Peter Burke
Ceist:205. Deputy Peter Burke asked the Minister for Health if he will provide an update on a person regarding an assessment for ADHD (details supplied). [51411/23]
Amharc ar fhreagraPsychological Assessments
Ceisteanna (205)
Freagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday, 6 October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
Hospital Services
Ceisteanna (206)
Martin Browne
Ceist:206. Deputy Martin Browne asked the Minister for Health if consideration will be given to opening medical assessment units at Nenagh, Ennis and St John's hospitals on a 24-hour basis in light of the continued high number of presentations at University Hospital Limerick; and if he will make a statement on the matter. [51415/23]
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 Service Executive
Ceisteanna (207)
Pearse Doherty
Ceist:207. Deputy Pearse Doherty asked the Minister for Health if there are properties in the Pettigo area of County Donegal that are owned by the HSE but not currently being used; and if he will make a statement on the matter. [51421/23]
Amharc ar fhreagraFreagraí scríofa
As the Health Service Executive is responsible for the management of the public healthcare property estate, I have asked the HSE to respond directly to you in relation to this matter.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday 6 th October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
Hospital Appointments Status
Ceisteanna (208)
Colm Burke
Ceist:208. Deputy Colm Burke asked the Minister for Health when a child (details supplied) will be contacted and scheduled to have surgery; and if he will make a statement on the matter. [51448/23]
Amharc ar fhreagraFreagraí scríofa
I fully acknowledge the distress and inconvenience for patients and their families when elective procedures are cancelled, particularly for clinically urgent procedures. While every effort is made to avoid cancellation or postponement of planned procedures, the HSE has advised that planned procedures and operations can be postponed or cancelled for a variety of reasons including capacity issues due to increased scheduled and unscheduled care demand.
Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.
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.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday 6th October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, there may be a delay in the Deputy receiving a response from the HSE.
General Practitioner Services
Ceisteanna (209, 210)
Colm Burke
Ceist:209. Deputy Colm Burke asked the Minister for Health if he if he will give due consideration to the creation of GP referral guidance for suspected childhood, adolescent and young adult cancers; and if he will make a statement on the matter. [51449/23]
Amharc ar fhreagraColm Burke
Ceist:210. Deputy Colm Burke asked the Minister for Health if he will take the necessary steps to promote awareness raising of childhood, adolescent and young adult cancer symptoms among the public; and if he will make a statement on the matter. [51450/23]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 209 and 210 together.
Last August, I welcomed the publication by the National Cancer Registry 'Childhood Adolescent and Young Adult Cancer: Cancer Trends Report'. The report describes ongoing significant improvements in 5-year survival and reductions in mortality for childhood, adolescent, and young adult (CAYA) cancers. This reflects advances in early detection, treatment, and care.
In 2014, mortality rates in Ireland for children and young people with cancer were among the lowest observed in Europe. Mortality rates have continued to decrease significantly for both sexes and age-groups. Of the 8,974 children, adolescents and young adults diagnosed with cancer between 1994 and 2020, 7,354 (82%) were still alive at the end of 2020. These trends attest to significant progress in timely diagnosis and effective treatment of CAYA cancers in Ireland.
There have been several important recent developments in the treatment of children and young people with cancer. Funding allocated for the implementation of the National Cancer Strategy in 2022 included €1.5 million for psycho-oncology and CAYA services more generally, enabling the recruitment of an additional 15 staff to these services. This includes a broad range of staff including social workers, psychologists and psychiatrists, clinical nurse specialists, advanced nurse practitioners, and play therapists.
For the first time last year, a national multidisciplinary team for adolescent and young adult cancer was established, which has been meeting to discuss patient cases this year. This type of coordinated approach has seen enormous benefits for patient outcomes in other cancer settings. Under the framework for the Care and Support of Adolescent and Young Adults with cancer in Ireland, three AYA cancer hubs have been established, based at St James’s Hospital, University Hospital Galway and Cork University Hospital.
The National Model of Care for Psycho-Oncology Services for Children, Adolescents and Young Adults with Cancer was launched in May of this year. This model of care focuses on supporting children or young adults, as well as their families with the psychological impact of a cancer diagnosis and provides for patient pathways to accessing appropriate care at all stages of their cancer diagnosis and treatment.
These new initiatives under the National Cancer Strategy mean that we can address the specific needs of children and young adults with cancer and continue to improve the services available to them. The HSE's National Cancer Control Programme (NCCP) continues to support targeted cancer awareness initiatives.
Question No. 210 answered with Question No. 209.
