Tuesday, 17 Oct 2023

Written Answers Nos. 537-564

Nursing Homes

Ceisteanna (537)

Alan Kelly

Ceist:

537. Deputy Alan Kelly asked the Minister for Health when the new community nursing home in Nenagh will be opened and staffed. [44880/23]

Freagraí scríofa

Minister of State at the Department of Health

As this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Budget 2024

Ceisteanna (538)

David Cullinane

Ceist:

538. Deputy David Cullinane asked the Minister for Health if he will provide an itemised breakdown of new developments funding announced in budget 2024, in tabular form. [44884/23]

Freagraí scríofa

Minister for Health

Following the announcement of the budget allocation for my Department, I will shortly be issuing a Letter of Determination to the HSE outlining my priorities and funding levels for 2024. This will be the basis on which the HSE will draw up its National Service Plan (NSP) for 2024. It is not until the conclusion of this process that a detailed breakdown of new development expenditure will be available.

Budget 2024

Ceisteanna (539)

David Cullinane

Ceist:

539. Deputy David Cullinane asked the Minister for Health if he will provide an itemised breakdown of the non-core current allocation announced in budget 2024, in tabular form. [44885/23]

Freagraí scríofa

Minister for Health

Following the announcement of the budget allocation for my Department, I will shortly be issuing a Letter of Determination to the HSE outlining my priorities and funding levels for 2024. This will be the basis on which the HSE will draw up its National Service Plan (NSP) for 2024. It is not until the conclusion of this process that a detailed breakdown of non-core expenditure will be available.

Nursing Homes

Ceisteanna (540)

Peadar Tóibín

Ceist:

540. Deputy Peadar Tóibín asked the Minister for Health the number of nursing homes that have given notice to the chief inspector of HIQA that they wish to deregister and repurpose their buildings in the past three years and to date in 2023; the reasons for repurposing their premises; the effect of the 36 weeks of cooling-off period on the number of places available to the elderly in nursing homes throughout the country; and if he will make a statement on the matter. [44887/23]

Freagraí scríofa

Minister of State at the Department of Health

The Department of Health takes the closures of nursing homes very seriously. The closure of nursing homes can put pressure on other local health and social care facilities. It is vital that the welfare of residents is ensured. There are several reasons for nursing home closures each year including retirement, non-compliance with HIQA regulations, financial viability and, in some cases, recognition that the premises would not be compliant with revised regulations. 

Ensuring the welfare and safety of residents is secured when nursing homes close is the most important thing and work to alleviate the concerns of residents and their families must continue.

There is a legal requirement of providers that they must give at least six months' advance notice to the Chief Inspector of their intention to cease the operation of the nursing home and to close, but they are not required to advise of their future plans for the centre following closure. This provides residents, families and public health authorities appropriate time to respond effectively.

To date in 2023, nine nursing homes have closed. Of these:

• Four notified the Chief Inspector in 2022 of their intention to close but did not close until this year.

• Five notified the Chief Inspector in 2023 of their intention to close.

An additional four nursing homes have also notified the Chief Inspector of their intention to close this year.

In 2022, registered providers of twelve nursing homes, following appropriate notification to the Chief Inspector, closed their nursing homes. 

In 2021, registered providers of four nursing homes, following appropriate notification to the Chief Inspector, closed their nursing homes.

In 2020, registered providers of seventeen nursing homes, following appropriate notification to the Chief Inspector, closed their nursing homes.

In 2022 I introduced a change to the procurement guidelines around accommodation for persons under temporary protection in order to remove from consideration active nursing homes that were still registered operators with HIQA on or after the date of 1 September 2022. Up to this point 7 former nursing homes had been contracted under the procurement guidelines and 5 other former nursing homes were contracted after that date, there were no further additions after November 2022.

The Department of Health's policy position in respect of the use of former nursing homes to accommodate beneficiaries of temporary protection was reviewed at the end of April this year and a more flexible approach adopted to allow the conversion of nursing homes into accommodation centres for international protection applicants and/or beneficiaries of temporary protection after 18 months following deregistration from the Health Information and Quality Agency Chief Inspector’s register.

