Written Answers Nos. 31-50
31. Deputy Donnchadh Ó Laoghaire asked the Minister for Health his plans to ensure all positions within the children's disability network teams in County Cork are filled and there are no staffing gaps. [17024/22]
Amharc ar fhreagraAs this question refers to service matters, I have asked the Health Service Executive to reply to the Deputy directly, as soon as possible.
32. Deputy Gino Kenny asked the Minister for Health his views on, and response to, the recent request by an organisation (details supplied) for the reintroduction of masks in indoor public and other crowded settings; and if he will make a statement on the matter. [17019/22]
Amharc ar fhreagraMy Department, through the Office of the Chief Medical Officer, together with colleagues in the HSE and the National Virus Reference Laboratory, continues to monitor the epidemiological profile carefully, and will provide public health advice to me as required for consideration.At present mask wearing is advised based on individual risk assessment, particularly while disease incidence is high. Anyone who wishes to wear a mask should not be discouraged from doing so. Individuals who are vulnerable to COVID-19 are further advised to be aware of the risk associated with activities they may choose to engage in and to take measures to optimally protect themselves. Vulnerable individuals are advised to consider wearing masks in crowded indoor settings, such as may relate, for example, to social gatherings or other activities and events.
33. Deputy Cathal Crowe asked the Minister for Health the status of the provision of a HSE health centre at Sixmilebridge, County Clare. [16795/22]
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.
34. Deputy Maurice Quinlivan asked the Minister for Health the steps that have been taken to address the continuous issue of overcrowding at University Hospital Limerick; and if he will make a statement on the matter. [15888/22]
Amharc ar fhreagra51. Deputy Rose Conway-Walsh asked the Minister for Health the emergency action he is taking to address the number of patients on trolleys in Mayo University Hospital; and if he will make a statement on the matter. [16866/22]
Amharc ar fhreagra73. Deputy Kieran O'Donnell asked the Minister for Health the steps he is taking to address overcrowding at University Hospital Limerick; and if he will make a statement on the matter. [17025/22]
Amharc ar fhreagra105. Deputy Pa Daly asked the Minister for Health his views on the current overcrowding crisis in University Hospital Kerry. [16197/22]
Amharc ar fhreagra109. Deputy David Cullinane asked the Minister for Health his plans to tackle emergency department overcrowding; and if he will make a statement on the matter. [16797/22]
Amharc ar fhreagraI propose to take Questions Nos. 34, 51, 73, 105 and 109 together.
I acknowledge the distress overcrowded Emergency Departments (EDs) cause to patients, their families, and frontline staff working in very challenging conditions in hospitals throughout the country.
The current congestion in Emergency Departments is due to constrained bed capacity caused by combination of the high number of patients in hospital with COVID-19 (1624 nationally on Monday 28th March), the increased number of delayed transfers of care cases which is partly due to COVID outbreaks in nursing homes and the very high number of people attending EDs in recent weeks.
The three highest attendances ever recorded in our EDs have occurred in recent weeks with attendances trending over 28,000 a week.
While attendance and admission numbers are now exceeding pre-pandemic levels, the continued requirement to provide separate Covid-19 and non-Covid-19 pathways presents an additional challenge to patient flow in all hospitals and Emergency Departments.
The HSE is actively working with hospitals and hospital groups to mitigate the situation. The HSE is continuing to utilise capacity in private hospitals and is reviewing elective care to reduce pressure on bed capacity. Patients are requested to use alternatives such as their local pharmacist, GP or minor injury unit as appropriate.
Investment of €1.1bn was provided in budget 2021 to expand capacity, increases services and support reform and this level of investment is being maintained in budget 2022. A further €77 million has been invested in the 2021/22 Winter Plan. To date over 800 additional beds have been provided in acute hospitals since the start of 2020.
To provide leadership, governance and oversight of the implementation of the Winter Plan at local level and national level, the Chief Operations Officer has established the Integrated National Operations Hub (INOH) with defined membership from all relevant service and enabling functions with a clear Terms of Reference. For the purposes of coordinating the response to COVID-19, each geographical area has an Area Crisis Management Team (ACMT). Many of the Winter Plan measures will continue for the rest of the year.
The current situation in hospital Emergency Departments is under constant review by my Department through ongoing engagement with the HSE.
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
35. Deputy Brendan Griffin asked the Minister for Health the up-to-date position on efforts to address problems and system deficiencies at University Hospital Kerry; and if he will make a statement on the matter. [16962/22]
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.
