Written Answers Nos. 855-874
857. Deputy Pa Daly asked the Minister for Health if he will make an extraordinary payment to University Hospital Kerry staff to ensure that the pandemic bonus payment is made urgently; and if he will make a statement on the matter. [36201/22]
Amharc ar fhreagra858. Deputy Pa Daly asked the Minister for Health the reason that the pandemic bonus payment was not paid to University Hospital Kerry staff on 30 June 2022 as expected; and if he will make a statement on the matter. [36202/22]
Amharc ar fhreagraI propose to take Questions Nos. 857 and 858 together.
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. Payment is currently receiving priority across all Hospital Groups and Community Services in the HSE.
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. 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 the Defence Forces to work in frontline Covid-19 exposed environments for the HSE;
6. Paramedics employed by the Department of Local Government, Housing and Heritage.
Rolling out the payment to eligible employees of those specific non-HSE/Section 38 organisations covered by the government decision 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, but this work is being given priority attention.
859. Deputy Pa Daly asked the Minister for Health if he will provide a 24/7 paediatric oncology consultant to be available in Crumlin for care questions that may arise for outpatients receiving services in or near their home hospitals; and if he will make a statement on the matter. [36203/22]
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.
860. Deputy Pa Daly asked the Minister for Health if he will provide on-site accommodation for those parents and children who must travel more than 50 km to Crumlin for care; and if he will make a statement on the matter. [36204/22]
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.
861. Deputy Pa Daly asked the Minister for Health if he will provide a paediatric oncology ward in University Hospital Kerry to facilitate a more co-ordinated level of care for paediatric cancer patients, including services such as haematology, port and wound dressings, administration of chemotherapy and other care services; and if he will make a statement on the matter. [36205/22]
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.
862. Deputy Pa Daly asked the Minister for Health if he will provide social workers, play therapists and psychologists within University Hospital Kerry in order to help paediatric cancer patients deal with the side effects of their cancer diagnosis and treatment, many of which lead to mental health struggles; and if he will make a statement on the matter. [36206/22]
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.
863. Deputy Mark Ward asked the Minister for Health if he will provide a report on exit interviews conducted in CHO7 for persons’ leaving the health service including the reason; the position the person held; and if he will make a statement on the matter. [36211/22]
Amharc ar fhreagraIn 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.
864. Deputy Ivana Bacik asked the Minister for Health if he intends to compile updated data on the prevalence of autism in Ireland [36218/22]
Amharc ar fhreagra866. Deputy Ivana Bacik asked the Minister for Health if he intends to introduce new guidance for health service providers on the way to meet the needs of persons with autism and their families and carers. [36227/22]
Amharc ar fhreagra867. Deputy Ivana Bacik asked the Minister for Health if he intends to develop further services to address the needs of children and adults with autism; and if the implementation of such services will be informed by feedback from members of the autism community. [36228/22]
Amharc ar fhreagraI propose to take Questions Nos. 864, 866 and 867 together.
As these are service matters, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
865. Deputy Thomas Gould asked the Minister for Health the funding provided respectively to an organisation (details supplied) in Dublin and Cork in each of the past five years in tabular form. [36224/22]
Amharc ar fhreagraMy Department has not made any payments directly to this organisation within the past five years. I have asked the HSE to respond to the Deputy directly with details of any funding it has provided to the organisation for the period in question.
868. Deputy John Lahart asked the Minister for Health the new and or expanded community health services being provided in each county since 27 June 2020, in tabular form; the new health capital projects in each county that have been completed; and if he will make a statement on the matter. [36235/22]
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.
869. Deputy John Lahart asked the Minister for Health the new services and investments that have been provided in each public and voluntary hospital since 27 June 2020; the new capital projects in each county that have been completed in each public and voluntary hospital in tabular form; and if he will make a statement on the matter. [36236/22]
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.
870. Deputy John Lahart asked the Minister for Health if he will outline the main improvements in the provision of mental health services since 27 June 2020; and if he will make a statement on the matter. [36237/22]
Amharc ar fhreagraThe provision of mental health services are in the main a matter for the Health Service Executive and I have requested the executive to respond to the Deputy directly in this regard. From a policy and budgetary point of view the Deputy may also be interested to note the following progress in areas such as enhancing all aspects of our mental health services and supports remains a key priority for Government. There have been significant improvements in the delivery of our mental health services over the past number of years and the Government is committed to ensuring their continued development throughout this year and into the future. I have outlined in my below response some of the key achievements in mental health in recent years.
