Written Answers Nos. 841-858
841. Deputy David Cullinane asked the Minister for Health the number of safeguarding plans which have yet to be reviewed by HSE safeguarding and protection teams by CHO in tabular form; the date on which the oldest of such plans was received; and if he will make a statement on the matter. [52181/21]
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.
842. Deputy David Cullinane asked the Minister for Health the number of residents in HSE disability or older persons services who are known to be abusive or potentially abusive, including but not limited to sexual abuse, who are still resident in community settings and not confined for the protection of residents, such as occurred in a case (details supplied); the protections in place for each setting by CHO in tabular form; and if he will make a statement on the matter. [52182/21]
Amharc ar fhreagraAs the Deputy's question relates to a service matter, I have arranged for the question to be referred to the HSE for direct reply to the Deputy as soon as possible.
843. Deputy Pa Daly asked the Minister for Health the HSE policy with respect to bereavement leave in a set of circumstances (details supplied). [52183/21]
Amharc ar fhreagraFollowing a process of engagement with health sector staff representative bodies at the Workplace Relations Commission and the Labour Court, revised arrangements in respect of Bereavement Leave for public health sector employees were agreed and introduced in 2019. I attach a copy of the circular that sets out all arrangements in this respect for the Deputy's information. Bereavement leave in respect of miscarriages is not provided for.
[<a ref=https://data.oireachtas.ie/ie/oireachtas/debates/questions/supportingDocumentation/2021-11-02_pq843-02-11-21_en.pdf >Circular</a>]
844. Deputy David Cullinane asked the Minister for Health the number of surgical theatres across the HSE; the number which are closed due to equipment reasons, staffing reasons or other reasons in tabular form; and if he will make a statement on the matter. [52186/21]
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.
845. Deputy Paul Murphy asked the Minister for Health if his attention has been drawn to the 10 to 13 hour waiting times given to patients in Tallaght University Hospital accident and emergency; and the steps that will be taken by his Department to ensure that there is immediate action to reduce this waiting time in an emergency department. [52188/21]
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.
846. Deputy Violet-Anne Wynne asked the Minister for Health if he will review the situation of a person (details supplied) who was referred for a hip replacement six years ago; and if it will be expedited. [52193/21]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
847. Deputy Richard Bruton asked the Minister for Health if there are conditions for which the use of cannabis-based products can be prescribed; and if he will make a statement on the matter. [52195/21]
Amharc ar fhreagraThere are two separate pathways for accessing cannabis for medical use in Ireland.
Medical Cannabis Access Programme (MCAP)
The provision of the Medical Cannabis Access Programme (MCAP) as a result of recommendations by the Health Products Regulatory Authority in their “Cannabis for Medical User – A Scientific Review”.
The review stated that if the policy decision is to make cannabis available for medical purposes, the HPRA advised that it should recognise patient need, but be evidence based. It was advised, that treatment with cannabis be only permitted under a controlled access programme for the treatment of patients with the following medical conditions which have failed to respond to standard treatments;
- spasticity associated with multiple sclerosis;
- intractable nausea and vomiting associated with chemotherapy;
- severe, refractory (treatment-resistant) epilepsy.
Subsequently the Minister for Health established an Expert Reference Group to advise on the development of a Medical Cannabis Access Programme. This Group developed detailed Clinical Guidelines for the MCAP to be followed by clinicians, which contained inter alia guidance on ingredient combinations that are recommended for each of the three indications included in the MCAP
The MCAP is a 5-year pilot programme. The purpose of the programme is to facilitate access to acceptable cannabis-based products for medical use that are of a standardised quality and which meet the requirements outlined in the Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) Regulations 2019 (as amended).
There are currently 4 products assessed by the HPRA for inclusion in Schedule 1 of the Regulations, more products are currently being assessed by the HPRA.
On the 19th July, I announced that the MCAP was now open for medical consultants to make an application for themselves and their patients to be registered for the programme.
Registration by consultants and their patients on the Cannabis for Medical Use Register, to be operated by the HSE, is required for the prescribing of cannabis-based products under the MCAP.
Ministerial Licence under Section 14 of the Misuse of Drugs Acts 1977-2016
For medical indications not included in the MCAP, doctors may continue to utilise the Ministerial licensing route to prescribe medical cannabis for their patients, should they wish to do so.
In line with the Chief Medical Officer's advice, the granting of a licence for cannabis for medical purposes must be premised on an appropriate application being submitted to the Department of Health, which is endorsed by a consultant who is responsible for the management of the patient and who is prepared to monitor the effects of the treatment over time.
Further information is available on the Department's website at the following link:
www.gov.ie/en/collection/fb8912-cannabis-for-medical-use/
It is important to note that the medical decision to prescribe or not prescribe any treatment, including cannabis treatment, for an individual patient is strictly a decision for the treating clinician, in consultation with their patient. The Minister for Health has no role in this clinical decision-making process.
