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Tuesday, 21 Jun 2022

Written Answers Nos. 831-850

Healthcare Policy

Ceisteanna (831)

Duncan Smith

Ceist:

831. Deputy Duncan Smith asked the Minister for Health his plans to ensure the provision of free contraceptives as a public health issue; and if he will make a statement on the matter. [32583/22]

Amharc ar fhreagra

Freagraí scríofa

The Report of the Working Group on Access to Contraception, published in October 2019, identified the barriers that exist to accessing contraception, which include accessibility, information, workforce capacity and, for a significant number of women just above the eligibility threshold for a full GMS (medical) card, cost.

In consideration of the recommendations of the Joint Oireachtas Committee on the 8th Amendment to the Constitution (JOC8) and the Working Group’s Report, the Programme for Government, 2020 commits to providing free contraception for women, starting with the 17-25 age cohort.  

My Department's Contraception Implementation Group was convened in July, 2021 and has been working with partners, including the HSE, towards ensuring that the scheme will commence in Q3, 2022. Funding of approximately €9m has been allocated for this in Budget 2022.

The scheme will provide for:

- The cost of prescription contraception;

- The cost of necessary consultations with medical professionals to discuss suitable contraception for individual patients and to enable prescription of same;

- The cost of fitting and/or removal of various types of long-acting reversible contraception (LARCs) plus any necessary checks, by medical professionals certified to fit/remove same;

- The cost of training and certifying additional medical professionals to fit and remove LARCs;

- The cost of providing the wide range of contraceptive options currently available to GMS (medical) card holders, which will also be available through this scheme, including contraceptive injections, implants, IUS and IUDs (coils), the contraceptive patch and ring, and various forms of oral contraceptive pill, including emergency contraception.

- The scheme will be open to all 17-25 year-olds ordinarily resident in Ireland. 

Formal consultations with medical representative bodies with regard to service provision under the scheme have commenced and are ongoing. Following advice from the Attorney General's office regarding the legal framework for the scheme, consideration is being given to providing this by way of primary legislation.

The design of citizen engagement information and publicity campaigns to support and promote the roll out of the scheme will be finalised in the coming months, to be launched in the month preceding and during the initial phase of scheme roll-out.

Some access to free contraception is already enabled in some contexts. the National Condom Distribution Service (NCDS), which was established by the HSE Sexual Health and Crisis Pregnancy Programme (SHCPP) in October 2015 and functions as a central point for distributing free condoms and lubricant sachets to HSE services and other organisations working with individuals and groups at increased risk of negative sexual health outcomes. The NCDS was expanded to 3rd level campuses in 2019 and will continue to operate in this context. 

It should be noted that, while oral contraception and various forms of long-acting reversible contraception can be more effective at preventing pregnancy, condoms provide protection against STIs that is not provided by non-barrier forms of contraception.

It is envisaged that continued expansion of the NCDS will be facilitated in line with demand, in order to support the STI prevention and sexual health promotion needs of people living in Ireland.

Health Services Staff

Ceisteanna (832, 833, 834, 835, 884, 885)

Duncan Smith

Ceist:

832. Deputy Duncan Smith asked the Minister for Health the number of persons that are employed in clinical staffing for Child and Adolescent Mental Health Services; and if he will make a statement on the matter. [32584/22]

Amharc ar fhreagra

Duncan Smith

Ceist:

833. Deputy Duncan Smith asked the Minister for Health how far below the optimum staffing levels of clinical staff for the Child and Adolescent Mental Health Services are; and if he will make a statement on the matter. [32585/22]

Amharc ar fhreagra

Duncan Smith

Ceist:

834. Deputy Duncan Smith asked the Minister for Health the current staffing levels of staff for the Child and Adolescent Mental Health Services helpline service; and if he will make a statement on the matter. [32586/22]

Amharc ar fhreagra

Duncan Smith

Ceist:

835. Deputy Duncan Smith asked the Minister for Health how far below the optimum staffing level of staff for the Child and Adolescent Mental Health Services helpline service are; and if he will make a statement on the matter. [32587/22]

