Wednesday, 18 Oct 2023

Written Answers Nos. 260-276

Health Services Staff

Ceisteanna (260)

Michael Healy-Rae

Ceist:

260. Deputy Michael Healy-Rae asked the Minister for Health if he will examine an issue (details supplied); and if he will make a statement on the matter. [45451/23]

Freagraí scríofa

Minister for Health

As this Parliamentary Question relates to an operational issue, it is a matter for the HSE. However, members of the Oireachtas are advised that the HSE is currently not in a position to answer PQs due to industrial action. It is hoped that normal services will resume soon. In the meantime, this Department will continue to refer PQs to HSE for their direct reply as soon as possible.

Health Services Staff

Ceisteanna (261)

Kathleen Funchion

Ceist:

261. Deputy Kathleen Funchion asked the Minister for Health what actions he has taken to shorten and streamline the vetting process for fully qualified medical doctors from the UK post-Brexit with the IMC; given that many doctors are waiting in excess of two months for their affiliation to be able to work with the HSE; and if he will make a statement on the matter. [45492/23]

Freagraí scríofa

Minister for Health

As the Deputy will be aware, the Medical Council is the statutory agency responsible for the registration and regulation of doctors in Ireland. In order to protect patients, it has a responsibility to ensure that all doctors registered to practise medicine in Ireland meet the requirements to practise, as set out in its legislation. The Medical Practitioners Act 2007 (as amended) makes provision for doctors to access the register depending on their qualifications.

Prior to Brexit, UK qualified doctors were entitled to “Automatic Recognition” of their qualifications under Directive 2005/36/EC. Following Brexit, the EU Commission decided to continue to recognise UK qualifications which are listed in Annex V of this EU Directive, once the qualification was issued before 1st January 2021. Doctors qualified in the UK since 1st January 2021, however, are no longer entitled to automatic recognition under EU law.

For doctors who have qualified in the UK since 1st January 2021, the following applies:

UK-qualified doctors who have completed their internship/Foundation Year 1 in the UK and are issued a Certificate of Experience/Internship, or who have a listed higher qualification in addition to an internship of at least twelve months which comprises of a minimum of two months in medicine in general and two months of surgery in general, OR have completed a minimum of two years in accredited training programme may be exempt from the Medical Council’s registration exam, the PRES, for the purposes of General Registration.

For UK-qualified doctors seeking Specialist Registration, the Council extended recognition of Certificates of Completion of Training (“CCTs”) under Section 47(1)(f) of the Medical Practitioner’s Act. From an applicant perspective this essentially operates in a similar way to “Automatic Recognition” in that they need only provide the same documentation as Pre-Brexit.

I am advised that the current turnaround time for UK applications have been reduced from 12 weeks to 6 – 8 weeks. The Medical Council has assured me that it is actively identifying processes that need to be improved and identifying solutions by way of undertaking an in-depth analysis of all the applications routes, reviewing application data, current processes and challenges. The Council appreciates the importance of providing a prompt registration service for both doctors and the wider health service and is fully committed to further reducing turnaround times. My Department will continue to engage with the Council in support of measures being taken to reduce application processing times.

Industrial Disputes

Ceisteanna (262)

Steven Matthews

Ceist:

262. Deputy Steven Matthews asked the Minister for Health if his attention has been drawn to proposed industrial action by some Section 39 workers related to pay disparity disputes; if his Department is engaging with representatives of these organisations to seek to avoid this escalation; and if he will make a statement on the matter. [45496/23]

Freagraí scríofa

Minister for Health

Officials from the Department of Children, Equality, Disability, Integration and Youth with support from the Department of Health, the HSE and Tusla attended a number of engagements with trade unions under the auspices of the WRC over recent months.

That process culminated in an offer being made to unions. The offer was in line with those accepted by community and voluntary staff in other sectors. The offer to workers in this sector amounted to a 5% increase in funding for pay effective from November 2023, with 3% backdated to April 2023. A commitment to re-engage with trade union representatives following any further public sector pay agreement was also offered.

This combined offer was not accepted by trade union representatives, and it is disappointing that their members were not afforded the opportunity to vote on whether they wished to accept the 5% increase in pay funding.

The Unions have balloted for industrial action and have advised they intend to strike from the 17th of October (2023).

Any industrial action will impact negatively on service users and the Departments urge all parties to work on resolving any disputes through the appropriate forums, in the interests of users of these services. Government remains committed to working with the unions to resolve these matters.

