Written Answers Nos. 282-301
282. Deputy Willie O'Dea asked the Minister for Health his plans to tackle the long waiting lists for audiology tests; his plans to establish a Departmental working group to assist in developing a cohesive, efficient and caring strategy that addresses the hearing needs of the Irish adult population and in turn, reduces the financial health burden on the State in the coming years; and if he will make a statement on the matter. [53946/22]
Amharc ar fhreagraThe National Audiology Review Group (NARG) Report, published by the Health Service Executive (HSE) in 2011, identified shortcomings in audiology services including access issues, poor information, inadequate staffing, and unacceptable waiting times and made recommendations to address these issues.
While many of these recommendations have been implemented, including the rollout of a National Audiology Clinical Management system for community and acute services, there is still much work to do in relation to the community audiology waiting lists. These have been exacerbated by the COVID-19 pandemic and the HSE is actively looking at all options to increase activity and minimise patient wait times nationally.
The proposal to establish a working group to assist in developing an updated strategy that addresses the hearing needs of the Irish population will be considered by the Department.
As this PQ also raises a service matter in regard to the audiology waiting lists, I have asked the HSE to respond to the Deputy directly, as soon as possible.
283. Deputy Róisín Shortall asked the Minister for Health if he will outline the psychiatric services in Dublin, which are working with children and adolescents, outside the Dublin CAMHS units; if he will provide an outline of the various services provided, including by consultant psychiatrists, psychiatrists, junior doctors, registrars; the oversight mechanisms in place (details supplied); and if he will make a statement on the matter. [53948/22]
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.
284. Deputy Paul Murphy asked the Minister for Health if he will provide the list of 128 nursing homes of concern that HIQA provided the HSE as stated by the 2020 expert panel; the number of those homes that went into crisis and the death rate in those homes in tabular form. [53949/22]
Amharc ar fhreagraAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
285. Deputy Paul Murphy asked the Minister for Health if he will confirm the number of those homes received HSE support in relation to the list of 128 nursing homes of concern that HIQA provided the HSE provided as stated by the 2020 expert panel and if any of those homes refused HSE support. [53950/22]
Amharc ar fhreagraAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
286. Deputy Paul Murphy asked the Minister for Health the supports the HSE provide to a nursing home in Dublin 7 (details supplied) from 2020 to 2022; the reason this support was provided; when did the home request support; on what grounds and the date the HSE provided this support. [53951/22]
Amharc ar fhreagraAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
287. Deputy Paul Murphy asked the Minister for Health the number of concerns that were received from directors of nursing regarding the non-transfer of residents to hospital who they felt had potential to benefit from hospital treatment. [53952/22]
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.
288. Deputy Eoin Ó Broin asked the Minister for Health if further funding will be made available to a nursing home (details supplied) to enable it to cover increasing costs and to avoid it being forced to increase fees. [53965/22]
Amharc ar fhreagraI am acutely aware of the specific challenges faced by the nursing home sector related to price inflation and increased energy costs. It is imperative that nursing homes manage potential cost pressures in line with their regulatory and contractual responsibilities, maintaining their quality of care so that residents’ lived experience and comfort is not affected.
The Government has provided substantial supports to the nursing home sector over the course of the pandemic. Over €144 million has been claimed by nursing homes under the Temporary Assistance Payment Scheme (TAPS) since its introduction in 2020. The Government has now agreed to extend TAPS to the end of the year by maintaining the availability of Outbreak Assistance support.Substantial additional supports have also been provided by the HSE in terms of serial testing, PPE, the deployment of specialist teams and other services. Many of these supports continue.
Budget 2023 saw an additional €180 million of funding for services for older people for winter 2022 and into 2023, building on unprecedented increases of recent years. This will bring investment in these services to over €2.4 billion in 2023, including nearly €12 million of new developments. Prior to Budget Day I stated that my priority was to secure additional funding for Budget 2023 to ensure the continuation of all services to a high standard. Long-term residential care will be supported through additional funding for the Nursing Homes Support Scheme (NHSS) to maintain services and manage inflationary increases.
