Written Answers Nos. 1502-1520
1502. Deputy Peadar Tóibín asked the Minister for Health the investment per child in mental health services in each county in Ireland for the past five years; and what the investment per person is in mental health services for each county in Ireland for the past five years. [37179/23]
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.
1503. Deputy Michael Healy-Rae asked the Minister for Health if a child will be referred to a hospital (details supplied) in the United Kingdom; and if he will make a statement on the matter. [37193/23]
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.
1504. Deputy Thomas Pringle asked the Minister for Health further to Parliamentary Question No. 224 of 22 March 2023, for an update on the case of a person (details supplied); if progress is being made on their return to some independent living; and if he will make a statement on the matter. [37194/23]
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.
1505. Deputy Richard Bruton asked the Minister for Health if he has received any reports on the long wait for infant blood tests even if they are needed for diagnostic purposes; and if steps can be taken to address this. [37207/23]
Amharc ar fhreagraEach month Children’s Health Ireland (CHI) perform phlebotomy on approximately 1,200 patients referred from general practice. These blood samples are processed in the associated laboratories of CHI at Temple Street, Crumlin and Tallaght University Hospital (TUH).
Blood samples performed at primary care and GP practices in the relevant areas are also forwarded to CHI laboratories for processing on the same day or the next day.
Access to appointments within CHI are available through an online portal called Swiftqueue. There is a 4-6 week wait time for available appointments with work ongoing to increase availability of blood testing and processing on all sites. As of 5 September, there are appointments in CHI at Connolly for Monday, 9 October.
1506. Deputy Jim O'Callaghan asked the Minister for Health whether consideration can be given to running a public information campaign warning persons about the consequences and dangers of illegal drugs and the impact they have on mental and physical health; and if he will make a statement on the matter. [37212/23]
Amharc ar fhreagraThe National Drugs Strategy, Reducing Harm, Supporting Recovery, provides a comprehensive health-led approach to drug use. By treating the use of substances as a public health issue, rather than solely as a criminal issue, we can better help individuals, their families and the communities in which we live. The Programme for Government endorses this health-led approach.
The Department of Health and the HSE raise awareness of the dangers associated with drugs as follows:
- In response to an increase in the use of cocaine powder and crack, the HSE developed a information campaign in partnership with the Ana Liffey Drug Project. The campaign was developed to raise awareness about the dangers of using cocaine (powder and crack), and how to reduce the harms associated with snorting, smoking or injecting. Cocaine Reduce the Harms - Drug and Alcohol Information and Support in Ireland - Drugs.ie.
- In May 2022, the HSE launched the Safer Nightlife Programme for Festival Settings 2022 programme. This multi-component programme for festivals involved a media campaign, the development of resources (leaflets, posters, and merchandise), and the recruitment and training of volunteers and outreach at a number of festivals over the summer months. The aims of this festival programme included engaging with festival attendees in a non-judgmental way on the topic of substance use and related issues such as mental health, as well as providing high quality drug education in festival settings. The programme also delivered harm reduction information concerning drug trends as well as brief interventions aiming to influence behaviour and encourage safer choices.
- The Drugs.ie website which provides a comprehensive range of information and supports related to substance use.
- The HSE provides a Drugs and Alcohol helpline, which is contactable though a confidential freephone helpline on 1800 459 459 from Monday to Friday between 9:30 am and 5:30 pm. This helpline allows people to talk through any concerns about drugs or alcohol and access information about services which may be required.
We cannot be complacent about the potential dangers which drugs can cause to individuals, our communities, or society at large. The Government is committed to a public health approach to drug use, that will lead to better outcomes for all.
1507. Deputy Peter Burke asked the Minister for Health if there are any plans in place to return/reopen the HSE orthodontic clinic to Mullingar due to the continuous growth and expansion of the town (details supplied). [37213/23]
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.
1508. Deputy Michael Lowry asked the Minister for Health further to Parliamentary Question No. 169 of 14 June 2023, if he will provide an update on the review of fees that pharmacies receive from the State for the state drug payment schemes; and if he will make a statement on the matter. [37218/23]
Amharc ar fhreagra1589. Deputy Michael Healy-Rae asked the Minister for Health if he will provide funding to a sector (details supplied); and if he will make a statement on the matter. [37641/23]
Amharc ar fhreagra1590. Deputy Michael Healy-Rae asked the Minister for Health if he agrees that additional funding should be available to the HSE primary reimbursement service to compensate pharmacies for the ongoing increase in administration requirements for administrating the community drug schemes; and if he will make a statement on the matter. [37642/23]
Amharc ar fhreagra1592. Deputy Michael Healy-Rae asked the Minister for Health if he will consider the introduction of a community pharmacy, triage-based service, to include a minor ailment scheme and facilitating women with a choice of accessing contraception through a pharmacy on foot of a structured consultation; and if he will make a statement on the matter. [37645/23]
Amharc ar fhreagraI propose to take Questions Nos. 1508, 1589, 1590 and 1592 together.
