Richard Bruton
Ceist:548. Deputy Richard Bruton asked the Minister for Health if he has examined the reports of elevated death rates; and whether any research is being undertaken to evaluate underlying factors. [41165/23]
Amharc ar fhreagraMedical Records
Ceisteanna (548)
Freagraí scríofa
The Department of Health does not produce estimates of excess mortality. However, the Department works closely with the Health Protection Surveillance Centre (HPSC) and other stakeholders to monitor estimates of excess mortality. Excess mortality refers to the number of deaths from all causes during a period of time above and beyond what we would have normally expected to see.
A number of different methodologies have been developed by organisations and academics internationally to try to estimate levels of excess mortality. It is important to note that estimation methods vary, for example in the years used to estimate a baseline, in how they estimate the level of expected deaths, the data source used for ‘actual’ deaths and whether statistical significance tests are applied before reporting deaths as excess. There is therefore no single source of data on estimated excess mortality.
Internationally work is currently underway to improve methods to estimate excess mortality including moving the baseline years used to calculate expected deaths forward from pre-pandemic years. The gap between the current period and the baseline period is relatively wide and growing. The gap is greater than would have been normal practice previously, which impacts on comparability between the current period and the period used to estimate ‘expected’ deaths.
In addition, most estimation methods, including Eurostat and EuroMOMO, do not currently take account of demographic changes such as population change or ageing which may have occurred since the baseline period and which can have a large impact on mortality. EuroMOMO has received four-year funding to further develop their model, including the incorporation of demographic change.
The Health Protection Surveillance Centre (HPSC) has monitored excess mortality in Ireland since 2009, using registered deaths data reported to HPSC on a daily basis from the General Register Office (GRO). HPSC participates in EuroMOMO for Ireland, a European mortality monitoring activity, aiming to detect and measure excess deaths related to seasonal influenza, pandemics and other public health threats. EuroMOMO publish a weekly update of estimates of excess mortality for all participating European countries www.euromomo.eu/graphs-and-maps. This is the primary indicator of excess mortality used in Ireland.
The latest HPSC excess mortality analysis of all registered deaths in Ireland for the 2022/2023 winter period, using the standardised European EuroMOMO algorithm, has shown:
• Excess all-cause mortality over five consecutive weeks (week 51 2022 – week 3 2023), reaching moderate levels of excess during weeks 51 and 52 2022 and week 2 2023 (data attached)
• All-cause, all ages mortality has been below the baseline and within the normal range since week 3 2023.
• EuroMOMO estimates that over the past 12 months, Ireland has experienced excess mortality during five weeks.
EuroMOMO excess mortality estimates (weekly z-scores) for all ages, Ireland, Week 37 2017 – Week 35 2023 www.euromomo.eu/graphs-and-maps#
See attached EuroMOMO_IRL_-z-scores.png
These data are provisional due to the time lag with death registration in Ireland. A country-specific adjustment function was applied to correct for the typical lag in registrations of deaths in Ireland (the legal period for death registration in Ireland is three months). Nonetheless, estimates of excess mortality for the most recent weeks are reported with some uncertainty and should be interpreted with caution.
It is important to note that excess mortality has been observed during previous periods when influenza viruses circulated at high levels in Ireland, for example in winter 2017/2018 which has previously been characterised as a severe flu season, and during certain periods of the COVID-19 pandemic (April 2020 and January 2021).
As Ireland experienced a winter of high levels of influenza cases and hospitalisations, it would not be unexpected to see excess mortality. Influenza activity was at very high levels in Ireland during December 2022 and early/mid-January 2023, with a high number of influenza hospitalisations reported (see www.hpsc.ie/a-z/respiratory/influenza/seasonalinfluenza/surveillance/influenzasurveillancereports/20222023season/). Other important factors that may impact excess mortality include the ongoing COVID-19 pandemic, circulation of other respiratory viruses, impacts of cold weather, and an ageing population.
