Written Answers Nos. 198-217
198. Deputy Violet-Anne Wynne asked the Minister for Health the steps that his Department is taking the address the nationwide shortage of community pharmacists; and if he will make a statement on the matter. [58393/22]
Amharc ar fhreagraThank you for your question. I understand that currently there are reports of a current workforce issue, particularly in relation to community pharmacy, and am aware of activities being undertaken by various stakeholders, as well as by my department to examine and mitigate this issue.
Pharmacists wishing to practise in Ireland must be registered with the Pharmaceutical Society of Ireland (PSI – the Pharmacy Regulator). The number of registered pharmacists on the Register of Pharmacists held and maintained by the PSI has continued to grow steadily, with an average increase of 187 registrants each year over the past five years. As of 1 November 2022, 6938 pharmacists were registered with the PSI, under established processes based in Irish and EU law.
The Pharmaceutical Society of Ireland (PSI), the independent statutory regulator for pharmacists and pharmacies that operates under the aegis of my department, has been liaising with stakeholders, including the Irish Pharmacy Union (IPU), on efforts being taken within the sector to understand and address the issue. In February 2022, PSI met with a number of superintendent pharmacists and the IPU. The PSI also circulated a survey on behalf of the IPU to all registrants to support efforts to understand and address the issue in the short term. The fieldwork on the research was undertaken online by the IPU between 22 March and 8 April 2022, and resulted in the publication of a report by the IPU. My Department are liaising with the IPU and other stakeholders to assess and consider the recommendations therein and to take action as appropriate.
In developing its Corporate Strategy 2021-2023, the PSI was cognisant of the reports of an increasing risk to the continued availability of a pharmacist workforce. This highlighted a need to focus on community and hospital pharmacy, with a concern being that the issue might be exacerbated into the future. The PSI are currently undertaking a project, due to run across 2022-’23, titled ‘Emerging Risks to the Future Pharmacy Workforce’. This project is set to “assess emerging risks to the continued availability of a professional pharmacy workforce within community and hospital pharmacy in Ireland”.
The European Commission is also currently supporting a health and social care workforce planning strategy and action plan, a health and social care workforce planning model, health and social care workforce projections and gap analysis project. Support includes recommendations for health and social care workforce reforms.
This is a complex problem with many contributing factors and multiple stakeholders. Workforce challenges are being experienced in other sectors nationally, and in the community pharmacy sector in a range of other countries. However, robust data for Ireland is needed to be able to determine the current landscape, assess future health system needs and understand existing sectoral challenges now and into the future. It will be on the basis of gathering and analysing this up-to-date, robust and relevant data, that recommendations can be proposed to address Ireland’s needs as our healthcare system evolves, and in the context of Sláintecare implementation.
I supported the inclusion of pharmacists on the critical skills occupations list and that Minister of State for Business, Employment and Retail, Damien English TD, announced on the 20th June of this year changes made by Statutory Instrument to the employment permits system which includes adding the occupation of Pharmacist to the Critical Skills Occupations List. This means that Pharmacists are now eligible for a Critical Skills Employment Permit.
The Department is engaging with external stakeholders, including the Department of Higher Education, Research, Science and Technology to fully assess the reported issue of shortages in the pharmacist workforce and to identify any necessary actions to be taken in the short, medium and longer term, and will continue to do so. The Higher Education Authority (HEA) sought expressions of interest from higher education institutions interested in building capacity in a number of healthcare disciplines including Pharmacy, under a process designed to respond swiftly to national skills needs. The EOIs were sought from institutions with capability to expand existing courses or create new courses in specified areas in academic years 2024-25 or 2025-26.
Pharmacy is a clinical service provided by highly qualified health care professionals within the community and hospital sectors, and I continue to recognise the key role played and the very significant contribution made by this sector to patients and the public.
199. Deputy Violet-Anne Wynne asked the Minister for Health his plans to recruit a chief pharmacy officer as a matter of priority who can assist in the development and delivery of a strategy for the future of pharmacy care within his Department; and if he will make a statement on the matter. [58394/22]
Amharc ar fhreagraThe Departmentof Health recognises the key role of Pharmacy in the Community, and the significant contribution made by this sector to patient and public health and wellbeing.
My Department has professionally qualified pharmacists among its staff, and they continue to work and engage with, key sectoral stakeholders such as the Pharmaceutical Society of Ireland and the Irish Pharmacy Union to address pharmacy matters in the patient and health system best interest.
Currently there are no active proposals to develop a Chief Pharmaceutical Officer role in the Department of Health. However, I have asked officials to engage with the Irish Pharmacy Union in order to afford them the opportunity to outline their position in relation to such a role. The matter will be kept under review in the context of wider workforce planning considerations.