While Government has engaged in this process, it is worth noting that Section 39 and Section 56 organisations are privately owned and operated, and the terms and conditions of employment for staff in those organisations are ultimately between the employer and their employee. The Government is not the employer for any of these staff. As this is an ongoing Industrial relations matter it would be inappropriate to comment any further.

Budget 2024

Ceisteanna (263)

Sorca Clarke

Ceist:

263. Deputy Sorca Clarke asked the Minister for Health what funding his Department will allocate to the National Educational Psychological Service as part of Budget 2024. [45499/23]

Freagraí scríofa

Minister for Health

I wish to advise the Deputy that this is a matter for the Department of Education.

Hospital Charges

Ceisteanna (264)

Paul Kehoe

Ceist:

264. Deputy Paul Kehoe asked the Minister for Health the reason public patients holding medical cards are being asked to pay fees for MRI scans referred through the public health system in Wexford; and if he will make a statement on the matter. [45502/23]

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.

Budget 2024

Ceisteanna (265)

Carol Nolan

Ceist:

265. Deputy Carol Nolan asked the Minister for Health if support centres (details supplied) have been allocated any funding in Budget 2024; and if he will make a statement on the matter. [45518/23]

Freagraí scríofa

Minister for Health

The National Cancer Strategy 2017-2026 recognises 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.

Community cancer support centres are voluntary and charity organisations delivering services directly to cancer patients and their families that emphasise the importance of quality of life during and after cancer treatment. These services can be availed of free of charge and in local communities. 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 NCCP Alliance of Community Cancer Support Centres & Services. Funding for current expenditure, including cancer services, is allocated on an annual (single-year) basis through the Estimates process with future levels of funding considered as part of the national estimates and budgetary process. 

The HSE will shortly be submitting its National Service Plan to my Department for approval which will set out the level of funding to be provided to the Alliance.

Health Services

Ceisteanna (266)

Martin Browne

Ceist:

266. Deputy Martin Browne asked the Minister for Health the measures that have been taken since 2020 to improve capacity within community health services in the mid-west to take pressure off the emergency department at University Hospital Limerick; the reasons that such measures have been unable to avoid the high number of presentations at University Hospital Limerick; and if he will make a statement on the matter. [45567/23]

Freagraí scríofa

Minister for Health

I remain concerned about overcrowding in the Emergency Department in Limerick, and acknowledge the distress this can cause to patients, their families and front-line staff. I am continuing work with the University of Limerick Hospital Group and HSE on addressing these challenges.

The Government is committed to improving services and capacity as a whole in the Mid-West region, and has made considerable investment in the region, including capital projects to increase capacity.

Under the Smaller Hospitals Framework, smaller Model 2 hospitals are providing high-volume and low-complexity care. This is ensuring people can access care, delivered safely and sustainably, often closer to home.

Ennis and Nenagh Model 2 Hospitals and St John's Model 2S Hospital are playing a pivotal role in delivering high-quality patient care in the Mid-West, and are accepting transfers of appropriate patients from University Hospital Limerick on a daily basis. Further funding of €5.2m was allocated in 2023 to Medical Assessment Units in these three hospitals, which now operate 12 hours a day, 7 days a week. These Units help address Emergency Department avoidance, and ensure appropriate community referrals.

As of August this year, all three hospitals also accept 112/999 patients. This means that patients who meet agreed clinical criteria can be transferred by ambulance and treated in these hospitals. This will reduce the number of people presenting at Emergency Departments. It will also release ambulances more quickly to serve other calls.

Furthermore, there have been a number of capital projects completed in the Mid-West region since 2020, including a 24 Bed Rapid Build Ward at Croom Orthopaedic Hospital, a second 24 Bed Rapid Build Ward at University Hospital Limerick, 16 single rooms and 4 double rooms Ward Block extension and refurbishment programme at Mid-Western Regional Hospital Nenagh, and a new 60 bed ward block University Hospital Limerick.

Further progress continues with a 96-bed ward block development at University Hospital Limerick, currently under construction. In parallel, works are advancing to facilitate a second ward 96-bed ward block at University Hospital Limerick.

A range of other projects across the mid-west region in acute and community settings are in train and outlined in the Capital Plan 2023.

Health Services Waiting Lists

Ceisteanna (267)

Martin Browne

Ceist:

267. Deputy Martin Browne asked the Minister for Health if research has been carried out by his Department to ascertain the impact that waiting lists are having on the effectiveness of antibiotics which in many cases are being prescribed repeatedly due to the length of such waiting lists; and if he will make a statement on the matter. [45568/23]

Freagraí scríofa

Minister for Health

It is recognised that waiting times for many scheduled appointments and procedures were too long before, and have been made worse by, the Covid-19 pandemic. The Department of Health continues to work with the HSE and the National Treatment Purchase Fund (NTPF) to identify ways to improve access to care.

