Written Answers Nos. 3262-3284
3262. Deputy Holly Cairns asked the Minister for Health the steps he is taking to fulfil the Programme for Government commitment to support the CervicalCheck screening programme and promote the uptake of the HPV vaccine. [41104/21]
Amharc ar fhreagraThe Programme for Government commits to supporting the CervicalCheck Screening Programme and promoting the uptake of the HPV vaccine. To achieve this requires a well organised screening programme, combined with HPV vaccination for boys and girls, so that Ireland can look forward to a significant reduction in the incidence of cervical cancer cases over the next 10-20 years.
The Programme for Government commits to fully implement the recommendations contained in Dr Scally’s Report of the Scoping Inquiry, and all other reports into CervicalCheck. In this regard, significant progress has been made in implementing the recommendations and associated actions from Dr Scally's report, across all themes and areas of work, by the Department of Health, the HSE and the National Cancer Registry Ireland. In addition, the CervicalCheck Steering Committee, chaired by Professor Anne Scott, and which includes representatives from 221+ Group and patient advocates in its membership have a role in oversight of the implementation of the remaining recommendations. At the end of Quarter 2 2021, 164 of the 170 actions, arising from 58 recommendations, are completed. Work is well underway in completing the 6 remaining actions. Since Quarter 1 2019, the Department of Health has been publishing quarterly progress reports on the implementation of the recommendations made in Dr Scally’s 2018 report and the full archive and previous quarterly progress reports is available on the Department of Health website. The Government approved €10 million in funding for Cancer Screening in 2021, this investment represents a real commitment to improving healthcare for the women of Ireland. Details of the specific service improvements and investments are set out in the HSE National Service Plan 2021.
In 2009, the National Immunisation Advisory Committee (NIAC) recommended HPV (human papillomavirus) vaccination for all 12 to 13 year old girls to reduce their risk of developing cervical cancer when they are adults. In September 2010, the HPV vaccination programme was introduced for all girls in the first year of secondary school. The NIAC recommended that the HPV vaccine should also be given to boys. On foot of NIAC’s recommendation, my Department asked the Health Information and Quality Authority (HIQA) to undertake a health technology assessment (HTA) to establish the clinical and cost-effectiveness of extending the current immunisation programme to include boys in the first year of secondary school. HIQA completed the HTA in December 2018, recommending that the HPV immunisation programme be extended to include boys. A policy decision was made to extend the HPV immunisation programme to include boys. This started in September 2019 with the introduction of a 9-valent HPV vaccine.
It is important to note that the schools-based immunisation programme for the 2019/2020 academic year has been completed and the uptake rates for the HPV vaccine in that academic year are 82% for the first dose of the vaccine and 77% for the second dose. This is the highest uptake for the HPV vaccination programme since 2015/2016 and is particularly encouraging because it was the first year that boys were included in the programme and it shows that the provision of vaccine in community clinics did not adversely affect the uptake.
The programme for the academic year 2020/2021 was paused during the first few months of 2021 due to school closures and redeployment of staff to the COVID-19 immunisation programme. The inputting of uptake information for the schools-based programme has also been delayed due to redeployment of administrative staff. However, Community Healthcare Organisations have reported that the vast majority of second level schools had their first dose of HPV vaccine delivered between October and December 2020.
The uptake rate for the first dose of the HPV vaccine, in the 2020/2021 academic year, is 67% as of the 12th May 2021, and this figure is expected to increase because data input on vaccine uptake is ongoing. The HSE expects the HPV vaccination programme for 2020/21 to be substantially complete before the start of the 2021/22 academic year.
3263. Deputy Holly Cairns asked the Minister for Health the steps he is taking to fulfil the Programme for Government commitment to ensure that community services assign a case manager for older people with chronic conditions to assist them with accessing the care they need. [41105/21]
Amharc ar fhreagraThe HSE's Integrated Care Programme for Older People seeks to design systems that recognise and meet the complex healthcare needs of older people across the care journey. The Programme aims to ensure that older persons with long-term complex care needs will have access to a single point of contact, when needed.
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 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.
3264. Deputy Holly Cairns asked the Minister for Health the steps he is taking to fulfil the Programme for Government commitment to develop the role of advanced nurse practitioners in older person services and chronic disease management. [41106/21]
Amharc ar fhreagraThe development of advanced nurse practitioner and advanced midwife practitioner roles has continued in line with the Policy on the Development of Graduate to Advanced Nursing and Midwifery Practice and with Sláintecare.
I can confirm that there are now 58 Registered Advanced Nurse Practitioners (RANP) working in Older Persons Services, with a further 17 undertaking the education programme, Masters in Advanced Practice. 21 of these posts have been approved in the last year.
As the Deputy will be aware, Chronic Disease Management covers a broad range of services and I have included the following conditions: Respiratory, Diabetes, Cardiovascular, Rheumatology, Tissue viability, Chronic pain and MND. There are 82 RANP’s working across these services with an additional 29 candidates undertaking the education programme. 25 of these posts have been approved in the last year.