848. Deputy Joe Carey asked the Minister for Health the position regarding a planned significant redevelopment project (details supplied) in County Clare; when he anticipates it will go to tender; and if he will make a statement on the matter. [52196/21]
Amharc ar fhreagraAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
849. Deputy Cathal Crowe asked the Minister for Health the minimum levels of qualification and experience required for a person to be appointed as a HSE disability services manager; if these thresholds are currently met by personnel serving in each CHO; and if he will make a statement on the matter. [52200/21]
Amharc ar fhreagraI have asked the HSE to respond directly to the Deputy in relation to this matter.
850. Deputy Pádraig O'Sullivan asked the Minister for Health his plans to extend the diseases and disabilities covered under the long-term illness scheme, particularly congenital adrenal hyperplasia; and if he will make a statement on the matter. [52204/21]
Amharc ar fhreagraThe Long Term Illness Scheme was established under Section 59(3) of the Health Act 1970 (as amended). The conditions covered by the scheme are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide.
Under the Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge. There are no plans to extend the list of conditions covered by the Scheme at this time. However, a review of the current eligibility framework, including the basis for existing hospital and medication charges, will be carried out under commitments given in the Sláintecare Implementation Strategy. In the meantime, for people who are not eligible for the Long Term Illness Scheme, there are other arrangements which protect them from excessive medicine costs.Under the Drugs Payment Scheme, no individual or family pays more than €114 a month towards the cost of approved prescribed medicines. The Scheme significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE.
In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where the applicant faces difficult financial circumstances, such as extra costs arising from illness. The HSE afford applicants the opportunity to furnish supporting documentation to determine whether undue hardship exists and to fully take account of all relevant circumstances that may benefit them in assessment, including medical evidence of costs and certain expenses.In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
854. Deputy Matt Carthy asked the Minister for Health the number of dentists who have cancelled their contract with the primary care reimbursement scheme since the onset of the Covid-19 pandemic; the number of dental contractors that have remained within contract but whose average medical card claims are since March 2020 below 10%, 20%, 30%, 40%, 50% and 60%, respectively of their pre-pandemic claims in tabular form; and if he will make a statement on the matter. [52225/21]
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.
855. Deputy David Cullinane asked the Minister for Health the number of children and adults on waiting lists for scoliosis treatment or spinal procedures, including fusion, by location; the median, mean and maximum waiting times; and if he will make a statement on the matter. [52227/21]
Amharc ar fhreagraI sincerely regret that children can experience a long waiting time for hospital appointments and treatment, and I remain conscious of the burden that this places on them and their families.
My priority as Minister for Health, and that of this Government, is to improve waiting times for all patients accessing hospital treatment, and reducing the paediatric waiting list for orthopaedic procedures remains a priority within that.
My Department, the HSE and the National Treatment Purchase Fund (NTPF) are working on a Multi Annual Waiting List Plan to address waiting lists and bring them in line with Sláintecare targets over the coming years. This process will be overseen by a Ministerial Taskforce chaired by the Secretary General of my Department and including representatives from the HSE and National Treatment Purchase Fund. It will take the learnings from the achievements of the Vaccine Taskforce to inform the plan.
An additional €250 million is being provided in Budget 2022 to improve access to care across the health system.
It is recognised that waiting times for scheduled appointments and procedures have been impacted in the last nineteen months as a direct result of the COVID-19 pandemic and more recently as a result of the ransomware attack.
The cyber-attack in May 2021 in particular, caused significant disruption to the orthopaedic service and all services across the Children’s Health Ireland Hospital Group. Children's Health Ireland advise that without access to a patient’s full history and previous diagnostic investigations, it was not considered safe to proceed without all electronic support systems in place. This impacted patients with complex needs in particular, and restricted the patient cohort that could safely proceed with surgery during this time.
Most systems are now back up and running across CHI sites, but back-loading of information is ongoing, and this continues to have an impact on waiting lists and the number of surgeries completed.
Despite the impact of the pandemic and the cyberattack Children’s Health Ireland advise that as of the end of September 2021, 266 spinal surgeries had been carried out which is an increase of 41 compared to the same period last year.
CHI remain committed to increasing activity levels and examining innovative methods to improve access to all specialties. For example, additional theatre sessions are being held in Cappagh National Orthopaedic Hospital, for non-complex, age-appropriate orthopaedic patients.
CHI also continues to develop the Advanced Clinical Triage clinic model in City West. Active Clinical Triage is a system which has been adapted for use within the paediatric orthopaedic unit at CHI Crumlin and its purpose is to reduce the overall orthopaedics out-patient waiting list, starting with the longest waiting clinically appropriate referrals.
A new Orthopaedic Consultant with a special interest in neuromuscular conditions started in Temple Street in September which should also enable the use of additional theatre capacity and support additional capacity as part of the Cappagh Kids programme.