I recognise the significant role community pharmacists play in the delivery of patient care and acknowledge the potential for this role to be developed further in the context of healthcare service reform.
In that regard, various approaches to extending the scope of practice of community pharmacists are being progressed by my Department. The implementation of these necessitates engagement with a range of stakeholders and full consideration of all the relevant legislative and operational issues involved.
The recent establishment of the Expert Taskforce to support the expansion of the role of pharmacists in Ireland is evidence of my commitment to that aim.
The regulations governing the pharmacy fee structure are set out in the Public Service Pay and Pensions Act 2017 (No. 34 of 2017) and in S.I. No. 639 of 2019, the Public Service Pay and Pensions Act 2017 (Payments to Community Pharmacy Contractors) Regulations 2019, which put the current fee structure in place, with effect from 1 January 2020.
Under Section 42(14) of the Public Service Pay and Pensions Act 2017 the pharmacy fee structure must be reviewed every third year after 2020. My Department is currently carrying out a comprehensive review.
Constructive engagement between Department officials and the Irish Pharmacy Union has taken place in that regard in recent months, and this engagement is continuing.
I believe that there is a real opportunity to work collaboratively with community pharmacists, and with other healthcare providers, to make a significant difference to patient outcomes. Of course, any publicly funded pharmacy service expansion should address unmet public healthcare needs, improve access to existing public health services, and provide better value for money.
1509. Deputy Paul Kehoe asked the Minister for Health whether he has received correspondence from community cancer support centres requesting sustainable funding at Government level to permit them to continue to provide their service; what actions he is taking on foot of this request; and if he will make a statement on the matter. [37221/23]
Amharc ar fhreagra1523. Deputy Fergus O'Dowd asked the Minister for Health to respond to serious concerns raised by a local charity (details supplied) in relation to the future provision of their services; and if he will make a statement on the matter. [37285/23]
Amharc ar fhreagra1530. Deputy Jennifer Murnane O'Connor asked the Minister for Health if there are any plans to increase funding for cancer support centres including an organisation (details supplied) in Carlow; and if he will make a statement on the matter. [37320/23]
Amharc ar fhreagra1700. Deputy John McGuinness asked the Minister for Health if he will outline his response to the serious concerns being expressed by those organisations providing cancer support services in Carlow and Kilkenny regarding the delivery and sustainability of the vital services they offer because of the lack of State funding; and if he will make a statement on the matter. [38070/23]
Amharc ar fhreagra1801. Deputy Neasa Hourigan asked the Minister for Health if his attention has been drawn to correspondence (details supplied); the engagements he has had with a named organisation in relation to the same; and if he will make a statement on the matter. [38680/23]
Amharc ar fhreagraI propose to take Questions Nos. 1509, 1523, 1530, 1700 and 1801 together.
Community cancer support centres are voluntary and charity organisations delivering services directly to cancer patients and their families. These centres provide a range of services, including information and advice about cancer, psychological and emotional support, and survivorship programmes to patients during and after their cancer treatment and are invaluable to those they support. These services can be availed of free of charge and in local communities.
The National Cancer Strategy 2017-2026 acknowledges cancer support centres as a valuable resource, providing access to support to cancer patients and their families outside of the acute care setting. The HSE's National Cancer Control Programme (NCCP) works closely with a network of Community Cancer Support Centres, particularly in regard to the psycho-oncology model of care and the implementation of survivorship programmes for those living with and beyond cancer.
The NCCP Revised Best Practice Guidance for community cancer support centres was published in March 2022. The Alliance of Community Cancer Support Centres was also established in 2022. The Alliance is a HSE initiative which aims to develop a collaborative framework for community-based cancer support centres and services. This programme promotes participation in capacity-building activities and communication and networking forums aimed at ensuring that community-based cancer support services are integrated.
The NCCP operates an activity-based funding model for organisations who have joined the Alliance of Community Cancer Support Centres. In order to qualify for an activity-based grant from the NCCP, each applicant needs to be able to show that they are adhering to the Best Practice Guidance. Funding for current expenditure, including cancer services, is allocated on an annual (single year) basis with future levels of funding considered as part of the national estimates and budgetary process.
