Written Answers Nos. 61-80
61. Deputy Cathal Crowe asked the Minister for Health if he will intervene in the case of fully qualified and competent Ukrainian dentists who are unable to practice in Ireland due to Quality and Qualifications Ireland not recognising their qualifications; and if he will make a statement on the matter. [61131/22]
Amharc ar fhreagraThe Dental Council of Ireland is the regulator for the dental profession in Ireland. The Council is responsible for establishing, maintaining and publishing a Register of Dentists and a Register of Dental Specialists and to provide for the registration and the retention of dentists names in these registers.
I welcome the news that some Ukrainian dentists who are currently living in Ireland wish to practise here. Officials in my Department are in regular contact with the Dental Council on this matter and the Dental Council have advised that it is doing everything it can to expedite the registration of these dentists.
The Dental Council have advised that a new registration process has opened specifically for those who have obtained refugee and temporary protection status in Ireland. This includes individuals granted temporary protection due to the conflict in Ukraine.
This process includes a new mentorship program that allows oral healthcare professionals practise under a period of adaptation where deemed necessary by the Dental Council to gain all the requirements to obtain full registration, such as English language proficiency.
The Dental Council began to issue versioned guidance to mentors and those undertaking a period of adaptation. This allowed applications to be processed more efficiently. The first version was issued on 11 September and the second on the 16 November 2022.
The Dental Council is available to advise any Ukrainian dentist who is seeking to be registered to practice in Ireland.
62. Deputy Verona Murphy asked the Minister for Health the status on the delivery of the 96-bed medical ward block replacement accommodation at Wexford General Hospital; and if he will make a statement on the matter. [61245/22]
Amharc ar fhreagraThe Department of Health has yet to receive any proposals in relation to the 96-bed medical ward block at Wexford General Hospital. However, my understanding is that the HSE is currently compiling a Strategic Assessment Report (SAR) for this proposal to ensure full compliance with the Public Spending code (PSC). As the proposal is forecast to cost in excess of €100m it is expected that this SAR will be submitted to my Department in Q2 2023.
The delivery of capital projects is a dynamic process and is subject to the successful completion of the various approval stages, in line with the new lifecycle approach of the updated Public Spending Code (PSC).
The PSC is designed to ensure that investment decisions are underpinned by a clear policy rationale, and that costs are well understood. In 2019, the PSC was updated and introduced a new project lifecycle, tightening the arrangements for project decision-making, and clarifying the roles of the parties involved including the responsibilities for Sponsoring Agencies and Approving Authorities.
These are defined processes in which all Departments and agencies are subject to and must follow to ensure that Government, as the approving authority for all major projects (i.e., those over costing over €100m) can be satisfied that the project is the best means to achieve a policy goal and that we achieve maximum value for money for the taxpayer.
63. Deputy Rose Conway-Walsh asked the Minister for Health if he will initiate an independent investigation into the performance and service provision of an organisation (details supplied); and if he will make a statement on the matter. [61349/22]
Amharc ar fhreagraThe organisation referenced by the Deputy receives funding from the HSE, under Section 39 of the Health Act, 2004.
Section 39 legally underpins the provision of services similar or supplementary to a service that the HSE may provide. While the Government does provide assistance to organisations that provide services similar or ancillary to services that the HSE may provide, it must be acknowledged that these organisations are privately owned and run.
The provision of these services is managed through an annually reviewed Service Arrangement with the HSE. Therefore, I am referring the PQ to the HSE for direct reply.
64. Deputy Verona Murphy asked the Minister for Health the provisions his Department is taking to secure dental services for medical card holders in County Wexford; when the current dental treatment services scheme will be replaced with a fit-for-purpose scheme; and if he will make a statement on the matter. [61248/22]
Amharc ar fhreagraThe Dental Treatment Services Scheme (DTSS) provides dental care, free of charge, to medical card holders aged 16 and over. I recognise that there is a need to substantively review and reform the DTSS to align with best international evidence and practice, as outlined in the National Oral Health Policy, Smile agus Sláinte (2019).
Work has begun on this review and officials in my Department are engaging with stakeholders. I expect significant further progress to be made in 2023 and have made an unprecedented additional allocation of €15 million in Budget 2023 to support this work and enhance the provision of oral healthcare services next year. This is additional to the €148 million that is already provided for oral healthcare each year across the DTSS, the HSE Public Dental Service and orthodontic services provided by the HSE.
