Written Answers Nos. 690-709
690. Deputy Paul Murphy asked the Minister for Health the number of nursing homes that took a case against HIQA to prevent publication of its report since March 2020; and if he will provide the details including the name and county of the homes. [60917/22]
Amharc ar fhreagraProceedings were concluded between HIQA and two nursing home providers during the period set out by the Deputy. One was an application seeking a judicial review of the regulatory judgements of the Chief Inspector contained in a report, the second was an application seeking leave to challenge certain decisions of the Chief Inspector contained in an inspection report. A stay on the publication of the relevant reports was granted, pending determination of the proceedings. Both reports are now published.
There is one further proceeding which is still ongoing, and as such it would not be appropriate for me to comment on the matter.
691. Deputy Paul Murphy asked the Minister for Health the number of safeguarding referrals that HIQA have forwarded to the guards and to the safeguarding teams from March 2020 to date in 2022. [60918/22]
Amharc ar fhreagraThe Health Information and Quality Authority (HIQA) has advised as follows:
All safeguarding issues are reviewed as a matter of priority to determine the most appropriate regulatory action. In situations where substantiated safeguarding issues are identified, providers are required to take action to ensure the safety of residents. If immediate risks to the safety of residents are identified, providers must take immediate action to address these issues and to prevent a recurrence. The Chief Inspector continues to monitor the actions of the provider to ensure they are effective in addressing the safeguarding concerns. The Chief Inspector can, and has, taken further action, up to and including the cancellation of registration, where providers fail to sustain improvements to residents’ safety.
Since 2020, 10 referrals were made to the HSE National Safeguarding Office and two to An Garda Síochána in relation to safeguarding incidents in registered designated centres. A further two situations are currently under review with a view to referral to An Garda Síochána.
In addition, a further 10 referrals were made to the HSE National Safeguarding Office and one to An Garda Síochána in relation to safeguarding incidents in services outside of HIQA’s remit.
692. Deputy Paul Murphy asked the Minister for Health if he will provide details of the blanket DNR (do not resuscitate) that was put in place in nursing homes in March and April 2020. [60919/22]
Amharc ar fhreagraTo ensure that Do Not Attempt Resuscitation (DNAR) orders are made consistently, transparently and in line with best practice, the Health Service Executive (HSE) provides guidance regarding advance care planning including making DNAR decisions. The HSE National Consent Policy 2019 – Part 4 Do Not Attempt Resuscitation - provides a decision-making framework that facilitates the advance discussion of personal preferences.
The Department of Health and the HSE developed a broad range of national ethical and clinical guidance throughout the course of the COVID-19 pandemic with a view to supporting healthcare workers, managers, and policy makers as they navigated their way through the ethical challenges and difficult decisions they were called upon to make during this challenging time.
The Department of Health published an Ethical Framework for Decision Making in a Pandemic in March 2020 which contained a set of ethical principles and procedural values to support and inform policy-makers, health care providers and clinicians in decision-making during the pandemic. Further guidance issued on the delivery and provision of healthcare matters, including Ethical Considerations Relating to Long-Term Residential Care Facilities in the context of COVID-19. This document specifically references blanket policies on DNARs and states – “Blanket policies relating to decisions such as transfer or non-transfer to hospital or Do Not Attempt Resuscitation Orders (DNAR) orders, should a resident become seriously ill due to COVID-19 or any other condition, are inequitable and discriminatory.”
The HSE also published a number of guidance documents to support clinicians. This includes Guidance Regarding Cardiopulmonary Resuscitation and DNAR Decision-Making during the COVID-19 Pandemic published in May 2020. This guidance was applicable to all care environments where services are provided for and on behalf of the HSE including acute hospitals, the ambulance service, community hospitals, residential care settings, general practice and home care. This guidance states - “There should be no discrimination for or against persons who have or are suspected to have COVID-19 in relation to DNAR decisions. Individualised care is at the heart of good clinical practice. The pandemic does not justify any healthcare workers deviating from that approach by making DNAR decisions on a group basis. Such a decision would be contrary to all guidance and human rights principles.”
The purpose of these guidance documents was to support clinicians in their care of patients and service users, including in respect of the making of appropriate clinical decisions. Such decisions, on the provision of healthcare or the transfer to another healthcare facility, are arrived at in consultation between the clinical experts and the resident or his or her representative, and in recognition of the needs and wishes of the resident.