The Government’s clear commitment to enhancing mental health services, is shown by significant mental health funding increases in recent years. I am pleased to have secured an unprecedented level of funding, totalling, €1.149 billion, for mental health in this year’s budget. This Budget, which is the largest mental health budget in the history of the state, is supporting the continued implementation of new developments under our national mental health policy, 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.
Budget 2022 includes an additional €47 million on 2021, comprising €24 million for new developments, €10 million for mental health initiatives in response to Covid and €13 million for existing levels of service. An additional once off €10 million was announced on Budget Day to further support the mental health sector.
Funding for a number of initiatives has been provided through the additional €10 million An Taoiseach Covid Recovery fund. This includes €2 million for continued enhancement of the HSE Digital Response programme and €0.66 for a collaborative project with Jigsaw to build mental health literacy.
In addition, through the additional once off €10 million announced on Budget Day €1m was provided for MyMind to continue to deliver free of charge counselling sessions, in over 15 languages, to clients impacted negatively by the COVID-19 pandemic. €1m was also provided to Mental Health Ireland to manage a grant scheme on behalf of the Department, to manage a grants scheme for community and voluntary agencies promoting mental health and well-being.
Funding allocated to mental health services in recent years has allowed for the continued investment in the mental health national clinical programmes and models of care, which has led to significant service improvements, including the full implementation of specialist perinatal mental health network provided for and the on-going expansion of specialist mental health teams for eating disorders, ADHD in adults, and dual diagnosis.
Telehealth services are fully established including YourMentalHealth.ie; the information line 1800 111 888, the crisis textline, 50808, and NGO online supports. These include youth specific supports, such as those provided through Jigsaw, SpunOut, and Turn2Me. The majority of telehealth supports are available seven days per week, with some providing 24hour support. In addition, the HSE has partnered with SilverCloud, on a national roll out of digital cognitive behaviour therapy to address depression and anxiety and to make mental health support more widely available.
Importantly, as budgets increase, we need to ensure that we have plans and strategies in place so that those resources are used effectively and efficiently to the benefit of people using our mental health services. All aspects of mental health services are being improved and developed, through Sharing the Vision in the short to longer term. 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.
In terms of implementation and oversight, the National Implementation Monitoring Committee (NIMC) implementation and implementation monitoring structures are well established, enabling policy implementation and governance. The NIMC is made up of the NIMC Steering Committee, supported by a NIMC Reference Group to provide the service user and family member perspective. The establishment of the Reference Group in March 2022 is a key development as it is absolutely vital that people who use our services and their families are at the heart of the design, development and delivery of the systems we build to serve them.
NIMC Specialist Groups, have been established in priority areas of development including Youth Mental Health Transitions, Acute Inpatient Bed Capacity, Women’s Mental Health, Primary Care Mental Health Services and Digital Mental Health.
Sharing the Vision Implementation Plan 2022 – 2024 was published on 23 March 2022. The Plan sets out individual programme pathways of implementation for each of the 100 policy recommendations for the next three years. Additionally, official reporting has commenced with Status Implementation Reports and NIMC Analysis Documents published on a quarterly basis online. As of Q1 2022, 68 of the 100 recommendations are in implementation, with 51 marked on track.
The implementation of Sharing the Vision will build on existing initiatives already underway, for example in the provision of digital mental health services, the continued phased development and rollout of our national clinical programmes, which are at the heart of service improvement, and the ongoing legislative reform through the review of the Mental Health Act.
In mid-2021, the Government approved a General Scheme of a Bill to amend the Mental Health Act. This General Scheme took into account the 165 recommendations of the Expert Group Review of the Act, the observations of key stakeholders such as the Mental Health Commission and the HSE, the results of a 2021 public consultation wherein 100 submissions were received, changes in domestic legislation, most significantly the Assisted Decision-Making (Capacity) Act 2015, and Ireland’s international commitments, including under the European Convention on Human Rights and the UN Convention on the Rights of Persons with Disabilities.
A Mental Health Bill is now being prepared in line with the General Scheme. The Bill will significantly update existing mental health legislation through, inter alia, the introduction of a set of guiding principles for adults and children receiving inpatient treatment, a revised set of criteria for detention, an overhauled approach to consent to admission and treatment, aligning capacity in mental health legislation with the provisions of the Assisted Decision-Making (Capacity) Act 2015, the introduction of a new, discrete Part on the care and treatment of children, and the introduction of additional safeguards for people receiving inpatient mental health treatment. The finalisation and introduction to the Oireachtas of a Mental Health Bill is a priority for the Government and it will be introduced as quickly as possible when drafting concludes, which is expected later this year.
