David Cullinane
Ceist:141. Deputy David Cullinane asked the Minister for Health if he will appoint chief executive officers for regional health area authorities in 2023; and if he will make a statement on the matter. [7558/23]
Amharc ar fhreagraHealthcare Policy
Ceisteanna (141)
Freagraí scríofa
The Government is committed to the implementation of Regional Health Areas (RHAs), as outlined in the Programme for Government. A draft of the detailed implementation plan will be presented to Government in the coming months, and transition to RHAs will take place through 2023.
Funding of €5.6m was approved and allocated to RHA implementation in Budget 2023. This includes funding for the appointment of RHA senior leadership teams. Sanction will be sought from DPER for the creation of six new RHA Chief Executive Officer posts. It is planned to advertise and recruit for these senior posts in Summer 2023. The intention is that RHA CEOs will be selected and appointed in 2023.
Primary Care Centres
Ceisteanna (142)
Cathal Crowe
Ceist:142. Deputy Cathal Crowe asked the Minister for Health if he will provide an update on the provision of primarycare centres and out of hours GP cover, ShannonDoc in County Clare. [7524/23]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Health Service Executive
Ceisteanna (143)
Seán Haughey
Ceist:143. Deputy Seán Haughey asked the Minister for Health when the HSE service plan will be published; and if he will make a statement on the matter. [7522/23]
Amharc ar fhreagraFreagraí scríofa
Following a review of the 2023 National Service Plan, the HSE is revising the plan in line with considerations and feedback provided. I expect to receive a revised NSP shortly for consideration.In line with Act, the NSP, when approved, will be laid before the Houses of the Oireachtas within 21 days. After this the HSE will ensure it is published at the earliest possible time.
Disability Services
Ceisteanna (144)
Richard Bruton
Ceist:144. Deputy Richard Bruton asked the Minister for Health if she is satisfied that available therapeutic resource for children with special needs is properly allocated between completing assessments and delivering therapeutic services; and if she will indicate the key performance targets for the new disability networks, and their capacity to achieve them. [6759/23]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Disability Services
Ceisteanna (145)
Pauline Tully
Ceist:145. Deputy Pauline Tully asked the Minister for Health to detail the full staffing level allocated to Cavan children’s disability network team; the current vacancy rate within this team; to provide a breakdown of the staffing grades within this team, in tabular form; if a new manager has been appointed to this team; if not, the timeframe for a new manager to be appointed and in place; and if he will make a statement on the matter. [7681/23]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Healthcare Infrastructure Provision
Ceisteanna (146)
Martin Browne
Ceist:146. Deputy Martin Browne asked the Minister for Health further to Parliamentary Question 304 of 26 January 2023, if the planned development of a community nursing unit at St. Patrick’s Hospital, Cashel will host 60 beds or 50 beds; the progress that has been made in the design stage for the project since the pandemic interrupted work on this project in March 2020; if the work of the design team has resumed since that interruption; to provide the details of that progress; the funding that has been made available or approved for the project to date; and if he will make a statement on the matter. [7718/23]
Amharc ar fhreagraFreagraí scríofa
As the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
Hospital Staff
Ceisteanna (147)
Duncan Smith
Ceist:147. Deputy Duncan Smith asked the Minister for Health to provide an update, as of February 2023, on the recruitment of additional nursing staff; the number of new nurses that have been employed by the HSE; the number of nurses that have left the service in the last 12 months; and if he will make a statement on the matter. [7766/23]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.
Care of the Elderly
Ceisteanna (148)
Joe Flaherty
Ceist:148. Deputy Joe Flaherty asked the Minister for Health if he will give consideration to a minor injuries’ unit for St Joseph’s Campus in Longford town; and if he will make a statement on the matter. [7447/23]
Amharc ar fhreagraFreagraí scríofa
As this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Healthcare Policy
Ceisteanna (149)
David Cullinane
Ceist:149. Deputy David Cullinane asked the Minister for Health if he will develop a specific population-based health capacity plan for the mid-west; and if he will make a statement on the matter. [7559/23]
Amharc ar fhreagraFreagraí scríofa
Regional Health Areas will have needs-based budget allocations and will be responsible for providing health and social care services. Each RHA will have a single budget and a single management team.
