Written Answers Nos. 307-324
307. Deputy Louise O'Reilly asked the Minister for Children, Equality, Disability, Integration and Youth the current caseload for Balbriggan CDNT as of 30 June 2023, or the latest available date for which data is compiled; how many children are receiving services; how many children are still on the waiting list; if the list has been validated, and if so, when this was completed. [33348/23]
Amharc ar fhreagraAs this refers to service matters, I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
308. Deputy Louise O'Reilly asked the Minister for Children, Equality, Disability, Integration and Youth how many staff are currently in posts (details supplied) in Balbriggan CDNT; how many vacancies exist for each discipline; if those vacancies have been advertised; what is the recruitment process for these vacancies; when the CRC expects to fill those roles; and the estimated start dates. [33349/23]
Amharc ar fhreagraAs this refers to service matters, I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
309. Deputy Mark Ward asked the Minister for Children, Equality, Disability, Integration and Youth the cost to the State in legal fees since late 2018 in defending the 115 court cases brought by parents whose children did not receive an assessment of need in a timely manner set out in the Disability Act 2005; and if he will make a statement on the matter. [33244/23]
Amharc ar fhreagraI have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
310. Deputy Holly Cairns asked the Minister for Children, Equality, Disability, Integration and Youth the progress made in fulfilling the Programme for Government commitment to holding a referendum on Article 41.2 of the Constitution; and if the draft wording of the referendum will be shared with civil society organisations in advance of the referendum to ensure that any proposed constitutional change will reinforce equality commitments at an international level, such as the UNCRPD. [33258/23]
Amharc ar fhreagraOn 8 March 2023, the Taoiseach and I announced that a referendum will be held to amend the Constitution as recommended by the Citizens’ Assembly on Gender Equality and the Special Joint Oireachtas Committee on Gender Equality.
An Inter-Departmental Committee (IDC), involving all Government Departments and chaired by the Department of Children, Equality, Disability, Integration and Youth, was then established to further examine and advance these recommendations. The IDC is continuing to work on policy proposals, which will be brought forward for consideration and decision by Government shortly. We will be in a position to update further at that stage.
311. Deputy Catherine Murphy asked the Minister for Children, Equality, Disability, Integration and Youth to clarify whether at any point over the past ten years the SSL certificates for his Department’s websites expired for a period of time; if so, the reason this occurred; and the duration they remained expired. [33267/23]
Amharc ar fhreagraI wish to inform the Deputy that the Department of Children, Equality, Disability, Integration and Youth has no records of any instances of expired SSL certificates on Department websites.
312. Deputy Steven Matthews asked the Minister for Health if his attention has been drawn to the Budget 2024 ask of an organisation (details supplied); if this can be considered under budgetary negotiations; and if he will make a statement on the matter. [33212/23]
Amharc ar fhreagraThe pre-budget submission to which the Deputy is referring is the Alzheimer Society of Ireland's 2024 pre-budget submission.
The Government is committed to ensuring that those living with dementia have access to the right services and supports to help them to live well in their communities, and has prioritised much-needed investment in dementia over the past three budgets.
We have invested €12.16 in dementia services and supports in 2023: €4.86 million has been provided for the National Dementia Strategy and €2.1 million for the full resumption of dementia-specific day care services. We have also prioritized investment valued at €5.2 million to allocate a minimum of 15% of 5 million new home support hours to people with dementia, up from 5% in 2021 and 11% in 2022. This investment is in addition to €5.9 million provided for the implementation of the National Dementia Strategy in 2021, and a further €7.3 million in 2022.
A new Model of Care for Dementia was published in May, setting out a framework for the provision of comprehensive dementia diagnostic and post-diagnostic support services on an equitable basis countrywide. To support the new Model of Care, funding has been provided for 10 new Memory Assessment and Support Services (MASS) countrywide over the past three years. Each of these MASS will provide dementia diagnostic and post-diagnostic support services, mainly focused on older people with typical dementia presentations. For those with more complex or atypical presentations, often people with early onset dementia, the Government has funded two new Regional Specialist Memory Clinics (RSMC) in Cork and Galway and boosted the provision of services in the existing RSMCs in St. James’ Hospital and Tallaght University Hospital in Dublin. We have also funded a National Intellectual Disability Memory Service at Tallaght Hospital.
In each of the past three years, funding has been allocated to improve the provision of care to people with dementia in acute hospitals. This includes an Assistant Director of Nursing in each hospital group to drive quality improvement, and the recruitment of 18 Clinical Nurse Specialists for dementia to implement a dementia and delirium care pathway in acute hospitals, ensuring a specific focus on the needs of people with dementia in hospital.