Excess mortality was also observed in other European countries over the course of winter 2022/2023. In Europe, the overall pooled EuroMOMO estimates of all-cause excess mortality in all age groups for the participating European countries have shown elevated mortality in all age groups for late 2022/early 2023.
Separately, Eurostat publishes monthly estimates of excess mortality for EU (and some non-EU) countries. This data only incudes excess mortality estimates from January 2020 onwards. Eurostat use the following methodology, ‘The excess mortality indicator simply takes the number of people who died from any cause, in a given period, and compares it with a historical baseline from previous years in a period which was not affected by the pandemic. In this case, the baseline consists of the average number of deaths that occurred in each month during the period 2016-2019’.
The methodology does not require a statistically significant difference to report excess deaths. As noted above, it also does not take account of factors such as demographic change. The recent Census 2022 summary results have shown that the number of persons in Ireland aged 65 years and over increased by 22% between 2016 and 2022. Within this category, the highest increases were among those aged 75-84 years (28%) and 85 years and over (25%). Over the same period, the total population only increased by 8.1% with declines in some younger age.
The 22% increase in the population aged 65 years and older in Ireland between 2016 and 2022, was more than double the 10% increase which occurred for the EU27 over the same period. For the 75-84 years age category the difference was greater, with a 3% increase across the EU27 compared with a 28% increase in Ireland. The extent of the demographic changes in Ireland between the baseline period (2016-2019) and the current year (2023) reduces the value of comparing current deaths with deaths in 2016-2019.
In relation to Ireland, it is also important to note that data from 2020 onwards is based on data provided by the CSO based on a web-scraped series from rip.ie. The comparison baseline (2016-2019) is built using official data on registered deaths. Caution is required in interpreting this indicator.
The latest data published by Eurostat (published 9 August 2023 www.ec.europa.eu/eurostat/statistics-explained/index.php?title=Excess_mortality_-_statistics), refers to deaths in June 2023. Based on the Eurostat methodology, it is estimated that Ireland experienced 13.6% additional deaths in June and has experienced additional deaths every month for the past 12 months (data attached). This means the number of deaths in each month was higher than the average number of deaths in that same month during the years 2016-2019. It does not account for population growth, ageing or other factors impacting on long-term mortality trends.
The Central Statistics Office (CSO) publishes official statistics on mortality in Ireland and publishes quarterly and yearly statistics on registered deaths through their Vital Statistics publications. The latest published data is for deaths registered in Quarter 1 2023 and data is provisional. Data on deaths in each quarter from Quarter 2 2022 to Quarter 1 2023 by cause of death is attached.
The Department of Health is actively monitoring and reviewing all available data on mortality as it becomes available to gain a better insight on the underlying mortality trends and factors influencing these. The Department supports the clear national commitment to learn from the COVID-19 pandemic, in particular with a view to ensuring the State’s preparedness for future public health threats.
Attached
Cause of Death_2022Q2-2023Q1.xlsx
EuroMOMO_Eurostat Excess Mortality.xlsx
EuroMOMO_IRL_-z-scores.png
Question No. 549 answered with Question No. 522.
Medical Aids and Appliances
Ceisteanna (550)
Eoin Ó Broin
Ceist:550. Deputy Eoin Ó Broin asked the Minister for Health the rationale behind the policy of allowing only one funded respiratory mask per annum for people suffering with chronic respiratory disease and using BiPAP machines; if there is a process for application for replacement masks if it is the case a replacement is necessary; if there is a process of reimbursement for the substantial cost of €250 in cases where patients have had to pay to replace a mask themselves; and if he will make a statement on the matter. [41178/23]
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.
Medical Aids and Appliances
Ceisteanna (551)
Eoin Ó Broin
Ceist:551. Deputy Eoin Ó Broin asked the Minister for Health if a person (details supplied) will be reimbursed by the HSE for the cost of replacing necessary medical equipment; and if so, if he will outline the process through which the person can apply for reimbursement. [41179/23]
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.
