Written Answers Nos. 294-313
297. Deputy Richard O'Donoghue asked the Minister for Health if his Department is considering extending the payment for those health care workers who remain unwell and in cases in which they continue to remain unwell up until July 2023 (details supplied); and if he will make a statement on the matter. [57138/22]
Amharc ar fhreagraThe Department of Public Expenditure and Reform have provided for Special Leave with Pay (SLWP) for the recommended isolation period, for all civil and public servants nationally who contract Covid. SLWP provides for paid leave, including full pay, any fixed allowances payable as well as premium payments.For certain employees who remain unfit to attend the workplace and are suffering from long-Covid, a scheme, specific to the public health service has been introduced to provide for Paid Leave for Public Health Service Employees unfit for work post Covid infection.The HSE have issued the full details of the Scheme to all public health service employers by circular, and employees who meet the criteria for eligibility for the Scheme will have transferred to the new Scheme retrospectively from 1st July 2022. The Scheme is temporary in nature and there is no proposal to extend the scheme beyond the 12 months that commenced on 1st July 2022.
Those who do not meet the eligibility criteria for the temporary Scheme may avail of the provisions of the Public Service Sick Leave Scheme if they remain unwell.
298. Deputy David Cullinane asked the Minister for Health if Children’s Health Ireland sought the use of medical students to work in emergency departments during the October 2022 bank holiday weekend at any of its location; if so, if this is standard practice; the number of occasions on which medical students have been sought for work in emergency departments outside of normal educational practice; and if he will make a statement on the matter. [57146/22]
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.
299. Deputy Éamon Ó Cuív asked the Minister for Health if he intends raising the income thresholds to qualify for a medical card for persons over 70 years of age in view of the 10% rate of inflation during the past year and the consequential rise in State and other pensions; and if he will make a statement on the matter. [57155/22]
Amharc ar fhreagraMedical Card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. The HSE assesses each application on a qualifying financial threshold. This is the amount of money that an individual can earn a week and still qualify for a card and is specific to the individual’s own financial circumstances. Regarding persons aged 70 or older, the medical card assessment is based on gross income. The weekly gross income thresholds for eligibility to a medical card for those aged 70 and over were increased in November 2020 and are currently €550 per week for a single person and €1,050 for a couple. However, It should be noted that those aged over 70 can also be assessed under the general means tested scheme where there are particularly high costs, e.g., medication, nursing home fees. Furthermore, the Deputy may be aware that, since 2015, every individual aged 70 and over has automatic eligibility for a GP visit card.Persons aged 69 and under are assessed under the general means tested medical card thresholds which are based on an applicant’s household income after tax and the deduction of PRSI and the Universal Social Charge. The means assessment determines an applicant’s eligibility allowing for taking account of one’s eligible expenses from their income. Given that this is a net assessment, it means that where one’s income or allowable expenses change there will be an impact on the decision about one’s eligibility. Examples of allowable expenses include rent, mortgage, insurance, childcare, maintenance, nursing home costs, (detailed guidelines are available at: www2.hse.ie/file-library/medical-cards/medical-cards-national-assessment-guidelines.pdf).
It is important to note that certain social welfare payments are not included in the means assessment for a medical card. Where income is from a social welfare payment such as a pension and other sources, some of the social welfare payments are assessed.
In situations where a person’s sole income is derived from a social welfare payment, even where this payment is in excess of the current income thresholds, the person will be awarded a medical card.
I can assure the Deputy that, to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues, including the current medical card income thresholds under review and any changes are considered in the context of Government policy and other issues which may be relevant.
300. Deputy Carol Nolan asked the Minister for Health the private companies that have been contracted to deliver the home support scheme home help service from 2018 to date; the costs paid out for the delivery of these contracts in tabular form; and if he will make a statement on the matter. [57164/22]
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.
301. Deputy Michael Healy-Rae asked the Minister for Health when the HSE will implement the 37.5 working week and the payment of overtime (details supplied) for a mental health nurse; and if he will make a statement on the matter. [57168/22]
Amharc ar fhreagraI have asked the HSE to respond directly to the Deputy on this matter.
302. Deputy David Cullinane asked the Minister for Health if he will advise on the matter raised in correspondence (details supplied); and if the matter will be brought to attention of Rotunda Hospital; and if he will make a statement on the matter. [57169/22]
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.