A population-based resource allocation (PBRA) model will be developed and implemented across the six RHAs, using a common analytical and reporting process, including RHA E (the Mid-West Area). This work has already commenced and will be developed and advanced with support and direct input from a PBRA Steering Group which will comprise members of the DoH, HSE, RHAs, Central Government and academic experts in the area of health resource allocation models.
This will directly support healthcare planning, with detailed population profiles being developed based on demographic and health data. In addition to supporting PBRA development, this work will be critical for the Strategic Healthcare Infrastructure Framework.
Nursing Education
Ceisteanna (150)
Peter Fitzpatrick
Ceist:150. Deputy Peter Fitzpatrick asked the Minister for Health if he will grant allowances for student nurses and midwives in line with the expenses incurred as part of their training, and recognising the additional challenges placed on students while they made their extraordinary contribution to the frontline; and if he will make a statement on the matter. [2934/23]
Amharc ar fhreagraFreagraí scríofa
I take the opportunity once again to acknowledge the real commitment of all nursing and midwifery students to healthcare and to their education. This was especially evident in recent times and I also thank all nurses and midwives and all healthcare workers for their dedication and commitment.
On 4 November 2021, following the publication of Longer-Term Review of Matters relating to Student Nurses and Midwives, an independent review, conducted by Mr. Seán McHugh at my request (McHugh Report), I announced that the Government had approved my proposal to provide significant additional supports, worth €12m, for student nurses and midwives while attending their clinical practice placements. Among these temporary measures, I extended the Pandemic Placement Grant (PPG) of €100 per week to all eligible nursing and midwifery students on supernumerary placement to the end of the academic year 2021/22.
I also announced additional support to nursing and midwifery students who required overnight accommodation away from their normal place of residence in order to attend some of their clinical practice placements. I doubled the cap on the vouched accommodation allowance to €100 per week of placement. Student nurses and midwives (for Academic Year 2021/22) on paid internship placement received additional financial support (50% of the PPG: totaling to €1,800 for the academic year) for the duration of their internship, from 1 January 2022.
Following approval by Government on 13 December 2022, I was pleased to announce €9 million in additional supports for student nurses and midwives. €5.4m will be used to introduce an enhanced Travel and Subsistence Scheme for eligible students while attending their supernumerary clinical practice placements. This scheme will provide a targeted and more equitable approach to supporting these students and its main features are set out hereunder:
- Eligible student nurses and midwives in years 1 to 3 of their studies will each receive €500 per year as a targeted measure to contribute towards meeting the extra costs of meals associated with practice placements outside the student’s core placement site.
- A new rate of €80 for overnight accommodation is being introduced, along with an increased weekly cap of €300, for those eligible supernumerary students who require accommodation away from their normal place of residence while attending practice placements. This weekly cap is three times the cap introduced on 1st January 2022, and almost six times the previous cap.
- Supernumerary students requiring overnight accommodation will also be able to avail of, on a vouched basis, the reasonable cost of uniform laundry services.
- Supernumerary students will continue to be entitled to a refund of the cost of transport for placements on a vouched basis.
The enhanced Travel and Subsistence Scheme will be backdated to the start of the current Academic Year, September 2022.
For student nurses and midwives on their final year internship, I am ensuring that their salary is set in line with the relevant recommendation in the McHugh Report, by increasing their rate of pay to 80% of Point 1 of the Staff Nurse/Midwife pay scale. This measure, worth €3.6 million, demonstrates further the Government's commitment to retaining talent throughout our nursing and midwifery degree programmes and our appreciation for the efforts and dedication shown by students during their crucial final-year internships. Finally, students will also be provided with two additional uniforms at the start of their internship.
A Letter of Sanction in relation to the above measures has been issued by my Department to the HSE.
Question No. 151 answered with Question No. 116.
Disability Services
Ceisteanna (152)
Darren O'Rourke
Ceist:152. Deputy Darren O'Rourke asked the Minister for Health if he will provide an update on the staff complement and existing vacancies in the four CDNTs serving County Meath; the number of children accessing services and on waiting lists; his plans to address staff vacancies; and if he will make a statement on the matter. [6922/23]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Healthcare Policy
Ceisteanna (153)
Bernard Durkan
Ceist:153. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he might be in a position to introduce a plan to deal with the most urgent health issues at the present time such as adequacy of staffing levels throughout the service, waiting lists, access to GP services, availability of rare and orphan drugs and bed shortages as required throughout the country in line with the ever-recurring issues; and if he will make a statement on the matter. [7685/23]
Amharc ar fhreagraFreagraí scríofa
The investment in Budget 2023 – of €23.4 billion - is the highest funding to the health service in the history of the state. This is the third-year in a row of record investment. It will facilitate better access to affordable, high-quality healthcare for people at a time when the cost-of-living crisis is impacting on everyone. Some key highlights in response to areas raised by the Deputy include:
- 430,000 more people will be eligible for free GP care. Adding children aged 6 & 7 later this year, means half a million more people with access.