3265. Deputy Richard Boyd Barrett asked the Minister for Health the estimated cost of clearing home care package waiting lists. [41197/21]
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.
3266. Deputy Richard Boyd Barrett asked the Minister for Health the estimated cost to hire 100 speech and language therapists, 100 psychologists, 100 occupational therapists and 100 physiotherapists. [41198/21]
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.
3267. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full year cost of employing all mental health staff to bring the public service up to recommended staffing levels recommended in Sharing the Vision: A Mental Health Policy for Everyone. [41199/21]
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.
3268. Deputy Richard Boyd Barrett asked the Minister for Health the estimated cost to clear assessment of needs waiting lists for children with autism and other additional needs. [41200/21]
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.
3269. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full year cost of adding 1,000 acute beds to the hospital network. [41201/21]
Amharc ar fhreagra3276. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full year cost of adding 1,000 acute beds to the hospital network. [41208/21]
Amharc ar fhreagra3280. Deputy Richard Boyd Barrett asked the Minister for Health the estimated cost full year cost of permanently increasing and fully staffing and on a permanent basis the number of acute beds to get 85% occupancy in the hospital network. [41212/21]
Amharc ar fhreagraI propose to take Questions Nos. 3269, 3276 and 3280 together.
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.
3270. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full year cost of hiring 4,000 new nurses on the pre-2011 rate of pay. [41202/21]
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.
3271. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full year cost of hiring 500 consultants. [41203/21]
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.
3272. Deputy Richard Boyd Barrett asked the Minister for Health the estimated amount it will cost to maintain the pre-Covid19 levels of service provision across the health service in 2022 in view of demographic changes and inflation and Covid-19. [41204/21]
Amharc ar fhreagraMy Department is engaging in ongoing dialogue with the HSE and the Department of Public Expenditure and Reform in relation to the 2022 Estimates, and this process will include an analysis of the potential impact of demographic change, inflation and COVID-19.
These discussions are still progressing and until they are concluded it would not be appropriate for me to anticipate the outcome.
3273. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full year cost to reduce prescription charges by €0.50. [41205/21]
Amharc ar fhreagraThe full year cost of reducing prescription charges by €0.50c for those over 70 is estimated at €12.5m.
The full year cost of reducing prescription charges by €0.50c for those under 70 is estimated at €12.1m.
Therefore the total full year cost of reducing prescription charges for both cohorts is estimated at €24.6m.
3274. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full year cost to abolish prescription charges. [41206/21]
Amharc ar fhreagraThe cost to the State of abolishing prescription charges is estimated at €61.2m.
3275. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full year cost of reducing the DPS threshold to €50 and €100, respectively. [41207/21]
Amharc ar fhreagraAs this Parliamentary Question relates to data only available through completion of a detailed analytical exercise, the Deputy is advised that the HSE is currently not in a position to provide such data by closing date for the Parliamentary Question. I am advised that due to the recent cyber-attack, the disruption to service is on-going, and the HSE will be in a position to provide material for response in due course. Once this data is received, my Department will forward same to the Deputy.
3277. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full year cost of abolishing accident and emergency charges. [41209/21]
Amharc ar fhreagraNormal patient activity has been affected due to the Covid-19 pandemic and as a result 2020 is not representative of normal services, and therefore the 2019 position would currently be the best representation of the likely costs associated with abolishing those service charges.
The Emergency Department charge is recorded by the HSE as an out-patient charge. In 2019 €20m was collected in Outpatient Charges from Acute Hospitals, which predominantly relates to Accident and Emergency charges. Therefore €20m is an approximate estimate of the full year cost of abolishing accident and emergency charges.
3278. Deputy Richard Boyd Barrett asked the Minister for Health the estimated cost to reinstate the 2008 dental treatment services scheme. [41210/21]
Amharc ar fhreagraThe Dental Treatment Services Scheme (DTSS) provides dental care, free of charge to medical card holders aged 16 and over. These services are provided by independent dental practitioners who have a contract with the HSE. As part of Budget 2010 measures, the range of treatments provided under the Scheme was reduced in order to cap expenditure at the 2008 level of €63 million. The cost in 2021 of restoring treatments which had been provided before 2010 would depend on a number of factors, including the underlying oral health of the population and the level of take-up of such services.
The national approach to future oral health service provision will be informed by Smile agus Sláinte, the National Oral Health Policy, which was published in 2019. The aim of the policy is to develop a model of care that will enable preventative approaches to be prioritised, improve access, and support interventions appropriate to current and future oral health needs.
3279. Deputy Richard Boyd Barrett asked the Minister for Health the number of mental health beds available in each CHO; and the number of persons waiting for mental health beds. [41211/21]
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.