In addition, a significant fund of up to €100m has been allocated this year to support community based service providers who are such an essential pillar in the provision of Health services across country. This fund is being made available in recognition of the challenges being faced by the sector in delivering and maintaining key health and social care services against a backdrop of increased inflationary pressures affecting energy, heating and related costs. These organisations are funded through the HSE to deliver a range of health and social care services on behalf of the HSE to communities around Ireland. This includes residential, day and ancillary services for people with a disability, older people, mental health services, palliative care services, addiction services and other health and social care services provided in the community.
The details of the plan are being finalised. It is proposed that the inflation support fund will be administered by the HSE utilising the mechanisms in place for funding eligible organisations in receipt of Service Level Arrangements and Grant Aid Agreements. These arrangements are already in place with organisations that provide key health and social care services for people in Ireland. It is proposed that payments will be made to eligible organisations in the final quarter of 2022 to meet the pressures of this coming winter. Many eligible organisations may be already operating within a context of increased inflationary pressures.
For providers of long-term residential care who participate in the nursing home support scheme, funding will be allocated through the established mechanism of the Temporary Assistance Payment Scheme. Precise details of the scheme are being finalised and will be communicated in the coming days.
To address strategic workforce challenges in the nursing home and home care sector, a Cross-Departmental Strategic Workforce Advisory Group (SWAG) was established in March 2022 and published a report on 15 October outlining 16 key recommendations spanning the areas of recruitment and retention, pay and conditions and overall sectoral reform. I strongly endorse the Group’s recommendations to address the critical shortage of care workers in Ireland and a dedicated Implementation Group will start to progress these immediately.
Funding to support people to access services in the sector continues to be provided in line with the long-established statutory mechanisms under the Nursing Homes Support Scheme Act 2009. This is the mechanism established by the Oireachtas to provide for the processes relating to funding under the NHSS and the negotiation of prices for services for private and voluntary providers with the designated State agency, the National Treatment Purchase Fund (NTPF). Maximum prices for individual nursing homes are agreed with the NTPF following negotiations and based on the NTPF’s cost criteria. These criteria include costs reasonably incurred by the nursing home, local market prices, historic prices and overall budgetary capacity.
The NTPF carry out this role independently under the NHSS Act 2009. The NTPF has statutory independence, and there is no role for Ministers or the Department of Health in these negotiations. The Department of Health published a review of the NTPF pricing system in June 2021. It recommended several actions to improve the pricing system which are now being taken forward by the Department of Health and the NTPF.
289. Deputy Sean Sherlock asked the Minister for Health if he will provide the minutes of the meetings held to date by the national working group developing policy and lists on aids and appliances for the year 2021 and to date in 2022; and if he will make a statement on the matter. [53971/22]
Amharc ar fhreagra290. Deputy Sean Sherlock asked the Minister for Health if he will provide any memos related to the establishment of the national working group on aids and appliances. [53972/22]
Amharc ar fhreagraI propose to take Questions Nos. 289 and 290 together.
The release of documents is most appropriately pursued through the Freedom of Information (FOI) process.
Details on how to make an FOI request to the Health Service Executive can be found at the following link:
www.hse.ie/eng/services/yourhealthservice/info/foi/making-a-request/.
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Making a Request - HSE.ie Making a Request under the 2014 Freedom of Information Act. How do I make an FOI request? You must make a request in writing using the following form.www.hse.ie |
291. Deputy Bríd Smith asked the Minister for Health further to Parliamentary Question No. 334 of 20 October 2022, if he will confirm that a person (details supplied) is carrying-out the second phase of the termination of pregnancy legislation review; if he will speak directly to the initial phase which included a report submitted by a UK university on service providers’ experiences of the implementation of legislation; if he will clarify whether this report from the university will be made available to the public; and if he will make a statement on the matter. [53985/22]
Amharc ar fhreagraThe Review of the Health (Regulation of Termination of Pregnancy) Act 2018 commenced in line with statutory and Government commitments in December 2021. The Review will assess the effectiveness of the operation of the legislation and will be conducted in a fair and transparent manner.
The Review has two main phases.
The first phase is comprised of a three-part appraisal of the operation of the Act, focusing on service users, service providers and a public consultation.
The second phase of the Review is being led by an independent Chair, Marie O’Shea BL, who will assess the extent to which the objectives of the 2018 Act have been achieved, including an analysis of the findings of Review’s first phase.