On the 7th of March, I published the 2023 Waiting List Action Plan, which is the latest stage of a new multi-annual approach to sustainably reduce and reform hospital waiting lists. The 30 actions in the Plan, which are governed by the Waiting List Task Force, focus on delivering capacity and reforming scheduled care.

For 2023, funding totalling €443 million is allocated to tackle Waiting Lists with €363 million of this being allocated to the 2023 Waiting List Action Plan to reduce hospital waiting lists by implementing longer term reforms and providing additional public and private activity to clear backlogs exacerbated during the pandemic. The remaining €80 million is being targeted at various measures to alleviate community/primary care waiting lists.

With the funding from Budget 2024, we are taking the next steps in the multi-annual approach towards achieving the vision of a world-class public healthcare system in which everyone has timely and transparent access to high-quality scheduled care, where and when they need it, in line with Sláintecare reforms.

Antimicrobial Resistance (AMR) poses a significant challenge to human, animal, and environmental health. Ireland’s second One Health National Action Plan on Antimicrobial Resistance 2021-2025 (iNAP2) provides a strategic roadmap for continued action to address the serious global public health challenge presented by AMR. A mid-term review of the Human Health actions in iNAP2 was undertaken in 2023 to ensure that ongoing learnings from the COVID-19 Pandemic are captured to inform the remainder of the lifecycle of the Plan. Monitoring and implementation of the actions under iNAP2 is ongoing.

The HSE has not commissioned research to ascertain the impact that waiting lists are having on the effectiveness of antibiotics. The HSE 2022-2025 AMRIC Action Plan sets out a range of HSE actions aligned to the five strategic objectives of iNAP2 that are under implementation.

The Department of Health is committed to continuing to work with HSE AMRIC, and to engaging with other stakeholders across the One Health sectors, to progress implementation of the actions under iNAP2.

Eating Disorders

Ceisteanna (268)

Martin Browne

Ceist:

268. Deputy Martin Browne asked the Minister for Health if the provisions of Budget 2024 will see an increase in services for people with eating disorders; if he has made any provision for the development of a specific model of care for avoidant restrictive food intake disorder; and if he will make a statement on the matter. [45569/23]

Freagraí scríofa

Minister of State at the Department of Health

The total allocation for mental health services for 2024 is almost €1.3bn, a record funding level which represents an increase for the fourth year in a row. As part of the additional funding secured under Budget 2024, a number of new posts will be available to support youth mental health service provision and development. This includes posts to support eating disorders, as well as across dual diagnosis and early intervention psychosis. Funding will also be used to ensure the strategic development and alignment of key services that are relied on by young people and their families.

In relation to eating disorder services specifically, the HSE has prioritised eating disorder (ED) services as part of its National Clinical Programmes (NCP) which aim to develop high-quality, person-centred, integrated care through a clinician-led, evidence-based approach to service reform.

While a small number of people benefit from more intensive treatment through day programmes or inpatient care, the most effective treatment setting is in the community. Dedicated community-based eating disorder services, where multidisciplinary teams have specialist training, can provide evidence-based care and treatment. 

The HSE also funds patients in private facilities based on individual clinical need, as assessed by the local mental health team, and the prioritisation of available funding.

In January 2018, the HSE published a National Model of Care for Eating Disorders (MOC) in partnership with College of Psychiatrists’ of Ireland and Bodywhys. This Model of Care was developed to guide the provision of high quality, accessible and value for money eating disorder services in Ireland. Key recommendations include:

• the development of a national network of dedicated eating disorder teams embedded within the mental health service

• a stepped model of outpatient, day patient and inpatient care provision based on clinical need

• the development of a skilled, trained workforce

The National Clinical Programme for Eating Disorders (NCPED) aims to establish an ED network (8 adult teams and 8 CAMHS teams) in accordance with the agreed Model of Care 2018. These multidisciplinary teams provide specialist eating disorder assessment and treatment in the community and are the foundations of delivering quality eating disorder care across the stepped model of care. Today there are 10 NCPED teams at various stages of development across the HSE.

In the context of the significant physical morbidity associated with eating disorders, this Model of Care also recommends a strong integration between primary care, mental health services and medical teams, including the bridging of the acute hospital and mental health service divide through mutual clinical commitments and shared pathways. Recently consultant paediatricians sessions have commenced in 2 community eating disorders teams to facilitate shared pathways.  Children and adolescents with eating disorders can access treatment through CAMHS community teams. There are currently 73 CAMHS teams nationwide.