Amharc ar fhreagra

Duncan Smith

Ceist:

884. Deputy Duncan Smith asked the Minister for Health the number of consultant child and adolescent psychiatrists that are employed by the HSE; and if he will make a statement on the matter. [32637/22]

Amharc ar fhreagra

Duncan Smith

Ceist:

885. Deputy Duncan Smith asked the Minister for Health how far below optimum levels of staffing of consultant child and adolescent psychiatrists employed by the HSE are; and if he will make a statement on the matter. [32638/22]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 832, 833, 834, 835, 884 and 885 together.

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Question No. 833 answered with Question No. 832.
Question No. 834 answered with Question No. 832.
Question No. 835 answered with Question No. 832.

General Practitioner Services

Ceisteanna (836, 837)

Duncan Smith

Ceist:

836. Deputy Duncan Smith asked the Minister for Health the number of doctors that are working in general practice; and if he will make a statement on the matter. [32588/22]

Amharc ar fhreagra

Duncan Smith

Ceist:

837. Deputy Duncan Smith asked the Minister for Health how far below optimum levels of staffing of doctors in general practice are; and if he will make a statement on the matter. [32589/22]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 836 and 837 together.

General practitioners are private practitioners. There is no prescribed ratio of GPs to patients and the State does not regulate the number of GPs that can set up in a town or community.

No central register exists specifically for GPs working in Ireland, however all doctors in practice in Ireland must be registered with the Medical Council. The number of GPs on the Specialist Division of the Register in General Practice continues to increase – up from 2,270 in 2010 to 4,433 as at 16 June 2022. However, holding registration does not necessarily mean that a medical practitioner is active in general practice at this time, nor does it equate to full time practitioners. 

ICGP data estimates that there are approximately 3,466 GPs working in general practice in Ireland. The number of GPs contracted by the HSE under the GMS scheme has risen from 2,098 in 2008 to 2,551 in June 2022. A further 535 GPs not contracted under the GMS scheme are registered to provide other services including the Primary Childhood Immunisation Scheme, Health Amendment Act 1996, Heartwatch, Methadone Treatment Scheme and the National Cancer Screening Service.

The HSE National Doctor and Training publication Medical Workforce Planning Future Demand for General Practitioners 2015-2025 predicted that by 2025 the shortage of GPs in Ireland would range from 493 to 1,380 depending on increased levels of access to free GP care. It notes that to address this shortfall through training of GPs in the State would require significant increases to the annual intake for GP postgraduate specialist training.

The number of GPs entering training has increased steadily over the past number of years, rising from 120 in 2009 to 233 in 2021, with 258 places available in 2022. The transfer of GP training from the HSE to the Irish College of General Practitioners (ICGP) which was concluded in 2021 will allow for the introduction of a new service model for GP training in Ireland and the further expansion GP training capacity in the years ahead. The ICGP aims to have 350 training places available for new entrants per year by 2026. 

The 2019 GP Agreement includes a commitment to undertake a strategic review of GP services within the lifetime of the Agreement, to examine how best to ensure the provision of GP services in Ireland for the future.  The review will examine the broad range of issues affecting general practice and will set out measures necessary to deliver a sustainable service into the future. The outcome of this review will inform future contractual changes, with preparatory work for the review having begun this year.

Question No. 837 answered with Question No. 836.

Health Services Staff

Ceisteanna (838)

Duncan Smith

Ceist:

838. Deputy Duncan Smith asked the Minister for Health the number of medical scientists that are employed in HSE laboratories across the country; and if he will make a statement on the matter. [32590/22]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.

Health Services Staff

Ceisteanna (839)

Duncan Smith

Ceist:

839. Deputy Duncan Smith asked the Minister for Health how far below optimum levels of staffing of medical scientists in HSE laboratories across the country are; and if he will make a statement on the matter. [32591/22]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.