The Government recognises the valuable work done by the staff and volunteers at cancer support centres throughout Ireland. Through the important work of voluntary cancer support services and the implementation of the National Cancer Strategy, I believe we can have a profound effect on the quality of life of many people who are living with a cancer diagnosis.
My office has received correspondence from community cancer support centres on this matter and a meeting to discuss the issue with representatives of the centres will be held in due course.
1510. Deputy Holly Cairns asked the Minister for Health when funding will be allocated for the building of the rehabilitation unit at Bantry General Hospital; whether failure to award funding this year would require the project to be re-tendered; if he has received advice as to the impact any delay in funding would have on the overall cost of the project; and if he will make a statement on the matter. [37233/23]
Amharc ar fhreagraAs 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.
1511. Deputy Matt Shanahan asked the Minister for Health the official policy position in relation to State supported IVF treatment; the criteria for access to IVF support funding; the range and breadth of the funding possible; the number of possible cycles that can be supported; the constraints or restrictions to State supported IVF in relation to income, age, gender bias, biological donor, underlying or pre-existing illness and so on; and if he will make a statement on the matter. [37236/23]
Amharc ar fhreagra1552. Deputy Fergus O'Dowd asked the Minister for Health if he will urgently review the defined age set out in this week’s IVF announcement to allow women older than 41 years to be included in the roll-out of the service, notwithstanding that the roll-out is a very welcome and important first step in addressing the need in this area; and if he will make a statement on the matter. [37425/23]
Amharc ar fhreagra1616. Deputy Paul Kehoe asked the Minister for Health the reason State-funded IVF treatment is not being offered to same-sex couples or single people; and if he will make a statement on the matter. [37694/23]
Amharc ar fhreagraI propose to take Questions Nos. 1511, 1552 and 1616 together.
As the Deputy may be aware, a commitment to “introduce a publicly funded model of care for fertility treatment” is included in the Programme for Government.
The Model of Care for Fertility was developed by the Department of Health in conjunction with the HSE’s National Women & Infants Health Programme 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) and ICSI (intra-cytoplasmic sperm injection)), 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, to facilitate the management of a significant proportion of patients presenting with fertility-related issues at this level of intervention without the need to undergo invasive IVF or ICSI treatment. 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. All six Regional Fertility Hubs are currently operational.
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 development of the first National Advanced AHR Centre, delivering IVF and ICSI through a wholly public clinic and scheduled to open in 2024. 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.
As an interim measure, I instructed that some funding be made available to support access to advanced AHR treatment via private providers from September 2023. As well as IVF and ICSI, this allocation is also being used to provide, initially through private clinics, IUI (intrauterine insemination), which can, for certain cohorts of patients, be a potentially effective, yet less complex and less intrusive treatment.
In July 2023, I updated the Government in relation to the commencement of publicly-funded, privately-provided IVF, ICSI and IUI. I provided details in relation to the new initiative, including the set of criteria prospective patients must meet to access fully-funded AHR services. The criteria were agreed following consultation with experts in the field of reproductive medicine and include limits in respect of the age of the intending birth mother, body mass index (BMI) and the number of children a couple already have. They are very much in keeping with those applied in other jurisdictions, even though in most European countries, for instance, such treatments are only partially funded and require often significant out-of-pocket payments by patients. More details on public fertility services, including information on the new publicly-funded AHR treatment initiative, are available at: www2.hse.ie/conditions/fertility-problems-treatments/fertility-treatment/
Given the complex regulatory and clinical issues to be addressed in respect of certain categories of AHR treatment, including donor-assisted treatment, public funding of a number of services will of necessity be commenced on a structured and phased basis. While some regulation regarding the provision of AHR services involving donor gametes is currently provided for, there are a number of important clinically relevant issues which are being addressed in the Health (Assisted Human Reproduction) Bill 2022 currently before the Oireachtas.
Advanced maternal age, unfortunately, is associated with a decrease in the number of eggs retrieved and an increase in the miscarriage rate. Most public fertility programmes in other jurisdictions apply an age restriction on the provision of IVF/ICSI treatment to women, commonly set at 39 or 40 years of age. It is proposed that in Ireland the maximum age for intending birth mother means that she must be referred from her GP to a Regional Fertility Hub prior to her 41st birthday. Therefore, she may be older by the time she actually avails of publicly-funded IVF treatment.