200. Deputy Violet-Anne Wynne asked the Minister for Health his plans to introduce a fit-for-purpose pharmacy contract, which reflects the needs of patients and supports the practice of community pharmacy; and if he will make a statement on the matter. [58395/22]
Amharc ar fhreagraI value the important role community pharmacists play in our Health Service in the delivery of holistic patient care. I also fully acknowledge that community pharmacists have played a vital role in responding to the health needs of the public during the COVID-19 pandemic.Community pharmacists have ensured the continued availability of a professional, accessible service for the public and have successfully managed to alleviate concerns around continuity of medicine supply. They have also played a central role in the national COVID-19 vaccination rollout – the largest ever undertaken by the state.During the COVID-19 pandemic the HSE established a Community Pharmacy Contingency Planning working group with relevant stakeholders, including the Irish Pharmaceutical Union and the Pharmaceutical Society of Ireland, to support the implementation of all COVID-19 support measures. This group – now called the Community Pharmacy Planning Forum – had examined the operational and clinical challenges confronting community pharmacists during the COVID-19 emergency and played a key role in resolving them to the benefit of the people of Ireland.The work of the Forum has now transitioned to discussing the strategic direction of the community pharmacy profession. These discussions will bring clarity to the role to be played by community pharmacy in the context of Sláintecare. The central objective of SláinteCare is providing the right care, in the right place, at the right time. This means providing more care to patients in the communities in which they live. Community pharmacists will play a vital and increasing role in delivering this care.The ongoing work of the Community Pharmacy Planning Forum will also prove invaluable in the context of future contractual reform. Of course, any publicly funded pharmacy service expansion should address unmet public healthcare needs, improve access to existing public health services, and provide better value for money.I believe there is a real opportunity to work collaboratively, and with other healthcare providers, to make a significant difference to patient outcomes. I welcome the ongoing work of the Community Pharmacy Planning Forum in that regard.
201. Deputy Violet-Anne Wynne asked the Minister for Health if he has any plans to expand pharmacy services to facilitate women with the choice of accessing contraception through a pharmacy without a prescription; and if he will make a statement on the matter. [58396/22]
Amharc ar fhreagraIn accordance with the Programme for Government and Women’s Health Action Plan commitments, the free contraception scheme for women aged 17-25 was launched on Wednesday 14th September.
Funding of approximately €9m has been allocated for the scheme in Budget 2022. Further funding of approximately €32 million is provided, through Budget 2023, to support the contraception scheme and to expand it to include 16-30 year olds in 2023.
The scheme will be widened to include 26-year-olds on 1 January 2023, with 27-30 year olds becoming eligible on 1st September 2023. The expansion of the scheme to 16 year olds is subject todetailed consultation, legal advice and the required legislative amendments, and is also funded from 1st September, 2022. The scheme is currently open to 17-25 year-old women ordinarily resident in Ireland and provides 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 are also 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 legal framework for the scheme is provided by the Health (Miscellaneous Provisions) (No. 2) Act, 2022, which was enacted in July and commenced in September, 2022. Digital information regarding the scheme, how to access it and wider information on contraceptive options is available through www.sexualwellbeing.ie.
Almost 2,000 GPs and over 1,800 pharmacists have entered into contracts with the HSE to be providers under the scheme.
The potential to make some forms of prescription contraception available through pharmacies, without prescription by medical practitioners, was considered as part of the work of the Contraception Implementation Group and is wider than the free contraception scheme.
In Ireland at present, accessing oral contraceptives is regulated and requires a prescription from a medical practitioner. In order to enable pharmacists to dispense such products without the need for a prescription, detailed clinical consideration would be required to ensure that various patient safety issues are fully considered.
Should the expert clinical advice recommend that certain forms of contraception, be made available through pharmacies without the need to attend a GP for prescription, this would require subsequent amendments to current regulatory frameworks.
Following previous engagement with representative groups, my officials have at my direction, submitted a formal request to the relevant clinical experts within the HSE to consider the clinical appropriateness of making some forms of contraception through pharmacies without the need for a prescription. This process is ongoing and the advice of the relevant clinical experts will be considered once it is received.
202. Deputy Violet-Anne Wynne asked the Minister for Health the number of children in Ireland referred and waiting to be seen by CDNT services by county in tabular form; and if he will make a statement on the matter. [58402/22]
Amharc ar fhreagra203. Deputy Violet-Anne Wynne asked the Minister for Health the number of children in Ireland referred and waiting to be seen by CDNT services by length of time waiting in tabular form; and if he will make a statement on the matter. [58403/22]
Amharc ar fhreagraI propose to take Questions Nos. 202 and 203 together.