Health Services Staff

Ceisteanna (840)

Duncan Smith

Ceist:

840. Deputy Duncan Smith asked the Minister for Health the number of section 39 healthcare workers that are employed by the HSE nationwide; and if he will make a statement on the matter. [32592/22]

Amharc ar fhreagra

Freagraí scríofa

Under Section 39 of the Health Act 2004, the HSE provides financial assistance to organisations to provide services similar or supplementary to a service that the HSE may provide. However, Section 39 organisations are privately owned and run, and staff in these organisations are not public servants. The HSE does not directly employ Section 39 workers. The HSE and the Department of Health do not have access to information relating to the numbers of staff employed in Section 39 organisations.

Health Services Staff

Ceisteanna (841)

Duncan Smith

Ceist:

841. Deputy Duncan Smith asked the Minister for Health how far below optimum levels of staffing of section 39 healthcare workers across the country are; and if he will make a statement on the matter. [32593/22]

Amharc ar fhreagra

Freagraí scríofa

Under Section 39 of the Health Act 2004, the HSE provides financial assistance to organisations to provide services similar or supplementary to a service that the HSE may provide. However, Section 39 organisations are privately owned and run, and staff in these organisations are not public servants. The HSE does not directly employ Section 39 workers. The HSE and the Department of Health do not have access to information relating to the numbers of staff employed in Section 39 organisations.

Covid-19 Pandemic Supports

Ceisteanna (842)

Duncan Smith

Ceist:

842. Deputy Duncan Smith asked the Minister for Health the number of healthcare workers that have received the Covid-19 pandemic bonus payment; and if he will make a statement on the matter. [32594/22]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.

Covid-19 Pandemic Supports

Ceisteanna (843)

Duncan Smith

Ceist:

843. Deputy Duncan Smith asked the Minister for Health the number of healthcare workers that are still waiting to receive the Covid-19 pandemic bonus payment; and if he will make a statement on the matter. [32595/22]

Amharc ar fhreagra

Freagraí scríofa

Firstly I would like to extend my sincere gratitude to all healthcare workers for their efforts during this most challenging period. 

On January 19th, the Government announced a COVID-19 pandemic recognition payment for frontline public sector healthcare workers, to recognise their unique role during the pandemic. Following extensive engagement with healthcare unions on the matter, on 19th April the HSE published eligibility guidelines and FAQs, as apply to the HSE and Section 38 agencies, which are available on its website:www.hse.ie/eng/staff/resources/hr-circulars/hr-circular-012-2022-pandemic-special-recognition-payment.html 

I am assured by HSE officials that all services are in the process of actioning the payment of this recognition payment to those staff that have been deemed eligible to receive it, and that this is receiving priority across all Hospital Groups and Community Healthcare Organisations. 

Figures from the HSE show that by 17 June, 33,431 eligible HSE staff had received payment. This figure does not include eligible staff of Section 38 organisations, many of whom have received payment also, including staff of Beaumont Hospital, Mercy University Hospital Cork, Rotunda Hospital, South Infirmary Victoria University Hospital Cork.

Additionally, the HSE and the Department are currently examining progressing the rollout to the list of 6 non-HSE/non-Section 38 organisation types covered by the Government Decision. Rolling out the payment to eligible non-HSE and non-Section 38 employees is a complex task, particularly as these employees are not normally paid by the public health service, duplicate payments need to be avoided, and there are many organisations to be covered.

Officials in the Department and the HSE are prioritising the work needed to progress this. It is hoped that information will be published shortly for those certain non-HSE/S38 healthcare employees that are covered by the Government Decision and the process available to their employers to implement this measure for their eligible staff. This shall cover eligible staff in:

1. Private Sector Nursing Homes and Hospices (e.g. Private, Voluntary, Section 39 etc.);

2. Eligible staff working on-site in Section 39 long-term residential care facilities for people with disabilities;

3. Agency roles working in the HSE;

4. Health Care Support Assistants (also known as home help / home care / home support) contracted to the HSE;

5. Redeployed members of Department of Defence to work in frontline Covid-19 exposed environments for the HSE;

6. Paramedics employed by the Department of Local Government, Housing and Heritage.

The Department is not yet aware of the exact number of employees who would meet the eligibility criteria in the above organisations.