On top of this €15 million allocation, resources will also be made available in 2023 for new clinical leadership posts and for other supporting staff to allow substantive reform of the provision of public oral healthcare services to all ages to commence. The implementation plan for Smile Agus Sláinte will prioritise the alleviation of access issues for oral healthcare.
In recognition of the issues that have been experienced in some parts of the country in accessing oral healthcare, including Co. Wexford, the €15m award includes €5 million to support the HSE to provide care to some of its patient cohorts in 2023, including adult medical card holders who are in need of emergency care and are still struggling to access a local dentist. This is intended to protect patient access to oral healthcare services while the transformative reform programme progresses.
These further measures come on top of a package of measures introduced from 1 May 2022 to expand the Scheme and increase the fees paid to contractors. The numbers of patients being seen, the numbers of treatments being provided and the number of claims being submitted under the DTSS have all increased in recent months.
65. Deputy Duncan Smith asked the Minister for Health if he plans to introduce legislation to allow a mobile supervised injecting centre while the approved injecting centre is being delayed; and if he will make a statement on the matter. [61094/22]
Amharc ar fhreagraIn December 2019, An Bord Pleanála granted planning permission to Merchants Quay Ireland for a medically supervised injecting facility (MSIF). Leave to apply for a Judicial Review of the decision by An Bord Pleanála was granted by the High Court in February 2020.
In November 2021, following a Judicial Review, the planning decision was overturned by the High Court and remitted back to An Bord Pleanála for further consideration. It is not appropriate to comment on or prejudge the outcome of this process.
The legislation providing for the establishment, licensing and operation of supervised injecting facilities is set out in the Misuse of Drugs (Supervised Injecting Facilities) Act 2017 (No 7 of 2017). The Act refers to the operation of a facility in respect of certain premises. It does not provide for mobile injecting facilities.
Furthermore, the Government decision approving the provision of supervised injecting facilities envisages the initial establishment of such a facility in Dublin city centre on a pilot basis. Therefore, there are no plans to amend existing legislation to allow a mobile supervised injecting centre.
I am committed to the establishment of a supervised injecting facility in Dublin city, as a harm reduction and life-saving service.
66. Deputy Brendan Griffin asked the Minister for Health the position regarding the action plan for University Hospital Kerry; and if he will make a statement on the matter. [61306/22]
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.
67. Deputy Michael Moynihan asked the Minister for Health if he will provide a report on the provision of disability respite services in CHO 4 to date in 2022; and if he will make a statement on the matter. [61023/22]
Amharc ar fhreagra74. Deputy Michael Moynihan asked the Minister for Health the status of the provision of a community neuro-rehabilitation team in CHO 4; and if he will make a statement on the matter. [61022/22]
Amharc ar fhreagraI propose to take Questions Nos. 67 and 74 together.
As these are service matters, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
68. Deputy Thomas Pringle asked the Minister for Health the progress that he has made in delivering on the commitment in the programme for Government to deliver further personal assistance hours to persons with disabilities; and if he will make a statement on the matter. [57249/22]
Amharc ar fhreagraThe HSE provides a range of assisted living services including Personal Assistance (PA) Services to support individuals to maximise their capacity to live full and independent lives.
The National Service Plan 2022 outlines the HSE’s commitment to deliver 1.7m hours of PA services to 2,587 people this year. The HSE expects that this target will be met by year end.
This target reflects an additional 120,000 hours of PA services in 2022 to expand and enhance supports for people to live self-directed lives in their own communities.
The Government and the HSE are committed to protecting the level of PA Services available to persons with disabilities. The Government is working to ensure that people with disabilities are enabled to live an independent life of their own choosing, like any other person, in line with the disability reform policy - “transforming lives”.
The HSE has consistently, year on year, increased the number of hours of PA Services delivered to people with a disability (please see table in attachment).
69. Deputy Pádraig O'Sullivan asked the Minister for Health if his attention has been drawn to the non–EU rural GP programme; if his Department and the Government are supportive of same; if the strategic review of GP services that is due to commence shortly will consider this programme; and if he will make a statement on the matter. [60862/22]
Amharc ar fhreagraMy Department are aware of the proposed programme concerned. The strategic review of GP services, which is to commence shortly, will examine the broad range of issues affecting general practice in general and in rural areas specifically, and will identify measures necessary to deliver a sustainable general practice. This programme and other initiatives that could support rural general practice will be considered.