I was very pleased to announce, in November 2020, the extension of Connecting for Life, our national suicide reduction strategy, by four years to 2024. This followed a recommendation from the independent strategy review conducted in 2018. It reflects the many achievements to date and the hard work and dedication of multiple stakeholders. The National Office for Suicide Prevention responsible for the implementation of Connecting for Life and overseen by the Department has a €13 million allocation. The extension and continued implementation of Connecting for Life demonstrates the government’s commitment to addressing suicide and self-harm in our communities.
Following the Programme for Government commitment, the interdepartmental High-Level Taskforce was established by Government last year to enhance links for those in contact with the criminal justice system accessing Mental Health, Addiction or Primary Care services. Significant progress has been made by the Taskforce, under the Chair of former Minister Kathleen Lynch, and a Final Report will be published shortly.
As the question also concerns operational matters, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
871. Deputy John Lahart asked the Minister for Health if he will outline the main improvements in the provision of primary care services since 27 June 2020; and if he will make a statement on the matter. [36238/22]
Amharc ar fhreagraThe development of primary care services – alongside social and community care more broadly – is central to this Government's determination to deliver a high-quality, integrated and cost-effective health care system.
In Budget 2022, the Minister secured annual investment of €195m to enable the continued expansion of primary care services through the Enhanced Community Care (ECC) programme. This level of investment in primary care reform is unprecedented and is intended to address historical capacity deficits in the sector. It forms part of wider efforts to deliver on Sláintecare and the promise of care being delivered in the right place at the right time and as close to home as possible. The ECC programme includes a number of different elements that will bolster primary care services across the country. Amongst other initiatives, the funding will allow for the rollout of 96 Community Healthcare Networks (CHNs) to be completed and enables the continued development of 30 Community Specialist Teams for Older Persons, and 30 Community Specialist Teams for the Management of Chronic Diseases.
79 of the planned 96 CHNs are now in place. It is expected that all 96 networks will be operational by the end of this year.19 Community Specialist Teams for Older Persons are now established, with 8 Specialist Teams for Chronic Disease Management already implemented. Full nationwide coverage by the Community Intervention Teams has been achieved with 21 now operational across the country.
The ECC programme represents a significant expansion in primary care capacity, and will see some 3,500 additional staff recruited overall, with a particular focus on nursing and health and social care professionals. Some 2,000 staff have been recruited, and approximately 1500 staff will be onboarded by year end.
We will also continue to develop new, state of the art Primary Care Centres (PCCs) to support the provision of the very highest standards of primary care. There are now 152 PCCs open nationwide, and 19 more are scheduled to become operational over the course of 2022.
In addition, several measures pertaining to General Practice will be implemented or expanded upon in 2022. The Minister ensured that Budget 2022 provided for the provision of GP care without charges to all children aged 6 and 7. This is the first stage of the phased expansion of GP care without charges to all children aged 12 years and under.
The Chronic Disease Management programme, which commenced in 2020 and was modified to facilitate remote reviews during the COVID-19 pandemic, is also being extended in 2022 to all adult GMS patients, while work is ongoing to explore the potential to further enhance the GP Access to Diagnostics programme introduced in 2021.
These investments and reforms are a demonstration of the commitment to shift the model of healthcare towards a more comprehensive and accessible primary care service in order to deliver better care closer to people’s home in communities across the country.
872. Deputy John Lahart asked the Minister for Health if he will outline the main improvements in the provision of health services for people with a disability since 27 June 2020; and if he will make a statement on the matter. [36239/22]
Amharc ar fhreagraAs the Deputy's question relates to a service issue, it has been referred to the HSE for direct reply.
873. Deputy John Lahart asked the Minister for Health if he will outline the main improvements in the provision of health services for older people since 27 June 2020; and if he will make a statement on the matter. [36240/22]
Amharc ar fhreagraOn Monday 20th June 2022, the HSE published its 2021 Annual Report and Annual Financial Statements. The report and accounts, which is available on the HSE’s website highlight the key health and social services, including older persons services provided by the HSE in 2021 out of a budget of €21.643 billion, including funding to non-statutory agencies of €5.691bn. The 2022 HSE National Service Plan also available on HSE website sets out the type and volume of health and personal social services to be provided by the HSE this year.