The Government has also prioritised funding for the national Dementia Adviser service, which now has 28 advisers and a coordinator. These Advisers play a crucial role engaging with people with dementia, their families and carers to provide free and confidential supports and signposting to help connect with essential services.
We have also funded a national network of 25 Memory Technology Resource Rooms (MTRRs) which provide free occupational therapist assessments and advice on assistive technology to help people adapt to their condition and maintain a degree of independence for as long as possible, while also providing support to family carers.
€2.1 million has been provided this year to ensure that dementia-specific day care can return to full capacity in a post-pandemic environment. In addition, day care at home continues for people with dementia who cannot, or do not wish to, attend a day care centre.
The ASI’s pre-budget submission focuses on strengthening a number of areas that have been the focus of Government funding over the past three years such as the provision of dementia nurse specialists in acute hospitals, the delivery of new Memory Assessment and Support Services, the provision of dementia day care at home, and the provision of increased home support hours for people with dementia.
In relation to the Deputy's request for a community centre to be made available in every county for meetings, social events and support classes, the ASI's pre-budget submission calls for funding to be made available for weekend activity clubs, with a particular focus on supporting people with early onset dementia. The ASI would provide this service by accessing local Community Hospitals, Older Persons Services and other suitable locations while also capitalising on existing ASI premises that are not in use at the weekends. The focus is therefore on using spare capacity in existing buildings to provide a weekend service.
The ASI’s pre-budget submission will be considered by the Department of Health in its preparations for the estimates and budgetary process.
313. Deputy Alan Dillon asked the Minister for Health when planning permission will be granted to an organisation (details supplied); and if he will make a statement on the matter. [33214/23]
Amharc ar fhreagraAs the Health Service Executive is responsible for the management of the public healthcare property estate, I have asked the HSE to respond directly to you in relation to this matter.
314. Deputy Róisín Shortall asked the Minister for Health if the target four-month waiting time for scoliosis surgery still applies; if so, the plans and timeline for achieving that target maximum waiting time; and if he will make a statement on the matter. [33215/23]
Amharc ar fhreagraI sincerely regret that children can experience a long waiting time for scoliosis treatment, and I remain conscious of the burden that this places on them and their families.
Last year I approved an ambitious plan from Children’s Health Ireland to reduce the number of children waiting for spinal orthopaedic procedures (scoliosis/spina bifida) by the year end. Some €19 million of current and capital funding was committed to implement the plan.
This funding is providing additional theatre access at Temple Street and Crumlin, diagnostic MRI capacity and enabling further activity and paediatric theatre lists at Cappagh Hospital or Cappagh Kids.
The additional activity is targeted at reducing the number of children waiting long periods for orthopaedic procedures (including scoliosis and spina bifida).
As of the 30th of December 2022, 509 scoliosis procedures had been carried out, compared to 380 for the same period in 2019 a 34% increase and an increase of 47% compared to 2021.
Children’s Health Ireland and Cappagh Kids continue to work to explore new innovative ways of working and develop initiatives to support additional orthopaedic and scoliosis activity.
The hospitals are working together to do as much as possible for patients. As of the 30th of December, Cappagh completed 549 (non-complex) orthopaedic surgeries and 68 surgeries for Spina Bifida patients transferred from CHI exceeding the target of 61 for the year.
Despite undertaking a record number of spinal procedures in 2022 corresponding reductions in the waiting list were offset by significant increase in demand and referrals compared to previous years with a 30% increase in additions to the spinal surgery list compared to 2021. CHI believes this is due to a loss of additional capacity elsewhere and latent Covid-19 demand via increased outpatient activity.
CHI remains committed to reaching its target of having no child that is clinically suitable waiting more than 4 months for treatment, although it is faced with considerable challenges including nursing staff shortages, and the impact of increased referrals during 2022.
315. Deputy Róisín Shortall asked the Minister for Health in view of the unacceptably long waiting times for scoliosis surgery which many children have to endure, if he will make a special allocation for mental health supports during this difficult period, as requested by an organisation (details supplied); and if he will make a statement on the matter. [33216/23]
Amharc ar fhreagraI sincerely regret that children can experience a long waiting time for scoliosis treatment, and I remain conscious of the burden that this places on them and their families.
Last year I approved an ambitious plan from Children’s Health Ireland to reduce the number of children waiting for spinal orthopaedic procedures (scoliosis/spina bifida) by the year end, and progress was made. As of the 30th of December 2022, 509 scoliosis procedures had been carried out, compared to 380 for the same period in 2019 - a 34% increase and an increase of 47% compared to 2021. Work to build on this progress is continuing in 2023 and to the end of June, 219 spinal procedures had been carried out, inclusive of 29 outsourced to Cappagh and Blackrock. Children’s Health Ireland and Cappagh Kids continue to work together to do as much as possible for patients. The partnership between CHI and Cappagh has grown successfully over the last number of years, with clinically suitable patients from CHI undergoing orthopaedic procedures at Cappagh, which is helping to address long waiting lists at the CHI hospitals.