As these are service matters, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
204. Deputy Violet-Anne Wynne asked the Minister for Health the number of children in County Clare referred and waiting to be seen by CDNT services by length of time waiting in tabular form; and if he will make a statement on the matter. [58404/22]
Amharc ar fhreagra205. Deputy Violet-Anne Wynne asked the Minister for Health the number of children in County Clare referred and waiting to be seen by CDNT services by age in tabular form; and if he will make a statement on the matter. [58405/22]
Amharc ar fhreagraI propose to take Questions Nos. 204 and 205 together.
As these are service matters, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
206. Deputy Violet-Anne Wynne asked the Minister for Health the number of specialist dietitians, nutrition specialists, and therapists specialising in eating disorders working out of Ennis General Hospital in tabular form; and if he will make a statement on the matter. [58406/22]
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.
207. Deputy Violet-Anne Wynne asked the Minister for Health the number of children who have been on the waiting list for Child and Adolescent Mental Health Services in County Clare at the end of each year between 2016 and 2020, in tabular form; and if he will make a statement on the matter. [58422/22]
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.
208. Deputy Violet-Anne Wynne asked the Minister for Health the number of children currently on the waiting list for Child and Adolescent Mental Health Services in County Clare by length of time under 3 months; 3-6 months; 6-9 months; 9-12 months; and in excess of 1 year in tabular form; and if he will make a statement on the matter. [58423/22]
Amharc ar fhreagra209. Deputy Violet-Anne Wynne asked the Minister for Health the number of children currently on the waiting list for Child and Adolescent Mental Health Services in County Clare by age and sex in tabular form; and if he will make a statement on the matter. [58424/22]
Amharc ar fhreagraI propose to take Questions Nos. 208 and 209 together.
As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
210. Deputy Violet-Anne Wynne asked the Minister for Health the number of children currently on the waiting list for eye examinations in County Clare by length of time waiting in tabular form; and if he will make a statement on the matter. [58425/22]
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.
211. Deputy Violet-Anne Wynne asked the Minister for Health the number of children currently on the waiting list for dental examinations and check-ups in County Clare by length of time waiting in tabular form; and if he will make a statement on the matter. [58426/22]
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.
212. Deputy Violet-Anne Wynne asked the Minister for Health the number of children currently on the waiting list for hearing examinations in County Clare by length of time waiting in tabular form; and if he will make a statement on the matter. [58427/22]
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.
213. Deputy Róisín Shortall asked the Minister for Health if his attention has been drawn to a campaign regarding junk food marketing to children (details supplied); the steps that he is taking to address this issue; and if he will make a statement on the matter. [58440/22]
Amharc ar fhreagra214. Deputy Róisín Shortall asked the Minister for Health the status of the public health (obesity) bill; the timeline that he is working towards; the reason for the delay in progressing this piece of legislation; and if he will make a statement on the matter. [58441/22]
Amharc ar fhreagraI propose to take Questions Nos. 213 and 214 together.
The WHO European Regional Obesity Report, published earlier this year, warns of the serious health risks associated with rising levels of obesity. In the European Region, overweight and obesity have reached epidemic proportions, with prevalence levels higher among males (63%) than among females (54%). In Ireland, overweight and obesity pose an increasing challenge, with one in five children and almost 60% of the adult population now living with overweight or obesity, according to the Healthy Ireland Survey, 2019. The Healthy Ireland Survey,2022 is due to be published in the coming weeks and will provide an update on overweight and obesity levels in Ireland, after the COVID-19 pandemic.
The policy instrument for addressing obesity in Ireland is “A Healthy Weight for Ireland’, the Obesity Policy and Action Plan (OPAP), which was launched in September 2016, under the umbrella of the Healthy Ireland Framework, our national policy for health and wellbeing in Ireland.
The OPAP covers a 10-year period, up to 2025, and aims to reverse obesity trends, prevent health complications and reduce the overall burden for individuals, families, the health system, and the wider society and economy. Implementation of the OPAP is overseen by a cross-sectoral and cross-Departmental group, the Obesity Policy Implementation Oversight Group (OPIOG), chaired by the Department of Health. Deliverables under the OPAP are also reflected in a number of key policy documents, including the Sláintecare Implementation Strategy and Action Plan and the Healthy Ireland Strategic Action Plan (HI SAP).
The OPAP recognises that obesity is a complex, multi-faceted issue and needs a multi-pronged solution, with every sector of society playing its part. This is also emphasised by the 2022 WHO European Regional Report. The OPAP also includes most of the recommended policy actions in the WHO 2022 report. Childhood obesity is a key priority under the OPAP, as is reducing the inequalities underlying obesity rates, where children (and adults) from lower socioeconomic groups have not only higher levels of obesity but are also facing challenges in accessing healthy food in the current cost of living crisis. Many initiatives and policies which address different aspects of the complexity of obesity have been developed and progressed over the last number of years. A review of the OPAP is scheduled to be published in the coming weeks, alongside an evaluation of the OPAP undertaken by the Centre for Health and Diet Research, University College Cork for the Department of Health.