The Programme for Government commits the government to ‘Introduce a statutory scheme to support people to live in their own homes, which will provide equitable access to high-quality, regulated home care’. In Budget 2021, I secured additional funding of €150 million for home support to progress the development of a reformed model of service delivery to underpin the statutory scheme for the financing and regulation of home-support services and to provide 5 million additional hours of home support or more than 25% above the 2020 target. The funding for these additional hours has been maintained for 2022.
On 27 April 2021, Government gave approval to the Minister for Health to draft a General Scheme and Heads of Bill to establish a licensing framework for home-support providers. The drafting of the Heads of a Bill is at an advanced stage and it is intended to bring this legislation through the Houses of the Oireachtas at the earliest opportunity. In tandem to this, draft regulations setting out the minimum requirements a home support provider must meet to obtain a licence are also at an advanced stage. A public consultation on these regulations is ongoing.
Testing of a reformed model of service delivery for home-support has commenced in four pilot sites. Last week, I announced the commencement of the recruitment of 128 Care Needs Facilitator posts to progress the national rollout of interRAI as the standard assessment tool for care-needs in the community. It is planned to have these posts in place by the end of Q3 2022. InterRAI standardised outputs will be used to determine prioritisation and levels of care required. A comprehensive and robust operational model for the roll-out of the interRAI has been developed which will facilitate effective, efficient, fair and transparent care needs assessment and planning and appropriate service delivery. A National Home Support Office is in the process of being established. Recruitment to posts to run this new office are at an advanced stage, and office buildings have been sourced.
I am very much aware of the strategic workforce challenges in the home support and nursing homes sector. I have established a Cross-Departmental Strategic Workforce Advisory Group to examine issues such as recruitment, retention, training, pay and conditions and the career development of front-line carers in home support and nursing homes into the future, so that solutions can be identified and implemented. Ensuring an adequate supply of appropriately skilled healthcare support assistants and healthcare assistants is a key objective of this initiative. The Group which is currently engaging with key sectoral stakeholders is committed to providing me with a set of recommendations by September.
Day centres are fundamental to the health and well-being of our older population and play a key role in enabling older people to live independently in their own communities and the reopening of these centres are a priority for me. The re-opening of day care centres following their necessary closure in 2020 began in the second half of 2021 and continues into 2022. About 85% of Day Care Services for Older People are open and have resumed service and by the end of 2022 it is expected that 92% of Day Care Centres will have resumed the service.
In 2021 the HSE has commenced the implementation of the Enhanced Community Care programme which aims to deliver increased levels of healthcare with service delivery reoriented towards general practice, primary care, and community-based services. Work continues on the roll-out and establishment of community healthcare networks and community specialist teams for older people and for chronic disease management. The National Integrated Care Programme for Older Persons (ICPOP) forms part of the ECC Programme and seeks to ensure older people with complex care needs can access care quickly, at or near home, through care pathways specifically designed for older people and targeting Frailty, Falls, and Dementia.
The Integrated Care Programme for Older Persons (ICPOP) has worked with acute hospitals and their local community older person’s services to develop end-to end care pathways for older people with complex care needs.
A total of 30 ICPOP Community Specialist Teams will be established across the country to deliver on the Sláintecare principle of delivering care as close to people’s home as appropriate. Each Community Specialist Team will service a population on average of 150,000 across an average of 3 CHNs. The teams will be co-located together in ‘hubs’ located in or adjacent to Primary Care Centres, reflecting the shift in focus away from the acute hospital towards general practice, a primary care & community-based service model. As of May 2022, 19 of 30 Community Specialist Teams for Older Persons are now established. The full complement of 30 ICPOP teams will be established by Q3 2022
Throughout the pandemic, the overall national response to COVID-19 has had a specific and sustained focus on older persons, and in particular, those resident in nursing homes. This included the establishment of a structured nursing home support system, in line with National Public Health Emergency Team (NPHET) recommendations, to provide enhanced supports to public and private nursing homes. A comprehensive package of direct and indirect supports was established in early 2020 and many of these remain active across the country to support nursing homes on a proactive basis and to respond in the event of a COVID-19 outbreak. Furthermore, an independent COVID-19 Nursing Homes Expert Panel was established in May 2020 to examine the complex issues surrounding the management of COVID-19 in nursing homes. The Expert Panel recommendations have provided a guiding framework not only for the pandemic response in nursing homes over the last two years but also more broadly for a wide-ranging programme of improvement and reform for older persons’ care, in particular in residential care settings. Four Expert Panel Progress Reports have been published to date, the latest published on the 21st of June 2022. This progress report sets out the progress achieved across the 86 recommendations in the Nursing Homes Expert Panel’s report and outlines the plans and structures in place to continue implementation along with details of next steps and timelines. It is available here - www.gov.ie/en/publication/c7f5b-covid-19-nursing-homes-expert-panel-report-implementation-oversight-team/#progress-reports
The Nursing Homes Support Scheme (Amendment) Act 2021 introduced further safeguards into the NHSS, also known as Fair Deal, to further protect the viability and sustainability of family farms and businesses. It also introduced a change which extends the three-year cap on contributions to the sale of a personal residence, removing a disincentive against the sale of a property. My Department has also developed an amendment to reduce the rate of at which rental income is assessed under the NHSS, to remove a disincentive to the rental of vacant homes owned by residents in long-term care. This change will be enacted imminently and the legislation will be commenced once appropriate preparations have been made within the HSE to ensure it can be operated effectively and in a way that addresses concerns I have raised in relation to safeguarding, consent and capacity.