This period is intended to allow for an appropriate closure process for residents and staff of nursing homes, while also preventing facilities from being empty indefinitely where they might provide at a future date following closure a source of accommodation for international protection applicants and/or beneficiaries of temporary protection.

The Department of Health currently has no plans to review this policy position further.

Health Services

Ceisteanna (541)

Niamh Smyth

Ceist:

541. Deputy Niamh Smyth asked the Minister for Health if scans at the early pregnancy unit in Cavan General Hospital are available at the weekend; if scans can be provided to concerned women at weekends; if he will review this and implement same; and if he will make a statement on the matter. [44888/23]

Freagraí scríofa

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Question No. 542 answered with Question No. 502.

Healthcare Infrastructure Provision

Ceisteanna (543)

Alan Kelly

Ceist:

543. Deputy Alan Kelly asked the Minister for Health if a price has been agreed for the purchase of the Mount Carmel nursing home and site in Roscrea that has been referenced in the HSE's 2023 capital plan; and if he will provide, in tabular form, dates and attendees of all meetings between the HSE and the owners of the site and any other parties to date. [44895/23]

Freagraí scríofa

Minister for Health

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.

Mental Health Commission

Ceisteanna (544)

Steven Matthews

Ceist:

544. Deputy Steven Matthews asked the Minister for Health the position regarding the 49 recommendations set out in the Mental Health Commission's report regarding Child and Adolescent Mental Health Services; and if he will make a statement on the matter. [44900/23]

Freagraí scríofa

Minister of State at the Department of Health

The Mental Health Commission report is a welcome contribution to a common objective of improving CAMHS services. Of the 49 Recommendations, many are already being progressed under workstreams arising from the Sharing the Vision Implementation Plan, the Maskey Report, the COG audit and the national audit of prescribing practice.

The Mental Health Commission plays a vital independent role in supporting and assisting the Department of Health and the HSE in developing and improving mental health services. I, the HSE and all advocates in the sector share the Commission’s commitment to ensure the safest and most effective service for children. To this end, on foot of the Maskey report I had extensive engagement with the Commission and encouraged them to undertake a comprehensive review of children’s mental health services as the topic for their annual mental health services review. I was also pleased to provide the necessary resources to the Mental Health Commission to enable this comprehensive review to take place, running in parallel with the HSE national CAMHS audits. 

While the Mental Health Commission Interim Report highlighted concerns regarding service delivery and administrative practices in five CHOs, many of these related to operational issues within CAMHS teams that have been recognised and resolved. It is reassuring that the final report identified evidence of clinical audits of open cases during the review of the final four CHOs. This final report along with the interim report highlight concerns regarding gaps in governance, both at corporate and clinical level across CHOs. In highlighting these areas where practices can, and should, be addressed, the Commission provides an opportunity to ensure that the HSE’s services are improved. 

Any area that falls short of the high standards that young people and their families should rightly expect is an area of concern. I am reassured from the on-going and extensive engagement between my Department, the HSE, and the Commission regarding the findings of the Final Report, that care in individual cases has not been seriously compromised. It should be noted that any areas of concern identified by the Commission in carrying out its report were escalated immediately to the HSE for immediate action and resolution.

I look forward to continuing to engage with the HSE, and specifically with the new office for youth mental health, to ensure that these recommendations are delivered on.

Question No. 545 answered with Question No. 484.

General Practitioner Services

Ceisteanna (546)

Michael Ring

Ceist:

546. Deputy Michael Ring asked the Minister for Health the payments made in 2022 to doctors under the GMS, to include payment details in all categories, GP name, location and provide this information on a county basis, in tabular form (details supplied); and if he will make a statement on the matter. [44905/23]

Freagraí scríofa

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Medicinal Products

Ceisteanna (547)

Cathal Crowe

Ceist:

547. Deputy Cathal Crowe asked the Minister for Health when the rapid HTA, undertaken by HIQA in November 2022, reviewing the evidence of the clinical and cost-effectiveness of continuous (includes the Dexcom, Medtronic and GlucoRx CGMs) and intermittent (Freestyle Libre) glucose monitoring systems for people with type 1 diabetes will be published; and if it recommends the widening of access to these devices; and if funding will be provided to do so. [44911/23]

Freagraí scríofa

Minister for Health

The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement under the community schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.