303. Deputy Neasa Hourigan asked the Minister for Health the number of service-users under the care of the Midleton, Youghal and Cobh, Glenville Adult Mental Health Services in east Cork who have availed of either short-term respite or longer-term placement in nursing-homes or in CHO4 mental health facilities from 1 January 2021; the names of the mental health facilities and the number of service-users transferred to each facility since that time; if the service-user is in single-occupancy or shared rooms in the case of each transfer to either a mental health facility or nursing home since 1 January 2021; and if he will make a statement on the matter. [57174/22]
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.
304. Deputy Willie O'Dea asked the Minister for Health if he will provide dedicated dietitians to work with autistic children given that it is common for autistic children to have issues with food or eating; and if he will make a statement on the matter. [57175/22]
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.
305. Deputy Mary Lou McDonald asked the Minister for Health if his officials have submitted their report regarding the North Inner City Drug and Alcohol Task Force to him. [57177/22]
Amharc ar fhreagraAs you are aware, the Department of Health is committed to addressing the drug and alcohol issues affecting the north inner city in conjunction with community-based service providers and has provided significant additional resources for drug and alcohol services in the area and wider north Dublin region. The Department is continuing to work with stakeholders in the north inner city to establish effective, inclusive, and transparent governance of the task force and of the funding that it allocates.
The Department has concluded a consultation process with members of the task force and other stakeholders on the next steps. This involved a series of meetings with public representatives, statutory and non-statutory members of the task force, frontline community and alcohol projects funded under the ambit of the task force, community and service user representatives, staff employed by the task force company and other stakeholders in the North East Inner City.I understand that a report on the consultation process is currently being drawn up to identify the next steps to establish effective, inclusive, and transparent governance of the task force in the north inner city. I look forward to receiving the report shortly.
306. Deputy Carol Nolan asked the Minister for Health the steps being taken by his Department to support and increase the provision of disability respite in counties Laois and Offaly; and if he will make a statement on the matter. [57036/22]
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.
307. Deputy Richard Bruton asked the Minister for Health the way that waiting lists compare now to the situation prior to the pandemic at the Mater, Beaumont, Cappagh, Temple Street and Blanchardstown; and the way that the waiting list initiative and winter bed initiative will impact on these services. [57187/22]
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 are still impacted by operational challenges arising from the pandemic.
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 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.
For 2023, funding of €443 million is being allocated to tackle Waiting Lists. This includes:
- €123 million in funding for delivery of the HSE Waiting List Action Plan, including priority areas such as Obesity/Bariatrics, Spina Bifida/Scoliosis and Gynaecology, as well as progressing longer-term reforms to sustainably enhance capacity. Other actions in the Action Plan will streamline and reconfigure care pathways.
- €150 million for the NTPF to procure additional capacity to reduce waiting lists.
- €90m for additional short-term measures to address acute scheduled care waiting list backlogs.
The HSE Winter Plan for 2022-23 was published on the 11th of October. The Plan will support acute and community services this winter to respond to anticipated high levels of emergency attendances and admissions across the acute sector, long waiting times in EDs and high occupancy rates across acute hospital settings. The plan is estimated to cost up to €169m to implement.
The Winter Plan adopts a bottom-up approach with bespoke local plans that seek to address hospital specific issues in conjunction with Community Healthcare Organisations.
The measures include:
- the recruitment of 51 emergency medicine consultants and associated support staff. This will represent an increase of just under 50% in the number of emergency medicine consultants in the HSE;
- the overall recruitment requirement in the Winter Plan is for 608 WTEs;
- increased Community Intervention teams, and GP Support and OOH services to reduce the need for attendances at EDs;
- increased community services for mental health, disability and palliative care;
- increased community and acute diagnostics;
- expansion of ambulances services, including completion of implementation of nine Pathfinder teams, and deployment of rapid handover teams to improve ambulance turnaround times; and
- a fund to support local site-specific initiatives.
I have attached a document detailing site specific actions in the Winter Plan for the relevant hospitals mentioned by the Deputy.
Details of waiting lists at The Mater, Beaumont, Cappagh, Temple Street and Blanchardstown hospitals, now and prior to the pandemic are outlined in the attached document.
308. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 680 of 1 March 2022, if he intends to retain the practice of remote telemedicine consultations in respect of abortions; the engagements he has had with the HSE and the chief medical officer; and if he will make a statement on the matter. [57201/22]
Amharc ar fhreagraAs part of the Government’s ongoing efforts to protect public health and limit the spread of COVID-19, the Department of Health and the Health Service Executive (HSE) worked together in 2020 to put arrangements in place to allow termination of pregnancy services in early pregnancy to be provided remotely.
For the duration of the COVID-19 public health emergency, where the need for social distancing, reducing personal contacts and reducing the burden on medical practitioners are paramount, it became possible for a woman to access a termination under section 12 of the Health (Regulation of Termination of Pregnancy) Act 2018 (i.e., before 12 weeks) from her medical practitioner by telephone or video conference consultation.
There is ongoing engagement between the Department of Health and the HSE to monitor service provision, facilitate the smooth-running of the service and resolve any issues that may arise. However, as restrictions began to ease, it became timely to revisit the Model of Care to review its operation and consider whether remote consultation as part of a blended approach to termination of pregnancy care should be continued post the COVID-19 public health emergency period.
At the request of the Department, the HSE conducted a review of the Revised Model of Care for Termination of Pregnancy.
The review of the Model of Care for the Termination of Pregnancy Service found that the majority of providers within primary care feel that a blend of remote and in-person care is optimal.
In-person consultations allow provision of personalised care and allow potential problems to be identified and mitigated, while remote provision improves access for many women and addresses geographical and logistical barriers. It also alleviates some of the difficulty associated with the mandatory 3-day waiting period.
The review found that the provision of a remote consultation as part of the termination of pregnancy service is safe, effective and acceptable to both service users and providers.
The findings of this review are currently being examined as part of a deliberative process. The consideration of appropriate next steps will form part of this process.
309. Deputy Róisín Shortall asked the Minister for Health the status of the Sláintecare consultant contract negotiations; the details of the reported offer (details supplied); the timeline that he is working towards for agreement between both parties; and if he will make a statement on the matter. [57202/22]
Amharc ar fhreagraOfficials of my Department and the HSE have been involved in intensive negotiations with the consultants' representative bodies, the IHCA and the IMO since June under the new Chair appointed at that time, Mr Tom Mallon.
As all parties have agreed that the negotiation process is confidential, I am not going to make any comment on the details supplied, other than to say that the headline is wrong. Similarly, given the agreement on confidentiality, it would not be appropriate to say anything further in relation to the details of the negotiations.
I can confirm that I and the Government are committed to introducing the new contract as soon as possible and in the coming months. From that point all new consultant appointments will be to the Sláintecare Consultant contract.
310. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 724 of 18 October 2022, the timeline that he is working towards for the publication of his amendments to the Health (Assisted Human Reproduction) Bill 2022 to include provisions for international surrogacy; when he expects this Bill to reach Committee stage; and if he will make a statement on the matter. [57203/22]
Amharc ar fhreagraFurther to Parliamentary Question No. 724 of October 18th 2022, as advised, following the publication of the Final Report of the Special Oireachtas Joint Committee on International Surrogacy, an Inter-Departmental Group was established to review the Report’s recommendations, along with other relevant matters, with the aim of determining an agreed policy position and suitable next steps, in the form of a unified Policy Paper and appropriate legislative proposals.
The work of the Group is at an advanced stage and it is envisaged that in the coming weeks Minister McEntee, Minister O’Gorman and myself will be in a position to submit policy and draft legislative proposals for the consideration of Cabinet in respect of both the regulation of international surrogacy and the recognition of past surrogacy arrangements (domestic and international).
It is to be noted that if such policy and legislative proposals are approved by Government they will be required to be formally drafted by the Office of the Parliamentary Counsel. Given the magnitude of the constitutional and legal issues which are likely to arise from such proposals, significant input from the Office of the Attorney General will also be required.
As previously advised, I cannot provide a definitive timeline as to when Committee Stage – which will obviously also involve close scrutiny of, and potential amendment to, the 11 Parts of the published Bill – will be scheduled. Nevertheless, I can assure the Deputy that I wish to progress this much-needed and long-awaited piece of legislation as quickly as possible to ensure both that the goal of providing for a route to formal recognition by the State of past surrogacy arrangements or surrogacy arrangements in other jurisdictions is achieved and that a robust regulatory framework for AHR more broadly is put in place.