In 2022, Cappagh completed 549 (non-complex) orthopaedic surgeries including spinal fusions, and 68 surgeries for Spina Bifida patients transferred from CHI exceeding the target of 61 for the year. In 2022, to the end of June, Cappagh had completed 11 spinal fusion surgeries for patients transferred from CHI.
Despite undertaking a record number of spinal procedures in 2022, corresponding reductions in the waiting list were offset by significant increase in demand and referrals compared to previous years with a 30% increase in additions to the spinal surgery list compared to 2021.
All patients with a diagnosis of scoliosis require a pre-operative work-up prior to spinal surgery, including multiple diagnostic investigations and review by a multidisciplinary team. The plan of care which is implemented for each patient is tailored to best meet the patient’s clinical requirements, with the complexity of a child’s total medical condition dictating the level of planning and pre-operative work and time needed.
Communication and engagement with patients and their families is a priority for CHI who are developing new patient information materials to enhance awareness of points of contact for support within the Orthopaedic service. With regard to the to the specific query raised regarding the mental health supports available to children awaiting scoliosis surgery, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
316. Deputy Pádraig O'Sullivan asked the Minister for Health if he will outline the progress being made by his Department to implement the EU Directive 2021/2282 on health technology assessment (HTAR); and how this will impact how HTA is undertaken in Ireland. [33218/23]
Amharc ar fhreagraThe Health Technology Assessment Regulation (HTAR) entered into force in January 2022 and will fully apply as of January 2025. Its purpose is to strengthen the quality of Health Technology Assessment (HTA) in the European Union and ensure efficiency in the evaluation of new medicines and technologies in a consistent way across member states. The European Commission recently sought member state nominations for representatives to the Committee on Health Technology Assessment. This committee will assist in the commission in implementation of the regulation. The initial implementation from 2025 to 2027 will include medicinal products for oncology and advanced therapeutic medicinal products.
Ireland has played a significant role to date both in the implementation through the consortium of EUnetHTA21 and the established HTAR Coordination Group. EUnetHTA21 was tasked by the European Commission (EC) with producing the procedures and guidelines to enable a smooth implementation. Experts from Ireland’s National Centre for Pharmacoeconomics (NCPE) were one of the most prominent contributors to this work.
Following the establishment of the HTA Coordination Group in 2022, which is the main governance body established under the HTA legislation the NCPE’s Head of HTA Strategy and External Engagement was elected by other Member States as the Chair of the group. Ireland is now represented on all subgroups which are part of the HTAR governance structure.
The NCPE is in the process of reviewing local procedures for any adaptations that are required to further enable the smooth implementation of the outputs of the HTAR. It is noted that the HTAR outputs will be a Joint Clinical Assessment report which will clearly outline the evidence and limitations for technologies relative to what is used in practice. Decisions in relation to reimbursement of technologies remain a national competency. In addition, early advice will be provided to Health Technology Developers on what evidence will be needed when they reach the stage of Joint Clinical Assessment.
Ireland, with experts from the NCPE, has been involved in the development of this work and how it will apply in Ireland.
317. Deputy Pádraig O'Sullivan asked the Minister for Health the number of medicines assessments carried out by the NCPE that have been subject to external review or audit; the extent to which NCPE activity has been subject to audit to date; the governance and oversight procedures in place for the NCPE via the HSE's chief clinical officer and/or his Department; and if he will make a statement on the matter. [33220/23]
Amharc ar fhreagraThe NCPE was subject to audit in 2019 as part of a review commissioned by the Department of Health and conducted by Mazars examining the governance arrangements to support the HSE’s drug reimbursement process. In relation to staffing and governance the report highlighted that: “As their roles are so specialist, we reviewed the qualifications of the staff at the NCPE. We noted that the assessors in the NCPE have all completed or are in the process of completing a PHD programme in Pharmacoeconomics. This is a highly unique skill set and these individuals are highly valuable to this process. The calibre of the staff resources employed in the NCPE is testament to the strong governance in this process”.
The NCPE is involved in multiple international collaborations and has completed two joint Health Technology Assessments (HTAs), Zolgensma® and Libmeldy®, as part of the Beneluxa Initiative. Collaboration on HTA requires that there is a peer review process. The NCPE contribution to the Joint Assessments is reviewed by HTA experts from other countries.