A final report will be submitted to me as Minister in late 2022 for my consideration.
292. Deputy Róisín Shortall asked the Minister for Health if consideration is being given to reforming the nursing homes support scheme, also known as fair deal; if so, the timeline that he is working towards; and if he will make a statement on the matter. [53989/22]
Amharc ar fhreagraPolicy change to the Nursing Home Support Scheme is being taken forward across a number of areas: Assessment of Means
The Government has approved a policy change to the Nursing Homes Support Scheme, also known as “Fair Deal”, to remove disincentive for participants in the Scheme to rent out their principal residence after they have entered long term residential care. The rate of assessment for rental income from all principal residences will be reduced from 80% to 40%. This will be reviewed after six months of operation, with the potential for further amendment after that point. This policy change addresses the commitments made under Housing For All Action 19.8.
The change was made through Committee-Stage amendment to the Regulation of Providers of Building Works and Building Control (Amendment) Bill 2022. The Bill was approved by the Oireachtas on 30 June and signed into law by President Higgins on 5 July. On foot of the legislation and in consultation with the Department, the HSE is currently working to make the necessary administrative, technical and operational changes to the Scheme that will enable this measure to be rolled out imminently.
Financial Supports
Budget 2023 saw an additional €180 million of funding for services for older people for winter 2022 and into 2023, building on unprecedented increases of recent years. This will bring investment in these services to over €2.4 billion in 2023, including nearly €12 million of new developments. Prior to Budget Day I stated that my priority was to secure additional funding for Budget 2023 to ensure the continuation of all services to a high standard. Long-term residential care will be supported through additional funding for the Nursing Homes Support Scheme (NHSS) to maintain services and manage inflationary increases.
The Government has provided substantial supports to the nursing home sector over the course of the pandemic. Over €144 million has been claimed by nursing homes under the Temporary Assistance Payment Scheme (TAPS) since its introduction in 2020. The Government has now agreed to extend TAPS to the end of the year by maintaining the availability of Outbreak Assistance support.
For providers of long-term residential care who participate in the Nursing Homes Support Scheme, funding supports to help meet increased operating costs due to inflation will be allocated from the €100m health sector fund announced in Budget 2023 and will be delivered through the established mechanism of the Temporary Assistance Payment Scheme. Precise details of the scheme are being finalised and will be communicated in the coming days.
Implementation of Policy Reviews
To address strategic workforce challenges in the nursing home and home care sector, a Cross-Departmental Strategic Workforce Advisory Group (SWAG) was established in March 2022 and published a report on 15 October outlining 16 key recommendations spanning the areas of recruitment and retention, pay and conditions and overall sectoral reform. I strongly endorse the Group’s recommendations to address the critical shortage of care workers in Ireland and a dedicated Implementation Group will start to progress these immediately.
Funding to support people to access services in the sector continues to be provided in line with the long-established statutory mechanisms under the Nursing Homes Support Scheme Act 2009. This is the mechanism established by the Oireachtas to provide for the processes relating to funding under the NHSS and the negotiation of prices for services for private and voluntary providers with the designated State agency, the National Treatment Purchase Fund (NTPF). Maximum prices for individual nursing homes are agreed with the NTPF following negotiations and based on the NTPF’s cost criteria. These criteria include costs reasonably incurred by the nursing home, local market prices, historic prices and overall budgetary capacity.
The NTPF carry out this role independently under the NHSS Act 2009. The NTPF has statutory independence, and there is no role for Ministers or the Department of Health in these negotiations. The Department of Health published a review of the NTPF pricing system in June 2021.
The Review of the Pricing System for Long Term Residential Care Facilities was carried out under the oversight of a steering group with representation from various departments and agencies. The group made four recommendations:
- Recommendation 1: formal assessment of using a formulaic approach in the pricing system as set out in Section 4 of the Report.
- Recommendation 2: formal assessment of amending the approach to the assessment of “Local Market Price” to reflect prices within other nursing homes within a certain distance of the nursing home rather than within the same county.
- Recommendation 3: NTPF to engage with nursing homes and their representatives in relation to enhancing the internal NTPF Review process.