311. Deputy Róisín Shortall asked the Minister for Health if he will provide an update on the six regional fertility hubs; the number that are open; the timeline that he is working towards for opening the remaining hubs; the treatments currently available in these clinics and the treatments which will be available once he has legislated for assisted human reproduction; and if he will make a statement on the matter. [57204/22]
Amharc ar fhreagraAs the Deputy will be aware, a commitment to “introduce a publicly funded model of care for fertility treatment” is included in the Programme for Government. The Model of Care for Infertility was developed by the Department of Health in conjunction with the HSE’s National Women & Infants Health Programme (NWIHP) in order to ensure that infertility issues are addressed through the public health system at the lowest level of clinical intervention necessary. This Model of Care comprises three stages, starting in primary care (i.e., GPs) and extending into secondary care (i.e., Regional Fertility Hubs) and then, where necessary, tertiary care (i.e., IVF, and other advanced assisted human reproduction (AHR) treatments), with patients being referred onwards through structured pathways.Phase One of the roll-out of the Model of Care has involved the establishment, at secondary care level, of Regional Fertility Hubs within maternity networks, in order to facilitate the management of a significant proportion of patients presenting with infertility issues at this level of intervention. Patients are referred by their GPs to their local Regional Fertility Hub, which provides a range of treatments and interventions, including: relevant blood tests, semen analysis, assessment of tubal patency, hysteroscopy, laparoscopy, fertility-related surgeries, ovulation induction and follicle tracking.There are five Regional Fertility Hubs currently operational, and these are located at Cork University Maternity Hospital, the Rotunda Hospital, the National Maternity Hospital, the Coombe Women & Infants University Hospital and University Hospital Galway. At this juncture, it is anticipated that the sixth and final Regional Fertility Hub will be in a position to be opened before the end of the year and will be located at Nenagh General Hospital, under the clinical governance of University Maternity Hospital Limerick. Therefore, the completion of Phase One of the roll-out of the model of care will result in fully operational Regional Fertility Hubs at six locations across the country.Phase Two of the roll-out of the Model of Care will see the introduction of tertiary infertility services, including IVF, provided through the public health system. In this regard, funding was secured in Budget 2023 to support access to advanced AHR treatments, including, crucially, to allow the commencement of Phase Two of the roll-out of the Model of Care.This investment will facilitate the first steps to be taken towards the provision of a complete publicly-provided fertility service, which is the ultimate objective of Government. In particular, it will allow the development of the first National Advanced AHR Centre, delivering IVF and ICSI through a wholly public clinic. This is scheduled to open in the early part of 2024 and will provide a nationwide service, with all six Regional Fertility Hubs having equity of access for onward referral to it, via a shared care pathway. Subject to the provision of additional funding in future, it is envisaged that additional National Advanced AHR Centres will be developed and become operational on a phased basis elsewhere in the country.The 2023 allocation will also be utilised to support the Regional Fertility Hubs in order to expand their scope of services next year by introducing the provision of IUI (intrauterine insemination), a significant, yet less complex and less intrusive, component of AHR treatment. Separately, as an interim measure, I have instructed that some funding be made available to support access to advanced AHR treatment via private providers from September 2023. My officials, in conjunction with NWIHP, are now planning for the operationalisation of both the publicly- and privately- provided service, including the development of a national eligibility framework, as well as determining how the interim funding for private treatments will be provided to individual eligible patients. Overall, my Department and the Government is fully committed, through the full implementation of the Model of Care for Infertility, to ensuring that patients always receive care at the appropriate level of clinical intervention and then those requiring, and eligible for, advanced AHR treatment such as IVF will be able to access same through the public health system. The underlying aim of the policy to provide a model of funding for AHR, within the broader new AHR regulatory framework, is to improve accessibility to AHR treatments, while at the same time embedding safe and appropriate clinical practice and ensuring the cost-effective use of public resources.
312. Deputy Róisín Shortall asked the Minister for Health the proposed staffing complement of each regional fertility hub; the number of staff recruited, going through the recruitment process and vacant posts by clinic and role in tabular form; and if he will make a statement on the matter. [57205/22]
Amharc ar fhreagraAs this question relates to service-related matters, I have referred it to the HSE for direct reply to the Deputy.
313. Deputy Bernard J. Durkan asked the Minister for Health when extra homecare help hours can be made available in the case of a person (details supplied); and if he will make a statement on the matter. [57229/22]
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.