The NCPE is highly regarded internationally and is playing a leading role in three international initiatives: the Beneluxa Initiative, International Horizon Scanning Initiative, and the European HTA Regulation. The Regulation on HTA entered into force in January 2022 and will fully apply as of January 2025. Its purpose is to strengthen the quality of HTA in the European Union and ensure efficiency in the evaluation of new medicines and technologies in a consistent way across member states. The HTA Coordination Group is the main governance body established under the HTA legislation and under which Joint Clinical Assessments and Joint Scientific Consultations for both pharmaceutical technologies and medical devices will be undertaken following established methodological procedures. The NCPE’s Head of HTA Strategy and External Engagement is the Chair of this Group.
All NCPE HTAs are disseminated to the HSE’S Chief Clinical Officer on completion. Therefore, there is full oversight of all HTAs completed by the NCPE.
318. Deputy Brendan Griffin asked the Minister for Health if a child (details supplied) will be considered for an urgent assessment in County Kerry; and if he will make a statement on the matter. [33225/23]
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.
319. Deputy Pauline Tully asked the Minister for Health when a person (details supplied) will be admitted to the National Rehabilitation Hospital, Dún Laoghaire; and if he will make a statement on the matter. [33228/23]
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.
320. Deputy Pauline Tully asked the Minister for Health when a person (details supplied) will be admitted to the National Rehabilitation Hospital, Dún Laoghaire; and if he will make a statement on the matter. [33229/23]
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.
321. Deputy Pauline Tully asked the Minister for Health what measures he is taking to address the extensive waiting list in the National Rehabilitation Hospital, Dún Laoghaire; and if he will make a statement on the matter. [33230/23]
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.
322. Deputy Denis Naughten asked the Minister for Health if he will outline the specific measures taken to enhance ambulance services in advance of the opening of the new major trauma centres in line with the Government decision; the specific funding allocated to each measure and its date of operation; when each of the network trauma hospitals will become operational; and if he will make a statement on the matter. [33243/23]
Amharc ar fhreagraAs this is a service matter I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
323. Deputy Fergus O'Dowd asked the Minister for Health to respond to concerns raised by an organisation (details supplied), in particular the significant disparity between over-8s eye care policy in each individual CHO area; and if he will make a statement on the matter. [33245/23]
Amharc ar fhreagraSight testing, eye examinations and optical appliances are provided to medical card holders by ophthalmologists, optometrists and dispensing opticians through the Community Ophthalmic Services Schemes (COSS). Patients may access these services following a referral by a healthcare professional such as their general practitioner.
All children, including those not covered by a medical card, receive a vision screen while in national school from a Public Health Nurse. The Health Service Executive (HSE) provides optical services free of charge to pre-school children and national school children referred from child health service and school health service examinations who are discovered to have sight problems. These children are referred to the appropriate consultant for treatment. In such circumstances, these services will continue to be provided until the child has reached the age of 16.
The HSE Primary Care Eye Services Review Group Report, published in June 2017, highlighted the limitations of the current model of service delivery and set out the way forward for a significant amount of eye services to be delivered in a primary care setting. The Report estimated that 60% of existing outpatient activity could be moved to primary care thus enabling hospital services to focus on patients who require more specialist diagnostics or treatments.
The National Clinical Programme for Ophthalmology has developed a model of care which details how the realignment of eye services from the acute hospitals to the community will be undertaken. Included in current priorities is transferring the care of children aged 8+ years to the care of local private optometrists.
A project team with a wide-ranging membership was established in late 2019 / early 2020 to progress this initiative. The work of the team was paused due to the requirement to focus resources on the COVID 19 pandemic. However, the project team has been reconvened and is progressing matters in relation to this initiative.
As this also involves a service matter, I have asked the HSE to respond to the Deputy directly in regards to progress made, as soon as possible.
324. Deputy Holly Cairns asked the Minister for Health the steps he is taking to ensure that current trainee educational psychologists in Irish third-level institutions will receive the same renumeration and funding supports as incoming first years. [33260/23]
Amharc ar fhreagraAs the Deputy will be aware, €750,000 has been provided in Budget 2023 to support counselling psychology training places. This funding demonstrates the Government’s commitment to strengthen access to psychology training.
I am focused on supporting counselling psychology students in an equitable way and that delivers value for money. The structure of this funding is still being finalised by officials in the Department. The approach will be based on best practice and knowledge gained from other health and social care funded training models.
Further detailed discussions are required between the Department and HSE to progress this. I hope to be in a position to announce the details shortly for academic year 2023-2024.
In relation to the question raised, the Deputy may wish to seek the view of the Minister for Education as regards funding opportunities for educational psychologists.