In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including clinical efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact.

I, as the Minister for Health, have no role in these decisions.

The Health Information and Quality Authority completed a Health Technology Assessment (HTA) in respect of the provision of glucose monitoring systems to adults with Type I diabetes in Ireland. This was published on 29 September 2023 and can be read at www.hiqa.ie/reports-and-publications/health-technology-assessment/rapid-health-technology-assessment-continuous.

The HTA advises the HSE that a single managed access programme with clearly defined eligibility criteria would improve equity of access and could help to control costs.

Health Service Executive

Ceisteanna (548)

Alan Kelly

Ceist:

548. Deputy Alan Kelly asked the Minister for Health the measurements that are in place year-on-year to ensure the HSE becomes carbon neutral over the coming years. [44912/23]

Freagraí scríofa

Minister of State at the Department of Health

As this is a service matter, I have referred the Deputy's question to the Health Service Executive for attention and direct response to him as soon as possible.

Health Services

Ceisteanna (549)

Seán Canney

Ceist:

549. Deputy Seán Canney asked the Minister for Health if he will provide funding to patients who have to travel to hospital for treatments who have no access to public transport and are not capable of driving; and if he will make a statement on the matter. [44939/23]

Freagraí scríofa

Minister for Health

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

Ceisteanna (550)

Carol Nolan

Ceist:

550. Deputy Carol Nolan asked the Minister for Health to provide a comprehensive breakdown of the €31.5 million allocated in 2023 to the free contraception scheme in tabular form; and if he will make a statement on the matter. [44951/23]

Freagraí scríofa

Minister of State at the Department of Health

The free contraception scheme was launched in September last year, for women and girls ordinarily resident in Ireland, aged 17-25. The scheme was extended to include women aged from 17-30 inclusive in 2023. Approximately €31.5m was allocated to support the scheme in 2023. 

Almost 2,400 GPs and 1,900 pharmacies in all regions of the country have signed up to provide services and products under the scheme to date; it can be accessed across the country. The scheme covers the cost of consultations, and, where appropriate, fittings, checks and removals of contraceptive devices, with GPs, family planning, student health and primary care centres. 

It also covers the cost of prescriptions for the wide range of contraceptive options available through the Health Service Executive (HSE) Re-Imbursement List, including long-acting reversible contraception (LARCs); injections, implants and hormonal and copper coils. It also includes emergency contraception in addition to the oral contraceptive Pill, patch and ring. Women who have had coils, IUDs, IUSs or implants inserted under the scheme will remain eligible for the subsequent checks and free removal of any devices that were inserted before their 31st birthday, in order to ensure continuity of care.

The majority of the budget for contraception is allocated to the HSE Primary Care Division, with most of this allocated to the Primary Care Reimbursement Service, such that GPs and pharmacists contracted to provide services under the scheme can reclaim their costs (as detailed in S.I. No. 451 of 2022 which describes the fees payable).

A subset of the Budget allocation is assigned to the National Women and Infants Health Programme (NWIHP), in order to provide support to maternity units and hospitals and access to contraceptive medicines and devices for those attending maternity Units and hospitals in post-natal or post-ToP settings

An additional allocation is to the Irish College of General Practitioners (ICGP), in order to fund additional training for GPs who may wish to provide specialist fittings, checks and removals of long-acting reversible contraception (LARCs: intrauterine devices and systems (IUS; IUD), coils and implants) as part of their services under the scheme. 

HSE Primary Care, PCRS: €29,409, 860

NWIHP: €428,000 – contraception in post-natal/post-ToP settings

ICGP: €211,263 – LARC training

In terms of more detailed information regarding 2023 expenditure, as this is a service matter, I have asked that the HSE respond to the Deputy directly, as soon as possible.

Covid-19 Pandemic

Ceisteanna (551)

Seán Sherlock

Ceist:

551. Deputy Sean Sherlock asked the Minister for Health why a person was excluded from the pandemic recognition payment (details supplied). [44953/23]

Freagraí scríofa

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.

I would also like to remind the Deputy that it is against Department policy to comment on individual cases.

Question No. 552 answered with Question No. 519.