The Department of Health will undertake detailed discussions with the HSE in the coming months to finalise the Mental Health element of the new HSE Service Plan 2024.

With regard to the Deputy’s specific query around avoidant restrictive food intake disorder, this is a service matter and I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Covid-19 Pandemic Supports

Ceisteanna (269)

Martin Browne

Ceist:

269. Deputy Martin Browne asked the Minister for Health if certain workers (details supplied) are to receive the pandemic bonus; the reasons for not receiving it to date; and if he will make a statement on the matter. [45570/23]

Freagraí scríofa

Minister for Health

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

Nursing Homes

Ceisteanna (270)

Robert Troy

Ceist:

270. Deputy Robert Troy asked the Minister for Health if he will provide an update on a fair deal review (details supplied). [45573/23]

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.

Mortality Rates

Ceisteanna (271)

Fergus O'Dowd

Ceist:

271. Deputy Fergus O'Dowd asked the Minister for Health if he will seek details from his Department on the total number of deaths from causations (detail supplied) from 2014 to 2021; and if he will make a statement on the matter. [45608/23]

Freagraí scríofa

Minister for Health

The total number of deaths from AIDS,  from Breast Cancer,  from Heart Attack,  from Stroke.

Statistic Label	Year	Sex	Cause of Death	Area	UNIT	VALUE
Deaths	2014	Both sexes	Aids (HIV disease)	All counties and regions	Number	8
Deaths	2014	Both sexes	Malignant neoplasm of breast	All counties and regions	Number	740
Deaths	2014	Both sexes	(Acute myocardial infarction)	All counties and regions	Number	1844
Deaths	2014	Both sexes	Cerebrovascular disease	All counties and regions	Number	1852
Deaths	2015	Both sexes	Aids (HIV disease)	All counties and regions	Number	8
Deaths	2015	Both sexes	Malignant neoplasm of breast	All counties and regions	Number	680
Deaths	2015	Both sexes	(Acute myocardial infarction)	All counties and regions	Number	1957
Deaths	2015	Both sexes	Cerebrovascular disease	All counties and regions	Number	1920
Deaths	2016	Both sexes	Aids (HIV disease)	All counties and regions	Number	8
Deaths	2016	Both sexes	Malignant neoplasm of breast	All counties and regions	Number	763
Deaths	2016	Both sexes	(Acute myocardial infarction)	All counties and regions	Number	1847
Deaths	2016	Both sexes	Cerebrovascular disease	All counties and regions	Number	1830
Deaths	2017	Both sexes	Aids (HIV disease)	All counties and regions	Number	11
Deaths	2017	Both sexes	Malignant neoplasm of breast	All counties and regions	Number	758
Deaths	2017	Both sexes	(Acute myocardial infarction)	All counties and regions	Number	1744
Deaths	2017	Both sexes	Cerebrovascular disease	All counties and regions	Number	1710
Deaths	2018	Both sexes	Aids (HIV disease)	All counties and regions	Number	5
Deaths	2018	Both sexes	Malignant neoplasm of breast	All counties and regions	Number	788
Deaths	2018	Both sexes	(Acute myocardial infarction)	All counties and regions	Number	1761
Deaths	2018	Both sexes	Cerebrovascular disease	All counties and regions	Number	1657
Deaths	2019	Both sexes	Aids (HIV disease)	All counties and regions	Number	6
Deaths	2019	Both sexes	Malignant neoplasm of breast	All counties and regions	Number	697
Deaths	2019	Both sexes	(Acute myocardial infarction)	All counties and regions	Number	1702
Deaths	2019	Both sexes	Cerebrovascular disease	All counties and regions	Number	1618
Deaths	2020	Both sexes	Aids (HIV disease)	All counties and regions	Number	7
Deaths	2020	Both sexes	Malignant neoplasm of breast	All counties and regions	Number	777
Deaths	2020	Both sexes	(Acute myocardial infarction)	All counties and regions	Number	1688
Deaths	2020	Both sexes	Cerebrovascular disease	All counties and regions	Number	1548
Deaths	2021	Both sexes	Aids (HIV disease)	All counties and regions	Number	5
Deaths	2021	Both sexes	Malignant neoplasm of breast	All counties and regions	Number	695
Deaths	2021	Both sexes	(Acute myocardial infarction)	All counties and regions	Number	1619
Deaths	2021	Both sexes	Cerebrovascular disease	All counties and regions	Number	1423

Child Abuse

Ceisteanna (272)

Thomas Pringle

Ceist:

272. Deputy Thomas Pringle asked the Minister for Health if an inquiry was ever held by the Eastern Area Health Board with regard to allegations of child abuse (details supplied) in 1996 as stated in the media (details supplied) at the time; what the outcome was; if a copy of the report is available; and if he will make a statement on the matter. [45625/23]

Freagraí scríofa

Minister for Health (Deputy Stephen Donnelly)

I wish to advise the Deputy that this is a matter for the Department of Children, Equality, Disability, Integration and Youth.