General Practitioner Services
Ceisteanna (552)
Eoin Ó Broin
Ceist:552. Deputy Eoin Ó Broin asked the Minister for Health the process through which a couple (details supplied) can obtain a new GP accepting medical cards; where the relationship with their current GP is irretrievably broken but all attempts at sourcing a new GP have been exhausted without success; and where the PCRS advise they cannot appoint a GP for the patients involved; and if he will make a statement on the matter. [41191/23]
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.
Primary Care Services
Ceisteanna (553)
Bernard Durkan
Ceist:553. Deputy Bernard J. Durkan asked the Minister for Health the efforts being made to ensure the continuation of speech and language services at Kilcock primary healthcare centre given the local demand for the continuation of this service; and if he will make a statement on the matter. [41195/23]
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.
Home Care Packages
Ceisteanna (554)
Bernard Durkan
Ceist:554. Deputy Bernard J. Durkan asked the Minister for Health when a homecare package will be reinstated in the case of a person (details supplied); if the necessary arrangements can be put in place as soon as possible to facilitate their return home; and if he will make a statement on the matter. [41197/23]
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.
Hospital Appointments Status
Ceisteanna (555)
Niamh Smyth
Ceist:555. Deputy Niamh Smyth asked the Minister for Health to review a case (details supplied); if he will ensure that this matter is dealt with speedily; and if he will make a statement on the matter. [41201/23]
Amharc ar fhreagraFreagraí scríofa
Under 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.
Health Strategies
Ceisteanna (556)
Catherine Murphy
Ceist:556. Deputy Catherine Murphy asked the Minister for Health if he and or the HSE have developed guidance for end users in respect of blue light from computer screens and digital devices in the context of eye health; and the number of persons in 2020, 2021, 2022 and 2023 with eye complaints as a result of prolonged exposure to blue light. [41244/23]
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 Services Waiting Lists
Ceisteanna (557)
Seán Canney
Ceist:557. Deputy Seán Canney asked the Minister for Health how many patients are on the orthodontic assessment waiting list in Galway; how long the current waiting time is; how many patients are on the orthodontic treatment waiting list; what the current wait time is; if there are currently any unfilled clinical positions in the Galway service; and if he will make a statement on the matter. [41260/23]
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 Services Waiting Lists
Ceisteanna (558)
Seán Canney
Ceist:558. Deputy Seán Canney asked the Minister for Health how many patients are on the podiatry waiting list in Galway; how long the current waiting time is; if the interval between appointments between patients has been shortened or lengthened in the past year; if there are currently any unfilled clinical positions; and if he will make a statement on the matter. [41261/23]
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.
Nursing Homes
Ceisteanna (559)
Michael Healy-Rae
Ceist:559. Deputy Michael Healy-Rae asked the Minister for Health his views on a matter (details supplied); and if he will make a statement on the matter. [41262/23]
Amharc ar fhreagraFreagraí scríofa
The Nursing Homes Support Scheme (Amendment) Act 2021 was signed into law by President Higgins on 22 July 2021 and became fully operational from 20 October the same year. The goal of this amendment is to assist in protecting the viability and sustainability of family farms and family-run businesses. The stated policy objective of the legislation is to introduce additional safeguards in the Scheme to further protect the viability and sustainability of family farms and businesses that will be passed down to the next generation of the family to continue to work them as productive assets to provide for their livelihood.A condition of receiving the financial relief offered under the Act is that a family successor commits to working the productive asset for a substantial part of their working time for a period of 6 years. In line with the policy objective to ensure the viability of family farms and businesses the Act clearly defines who can be a family successor.The principal amendment introduced under the Act extended the three-year cap on contributions based on farm and business assets where an appointed family successor commits to working the productive asset for a period of 6 years. To be considered for the 3-year cap, the legislation requires that an asset owned by an applicant for the Scheme, or recently transferred to a family member, is a productive family asset that has been actively worked by a family member for a significant period of time in advance of the person entering care. There are no plans to further amend these conditions.However, the Department of Health is in the process of amending the Nursing Homes Support Scheme to broaden the definition who could act as the family successor. Even though cousins have been the main request for inclusion, to avoid challenges and to be consistent, all family members with an equivalent order of relationship to the resident will be included. This would expand those eligible to act as family successor to cousins, great-nephews and great-nieces, and great-grandchildren of either the resident or their partner.It is envisaged that this will retain the policy intention for family farms and businesses, whilst providing enough flexibility in the case that people will be in a situation where they would have no eligible family successor. It is worth noting that any family successor will also need to commit to follow the obligations as outlined under the 2021 Act.The exact wording of this legislation can be found at the following link: www.irishstatutebook.ie/eli/2021/act/27/enacted/en/print#sec2
Healthcare Infrastructure Provision
Ceisteanna (560)
Alan Dillon
Ceist:560. Deputy Alan Dillon asked the Minister for Health what mediation process is in place for developers and contractors who cannot fulfil their signed agreements in capital building projects; and if he will make a statement on the matter. [41268/23]
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.