70. Deputy Fergus O'Dowd asked the Minister for Health the total funding allocated under each individual scheme of support for nursing homes during the Covid-19 pandemic; if he will ensure that this funding is audited and the audit findings will be published; if he will carry out an inquiry into the way that nursing homes performed during the Covid-19 pandemic; and if he will make a statement on the matter. [60912/22]
Amharc ar fhreagraThe Government has provided substantial supports to the nursing home sector over the course of the pandemic. Over €145 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.
A robust control framework was put in place for the Temporary Assistance Payment Scheme, including requirements for validation, review of claims by an external accountancy firm, and provision for all claims to be audited and any misallocated funds clawed back for up to six years following. The thresholds also provided a strong control on costs.
Claims to the scheme were administered by the NTPF (National Treatment Purchase Fund). An external audit has been carried out on behalf of the NTPF for the majority of the period during which TAPS has been operating.
Private and voluntary nursing homes also received a substantial package of non-financial assistance throughout the pandemic, including the provision of almost € 72m of PPE, staff accommodation, training, COVID Response Teams and more. Many of these supports continue.
The NTPF and the HSE are currently undertaking an audit of payments and a report will be published when this audit is finalised.
In addition, providers of long-term residential care who participate in the Nursing Homes Support Scheme (NHSS) can, from 11 November, obtain additional funding supports to help meet increased energy costs due to inflation through the Temporary Inflation Payments Scheme (TIPS). Eligible private and voluntary nursing homes can claim for vouched heating and electricity increases of up to €7,000 per month, with 75% of year-on-year cost increases to be reimbursed up to a maximum payment of €5,250 per month per nursing home. Claims for increased energy costs can be backdated to 1 July 2022 which means that each nursing home can apply for up to €31,500 in vouched energy increases. The aim of the new scheme (TIPS) is to alleviate pressures put on nursing homes by an increase in energy prices. The new scheme will run in parallel with the Temporary Assistance Payment Scheme (TAPS). The Temporary Inflation Payment Scheme will be kept under review and further funding of these supports will be looked at towards the end of this year. The Scheme is not intended to be allocated on a per resident cost but rather per nursing home in line with their actual increased costs. As designed, TIPS recognises that individual nursing homes may have different existing arrangements in place with energy providers and therefore experience varying cost increases.
In addition to the significant supports put in place for nursing homes during the pandemic, the situation at both a local and a national level was kept under ongoing and active review. An independent Nursing Homes Expert Panel was established early in the pandemic to examine the management of COVID-19 in nursing homes and provide real-time learnings and recommendations to inform the ongoing response. The Expert Panel reported in August 2020 and significant progress has been made in implementing its recommendations.
The Taoiseach has indicated that a comprehensive evaluation of how the country managed COVID-19 will be undertaken which will provide an opportunity to learn lessons from our experiences in dealing with a pandemic over the past 2 years. This will help ensure that we are in a better, stronger position if another pandemic or another similar type of emergency arrives. Consideration is being given as to what the best model for this evaluation will be.
Separately, the Minister for Health has stated that he believes that a review of the management and impact of COVID-19 in nursing homes is warranted. He has asked the Department of Health to consider the options available for undertaking such a review, taking account of the experience of, and learnings, from other review processes undertaken in recent years.
71. Deputy Mark Ward asked the Minister for Health the number of community disability network teams in Dublin Mid-West; the staffing levels per team; the location of each team; and if he will make a statement on the matter. [61274/22]
Amharc ar fhreagraAs the Deputy's question relates to a service issue, it has been referred to the HSE for direct reply.
72. Deputy Thomas Pringle asked the Minister for Health the status of the review or oversight of safeguarding in County Donegal, promised by the Minister of State of his Department and of the Department of Health, in reply to a topical issue of 5 May 2022, on the Brandon report; and if he will make a statement on the matter. [56755/22]
Amharc ar fhreagraMy primary objective in this regard is to ensure that the recommendations of all relevant reports are being appropriately addressed.
It is worth noting that over the course of 2022, HIQA’s chief inspector undertook an escalated programme to inspect all of the centres operated by the HSE in Co. Donegal, to assess whether the HSE was implementing its improvement plan and whether its actions were effective in improving the services for residents in designated centres. I am advised that this programme of inspection will be completed by the end of the year.