- Budget 2023 sees €443 million specifically targeted at waiting lists.
- Since 2020, we have delivered approximately 2,000 acute, critical care and community beds to date, with a further 232 beds on stream in 2022. Approximately 200 more beds will be delivered in 2023.
- Our health workforce is continuing to grow at a record pace with the workforce expanding by 5,422 by the end of 2022. Budget 2023 sees funding for a further expansion of up to 6,000 in 2023 to continue the government’s significant investment in the Irish healthcare system.
There are many important new initiatives across a range of important health issues that impact all of us. Under the Health Act 2004, the HSE prepare and submit a service plan for my approval. This plan must indicate the type and volume of health and personal social services to be provided, capital plans proposed, contain estimates of the number of employees of the Executive for the period, the services to which the plan relates and any other information that is specified. That is to say, the National Service plan addresses all the areas to which you refer; waiting lists, addition of bed capacity, recruitment and workforce planning etc.
Following a review of the 2023 National Service Plan, the HSE is currently revising the plan in line with considerations and feedback provided by my Department and other stakeholders. On that basis, I expect to receive a revised NSP shortly for consideration.
In line with the Act, the NSP, when approved, will be laid before the Houses of the Oireachtas within 21 days. After this the HSE will ensure it is published at the earliest possible time.
Care of the Elderly
Ceisteanna (154)
Fergus O'Dowd
Ceist:154. Deputy Fergus O'Dowd asked the Minister for Health to provide an update on the expected timelines on the establishment of a commission of care for aging and older people; the way he intends to scope and plan for such a commission; and if he will make a statement on the matter. [7519/23]
Amharc ar fhreagraFreagraí scríofa
The Government is committed to supporting healthy and positive ageing as well as to ensuring that older persons can continue to live independently in their homes and communities for as long as possible. Acknowledging the disproportionately negative impact of the pandemic on older persons, the Programme for Government: Our Shared Future (2020) commits to the establishment of a commission on care that will ‘assess how we care for older people and examine alternatives to meet the diverse needs of our older citizens’, learning the lessons from COVID 19. In 2022 preliminary desk research was undertaken within the Department of Health in preparation for the establishment of a commission on care. In 2023 the scoping and planning for the commission on care will be further advanced as a priority.
Disability Services
Ceisteanna (155)
Pauline Tully
Ceist:155. Deputy Pauline Tully asked the Minister for Health the number of announced, short notice announced or unannounced inspections of residential centres for people with disabilities carried out by HIQA in 2021, in tabular form; if he has plans to increase the number of unannounced inspections; and if he will make a statement on the matter. [7682/23]
Amharc ar fhreagraFreagraí scríofa
The Health Information and Quality Authority (HIQA) is the independent Authority established to drive continuous improvement in Ireland's health and personal social care services, monitor the safety and quality of these services, and promote person-centred care for the benefit of the public.
During 2021, HIQA completed 1,220 inspections of centres for people with disabilities. Of the 1,220 inspections completed in 2021, 16% were announced, 53% were short-notice announced, with the remaining 31% unannounced.
|
Fieldwork type (2021) |
No. inspections |
% of inspections |
|
Fieldwork type (2021) |
No. inspections |
% of inspections |
|
Unannounced |
384 |
31% |
|
Announced |
193 |
16% |
|
Announced (Short Notice) |
643 |
53% |
|
Grand Total |
1220 |
100.00% |
The short-notice announced inspections were introduced as a necessary infection prevention and control measure during the pandemic. It is important to note that where there were concerns about potential risk to residents, HIQA also undertook unannounced inspections.
Normally, each centre will receive one announced inspection in a three-year cycle. This announced inspection serves an important purpose in giving residents and relatives notice of the inspection so that they can make arrangements to meet with and speak with inspectors if they wish.