36. Deputy Brian Leddin asked the Minister for Health his position in relation to locating the new elective hospital at the site of St. John’s Hospital in Limerick; and if he will make a statement on the matter. [16876/22]
Amharc ar fhreagraThe Cross Party Sláintecare Report in 2017 articulated a new vision for healthcare in Ireland, including the provision of elective only hospitals, providing protected capacity for elective care. The “Elective Hospitals Oversight Group”, under the joint governance of the Department of Health and HSE has been guiding the development of the elective hospital proposals, following the process outlined in the updated Public Spending Code, setting out the value for money requirements for the evaluation, planning, and management of large public investment projects.
The provision of additional protected capacity for elective care is further confirmed by the Government Decision, in December 2021 and subject to the necessary approvals and requirements under the Public Spending Code being met, on a new National Elective Ambulatory Care Strategy. This new strategy aims to change the way in which day case, scheduled procedures, surgeries, scans and outpatient services can be better arranged to ensure greater capacity in the future and help to address waiting lists. The development of additional capacity will be provided through dedicated, standalone Elective Hospitals in Cork, Galway and Dublin. The Government decision is very clear on this. No other locations are under active consideration. It is important to note that the locations chosen will allow for new facilities of a size and scale to implement a national elective care programme that will tackle waiting lists on a national basis. This means that the new facilities will be designed to maximise their capacity and in doing so will operate to cover as a wide catchment area as possible, extending beyond existing and future health areas including Limerick and neighbouring mid-west counties.
The elective care scope of service will be developed in two phases commencing with day cases, diagnostics, and outpatients and then by in-patient treatment. On this basis, the Elective Care Centres (ECCs) will be designed to provide sufficient capacity to facilitate future phases, including some elective in patient capacity, thereby providing a sustainable and strategic response to cater for the highly dynamic landscape of healthcare policy and practice.
37. Deputy Richard Boyd Barrett asked the Minister for Health if he will now consider the compulsory purchase of the site at St. Vincent's hospital, or any other site, to ensure the new national maternity hospital is publicly owned and publicly run; and if he will make a statement on the matter. [16849/22]
Amharc ar fhreagraThe Government is committed to the development of the new National Maternity Hospital (NMH) planned for the St Vincent’s University Hospital Campus at Elm Park, as set out in the Programme for Government. The Government is also aware of the concerns that have been raised regarding ownership and governance of the new NMH, and recognises that these matters must be addressed.
When it comes to the new NMH, howsoever achieved, we all ultimately want the same outcome and that is to ensure that all legally permissible services are provided in the new hospital. This is an absolute requirement. We must also ensure that the State’s significant investment in the facility is protected.
The proposed corporate and clinical governance arrangements for the new NMH were set out in the Mulvey Agreement, that provides for the establishment of a new company - National Maternity Hospital at Elm Park DAC - which will have clinical and operational, as well as financial and budgetary, independence in the provision of maternity, gynaecology and neonatal services.
The draft legal framework subsequently developed is designed to copperfasten these arrangements and will address both the ownership and governance of the new hospital, in order to:
- ensure that all clinically appropriate and legally permissible services will be available in the new NMH;
- prevent any influence, religious or otherwise, on the operation of the new hospital; and
- safeguard the State’s significant investment in the hospital.
There is a process ongoing to finalise the legal arrangements, however, I will not bring any proposal on ownership and governance of the new National Maternity Hospital to Government unless it provides assurances around full healthcare for women being provided there in line with the objectives I have set out above.
38. Deputy Joe Carey asked the Minister for Health if he will report on his recent visit to University Hospital Limerick; his action plan to address the ongoing chronic trolley crisis following his visit setting out a timeframe for these actions; and if he will make a statement on the matter. [16846/22]
Amharc ar fhreagraI visited Limerick University Hospital on the evening of 16th February and again on 17th February when I also visited Croom Orthopaedic Hospital. I met patients, staff and the management team. My discussion with the Chief Executive Officer and the Executive Management Team of the hospital included unscheduled care activity, recruitment and staffing and waiting lists. We also discussed current pressures and possible solutions including pathways through ED, discharge options, the impact of recent investment including beds and the new ED, and additional capacity requirements.
I also met with staff of the hospital and listened to their experiences of dealing with Covid over the past two years and their ideas for improving services to patients. This included a group of Clinical Nurse Managers and a group of Non Consultant Hospital Doctors.
I also met with staff from the Community Health Organisation including the Head of Service, Primary Care, the Head of Disability Services and the Head of Older Persons Services.
I had the opportunity to see the new infrastructure provided recently including the Haematology/Oncology Ward, the new Emergency Department and the new Bed Block. I also saw the new theatre block in Croom.
The current congestion in Emergency Departments is due to constrained bed capacity caused by combination of the high number of patients in hospital with COVID-19 (1624 nationally on Monday 28th March, of which 105 were in UHL), the increased number of delayed transfers of care cases which is partly due to COVID outbreaks in nursing homes and the very high number of people attending EDs in recent weeks.