It has been decided that one cycle of IVF or ICSI should be publicly funded for eligible patients and be undertaken in an authorised private clinic of their choice. This is to ensure that as many eligible patients as possible can avail of publicly-funded AHR treatment during the initial phase. It should be noted that one cycle shall consist of an episode of ovarian stimulation, egg retrieval, fertilisation and transfer of one fresh embryo (if appropriate, with single embryo transfer as standard). All other suitable embryos created should be frozen and can then be subsequently transferred through a publicly-funded procedure if the access criteria are still being fulfilled. Therefore, a publicly-funded IVF/ICSI cycle may consist of a number of separate embryo transfers.
The access criteria and the scheme will be kept under review as new evidence becomes available, an understanding of how the service provision is working in practice emerges, and when the AHR legislation is finalised.
My Department and the Government are focused, through the full implementation of the Model of Care for Fertility, on ensuring that patients 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.
1512. Deputy Matt Shanahan asked the Minister for Health In a recent visit to University Hospital Waterford if he will give a public commitment to seven days x 12 hours per day accessibility for emergency procedures in the UHW cath lab suite to begin in September 2023; if the appropriate staff compliment has been authorized or is in place to provide the required level of cover over the proposed seven day 12-hour schedule; if once operational the cath lab suite will be noted for seven-day semi-referral under the acute coronary syndrome programme; if the National Ambulance Service will also be immediately updated of the change in status as soon as it happens; and if he will make a statement on the matter. [37237/23]
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.
1513. Deputy Matt Shanahan asked the Minister for Health if he will provide an explanation of a procurement process (details supplied); and if he will make a statement on the matter. [37238/23]
Amharc ar fhreagra1514. Deputy Matt Shanahan asked the Minister for Health further to the timelines already highlighted in previous a Parliamentary Question regarding the development of surgical hubs in Dublin, Cork, Limerick and Galway, the reason the design specification expedited for the Galway project was not given as a construction template for the other three projects in order that these could be expedited along with the Galway-based project; and if he will make a statement on the matter. [37239/23]
Amharc ar fhreagra1521. Deputy Matt Shanahan asked the Minister for Health to provide an explanation of the following procurement process (details supplied); and if he will make a statement on the matter. [37267/23]
Amharc ar fhreagra1522. Deputy Matt Shanahan asked the Minister for Health given the timelines already highlighted in previous Parliamentary Question regarding surgical hubs development in Dublin, Cork, Limerick and Galway, the reason the design specification, obviously expedited for the Galway project, was not given as a construction template for the other three projects so that these could be expedited along with the Galway based project; and if he will make a statement on the matter. [37268/23]
Amharc ar fhreagraI propose to take Questions Nos. 1513, 1514, 1521 and 1522 together.
I have asked the HSE, which has responsibility for the delivery of the new Surgical Hubs, to respond to you directly in relation to the matters raised.
1515. Deputy Michael Healy-Rae asked the Minister for Health when an appointment will issue to a person (details supplied); and if he will make a statement on the matter. [37251/23]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1516. Deputy Duncan Smith asked the Minister for Health what measures are being taken to address the shortage of ADHD medications in Ireland, particularly medications such as tyvense; and if he will make a statement on the matter. [37252/23]
Amharc ar fhreagraTakeda Pharmaceuticals International AG Ireland Branch notified of shortages of a number of strengths of Tyvense (30mg, 40mg, 50mg, 60mg and 70mg) due to an unexpected increase in demand, impacting multiple global markets, not just Ireland. The company has observed a 25% global increase in demand. The company anticipates resupply of the 50mg strength on 14 September, 60mg strength on 21 September, the 30mg and 40mg strengths on 12 October and the 70mg strength on 19 October. The company has provided a letter to healthcare professionals detailing this information.
The 20mg strength of Tyvense is currently available. The company has stated that it has aligned its forecasts with the current growth trend to meet future demand. It takes some time to produce these products, and in the immediate term, the company has stated it will experience intermittent supply issues. The company has stated that it is working with wholesalers in Ireland to ensure monthly equitable distribution and prevent prolonged supply disruption.
Janssen, the company that places the Concerta XL products on the market, has informed the Health Products Regulatory Authority (HPRA) that it is encountering global supply chain issues related to component availability and increased demand in multiple markets. The company has stated that there are allocations in place to ensure equitable distribution to mitigate the impact on patients in Ireland and that it is working closely with pharmacies to ensure patients receive their medication.
At any given time, shortages of medicines can occur in any country. Increases in demand for medications and medicines shortages have been observed in the UK, throughout the EU and across the world in recent months.