The Programme for Government, 2022 includes a commitment to introduce a Public Health Obesity Bill, including examining restrictions on promotion and advertising aimed at children. In relation to the issues around advertising and marketing of unhealthy foods aimed at children, significant work is ongoing at both EU and national levels to restrict such marketing through other channels and the need to introduce a Public Health Obesity Bill needs to be considered in this context.
At an EU level, since 2020, Ireland and Portugal have co-led a Work Package on Restricting the marketing of unhealthy foods to children and adolescents under the EU Joint Action “Best ReMaP” (Best practices in Reformulation, Marketing and public Procurement), working with 15 other Member States which is due to complete its work in 2023. This includes proposing a revised WHO Nutrient Profiling Model for use throughout Europe in implementing the Audio-Visual Media Services Directive. This model will also be used in the EU Codes of Practice templates, adaptable by Member States, for use with non-broadcast media, including digital media; product placement (including multi-buy options) and sponsorship. As part of this Work Package, a Digital Media Monitoring Framework is being developed for EU-wide use.
Member States have also recently established National Intersectoral Working Groups, to facilitate the implementation of the food marketing tools developed by the Joint Action Best-ReMaP and the integration of policies into national legislation after the end of the Joint Action.
An EU Protocol aimed at monitoring unhealthy food marketing to children is well underway which is expected to draw on existing WHO Protocols, address gaps that may exist, and create substantive guidance and hands-on materials to support MS and institutions wishing to carry out food marketing monitoring.
The EU Framework for Action is the final deliverable of the Joint Action Best-ReMaP Work Package 6, expected to be finalized by September 2023. This framework will contain all the tools developed by the Work Package, including the WHO/EU harmonized Nutrient Profiling Model, the EU coordinated monitoring protocol and technical guidance to implement best practices when restricting marketing of unhealthy foods to children as mentioned above.
With regard to current rules in Ireland regarding advertising, sponsorship, product placement and other forms of commercial promotion aimed at children or broadcast in or around children’s programming, these are contained in the Children's Commercial Communications Code (CCCC). This is a statutory broadcasting code issued by the Broadcasting Authority of Ireland pursuant to section 42 of the Broadcasting Act 2009.
In relation to specific legislation which seeks to address the promotion of “junk food”, my colleague, the Minister for Tourism, Culture, Arts, Gaelteacht, Sport and Media, is currently bringing a Bill through the Oireachtas which will do just this. The Online Safety and Media Regulation Bill 2022, which has completed all stages in the Seanad and has passed the first three stages in the Dáil, will dissolve the BAI and establish a new regulator, Coimisiún na Meán. It is understood that it is hoped the Bill will be enacted before year end.
Under the Bill, broadcasting codes will ultimately be superseded by media service codes, which will apply to both video-on-demand and broadcasting services. Furthermore, An Coimisiún will be enabled to make online safety codes which apply to designated online services, such as video-sharing platform services (e.g. YouTube). Similar to broadcasting codes such as the CCCC, media service and online safety codes may provide for the regulation of commercial communications relating to foods or beverages which may be the subject of public concern in respect of the general public health interests of children. The consultation process for a new CCCC is expected to be undertaken by the new Media Commission, Coimisiún na Meán, following the enactment of the Online Safety and Media Regulation Bill. As the Department responsible for public health policy, the Department of Health would expect to contribute to, and be consulted on, the making of any codes by Coimisiún na Meán relating to the advertisement of food or beverages at children.
Accordingly, as the policy objective within the PfG will be achieved should the Online Safety and Media Regulation Bill pass through the Oireachtas, there are no plans at present to bring forward a Public Health Obesity Bill to address promotion and advertising of unhealthy food aimed at children.
215. Deputy Holly Cairns asked the Minister for Health the number of children currently on waiting lists for therapeutic care in each CDNT according to each speciality; the average waiting time for an appointment; and if he will make a statement on the matter. [58454/22]
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.
216. Deputy Holly Cairns asked the Minister for Health if the budget for medical aids and equipment for children is ring-fenced within each CHO budget; if he will provide figures on the breakdown of different types of aids/equipment, for example wheelchairs and walkers, provided by each CHO for the period between 1 January 2019 and 31 October 2022. [58455/22]
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.
217. Deputy Holly Cairns asked the Minister for Health if he will set a national ambition to reduce the number of stillbirths and neonatal deaths. [58456/22]
Amharc ar fhreagraAs the National Women and Infants Health Programme leads on the management, organisation and delivery of maternity, gynaecological and neonatal services, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