694. Deputy Paul Murphy asked the Minister for Health the role that the geriatricians on the Covid-19 response teams played in engagement with nursing homes which had outbreaks and in the meetings with specific homes, who made decisions on medication and transfer to hospital for residents. [60921/22]
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.
695. Deputy Niall Collins asked the Minister for Health the reason that the waiting time for colposcopy appointments in Limerick is so long; the plans to improve the service availability; and if he will make a statement on the matter. [60936/22]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
696. Deputy Josepha Madigan asked the Minister for Health if his Department is considering adding rare diseases, including spinal muscular atrophy. to the heel prick test for babies; and if he will make a statement on the matter. [60937/22]
Amharc ar fhreagraI am fully committed to supporting our population screening programmes which are a valuable part of our health service, enabling early treatment and care for many people, and improving the overall health of our population.
It is important to be aware that any decisions about changes to our national screening programmes, such as screening for spinal muscular atrophy (SMA), will be made on the advice of our National Screening Advisory Committee (NSAC). This independent expert group considers and assesses evidence in a robust and transparent manner, and against internationally accepted criteria. It is important we have rigorous processes in place to ensure our screening programmes are effective, quality assured and operating to safe standards, and that the benefits of screening outweigh the harms.
The Committee's first Annual Call in 2021 for proposals for new screening programmes or changes to our existing programmes, received a significant response with a total of 53 submissions received. Submissions were received from various sources, including members of the public and patient advocates, and have been undergoing consideration by the committee at its scheduled meetings during 2022.
Significant progress has been made by the Committee in the past 18 months. Most notably, the NBS Programme was expanded earlier this year and now screens for nine conditions following a recommendation from the NSAC to add ADA-SCID to the Programme.
A number of conditions, including SMA, are undergoing active consideration by NSAC. A recommendation regarding further expansion before the end of 2022 is expected, when the final report from HIQA on its Health Technology Assessment (HTA) for the addition of a tenth condition (SCID), is presented to the NSAC at its December meeting.
The NSAC has now launched its Annual Call 2022, inviting members of the public and health professionals to make submissions on screening programmes in Ireland. The Committee also published its Work Programme on its website, setting out the proposals currently being considered as a result of last year’s Annual Call.
697. Deputy Claire Kerrane asked the Minister for Health if he will provide an update on the dental treatment scheme; the number of dentists active in the scheme by county; the number of dentists who having previously left the scheme have returned by county; and if he will make a statement on the matter. [60942/22]
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.
699. Deputy Cian O'Callaghan asked the Minister for Health the current status of the Neuro-Rehabilitation Strategy 2019-2021; the progress of the implementation of the strategy in CHO9; the action that he will take to ensure the effective roll-out of the strategy in the remaining seven CHO areas; and if he will make a statement on the matter. [60979/22]
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.
700. Deputy Neasa Hourigan asked the Minister for Health further to Parliamentary Question No. 561 of 15 November 2022, the duration of placement already spent of each resident of a facility (details supplied) at the time the facility was vacated in April 2020; the number of residents who moved from the facility in April 2020 who remain in residential care; and if he will make a statement on the matter. [60980/22]
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.
701. Deputy Richard Bruton asked the Minister for Health if an evaluation has been carried out of the procurement of supplies during the Covid pandemic to establish the successes and the disappointments of the emergency arrangements used to establish the lessons that can be learnt for the future; and if he will make a statement on the matter. [60985/22]
Amharc ar fhreagraAs the Health Service Executive is responsible for procurement, I have asked them to respond to the Deputy directly, as soon as possible.
702. Deputy James Lawless asked the Minister for Health if the case of a child (details supplied) will be examined; and if he will make a statement on the matter. [60991/22]
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.
703. Deputy Ivana Bacik asked the Minister for Health his views on the adequacy of mobility supports for persons with a disability. [61005/22]
Amharc ar fhreagraAs the Deputy is aware, I committed to a comprehensive review of the DDS as part of a broader review of mobility supports. In order to achieve this objective, Minister O’Gorman agreed in September 2021 that the DDS review should be incorporated into the work of the National Disability Inclusion Strategy (NDIS) Transport Working Group (TWG).
The Working Group, under the Chairpersonship of Minister of State Anne Rabbitte, held a number of meetings across 2022. A draft final report will be considered at its final meeting on 8th December. It is expected the final report will be published soon after.