Medicinal Products

Ceisteanna (553)

Michael Healy-Rae

Ceist:

553. Deputy Michael Healy-Rae asked the Minister for Health if his attention has been drawn to the fact that low dose naltrexone is not covered under the medical card or hardship scheme and that this is used to treat long Covid; and if he will make a statement on the matter. [44971/23]

Freagraí scríofa

Minister for Health

Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for decisions on the pricing and reimbursement of medicines; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

Hospital Staff

Ceisteanna (554)

Pádraig Mac Lochlainn

Ceist:

554. Deputy Pádraig Mac Lochlainn asked the Minister for Health what arrangements will be in place for dermatology patients at Letterkenny University Hospital when the only dermatologist retires shortly. [44974/23]

Freagraí scríofa

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Hospital Overcrowding

Ceisteanna (555)

Pádraig Mac Lochlainn

Ceist:

555. Deputy Pádraig Mac Lochlainn asked the Minister for Health if he is aware of the letter from 78 GPs in Donegal, conveying their serious concerns about the ongoing crisis at Letterkenny University Hospital, calling for a review of services at the hospital and asking him to come to Donegal and meet with them to discuss their concerns; and if he will agree to this request. [44975/23]

Freagraí scríofa

Minister for Health

Urgent and Emergency Care pressures are no longer just experienced during winter periods and levels of high daily presentations and congestion are now being experienced throughout the year. While significant investment has been driven through Winter Planning and National Service Plans over the past three years, a new approach to Urgent and Emergency Care (UEC) planning in now required in response this changing and increasing demand profile. 

This approach is twofold:

• The delivery of an operational plan for Urgent and Emergency Care for the remainder of 2023, which was signed off by Government in July; and 

• The delivery of a 3-year multi-annual Urgent and Emergency Care Strategy to provide a Vision and Framework for UEC for the next 3 years, which is expected to be submitted to Government in the Autumn. 

The Urgent and Emergency Care Operational Plan 2023 outlines targeted reform activities and initiatives which will run to the end of 2023, utilising current investment in hospital and community settings to ensure better outcomes in Urgent and Emergency Care.

I am aware of the letter received from a group of General Practitioners in Donegal expressing their concerns at the situation at Letterkenny University Hospital. A large number of meeting requests are received by my Office, and the request to meet with the Donegal GPs is being actively considered, and a response will be issued shortly.

Dental Services

Ceisteanna (556)

Holly Cairns

Ceist:

556. Deputy Holly Cairns asked the Minister for Health the current orthodontic waiting times for Dublin, Limerick and Cork; the number of patients in each area seen by public orthodontists to date in 2023; the number of patients in each area outsourced to private orthodontists to date in 2023; and if he will make a statement on the matter. [44984/23]

Freagraí scríofa

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Mental Health Services

Ceisteanna (557)

Holly Cairns

Ceist:

557. Deputy Holly Cairns asked the Minister for Health to provide a breakdown of mental health funding under Budget 2024. [44989/23]

Freagraí scríofa

Minister of State at the Department of Health

The total allocation for mental health services in 2024 is approximately €1.3 billion, which is the fourth year in a row in which the mental health budget has been increased. This significant investment will enable continued policy implementation and service improvement in line with our national mental health policy, Sharing the Vision. This year’s budget allocation builds on the investment this Government has made over the last number of years to deliver the policy priorities of Sharing the Vision through the provision of mental health supports across a broad continuum from mental health promotion, prevention and early intervention, to acute and specialist mental health service delivery, and enabling us to continue to deliver our vital services to as many people as possible, as we move into 2024.  

As occurs each year following the Budget, discussions will now take place with the HSE on details relating to specific service initiatives in the context of preparing the HSE Service Plan 2024, including that for Mental Health.