Last year, HIQA incrementally returned to a normalised approach to inspection, as the full impact of the pandemic abated. The information on announced and unannounced inspections for 2022 will be verified and prepared for inclusion in HIQA’s Annual Report to be published in the next few months.
Assisted Human Reproduction
Ceisteanna (156)
Paul Murphy
Ceist:156. Deputy Paul Murphy asked the Minister for Health to provide an update on the rollout of public funding for IVF treatment; and if he will make a statement on the matter. [7650/23]
Amharc ar fhreagraFreagraí scríofa
As the Deputy may be aware, the Model of Care for Fertility was developed by the Department of Health in conjunction with the HSE’s National Women & Infants Health Programme (NWIHP) in order to ensure that fertility-related 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 (in-vitro fertilisation), ICSI (intra-cytoplasmic sperm injection) 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 fertility-related 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. The completion of Phase One of the roll-out of the Model of Care, envisaged later this year, 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 fertility 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 historic 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 is also being utilised to support the Regional Fertility Hubs in order to expand their scope of services later this 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. Substantial planning, development and policy work to establish the scope, design and requirements for Phase Two of the roll-out of the Model of Care is ongoing. My officials, in conjunction with NWIHP, are continuing to actively prepare for the operationalisation of both the publicly- and privately- provided service, including finalising a national eligibility framework and 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 Fertility, 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.
Medical Cards
Ceisteanna (157)
Willie O'Dea
Ceist:157. Deputy Willie O'Dea asked the Minister for Health if there are any plans to raise the income threshold for the medical card; and if he will make a statement on the matter. [7549/23]
Amharc ar fhreagraFreagraí scríofa
Eligibility for a Medical Card is primarily based on a financial assessment which is conducted by the HSE in accordance with the Health Act 1970 (as amended). The HSE assesses each medical card 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. It is specific to the individual’s own financial circumstances.
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. Certain expenses are also taken into account, i.e. mortgage payments, which help to increase the amount a person can earn and still qualify for a medical card.
Persons aged 70 or older are assessed under the over 70s medical card income thresholds which are based on gross income. It should be noted that in November 2020, the weekly gross medical card income thresholds for those aged 70 and over were increased to €550 per week for a single person and €1050 for a couple. This increase helps to ensure that a greater proportion of those aged 70 and over qualify for a medical card.
I can assure the Deputy that, in order 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 proposals are considered in the context of any potential broader implications for Government policy, the annual budgetary estimates process and legislative requirements arising.
Cross-Border Co-operation
Ceisteanna (158)
David Stanton
Ceist:158. Deputy David Stanton asked the Minister for Health the number of applications made under the Cross Border Directive in 2021 and in 2022 respectively; the number of these applications that were successful and the number that were not granted; to provide a breakdown, in tabular form of the procedures involved and countries involved in each year; the overall cost to the State in each of the two years; the number of successful patients awaiting payment at present; the waiting times involved for same; and if he will make a statement on the matter. [7683/23]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Hospital Services
Ceisteanna (159)
Cathal Crowe
Ceist:159. Deputy Cathal Crowe asked the Minister for Health if he will provide an update on measures he intends to put in place to increase acute public healthcare capacity within the UL Hospitals Group. [7523/23]
Amharc ar fhreagraFreagraí scríofa
There has been, and continues to be, substantial investment in the University of Limerick Hospital Group. In October 2022, I broke ground on the new 96-bed inpatient block project at University Hospital Limerick. This €90m capital project will deliver a 4-storey, 96 single bed acute inpatient ward block, which will go some way toward addressing capacity issues in the region.
In 2021, a new 60-bed modular ward block opened at UHL, which provides modern, single-room inpatient accommodation with improved infection prevention and control capabilities as well as patient flow throughout the hospital. This follows the completion of two separate rapid-build projects, constructed in response to the Covid-19 emergency, which provided an additional 38 inpatient beds on site at UHL.
The new €2m Injury Unit at Ennis Hospital opened last April bringing an immediate improvement in the clinical environment and experience for healthcare staff and the thousands of patients who use this service every year. In addition, a €9.95m theatre upgrade was approved for Ennis Hospital as part of the HSE’s Capital Programme for 2022.