Officials in the Department of Health remain in regular contact with CHI regarding scoliosis services. CHI have advised that all patients with a diagnosis of scoliosis require a pre-operative work-up prior to spinal surgery, including multiple diagnostic investigations and review by a multi-disciplinary team. The plan of care which is implemented for each patient is tailored to best meet the patient's clinical requirements. It is the responsibility of the treating Consultant to clinically prioritise patients for surgery on the waiting list.
In relation to the information requested by the Deputy, as this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
856. Deputy Michael Healy-Rae asked the Minister for Health if the home help allocation for a person (details supplied) will be reviewed; and if he will make a statement on the matter. [52228/21]
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.
857. Deputy David Cullinane asked the Minister for Health the number of children and adults with scoliosis who received an outpatient appointment within 12 weeks of referral, a diagnostic scan within 10 days or an outpatient appointment within 10 weeks; the number which did not; the current waiting times for an outpatient, diagnostic or inpatient appointment for scoliosis; and if he will make a statement on the matter. [52229/21]
Amharc ar fhreagraI sincerely regret that children can experience a long waiting time for hospital appointments and treatment, and I remain conscious of the burden that this places on them and their families.
My priority as Minister for Health, and that of this Government, is to improve waiting times for all patients accessing hospital treatment, and reducing the paediatric waiting list for orthopaedic procedures remains a priority within that.
It is recognised that waiting times for scheduled appointments and procedures have been impacted in the last nineteen months as a direct result of the COVID-19 pandemic and more recently as a result of the ransomware attack.
The cyber-attack in May 2021 in particular, caused significant disruption to the orthopaedic service and all services across the Children’s Health Ireland Hospital Group. Children's Health Ireland advise that without access to a patient’s full history and previous diagnostic investigations, it was not considered safe to proceed without all electronic support systems in place. This impacted patients with complex needs in particular, and restricted the patient cohort that could safely proceed with surgery during this time.
Most systems are now back up and running across CHI sites, but back-loading of information is ongoing, and this continues to have an impact on waiting lists and the number of surgeries completed.
Despite the impact of the pandemic and the cyberattack Children’s Health Ireland advise that as of the end of September 2021, 266 spinal surgeries had been carried out which is an increase of 41 compared to the same period last year.
CHI remain committed to increasing activity levels and examining innovative methods to improve access to all specialties. For example, additional theatre sessions are being held in Cappagh National Orthopaedic Hospital, for non-complex, age-appropriate orthopaedic patients.
CHI also continues to develop the Advanced Clinical Triage clinic model in City West. Active Clinical Triage is a system which has been adapted for use within the paediatric orthopaedic unit at CHI Crumlin and its purpose is to reduce the overall orthopaedics out-patient waiting list, starting with the longest waiting clinically appropriate referrals.
A new Orthopaedic Consultant with a special interest in neuromuscular conditions started in Temple Street in September which should also enable the use of additional theatre capacity and support additional capacity as part of the Cappagh Kids programme.
Officials in the Department of Health remain in regular contact with CHI regarding scoliosis services. CHI have advised that all patients with a diagnosis of scoliosis require a pre-operative work-up prior to spinal surgery, including multiple diagnostic investigations and review by a multi-disciplinary team. The plan of care which is implemented for each patient is tailored to best meet the patient's clinical requirements. It is the responsibility of the treating Consultant to clinically prioritise patients for surgery on the waiting list.
My Department, the HSE and the National Treatment Purchase Fund (NTPF) are working on a Multi Annual Waiting List Plan to address waiting lists and bring them in line with Sláintecare targets over the coming years. This process will be overseen by a Ministerial Taskforce chaired by the Secretary General of my Department and including representatives from the HSE and National Treatment Purchase Fund. It will take the learnings from the achievements of the Vaccine Taskforce to inform the plan.
An additional €250 million is being provided in Budget 2022 to improve access to care across the health system.
In relation to the information requested by the Deputy, as this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
858. Deputy David Cullinane asked the Minister for Health when a report (details supplied) will be published; and if he will make a statement on the matter. [52230/21]
Amharc ar fhreagraThe HSE commissioned the National Independent Review Panel to carry out a review of a residential service for adults with a disability. The review report, the Brandon Report, focuses on matters of a sensitive nature, and how they were managed.
The HSE has advised me that there is no ongoing risk to service users and that there is a commitment to the implementation of the specific recommendations arising from the report. This is in addition to making substantial changes to the wider Disability services in the area concerned and nationally in line with National Policy.
The Board has also advised that it is focused on ensuring that all of the recommendations of the report are promptly and appropriately actioned by the HSE. Actions are being taken to seek assurances requested by me and will be reported to me once concluded.
The HSE has informed me that An Garda Síochána has requested it not to publish the report at this time. I will continue to engage with the HSE and its Board on this matter in the weeks ahead.