Hospital Waiting Lists

Ceisteanna (558)

Pádraig Mac Lochlainn

Ceist:

558. Deputy Pádraig Mac Lochlainn asked the Minister for Health the number of patients awaiting knee and hip surgeries at Letterkenny University Hospital; and the number of cancellations of appointments for knee and hip surgeries at Letterkenny University Hospital in each of the years 2021, 2022, and 2023, in tabular form. [45000/23]

Freagraí scríofa

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Hospital Procedures

Ceisteanna (559)

Pádraig Mac Lochlainn

Ceist:

559. Deputy Pádraig Mac Lochlainn asked the Minister for Health the number of day surgeries that have been cancelled at Letterkenny University Hospital in 2021, 2022, and 2023, in tabular form. [45001/23]

Freagraí scríofa

Minister for Health

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 Services

Ceisteanna (560)

Michael Healy-Rae

Ceist:

560. Deputy Michael Healy-Rae asked the Minister for Health if two minor injury clinics will be established in Kerry (details supplied); and if he will make a statement on the matter. [45003/23]

Freagraí scríofa

Minister for Health

As this is an operational matter, I have asked the HSE to respond to the Deputy directly.

Hospital Facilities

Ceisteanna (561)

Pádraig Mac Lochlainn

Ceist:

561. Deputy Pádraig Mac Lochlainn asked the Minister for Health if he will ask the HSE to urgently review the decision not to include a surgical hub for the north west and to consider Donegal town as one of the locations for a surgical hub, due to its location between Sligo University Hospital and Letterkenny University Hospital (with almost 40,000 inpatients combined annually) and to support the ability of surgeons and consultants to work through the long waiting lists for surgical procedures at both hospitals and to deliver equality of access to healthcare for the people of the north west. [45005/23]

Freagraí scríofa

Minister for Health

The Government’s €22.5bn health budget for 2024 will facilitate the continued delivery and expansion of quality, affordable healthcare services. This includes provision for the opening and staffing of six new Surgical Hubs across the country.Based on this allocation, the HSE will now work with hospital groups to progress the new Surgical Hubs in Cork, Dublin, Galway, Limerick and Waterford.If further capacity is required beyond this, the HSE will consider how best to address this in the wider context of service delivery reform and future plans for healthcare provision

Cancer Services

Ceisteanna (562)

Mairéad Farrell

Ceist:

562. Deputy Mairéad Farrell asked the Minister for Health the measures that were put in place for patients with complex cancer cases in Portiuncula Hospital prior to the hiring of a consultant radiologist six weeks ago, in terms of their representation at the multidisciplinary meetings at Galway University Hospital; and if he will make a statement on the matter. [45034/23]

Freagraí scríofa

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Hospital Procedures

Ceisteanna (563)

Pádraig Mac Lochlainn

Ceist:

563. Deputy Pádraig Mac Lochlainn asked the Minister for Health the number of primary total hip and primary total knee replacement surgeries performed at Letterkenny University Hospital during each of the calendar years 2018 to 2022, in tabular form. [45041/23]

Freagraí scríofa

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

National Treatment Purchase Fund

Ceisteanna (564, 566, 567, 568)

Pádraig Mac Lochlainn

Ceist:

564. Deputy Pádraig Mac Lochlainn asked the Minister for Health the number of primary total hip and primary total knee replacement surgeries outsourced from Letterkenny University Hospital to the private sector by the NTPF during each of the calendar years 2018 to 2022, in tabular form. [45042/23]

Pádraig Mac Lochlainn

Ceist:

566. Deputy Pádraig Mac Lochlainn asked the Minister for Health the number of primary total hip and primary total knee replacement surgeries outsourced by NTPF from Sligo University Hospital to the private sector during each of the calendar years 2018 to 2022, in tabular form. [45044/23]

Pádraig Mac Lochlainn

Ceist:

567. Deputy Pádraig Mac Lochlainn asked the Minister for Health the total value (cost) of NTPF funding for outsourcing surgical patients from Letterkenny University Hospital to undergo all surgical procedures in the private sector during each of the calendar years 2018 to 2022, in tabular form. [45045/23]

Pádraig Mac Lochlainn

Ceist:

568. Deputy Pádraig Mac Lochlainn asked the Minister for Health to provide the total value cost of NTPF funding for outsourcing surgical patients from Sligo University Hospital to undergo all surgical procedures in the private sector during each of the calendar years 2018 to 2022, in tabular form. [45046/23]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 564, 566, 567 and 568 together.

As regards the specific information requested by the Deputy, the NTPF has provided my Department with the attached tables.

NTPF tables