- Recommendation 4: amending the process for allowing for high dependency residents when the necessary systems are in place.A steering group has been established to oversee the delivery of the recommendations; this group has met on a regular basis since publication of the review.
The delivery of recommendations 1-3 primarily sit with the NTPF. As per the recommendations of the review, the NTPF is reporting periodically to the steering group on progress in implementing the recommendations. It is recognised, however, that recommendation 4 has dependencies going well beyond the scope of the pricing review. This recommendation is therefore being addressed within the broader context of the reform of older persons' services., with appropriate links established between the pricing review steering group (including shared membership) to ensure that appropriate links are made between this recommendation and the others.
The terms of reference for the group include a final report to be submitted to ministers, reporting on delivery of recommendations 1-4 set out above and making any further recommendations as appropriate.
A Value for Money (VFM) Review on Nursing Home Care Costs has also been carried out under the direction of a Steering Committee with an independent chair. The VFM Review sought to identify, quantify and analyse the reasons for any cost differential between private/voluntary and public nursing homes and, following analysis, to make recommendations for improving the value for money obtained by the Health sector. The review was published in December 2021 and can be viewed by following this link: www.gov.ie/en/publication/3859f-a-value-for-money-review-of-nursing-home-care-costs/
Among the issues raised were the pay costs of staff in nursing homes, the dependency levels of residents, energy costs, and medical supplies charges to the NHSS. The report found that the cost differential is largely driven by variances in staff-to-resident ratios and the skill mix in public and private nursing homes. However, the review also found that establishing like-for-like comparisons was complex and not always possible, especially when considering differences in dependency levels.
The VFM Review made nine recommendations which the Department continues to take forward.
293. Deputy Sean Fleming asked the Minister for Health if he has identified a timeline for updating the Dental Act 1985, as committed to in the national oral health policy in 2019; and if he will make a statement on the matter. [53995/22]
Amharc ar fhreagraI am aware that the Dentists Act 1985 needs to be updated to align with other healthcare profession regulatory legislation. The Act was amended by the Regulated Professions (Health and Social Care) (Amendment) Act 2020, which was signed into law in October 2020.
Legislation to replace the Dentists Act 1985 will provide for comprehensive regulatory governance of the dental profession, in alignment with the National Oral Health Policy, Smile Agus Sláinte. It will also support a range of strategic workforce planning initiatives, including education and training, in the Policy, to underpin the comprehensive service reforms set out.
I have already asked my officials to progress with this work, including the identification of a timeline for completion. Officials are engaging with relevant stakeholders on this.
294. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 248 of 28 September 2022, the status of the payment of the Covid-19 recognition payment to eligible workers in non-HSE and non-Section 38 organisations; if a contractor is in place to assist with payment to cohorts 1-4; the timeline that he is working towards for paying all remaining staff; if payments will be issued before Christmas 2022; and if he will make a statement on the matter. [54000/22]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly.
295. Deputy John McGuinness asked the Minister for Health if he will extend the expiry date on a medical card issued to a person (details supplied) until such time as the card renewal process is completed; and if a positive response will be expedited. [54002/22]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.
296. Deputy Richard O'Donoghue asked the Minister for Health if trained medics amongst the Ukrainian community, including nurses, doctors and so on, could be allowed to practice in centres around the country, provided that they have the relevant paperwork, given that there is a shortage of GPs around the country and that many Ukrainians are finding it difficult to access GP-care; and if he will make a statement on the matter. [54005/22]
Amharc ar fhreagraThe Government is aware of the workforce issues currently facing general practice, including the limited access to GP services in certain areas. It has implemented a number of measures and increased investment in general practice significantly to improve recruitment and retention. Under the 2019 GP Agreement the additional annual expenditure provided for general practice has to date been increased by €206.6m and is set to increase to €211.6m per annum next year when the Agreement is fully rolled out. Furthermore, the number of GPs entering training has increased steadily over the past number of years, rising from 120 in 2009 to 258 in 2022, and following the transfer of GP training from the HSE to the Irish College of General Practitioners (ICGP), the ICGP aims to have 350 training places available for new entrants per year by 2026. This will see an increase in the number of GPs working in the State, improving access to GP services for patients throughout the country.