Healthcare Infrastructure Provision
Ceisteanna (561)
Alan Dillon
Ceist:561. Deputy Alan Dillon asked the Minister for Health what contingency plans are in place for developers who cannot fulfil their obligations due to rising construction costs; and if he will make a statement on the matter. [41269/23]
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.
Healthcare Infrastructure Provision
Ceisteanna (562)
Alan Dillon
Ceist:562. Deputy Alan Dillon asked the Minister for Health what steps his Department and the HSE can take when a contracted developer fails to complete a project due to cost inflation (details supplied); and if he will make a statement on the matter. [41270/23]
Amharc ar fhreagraFreagraí scríofa
The Health Service Executive (HSE) holds responsibility for the delivery, maintenance and operation of Primary Care Centres (PCCs). This includes responsibility for the terms and conditions of the lease agreements for PCCs delivered through the operational lease mechanism. As such, I have asked the HSE to respond directly to the Deputy as soon as possible.
Covid-19 Pandemic
Ceisteanna (563)
Seán Canney
Ceist:563. Deputy Seán Canney asked the Minister for Health the reason that the pandemic special recognition payment is not being paid to haematology staff, given the heroic work that they performed in keeping the service open and operational for patients during the Covid-19 pandemic; if he is aware that blood transfusions were made available to cancer patients throughout the course of the various lockdowns; if he will reverse this decision; and if he will make a statement on the matter. [41271/23]
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. Eligibility criteria for the payment were set following significant consideration and consultation.While the Department does not comment on individual cases, I can confirm that in order to receive the recognition payment, staff must have:• Been in COVID vaccination cohorts 1 or 2, and• Worked ordinarily onsite in a COVID-19 exposed healthcare environment, and• Worked for at least 4 weeks in the 1/3/2020 – 30/6/2021 period, and• Worked in a HSE/Section 38 organisation, or one of the following:1. Private Sector Nursing Homes and Hospices (e.g. Private, Voluntary,Section 39 etc.);2. Section 39 long-term residential care facilities for people with disabilities, working on-site;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;5. Members of the Defence Forces redeployed to work in frontline Covid-19 exposed environments in the HSE;6. Paramedic staff employed by Dublin Fire Brigade to deliver services on behalf of the HSE.Only those staff who meet all of the above eligibility criteria are covered for this payment. I appreciate that many other workers, volunteers, and other citizens, provided important services during this most difficult time. While this is not questioned, it is important to recognise that this in itself is not sufficient to be considered eligible for this payment.
The Government appreciates that those organisations and staff who are not encompassed in this particular payment may feel disappointed. It was tough to draw a line on this matter, but the Government based its decision on the risks which eligible frontline workers faced, following careful consideration. While undoubtedly immense efforts have been made by other healthcare staff since the onset of this pandemic, it is right that the Government pursue this course to recognise those at greatest risk in the performance of their duties throughout the pandemic, including those who worked in the very acutely affected environments above.