A modern state-of-the-art ward complex, with 24 en-suite single rooms opened at Croom Orthopaedic Hospital in March 2021. A new €15m theatre suite, complete with four new operating theatres, a first stage recovery room and reception area, as well as a new Sterile Services Department and other ancillary support spaces also opened during 2021.
On 7th December 2022, the Government approved the next stage of the Enhanced Provision of Elective Care Programme. As part of this Programme, new national Elective Hospitals will be delivered in Cork, Dublin, and Galway. The new Elective Hospitals will provide significant additional capacity, enabling the separation of scheduled and unscheduled care. The introduction of this new delivery capability into the Public Healthcare System will benefit the whole population, including those who do not fall within the immediate traditional geographical catchment. It is envisaged that the new Cork and Galway facilities combined (which will treat patients from the mid-west) will cater for up to 350,000 patients/procedures annually.
Complementary to the development of the new Elective Hospitals, the HSE also plans to work with Hospital Groups and forthcoming Regional Health Areas to progress proposals for a shorter-term measure by developing ‘Surgical Hubs’ in Cork, Galway, Limerick, Waterford, and Dublin with a narrower scope of procedures. This intervention will also support efforts to consider the necessary reforms and enablers needed to separate unscheduled and scheduled care pathways that will be required by the longer-term provision of the Elective Care programme.
Regarding the Surgical Hub for Limerick, planning is at an early stage, and I have asked the HSE to expedite the development, so it is operational as soon as possible.
The UL Hospitals Group comprises six hospitals, led by University Hospital Limerick, which is a Model 4 Hospital. There are two Model 2 Hospitals, Ennis, and Nenagh Hospitals, while St John's Hospital is classified as a Model 2S Hospital, i.e., St. John's can carry out intermediate surgery, which requires in-patient stay and accommodation in addition to day case surgery. The UL Group also includes Croom Orthopaedic Hospital, and University Maternity Hospital Limerick. The model 2 hospitals accept transfers of appropriate patients from UHL daily. These patients can either be stepped down from an inpatient ward in UHL or they may, where a clinician has decided it is appropriate, transfer to Ennis, Nenagh or St John's directly from the ED in UHL.
The National Ambulance Service has implemented a new protocol which enables patients who meet agreed clinical criteria to be transported directly to a Medical Assessment Unit rather than being brought to an ED. This protocol was rolled out at Ennis Hospital on 9th January and extended to Nenagh Hospital on 7th February, with further roll-out to St John’s Hospital to follow soon after.
I would like to assure the Deputy that my department continues to work closely with the HSE to ensure that the UL Hospitals Group is fully supported and that the necessary improvements to address capacity in the region are actioned in a timely manner.
Covid-19 Pandemic
Ceisteanna (160)
Joe Flaherty
Ceist:160. Deputy Joe Flaherty asked the Minister for Health if steps are being taken to address the non-payment of the Covid-19 pandemic payment bonus to certain staff in section 39 organisations; and if he will make a statement on the matter. [7448/23]
Amharc ar fhreagraFreagraí scríofa
Last year the Government announced a once-off, ex-gratia COVID-19 pandemic recognition payment for certain frontline public sector healthcare workers, to recognise their unique role during the pandemic.
Certain non-HSE/Section 38 healthcare employees are also covered by the Government Decision, and the HSE and KOSI Corp are currently progressing the rollout to eligible staff in the cohorts below:
1. Private Sector Nursing Homes and Hospices (e.g. Private, Voluntary, Section 39 etc.);
2. Eligible staff working on-site in Section 39 long-term residential care facilities for people with disabilities;
3. Agency roles working in the HSE;
4. Health Care Support Assistants (also known as home help / home care / home support) contracted to the HSE;
As of 10th February, 694 organisations have applied for funding to make the recognition payment. I am pleased to confirm that 542 organisations have already been paid or approved for payments for 45,383 eligible staff, with more due in the coming weeks.
The HSE is working on rolling out the payment with assistance from KOSI Corporation and while they are processing applications as quickly as possible, they are also undertaking important work to validate applications as they come in, to improve accuracy and ensure funds are handled appropriately. Thus far this work has identified errors in a large number of applications and has prevented €1.6 million in potential overpayments.
While every effort is being made to expedite payments, until KOSI Corp and the HSE receive information regarding the number of eligible staff in an organisation, funding cannot issue.
I would like to thank all healthcare workers for their extraordinary efforts during the COVID-19 pandemic