While attendance and admission numbers are now exceeding pre-pandemic levels, the continued requirement to provide separate Covid-19 and non-Covid-19 pathways presents an additional challenge to patient flow in all hospitals and Emergency Departments.
The HSE is actively working with hospitals and hospital groups to mitigate the situation. The HSE is continuing to utilise capacity in private hospitals and is reviewing elective care to reduce pressure on bed capacity. Patients are requested to use alternatives such as their local pharmacist, GP or minor injury unit as appropriate.
Investment of €1.1bn was provided in budget 2021 to expand capacity, increases services and support reform and this level of investment is being maintained in budget 2022. A further €77 million has been invested in the 2021/22 Winter Plan. To date over 800 additional beds have been provided in acute hospitals since the start of 2020.
It is accepted that a key part of the solution for Limerick is additional beds. The new 60-bed modular ward block at University Hospital Limerick is a significant step in addressing this, and provides modern, single-room inpatient accommodation with improved infection prevention and control capabilities as well as patient flow throughout the hospital.
This follows the completion of two separate rapid-build projects delivered under the Government National Action Plan in Response to Covid-19, which provided an additional 38 inpatient beds on site at UHL.
Furthermore, Project Ireland 2040 includes provision for a 96-bed replacement ward block at UHL. The project has now been tendered in line with public procurement requirements, with tenders returned on 3rd February. The tender evaluation process is currently underway. It is hoped to progress this process in the coming weeks with a view to then seeking HSE Board approval for the award of the works contract.
The Department and the HSE will continue to work with local hospital management to further improve patient experience in UHL.
39. Deputy Ruairí Ó Murchú asked the Minister for Health if he will provide an update on the status of the home care pilot project in CHO 8; and if he will make a statement on the matter. [16684/22]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
40. Deputy Gino Kenny asked the Minister for Health the reason for the absence of records relating to the selection of the Mater hospital for the new national trauma centre; and if he will make a statement on the matter. [17018/22]
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.
41. Deputy John Lahart asked the Minister for Health if his Department will continue to fund a service (details supplied) as a result of the wind-down of Covid-19 services in Dublin 24; and if he will make a statement on the matter. [13009/22]
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.
42. Deputy Joe Flaherty asked the Minister for Health if he will provide a report on community specialist teams for older persons. [16863/22]
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.
43. Deputy Jim O'Callaghan asked the Minister for Health when he expects palliative care services to return to pre-pandemic levels. [16851/22]
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.
44. Deputy Michael Moynihan asked the Minister for Health the way that neuro-rehabilitation services are being developed in 2022; and if he will make a statement on the matter. [16777/22]
Amharc ar fhreagraAs this question relates to a service matter I have asked the HSE to respond to the Deputy directly.
45. Deputy Niamh Smyth asked the Minister for Health the action that is being taken to address lengthy waiting times that children are experiencing for services in occupational therapy, psychology, physiotherapy and speech and language therapy; and if he will make a statement on the matter. [16775/22]
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.
46. Deputy Steven Matthews asked the Minister for Health the position regarding the departmental review of the dental medical card scheme; if a timeline will be provided for its completion; his plans to alleviate access issues to dentists for medical card holders in the short term; and if he will make a statement on the matter. [16780/22]
Amharc ar fhreagra70. Deputy David Cullinane asked the Minister for Health his plans for arresting the collapse of the dental treatment services scheme; and if he will make a statement on the matter. [16800/22]
Amharc ar fhreagraI propose to take Questions Nos. 46 and 70 together.
The Dental Treatment Services Scheme (DTSS) is available to medical card holders aged 16 and over. I recognise that the DTSS, which dates from the 1990s, needs to be reviewed and aligned with best international evidence and practice, and legislation, as outlined in Smile agus Sláinte, the National Oral Health Policy. Regretfully, the COVID-19 pandemic caused the roll-out of the Policy to be delayed and the proposed review of the DTSS contract to be deferred. Work on a substantive review of the DTSS Contract will commence by the end of Q2, 2022. I have also acknowledged immediate issues of concern with the Scheme, which I am addressing as a matter of priority. Officials from my Department and from the HSE have held three rounds of discussions with the Irish Dental Association, the most recent on 2nd March when my Department and the HSE presented proposals to invest additional resources in the Dental Treatment Services Scheme.
I have now given approval for significant fee increases to be paid to contracted dentists across a number of items, including the Dental Examination and Fillings. I have also approved the reintroduction of Scale and Polish for medical card patients on the DTSS. These new measures are designed to address access problems for patients, and address dentist’s concerns about the viability of the DTSS, while aligning the DTSS more closely with the Dental Treatment Benefits Scheme, which is widely operated by private dentists for PRSI patients.