Furthermore, if residents wish to make their properties available to house refugees without charge, this will have no impact on their contributions to the scheme. It is also anticipated that the financial contribution for hosting of temporary protection beneficiaries will be exempt from means-testing under the NHSS, once the related legislation, which is currently with the Oireachtas, has been enacted.
My Department is at an advanced stage of developing a national policy on adult safeguarding specifically for the health and social care sector, the policy will cover all public, private, and voluntary settings including private nursing homes. The Department expects in the near future to announce details of a public consultation with the intention of submitting a costed policy to the Government for its approval around the end of 2022. Any required underpinning legislation will be prepared following Government approval of the new policy.
I have long been an advocate for the development of services for people with dementia and their families and this is representative in the focused investment in these supports and services in recent years. A key commitment of the Programme for Government is to continue implementing the National Dementia Strategy with an aim of improving dementia supports and services so that people living with dementia can live well for as long as possible.
Funding of €12.9million for dementia specific supports and services in 2021 allowed for substantial advancements in the areas of:
- Enhanced Memory Technology Resource Rooms in 9 sites across the country
- Dementia diagnostic services through a specialist regional memory clinic in Cork and four new memory assessment and support services in Mayo, Wexford, Waterford and Sligo
- Enhancement of acute care pathways for people with dementia through the recruitment of more clinical nurse specialists
- The implementation of a National Clinical Guideline on the appropriate prescribing of psychotropic medication for non-cognitive symptoms in people with dementia
- Increased access to in-home day care and support and
- Dementia: Understand Together initiatives
In addition, in November 2021 I officially launched an expansion of the National Dementia Advisor Service. The Dementia Adviser Service provides a key focal point to help people navigate the health and social care system, ensuring they receive the right support at the right time. I was delighted to secure funding for 11 new dementia advisers in 2021, to expand this vital service. This brought the total number of dementia advisers to 28 nationally.
In 2022, an additional €7.3million has been allocated for the continued implementation of the National Dementia Strategy which will work to continue to improve care pathways for people with dementia across the country.
Funding in 2022 will allow for substantial advancements in the areas of:
- 5 new memory assessment and support services and one new regional specialist memory clinic in Galway
- Specialist diagnostic services for people with an intellectual disability through the National Intellectual Disability Memory Service in Tallaght University Hospital
- Enhancement of memory technology resource rooms to demonstrate assistive technology options for people living with dementia
- Implementation of a dementia minimum dataset across all care settings to standardise data collection and reporting
- 6 dementia assistant director of nursing posts (one in each hospital group) to improve quality and safety of care for people with dementia
- 4 additional dementia clinical nurse specialists to improve care pathways in acute care settings
- Undertake the third wave of the Irish National Audit of Dementia in acute hospitals
- Promote brain health and reduce the prevalence and delay the onset of dementia through collaboration with clinical programmes, the understand together campaign and dementia risk reduction group through the provision of a brain health project manager
In addition to the €7.3m for dementia services outlined above, the proportion of new home support hours ringfenced for people with dementia will more than double from 5% in 2021 to 11% in 2022.
Taken together, this will represent 15 million euro of investment dedicated to dementia specific supports and services in 2022, on top of the €12.9m of additional funding in 2021.
874. Deputy Emer Higgins asked the Minister for Health the way that his Department is supporting children with speech and language communication needs in the classroom; and if he will make a statement on the matter. [34862/22]
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.