Noteworthy is the fact that as the inspection reports for these centres have been finalised during the year, they have been published on the HIQA website. I am advised that while there have been compliance issues with a number of centres, overall inspectors have found that the HSE is implementing its improvement plan and is progressing with improvements in the quality of support and care to residents. In centres where inspectors have identified non-compliances, they have required the HSE to take action to address areas of concern and have returned to inspect those centres again to verify that there have been improvements.
The chief inspector will provide a more detailed analysis of the inspection programme when it is completed.
This is indeed assurance that improvements are being made. I am, however, keen to see that the recommendations of the various reports concerning CHO/Donegal are being progressed and appropriately maintained. I am actively considering options for an assurance mechanism in this regard.
The findings of HIQA’s regulatory programme, and the mechanisms put in place by the HSE to address the recommendations etc. of various reports concerning CHO1/Donegal, may inform wider safeguarding practice, governance and policy, as appropriate. The ultimate aim, however, is to ensure that services are safe for clients and that those working in the services are appropriately supported.
Separately, the Department of Health is at an advanced stage of developing an overarching national policy to enhance and strengthen adult safeguarding in the health and social care (including disability) sector. The Department plans to launch a public consultation on the draft policy early next year and has allocated €4m in development funding in 2023 to support the introduction of the new policy and to enhance operational safeguarding services within the sector.
73. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Question No. 98 of 20 October 2022, the expected timeline for when he will bring the memorandum regarding the new elective hospital for Galway before Government; if the promised new elective hospital for Galway will be located on the Merlin Park site; if this will be a stand-alone facility, separate from the preferred option recommended in the 2019 options appraisal for model 4 hospital services; and if he will make a statement on the matter. [61355/22]
Amharc ar fhreagraThis week the Government has approved the Enhanced Provision of Elective Care Programme and the preferred locations for the development of new Elective Hospitals in Cork and Galway. In Galway, the preferred site is at Merlin Park University Hospital.
In December 2021 the Government agreed, subject to the necessary approvals and requirements under the Public Spending Code being met, a new National Elective Ambulatory Care Strategy. This new strategy aims to change the way in which day cases, scheduled procedures, surgeries, scans and outpatient services can be better arranged to ensure greater capacity in the future. The initial phase of elective care reform will be focussed on addressing demand for high volume/low complexity procedures and treatments. The Elective Hospitals will also be designed to provide sufficient capacity to facilitate future phases, including some elective in-patient capacity.
The development of additional capacity will be provided through dedicated, standalone Elective Hospitals in Cork, Galway and Dublin. The locations chosen will allow for new facilities of a size and scale to implement a national elective care programme that will tackle waiting times on a national basis. The new facilities will be designed to maximise their capacity and coverage. In doing so they will provide a national service, operating to cover as wide a catchment area as possible, extending beyond existing and future health areas. The introduction of this new delivery capability into the Public Healthcare System will benefit the whole population by providing a sustainable and strategic response to cater for the highly dynamic landscape of healthcare policy and practice.
Following detailed internal and external assurance the Preliminary Project Business Cases for the new Elective Hospitals in Cork and Galway have now received Government approval-in-principle at Decision Gate 1 of the Public Spending Code (PSC). The projects can now move to Gate 2 of the PSC (detailed project brief and procurement strategy). I have asked my officials to engage with the Department of Public Expenditure and Reform to explore options to expedite the delivery of the Elective Hospitals wherever possible.
75. Deputy Jackie Cahill asked the Minister for Health the plans that are in place for a new model of dementia care; and if he will make a statement on the matter. [61050/22]
Amharc ar fhreagraThe HSE's National Dementia Office has developed a draft Dementia Model of Care which outlines care pathways within the Irish health and social care system for people living with dementia, extending from identification of symptoms/signs, through to assessment, diagnosis, disclosure, care planning and post-diagnostic support. It includes all types of dementia, including where impaired memory is not the presenting complaint
The Model of Care sets out a range of targets and practice recommendations to advance treatment, care and support for those living with dementia in Ireland. It has four key elements:
- A diagnostic model which includes pathways to diagnosis and guidance on assessment for clinicians;
- Guidance on disclosure, drawing on national and international best practice;
- Care planning and guidance on personalised care planning processes that are inclusive of the person with dementia and their supporter/carer.
- Post-diagnostic treatment and support across five strands of support.