My Department has no mandate to widen these to include other groups or employers.
In recognition of the efforts of all workers, volunteers, and the general public during the COVID-19 pandemic, and in remembrance of people who lost their lives due to the COVID-19 pandemic, the Government announced a public holiday which took place on 18 March 2022. As of February this year there i also a new permanent public holiday established to mark Imbolc/St Brigid’s Day.Finally I want to again express my sincere gratitude to all healthcare workers for their efforts during what has been a challenging period for our health services.
Health Services Staff
Ceisteanna (564)
Richard Bruton
Ceist:564. Deputy Richard Bruton asked the Minister for Health whether the HSE has started to recruit to the position of physician associates; whether the extent of the responsibility of such posts have been defined: and whether there is a need for registration and regulation of such posts by an appropriate body to ensure that they only work within their area of established qualifications. [41276/23]
Amharc ar fhreagraFreagraí scríofa
Having sufficient capacity in the health workforce and appropriate configuration of staff and skill-mix are integral to the delivery of safe and timely health services. The Department of Health is supportive of any initiative which ensures that sufficient professionals are trained, recruited and retained in the areas where healthcare need is anticipated.
Engagement between my Department and the HSE is ongoing in relation to reviewing the future role of Physician Associates in the Irish health service. A number of issues including but not limited to the role, responsibilities, scope of practice, clinical governance and regulatory requirements, need to be considered.
Statutory regulation forms a part of a system of assurance that the Department utilises to mitigate risk posed to the public by the practise of health and social care professions. There are many professions engaged in the health service who are not subject to regulation. The issues to be considered regarding the proportionate degree of regulatory force required to protect the public are complex.
In line with ongoing work in the Department of Health, the Health Research Board carried out research on behalf of the Department to assist in policy development in this area. The report, “National Approaches to Regulating Health and Social Care Professions”, examines approaches to the regulation of health and social care professionals internationally and is publicly available on the Department’s website www.gov.ie/en/publication/ea62b-national-approaches-to-regulating-health-and-social-care-professions/
Officials in my Department are drawing from this report and other relevant sources to develop a framework to guide policy on the regulation of health and social care professionals into the future. This framework will also be informed by an evidence and risk-based approach to regulation in line with requirements set out in the EU Proportionality Test Directive, which was transposed into Irish law on 19 August 2022 (S.I. No. 413/2022). Further information on the Proportionality Test Directive can be found here:
www.single-market-economy.ec.europa.eu/news/services-directive-handbookproportionality-test-directive-guidance-2022-12-22_en
There are no plans in place to progress regulation of individual professions until appropriate risk-assessment and evaluation tools are in place in compliance with best practice, international evidence, and the Proportionality Test Directive.
Hospital Services
Ceisteanna (565)
Seán Canney
Ceist:565. Deputy Seán Canney asked the Minister for Health if a multidisciplinary medical team can be assembled at University Hospital Galway to assess the case of a 17-year-old (details supplied) who is wheelchair- and bed-bound, seven months after an acute viral illness; and if he will make a statement on the matter. [41280/23]
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 Appointments Status
Ceisteanna (566)
Alan Kelly
Ceist:566. Deputy Alan Kelly asked the Minister for Health if he is aware that a patient is being asked to wait until 15 January 2025 for an dermatology consultation in St. James's Hospital (details supplied) for treatment of severe hyperhidrosis which requires urgent intervention; if he will arrange to expedite this appointment, or if not, if he will make arrangements to fund Botox treatment for the condition privately; and if he will make a statement on the matter. [41308/23]
Amharc ar fhreagraFreagraí scríofa
Under 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.
Hospital Appointments Status
Ceisteanna (567)
Niamh Smyth
Ceist:567. Deputy Niamh Smyth asked the Minister for Health the reason that a person (details supplied) is waiting five years on a hospital appointment in Cavan General Hospital; and if he will make a statement on the matter. [41345/23]
Amharc ar fhreagraFreagraí scríofa
Under 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.