Disability Services

Ceisteanna (273)

David Cullinane

Ceist:

273. Deputy David Cullinane asked the Minister for Health the revised capital ceilings under the National Development Plan for his Department given the transfer of specialist disability services to the Department of Children; Equality; Disability; Integration and Youth, in tabular form. [45651/23]

Freagraí scríofa

Minister for Health

As part of the overall NDP funding, the Health Sector capital allocation is €5.657bn for the period 2021-2025.

As set out in the 2023 HSE Capital Plan, total funding of €21.37m is provided for specialist community-based disability services capital projects, and has transferred to DCEDIY in 2023. This funding will increase, up to 11% annually to 2025, in line with the National Development Plan.

Health Vote Capital Funding of €1.231bn in 2024 was announced as part of Budget 2024.

Responsibility for, and oversight of, specialist community-based disability services capital funding has transferred to DCEDIY as part of the Transfer of Functions and is included in that Vote.

Allocations to the health vote, before and after the transfer of specialist community-based disability services are set out in the table below.

	2023	2024
Original NDP Allocation (Including specialist community-based disability services)	€1,127m	€1,255m
Revised health NDP Allocation (Net of specialist community-based disability services transferred)	€1,106m	€1,231m

Medical Qualifications

Ceisteanna (274)

Emer Higgins

Ceist:

274. Deputy Emer Higgins asked the Minister for Health if he is aware of concerns raised regarding the potential implications of CORU draft registration standards for psychotherapy training and if the proposed standards ensure the highest quality of care for clients; and if he will make a statement on the matter. [45656/23]

Freagraí scríofa

Minister for Health

As the Deputy may be aware, the Health and Social Care Professionals Council and Registration Boards, collectively known as CORU, are responsible for protecting the public by promoting high standards of professional conduct, education, training, and competence amongst the professions designated under the Health and Social Care Professionals Act (2005). The Act is being implemented on a phased basis as registration boards and their registers are being established.

Regulations under SI No. 170 of 2018 were made by my predecessor in 2018 to designate the professions of counsellor and psychotherapist under the 2005 Act and to establish one registration board for both professions. Members were appointed to the Counsellors and Psychotherapists Registration Board in February 2019 and they held their inaugural meeting in May 2019.

The work of the Counsellors and Psychotherapists Registration Board (CPRB) includes consideration of the titles to be protected and the minimum qualifications to be required of existing practitioners and the qualifications that will be required for future graduates. The work of the CPRB is significantly more challenging than it is for registration boards for some of the more established professions owing to the different and complex pathways into these professions, the variety of titles used, and the variety and number of courses and course providers.

To date, the following progress has been made by the CPRB:

• Identification, verification and comprehensive assessment of legacy/historical qualifications to determine if they are appropriate for transitioning existing practitioners onto the respective registers (when open);

• Scoping and research on the regulation of counsellors and psychotherapists internationally has been conducted;

• Drafting of separate and distinct Standards of Proficiency for counsellors and psychotherapists and Criteria for Education and Training Programmes has been finalised.

A public consultation on the draft Standards of Proficiency and Criteria for Education and Training Programmes has been launched and will run until 5pm on Friday 1st December 2023. As part of this consultation, the CPRB welcomes feedback from stakeholders, including members of the professions, education providers, employers, professional and representative bodies, as well as members of the public.

Further information on the consultation process is available on the CORU website here: www.coru.ie/public-protection/public-consultations/current-consultations/public-consultation-psychotherapists-standards-of-proficiency-and-criteria-for-education-and-training-programmes-for-psychotherapists.html.

Public Procurement Contracts

Ceisteanna (275)

Matt Shanahan

Ceist:

275. Deputy Matt Shanahan asked the Minister for Health to provide a detailed explanation of the processes, milestones and timelines that led to the recently released HSE tender for Cork University Hospital Clinical Medical School; and if he will make a statement on the matter. [45661/23]

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.

Public Procurement Contracts

Ceisteanna (276)

Matt Shanahan

Ceist:

276. Deputy Matt Shanahan asked the Minister for Health to detail the source of funding for the recently released tender for Cork University Hospital Clinical Medical School; and if he will make a statement on the matter. [45662/23]

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.