concern patient support initiative.
Furthermore, funding of €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.
160. Deputy Paul Murphy asked the Minister for Health the action he will take to ensure that persons who suffered narcolepsy after receiving the pandemrix vaccine will receive appropriate compensation without the need for drawn out conflict with the State. [28316/21]
Amharc ar fhreagraThe State Claims Agency (SCA) has a statutory remit to manage personal injury claims on behalf of Delegated State Authorities including the Health Service Executive. The management of cases taken by persons who allege they developed Narcolepsy and/or Cataplexy as a result of receiving the H1N1 vaccine, Pandemrix, is delegated to SCA and, as such, the Government has no role in determining how these cases are conducted.
I understand, however, that the SCA has established a Scheme of Settlement in relation to this litigation whereby plaintiffs have the facility of resolving their claims through a formal mediation process with an ultimate right of appeal to a retired superior court judge. I am informed that the Scheme is functioning well and a number of cases have been successfully resolved. Other cases are in the process of resolution by the Scheme.