These measures should amount to an additional investment this year of about €26 million over what was spent on the Scheme in 2021. My Department and the HSE will work together to quickly implement the changes to the Scheme for the benefit of patients.
47. Deputy Seán Haughey asked the Minister for Health if he will report on the specialist group on youth mental health transitions from child to adult mental health services under the Sharing the Vision plan; and if he will make a statement on the matter. [16778/22]
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.
48. Deputy Michael Moynihan asked the Minister for Health the action that is being taken to address long waiting times in neurology; and if he will make a statement on the matter. [16776/22]
Amharc ar fhreagraIt is recognised that waiting times for scheduled appointments and procedures have been affected by the Covid-19 pandemic. While significant work continues to positively impact on waiting times and improve pathways to elective care, acute hospitals have been impacted by operational challenges arising from surges in cases related to the Omicron variants.
The HSE has confirmed to the Department that patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.
The Department of Health continues to work with the HSE and the National Treatment Purchase Fund (NTPF) to identify ways to improve access to care, including through increased use of private hospitals, funding weekend and evening work in public hospitals, funding “see and treat” services, providing virtual clinics, and increasing capacity in the public hospital system.
The 2022 Waiting List Action Plan, which was launched on the 26th of February, allocates €350 million to the HSE and NTPF to reduce waiting lists. Under this plan the Department, HSE, and NTPF will deliver urgent additional capacity for the treatment of patients, as well as investing in longer term reforms to bring sustained reductions in waiting lists.
The plan builds on the successes of the short-term 2021 plan that ran from September to December last year. The 2021 plan was developed by the Department of Health, the HSE and the NTPF and was driven and overseen by a senior governance group co-chaired by the Secretary General of the Department of Health and the CEO of the HSE and met fortnightly.
This rigorous level of governance and scrutiny of waiting lists has continued into this year with the oversight group evolving into the Waiting List Task Force. The Task Force will meet regularly to drive progress of the 2022 plan.
This is the first stage of an ambitious multi-annual waiting list programme, which is currently under development in the Department of Health. Between them, these plans will work to support short, medium, and long term initiatives to reduce waiting times and provide the activity needed in years to come.
Waiting list reductions and maximum waiting time targets apply to all acute hospital scheduled care active waiting lists. The HSE is engaged with hospital groups in a process to focus on specialties and procedures towards which the waiting list fund needs to be specifically directed to ensure the targets are achieved by year end.
49. Deputy Joe Flaherty asked the Minister for Health the number of additional home support hours that are being provided in 2022 for persons living with dementia. [16862/22]
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.
50. Deputy Barry Cowen asked the Minister for Health if he will report on the implementation plan for Sharing the Vision – A Mental Health Policy for Everyone. [16858/22]
Amharc ar fhreagraOn 23 March 2022, Minister Butler, in conjunction with the HSE launched Sharing the Vision: Implementation Plan 2022 - 2024.
Sharing the Vision - A Mental Health Policy for Everyone, Ireland’s national mental health policy, was published in June 2020. Sharing the Vision aims to enhance the provision of mental health services and supports across a broad continuum, from mental health promotion, prevention and early intervention to acute and specialist mental health service delivery, during the period 2020-2030.
Sharing the Vision Implementation Plan 2022 – 2024 was collaboratively developed by the HSE and the Department of Health, overseen by the National Implementation and Monitoring Committee (NIMC). The NIMC is tasked with the implementation monitoring of the policy. The Plan sets out individual programme pathways of implementation for each of the 100 policy recommendations for the next three years.
The Implementation Plan will build on existing initiatives already underway, for example in the provision of digital mental health services, the continued phased development and rollout of the national clinical programmes, which are at the heart of service improvement, and the ongoing legislative reform through the review of the Mental Health Act.
A whole-of-government National Implementation Monitoring Committee (NIMC) was established in December 2020 to oversee the implementation of the recommendations in the policy and to monitor progress. The NIMC is made up of the NIMC Steering Committee, supported by a NIMC Reference Group of Service Users and Family Members, which has been established, and NIMC Specialist Groups, which have been established in priority areas of development including Youth Mental Health Transitions, Acute Bed Capacity development and also in Women’s Mental Health.
Additionally, there is work ongoing across the HSE and public sector more broadly that aligns to the recommendations of Sharing the Vision, including the Sláintecare Implementation Strategy and Action Plan, (2021-2023) and the Women’s Health Action Plan (2022-2023).
The Government, along with NIMC, the HSE and its partners, remains fully committed to the reform of our mental health system as promised by Sharing the Vision.
A total of €1.149 billion has been allocated to mental health in Budget 2022. Specifically, this Budget is supporting the continued implementation of new developments under Sharing the Vision, including out of hours supports, CAMHS services, crisis resolution team, the national clinical programmes, and specialist mental health services for older people.