3281. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full year cost of permanently increasing and fully staffing and on a permanent basis to bring the level of ICU beds to 560 in the hospital network. [41213/21]
Amharc ar fhreagraThe cost of a critical care bed has several determining factors. The HSE has advised that a new critical care bed will typically cost between €1m and €1.5m, depending on a variety of factors, including design, construction, equipping and all other associated capital costs.
The HSE has advised that the average annual cost of running a critical care bed is estimated to be €747k, based on 2018 data. However, it should be noted that this figure includes costs for both ICU and HDU beds, with the ICU beds the more expensive of the two.
Regarding plans to increase critical care capacity, as the Deputy may be aware, a Strategic Plan for Critical Care was noted by Government in December 2020. This Plan aims to increase capacity from a baseline of 255 in 2020 to 321 by end-2021, and to 446 in the longer term, fully addressing the recommendations of the Health Service Capacity Review. Funding of €52m provided for 2021 will see the 40 beds provided in 2020 retained permanently and a further 26 added, to bring permanent baseline capacity to 321 by the end of 2021. The HSE has advised that 42 of these 66 beds are now in place, bringing baseline capacity to 297, with the number open on any particular day fluctuating as a result of a variety of factors.
3282. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full year cost of the current levels of nursing home care provided through the public health system. [41214/21]
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.
3283. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full year cost of the subsidies paid to private nursing homes. [41215/21]
Amharc ar fhreagraThe Nursing Homes Support Scheme (NHSS), commonly referred to as Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term residential care is accessible and affordable for everyone, and that people are cared for in the most appropriate settings.
Participants in the Scheme contribute up to 80% of their assessable income, such as their pension, and a maximum of 7.5% per annum of the value of assets held, such as their principal private residence or cash assets (these values are halved if the applicant is part of a couple).
The capital value of an individual’s principal private residence is only included in the financial assessment for the first three years of their time in care. This is known as the three-year cap, which is intended to protect the value of a principal private residence, along with the other safeguards built into the Financial Assessment which ensure that:
- Nobody will pay more than the actual cost of care;
- A participant will keep a personal allowance of 20% of their income or 20% of the maximum rate of the State Pension (Non-Contributory), whichever is the greater, and;
- If a participant has a spouse or partner remaining at home, they will be left with 50% of the couple’s income or the maximum rate of the State Pension (Non-Contributory), whichever is the greater.
All cash assets are included in the financial assessment, subject to the general assets deductible amount.
The NHSS is expected to support approximately 22,500-23,000 people at any one time in 2021, with a budget of €1.04bn. Although it has seen significant increases in the last number of years, the NHSS budget saw a small reduction in 2021 due to an expected reduction in resident numbers. This budget covers both private and public nursing homes. In 2020 private nursing homes received €680.2m in state funding through the NHSS, out of a total budget of €1.07 bn.
Private nursing homes have also been supported through the Temporary Assistance Payment or TAPS over the course of the COVID-19 pandemic. The TAPS was originally set up to cover the period of April, May and June 2020. It was then further extended until the end of September 2020. Following this, the Government document ‘Resilience and Recovery 2020-2021: Plan for Living with COVID-19’ committed to the further extension of the Scheme. The Scheme continued to support nursing homes to the end of June 2021.
The total amount of support available through the scheme from March 2020 to June 2021 was €134.5 million:
- TAPS was extended to the end of 2020 which provided for a total value of TAPS to the end of 2020 of €92.5m.
- The further extension of TAPS for the first 6 months of 2021 was allocated funding of €42m.
3284. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full year cost of the fair deal scheme. [41216/21]
Amharc ar fhreagraThe Nursing Homes Support Scheme (NHSS), commonly referred to as 'Fair Deal', is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term residential care is accessible and affordable for everyone, and that people are cared for in the most appropriate settings.
Participants in the Scheme contribute up to 80% of their assessable income, such as their pension, and a maximum of 7.5% per annum of the value of assets held, such as their principal private residence or cash assets (these values are halved if the applicant is part of a couple).
The capital value of an individual’s principal private residence is only included in the financial assessment for the first three years of their time in care. This is known as the three-year cap, which is intended to protect the value of a principal private residence, along with the other safeguards built into the Financial Assessment which ensure that:
- Nobody will pay more than the actual cost of care;
- A participant will keep a personal allowance of 20% of their income or 20% of the maximum rate of the State Pension (Non-Contributory), whichever is the greater, and;
- If a participant has a spouse or partner remaining at home, they will be left with 50% of the couple’s income or the maximum rate of the State Pension (Non-Contributory), whichever is the greater.
All cash assets are included in the financial assessment, subject to the general assets deductible amount.
The NHSS is expected to support approximately 22,500-23,000 people at any one time in 2021, with a budget of €1.04bn. Although it has seen significant increases in the last number of years, the NHSS budget saw a small reduction in 2021 due to an expected reduction in resident numbers.