As part of its engagement in this process, the Department of Finance established an information-gathering Criteria Sub-group (CSG) at the start of this year. Its membership comprised of former members of the DDMBA and Principal Medical Officers (PMOs) in the HSE. Its purpose was to capture their experiences, expertise and perspectives in relation to the practical operational and administrative challenges of the DDS, as well as to explore what alternative vehicular arrangements were available for those with mobility issues based on international experience. The CSG work led to the production of five papers and a technical annex, submitted to the Department of Children, Equality, Disability, Integration and Youth in July 2022.
The main conclusion of the CSG is that the DDS needs to be replaced with a fit for purpose, needs-based vehicular adaptation scheme in line with best international practice. Both I and my Department share this view.
In short, the DDS significantly diverges from international best practice. It does not meet the standards expected of a 21st administrative and operational model. It adheres to an outdated medical-based perspective of disability, requiring individuals to 'prove' their disability in order to access the scheme.
In relation to the argument that the scope of the DDS should be broadened, I do not believe this is either feasible or credible as any change or expansion of eligibility criteria for the DDS will still require an individual to 'prove' they meet that criteria and conversely there will still be individuals that will be deemed not to meet the criteria i.e. the scheme will still adhere to an 'in or out' policy rationale. Such an approach has the potential to make already highly contested Primary Medical Certificate and appeals processes even more difficult, for the HSE, for the DDMBA, and for individuals.
This conclusion, together with design principles and parameters for the new scheme as based on international practice, were incorporated into a response to three questions posed in September 2022 to members of the NDIS Transport Working Group, in respect of proposals for enhanced, new and/or reconfigured supports to meet the transport and mobility needs for those with a disability. I hope that steps to implement these proposals, particularly with respect to introducing a new vehicular adaptation scheme, will be incorporated into the Working Group's final report.
704. Deputy Holly Cairns asked the Minister for Health if he will ensure that all persons with diabetes are provided medical equipment to monitor their sugar levels free-of-charge. [61016/22]
Amharc ar fhreagraThe Health Service Executive (HSE) provides a wide range of medical and surgical aids and appliances free of charge to eligible patients (those with medical cards or on the Long-Term Illness scheme) following assessment by a relevant health professional.
The Community Funded Schemes (CFS) is a collective name for the many products, supports, supplies, appliances and aids that are provided through community services. Provision is based on an appropriate clinical assessment and a determination of the most appropriate products that will meet the eligible person’s needs.
In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE and is primarily based on an assessment of means and is not granted on the basis of any particular condition. In certain circumstances, the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness.
The Long-Term Illness (LTI) scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations specified 16 illnesses covered by the scheme, including diabetes. Under the LTI scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
The CFS provides aids and appliances and assistive technologies to a wide section of the community including older people, people with diverse chronic illnesses, and people with disabilities. Hearing aids, wheelchairs, communication aids, spectacles, prostheses, pill organizers and memory aids are all examples of assistive products.
The actual products and services provided are subject to ongoing assessment and change in line with developments in clinical practice, and as new products are developed and become available to the market.
In order for glucose monitoring devices to be added to the devices available under the CFS national tender arrangements, the relevant marketing authorisation holder needs to apply to the HSE through the national framework application process.
706. Deputy Violet-Anne Wynne asked the Minister for Health his plans to fully resource existing community neuro-rehabilitation teams and if he will set up a community neuro-rehabilitation team in every CHO; and if he will make a statement on the matter. [61038/22]
Amharc ar fhreagra707. Deputy Violet-Anne Wynne asked the Minister for Health the number of CHO areas that have a community rehabilitative team; and the number of members that comprise that service; and if he will make a statement on the matter. [61039/22]
Amharc ar fhreagra708. Deputy Violet-Anne Wynne asked the Minister for Health if persons with multiple sclerosis and Parkinson's disease have access to community rehabilitative teams; and if he will make a statement on the matter. [61040/22]
Amharc ar fhreagraI propose to take Questions Nos. 706 to 708, inclusive, together.
As these are service matters, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
709. Deputy Jackie Cahill asked the Minister for Agriculture, Food and the Marine the number of contracts that Bord na gCon awarded for the rehoming of dogs from January 2018 to November 2022; to whom were they awarded in tabular form; and if he will make a statement on the matter. [60157/22]
Amharc ar fhreagraRásaíocht Con Éireann (RCÉ) is a commercial state body, established under the Greyhound Industry Act, 1958 chiefly to control greyhound racing and to improve and develop the greyhound industry. RCÉ is a body corporate and a separate legal entity to the Department of Agriculture, Food and the Marine.
The question raised by the Deputy is an operational matter for RCÉ and, therefore, the question has been referred to the body for direct reply.