The Model of Care is underpinned by five core principles: citizenship, person-centred approaches, integration, personal outcomes and timeliness.
A new National Clinical Lead for Dementia has recently been appointed and it is expected that the Model of Care will be published in the first Quarter of 2023.
76. Deputy Verona Murphy asked the Minister for Health if his attention has been drawn to the chronic lack of services within the children's disability network teams; and if he will make a statement on the matter. [61249/22]
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.
77. Deputy Sean Sherlock asked the Minister for Health if he will report on the engagement that he has had on the provision of staffing numbers at children's disability network teams; and if he will make a statement on the matter. [56898/22]
Amharc ar fhreagraFunding has been provided to the HSE for additional posts in recent years to strengthen the capacity of Children’s Disability Network Teams to ensure services can be enhanced. This funding provides for over 600 additional Whole Time Equivalent posts for Children’s Teams throughout the country.
However, HSE Disability Services continue to experience ongoing challenges recruiting and retaining staff across all disciplines and grades on their Children’s Network Teams. Most of the disciplines working in CDNTs are similar to those working in other areas of the health and social care sector, both public and private.
The HSE continues to pursue a range of options to enhance the recruitment and retention of essential staff across all aspects of the health services, such as:
- Targeted National & International Recruitment for CDNTs, to include an agreed relocation allowance where appropriate.
- Both Apprentice and Sponsorship Programmes for therapy grades
- Employment of graduates as therapy assistants as they await CORU registration, and
- Expansion of therapy assistants in the system with HSE supporting individuals to return to education to qualify as therapists.
78. Deputy Richard Bruton asked the Minister for Health if he will report on the improvements in the context of early intervention with children who have need for assessments and for therapeutic intervention. [60832/22]
Amharc ar fhreagraAs the Deputy's question relates to a service issue, it has been referred to the HSE for direct reply.
79. Deputy Robert Troy asked the Minister for Health the plans that are in place to improve and expand disability health services in 2023; and if he will make a statement on the matter. [61180/22]
Amharc ar fhreagraIn recent years, significant resources have been invested by the health sector in disability services. This year, the overall Budget for disability services in 2023 will be €2.4 billion, including a significant level of funding for specialist disability services. Building on the previous year, this is an unprecedented level of funding for Disability services. It follows substantial increases in the budget in 2021 and 2022; and reflects this Government’s commitment to strengthening the funding provided for the disability sector and working to act to address the shortfalls identified in the Disability Capacity Review.
The following increased funding has been provided for 2023:
|
Funding |
Measure |
|
€109m |
To support existing levels of service |
|
€4.3m |
Digital Initiatives/Disability Awareness and Participation Fund |
|
€25m |
Building Capacity (Core Services) |
|
€39m |
One off Costs associated with activity during Covid-19 |
A significant fund of up to €100m has been allocated this year to support community based voluntary organisations 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. Details of the fund including its administration are being finalised.
The HSE, in preparing its National Service Plan, will examine how services, including relevant KPIs, can be progressed in 2023 within the overall increased envelope of funding for disability services.
The Department of Health published the Disability Capacity Review in July 2021. This report set out the capacity requirements for health-funded disability services for the period up to 2032 and it is intended to address the capacity deficits in a phased approach over this period. This reflects the obligation under the UNCRPD for progressive implementation of social, cultural and economic rights.
In order to drive the process of implementing the recommendations of the Capacity Review, a Working Group was set up to develop an Action Plan for Disability Services. This group has now completed its work and the draft Action Plan, which will be an implantation plan for the first phase, is currently being finalised for approval.
In a Primary Care context, the Enhanced Community Care (ECC) Programme is a suite of strategic reform initiatives which seeks to reduce dependency on the hospital system by delivering increased levels of healthcare provision in the community setting, with service delivery reoriented towards general practice, primary care and community-based services. ECC was initially developed in 2019 as part of Sláintecare.
In addition to an annual revenue budget of €195 million, which was allocated in Budget 2022 for the recruitment of staff to the Enhanced Community Care (ECC) Programme, a further €13.8 million was allocated in Budget 2023 to Primary Care for new developments, including for the continued roll out of Programme.
80. Deputy Joan Collins asked the Minister for Health when a full complement of therapists will be provided to a school (details supplied) in Dublin 12. [58408/22]
Amharc ar fhreagraAs the Deputy's question relates to a service issue, it has been referred to the HSE for direct reply.