Health Services Staff

Ceisteanna (844)

Duncan Smith

Ceist:

844. Deputy Duncan Smith asked the Minister for Health the number of lactation consultants that are employed by the HSE; and if he will make a statement on the matter. [32596/22]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.

Health Services Staff

Ceisteanna (845)

Duncan Smith

Ceist:

845. Deputy Duncan Smith asked the Minister for Health how far below optimum levels of staffing of lactation consultants employed by the HSE are; and if he will make a statement on the matter. [32597/22]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Medical Cards

Ceisteanna (846)

Duncan Smith

Ceist:

846. Deputy Duncan Smith asked the Minister for Health the status of the proposal announced in Budget 2022 to extend the automatic entitlement to free general practitioner visit cards to children under eight years of age as of June 2022; and if he will make a statement on the matter. [32598/22]

Amharc ar fhreagra

Freagraí scríofa

My officials and the HSE are engaged in preparatory work for the commencement of the initial stage of the phased expansion of GP care without fees to all children aged 12 years and under, the provision of GP care without fees to all children aged 6 and 7.  Consultations with the IMO, representing GPs, are currently underway with the intention of introducing this service this year.

Health Services Staff

Ceisteanna (847)

Duncan Smith

Ceist:

847. Deputy Duncan Smith asked the Minister for Health the number of midwives that are employed by the HSE nationwide; and if he will make a statement on the matter. [32599/22]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.

Health Services Staff

Ceisteanna (848, 855)

Duncan Smith

Ceist:

848. Deputy Duncan Smith asked the Minister for Health how far below optimum levels of staffing of midwives employed by the HSE are; and if he will make a statement on the matter. [32600/22]

Amharc ar fhreagra

Duncan Smith

Ceist:

855. Deputy Duncan Smith asked the Minister for Health how far below optimum levels of staffing of nurses employed by the HSE are at; and if he will make a statement on the matter. [32608/22]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 848 and 855 together.

The Safe Staffing Framework is an evidence-based methodology to determine the required nursing workforce and skill mix based on patient acuity and dependency. The Framework for Safe Nurse Staffing and Skill Mix in General and Specialist Medical and Surgical Care Settings in Ireland 2018 (Phase 1) was launched in 2018 and The Framework for Safe Nurse Staffing and Skill Mix in Adult Emergency Care Settings in Ireland 2022 (Phase 2) was launched on the 2 June 2022 (www.gov.ie/en/collection/bebf28-taskforce-publications/).

Phase 3 of the Framework for Safe Nurse Staffing in Community settings includes (i) Long-Term residential care settings for older persons, (ii) Community care settings, and (iii) Step-down and Rehabilitation settings.

As the Deputy may be aware, my Department is currently testing the first part of Phase 3 of the Safe Nurse and Skill Mix Framework in Long-Term residential care settings for older persons. Based on the evidence and in line with the recommendation of the  COVID-19 Nursing Home Expert Panel, Phase 3 (i) will, in line with other phases, be developed into a national policy for broader implementation. 

The Safe Staffing Framework does not include determining the required midwifery workforce and skill mix. 

As the staffing levels of nurses and midwives employed within the HSE is an operational matter for the HSE, I have asked the HSE to respond directly to the Deputy. 

Health Services Staff

Ceisteanna (849, 850)

Duncan Smith

Ceist:

849. Deputy Duncan Smith asked the Minister for Health the number of consultants specialising in endometriosis care that are employed by the HSE; and if he will make a statement on the matter. [32601/22]

Amharc ar fhreagra

Duncan Smith

Ceist:

850. Deputy Duncan Smith asked the Minister for Health far below optimum levels of staffing of consultants specialising in endometriosis care employed by the HSE are; and if he will make a statement on the matter. [32602/22]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 849 and 850 together.

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Question No. 850 answered with Question No. 849.
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