Officials from my Department have been working closely with colleagues in the HSE and the six health profession regulators to examine ways to support Ukrainian doctors, nurses and others arriving in the State. The regulators fully recognise the importance of assisting health practitioners arriving in the State and have been actively examining the measures that might need to be taken to further support Ukrainian health professionals in Ireland.
The HSE is fully committed to supporting Ukrainians working in healthcare in Ireland and is currently working on providing employment pathways for those with health care qualifications and/ or experience.
The Medical Council is also actively examining the measures required to assist Ukrainian doctors in Ireland with the registration process. It is continuing to work with stakeholders and has a dedicated webpage and email address for Ukrainian doctors.
My Department, along with the Medical Council and the HSE will continue to ensure that all avenues are being explored with a view to enabling Ukrainian qualified doctors to apply for registration, always conscious of the need to ensure that patient safety, is to the fore of any decisions regarding registration.
297. Deputy Richard O'Donoghue asked the Minister for Health if discussions are expected to allow cataract operations to be carried-out privately in Ireland to medical-card patients and reimbursed to persons, in the same way as the Cross-Border Directive (details supplied); and if he will make a statement on the matter. [54006/22]
Amharc ar fhreagraThe Health Act 1970 (as amended) provides for two categories of eligibility for persons ordinarily resident in the country, i.e. full eligibility (medical card holders) and limited eligibility (all others). Adults with full eligibility can access a range of services including GP services, prescribed drugs and medicines, all in-patient public hospital services in public wards, including consultants’ services, all out-patient public hospital services including consultants’ services, dental, ophthalmic and aural services and appliances, and maternity and infant care service.
Persons with limited eligibility are eligible for in-patient and outpatient public hospital services including consultant services, Emergency Department or minor injury care, are subject to certain charges. Other services such as allied healthcare professional services may also be made available to persons with limited eligibility. The EU Cross Border Directive (CBD) provides rules for the reimbursements to patients of the cost of receiving treatment abroad, where the patient would be entitled to such treatment in their home Member State, and supplements the rights that patients already have at EU level. The CBD enables persons resident in the State to access and be reimbursed for healthcare in another Member State by the HSE, provided such healthcare is publicly available within Ireland. Where a person accesses private healthcare in Ireland there is no facility for the cost of that care to be reimbursed by the public health system.
Within Ireland, it is recognised that waiting times for scheduled appointments and procedures have been affected by the Covid-19 pandemic. The 2022 Waiting List Action Plan allocated €350 million to the HSE and NTPF to reduce acute scheduled care waiting lists. Under this Plan, the Department, HSE, and NTPF are delivering additional capacity for the treatment of patients, as well as investing in longer term reforms to bring sustained reductions in waiting lists, including in the area of ophthalmology. The Waiting List Action Plan identifies 15 high volume procedures, one of which is cataract operations, and provides a commitment that by end-2022 anybody waiting more than 6 months who is clinically suitable will receive an offer of treatment by the NTPF. As of the 11th October, 81% of patients waiting for one of the high-volume procedures have been authorized by the NTPF to receive an offer of treatment.
298. Deputy Matt Carthy asked the Minister for Health the reason that speech and language therapy has not been available for in-patients at Monaghan Hospital in recent weeks; when such therapy services will resume; and if he will make a statement on the matter. [54029/22]
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.
299. Deputy Matt Carthy asked the Minister for Health the whole-time equivalent number of speech and language therapists for in-patients that have been available at Monaghan Hospital on the first day of each month from January 2020 to October 2022, in tabular form; and if he will make a statement on the matter. [54030/22]
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.
300. Deputy Thomas Gould asked the Minister for Health the timeframe for temporary facilities expected to be utilised to house the emergency department in the Mercy Hospital; and if he will make a statement on the matter. [54040/22]
Amharc ar fhreagraAs this is a service issue, I have asked the HSE to respond directly to the Deputy.
301. Deputy Fergus O'Dowd asked the Minister for Health the number of independent investigations finalised by the HSE since January 2019; the reason that such investigations were carried out; the persons/companies carrying out the investigations; the cost of same to date; the outcome of these investigations; and if he will make a statement on the matter. [54041/22]
Amharc ar fhreagraAs this is a operational matter I have referred this to the Health Service Executive for direct reply to the Deputy.