Ireland has a multi-stakeholder medicine shortage framework in place, operated by the HPRA on behalf of the Department of Health. The multi-stakeholder framework includes representation from the pharmaceutical industry, healthcare professionals, the HSE, the Department of Health and patients.
Unfortunately, there are a multitude of reasons why a medicine may not be available including: shortages of raw materials; manufacturing difficulties; sudden unexpected increase in demand; or product recalls due to potential quality issues.
The HPRA publishes a list of medicines currently in short supply on its website (Medicines Shortages (hpra.ie) with the reason for the shortage and expected dates for the return of supply. The information is available to assist healthcare professionals in managing medicine shortages when they arise and reduce their impact on patients. The webpage is updated daily as the HPRA receives new information.
Any patient who is concerned regarding a medicine shortage is advised to discuss their treatment and alternative options with their doctor, pharmacist, or other healthcare professional.
1517. Deputy Michael Collins asked the Minister for Health to provide a list, in tabular form, of all informal and formal meetings or engagements held by him or his Department since his appointment with the group Together for Safety or the Limerick Feminist Network on the topic of the development of safe access zones legislation; and if he will make a statement on the matter. [37262/23]
Amharc ar fhreagraThe Department of Health is not aware of any meetings taking place between the Minister and Together for Safety or the Limerick Feminist Network regarding Safe Access Zones legislation.
1518. Deputy Sean Sherlock asked the Minister for Health if a person (details supplied) in County Cork is to receive a reimbursement of funds under the HSE's Cross Border Directive. [37263/23]
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.
1519. Deputy Fergus O'Dowd asked the Minister for Health if he will respond to concerns raised in a press release (details suppled) in respect of a case; and if he will make a statement on the matter. [37264/23]
Amharc ar fhreagraI welcomed the HSE’s unequivocal apology for the failures in Emily’s care. I also very much welcomed the decision of the Health Service Executive’s CEO to appoint a safeguarding expert from another jurisdiction. The CEO commissioned Ms Jackie McIlroy and assigned her with two Terms of Reference.
Term of Reference 1 to commence on Monday, 3 July for a six-week duration, after which the second Term of Reference will begin, spanning a further 16 weeks.
The Terms of Reference set are as follows:
1. To review the relevant reports “Emily” (specifically NIRP, CHO Safeguarding, NIRP Summary) and conduct any engagements necessary to advise the HSE CEO on the specific question as follows; Based on the material available and considering best practice is a further examination of individual records warranted such as would likely identify past harm and if so is that examination limited to particular scope and time or full lookback. Report 6 weeks from start.
2. Against the backdrop of the examination but not limited to that, to conduct a high-level review of the HSE safeguarding policy, procedures, structures and advise the CEO on possible options for the future of safeguarding recognising that the HSE has roles in safeguarding in both the community and alternative care settings for adults. Report 16 weeks from start.
On Friday, 1 September the CEO received Ms McIlroy’s report in respect of TOR1, which I understand, subject to a short timeline of processing, will be published in full, no later than the start of October.
The Government takes the protection of adults at risk of abuse very seriously. The independent Law Reform Commission is undertaking a review on A Regulatory Framework for Adult Safeguarding which is expected to inform future legislation on adult safeguarding across all sectors. Upon completion, the Department of Health will consider any recommendations the Commission may make where relevant to the Department's functions and I anticipate that other Departments will do the same.
Specifically, within the health and social care sector, there are various structures and processes currently in place to protect against abuse and to ensure prompt action. To further strengthen this framework, the Department is at an advanced stage of developing an overarching national policy on adult safeguarding in the health and social care sector. The Department is preparing for a public consultation commencing in the coming weeks and a costing study, prior to submitting a costed draft policy to Government for its approval. Subject to Government approval, this sectoral policy will further strengthen the sector’s adult safeguarding framework and will apply to all public, voluntary and private healthcare and social care settings. In the event that the Government approves this sectoral policy, legislation as required to underpin it will then be prepared.
1520. Deputy Matt Shanahan asked the Minister for Health if he will confirm that the appropriate staff complement has been authorised or is in place to provide the required level of cover over the proposed seven day 12 hour schedule at University Hospital, Waterford (details supplied); if he will also confirm that once operational, the catheterisation laboratory suite will be noted for seven day semi-referral under the acute coronary syndrome programme; if he will further confirm that the national ambulance service will also be immediately updated of the change in status as soon as it happens; and if he will make a statement on the matter. [37266/23]
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.