Addiction Treatment Services
Ceisteanna (211)
Thomas Gould
Ceist:211. Deputy Thomas Gould asked the Minister for Health for an update on the reopening of Keltoi. [51451/23]
Amharc ar fhreagraFreagraí scríofa
As this refers to a service matter, I have sent this PQ to the HSE for direct response. As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday 6th October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
Departmental Policies
Ceisteanna (212)
Colm Burke
Ceist:212. Deputy Colm Burke asked the Minister for Health if he will give due consideration to publishing a new cardiovascular health policy, as the current Changing Cardiovascular Policy (2010-2019) requires updating; and if he will make a statement on the matter. [51483/23]
Amharc ar fhreagraFreagraí scríofa
The national policy, Changing Cardiovascular Health, covering the period 2010-2019 addressed cardiovascular disease and stroke, including prevention and management and how these are integrated to reduce the burden of these conditions. Ireland has made significant progress under the strategy and is performing better than the Organisation for Economic Co-operation and Development (OECD) average across a number of indicators.
The National Review of Specialist Cardiac Services commenced in January 2018 under the Chairmanship of Professor Phillip Nolan and a Steering Group formed from nominations of interested stakeholders representing medical, professional/technical staff, nursing and patient representatives.
The aim of the Cardiac Services Review is to recommend configuration for a national adult cardiac service to achieve optimal patient outcomes at population level with particular emphasis on the safety, quality and sustainability of the services that patients receive. This aligns with the Sláintecare reform programme. In terms of scope, the National Review covers scheduled and unscheduled hospital-based services for the diagnosis and treatment of cardiac disease in adults.
The Review is finalised and has been presented to my office, where it is under my consideration. The recommendations of the review will inform the future provision of cardiac services nationally.
Health Services Staff
Ceisteanna (213)
Colm Burke
Ceist:213. Deputy Colm Burke asked the Minister for Health if he will set aside funding to invest in training and career development for non-clinical public health staff within public health departments and other agencies for the purposes of planning future health and social care needs and to respond to a wide range of public health emergencies; and if he will make a statement on the matter. [51484/23]
Amharc ar fhreagraFreagraí scríofa
Since the onset of the COVID-19 pandemic, a reform process aimed at strengthening Public Health in Ireland has been underway. Implementation of a national hub-and-spoke model for Public Health based on the introduction of the role of Consultant in Public Health Medicine is underway. The recruitment of 84 new Consultant in Public Health Medicine posts is being implemented on a phased basis. The first phase, recruitment and appointment of 34 WTE Consultant posts is complete. Recruitment of Phase 2 (30 WTE) Consultant posts is progressing well with 19 posts in place, a further 9 posts in various stages of short-listing prior to contracting and the remaining 2 posts are pending advertisement with the HSE National Recruitment Service (NRS). Phase 3, comprising recruitment of a further 20 WTE Consultant posts is underway. Ten of these posts are currently advertised with the remainder in progress. It is intended that all 84 Consultant posts will be in place in the coming months.
Six new Public Health Areas have been established, aligned to future Sláintecare areas, led by Area Directors of Public Health and delivering a Consultant-led Public Health service operating on a hub-and-spoke model.
In addition to the introduction of the Consultant role, considerable progress has been made in recruitment to our broader Public Health workforce making up the multi-disciplinary teams (MDTs) being led at Consultant level as envisaged by the Crowe Horwath Report. Since 2020, we have almost doubled the Public Health workforce with the recruitment of over 237 additional new WTEs at posts including public health doctors, nurses, scientists, and support staff.Additional resources have also been provided to the HSE to ensure enhancements are put in place to existing infectious disease surveillance systems in the Health Protection Surveillance Centre (HPSC). This will ensure effective monitoring and signalling of what is happening with infectious diseases at population level, so that we can greater understand disease transmission and severity along with population immunity and risk. Following provision of additional resources in Budget 2023, eighty nine new posts in disease surveillance are being created with 55 of these already recruited.
This has enabled expansion of GP Sentinel Surveillance, with 90 GP practices now participating in the scheme. In addition, a Biostatistics and Modelling Unit is being established in the HPSC. Wastewater Surveillance and Whole Genome Sequencing programmes are in place and operational. The HSE has also made progress towards procurement of an Outbreak Case and Incident Management System, a key enabler of a national health protection service.
My Department and the HSE are fully committed to building on the significant progress already made to enhance our public health systems and workforce.
Pharmacy Services
Ceisteanna (214)
Colm Burke
Ceist:214. Deputy Colm Burke asked the Minister for Health to undertake the necessary research to assess the feasibility of involving pharmacists in Ireland in the management of confirmed hypertension; and if he will make a statement on the matter. [51485/23]
Amharc ar fhreagraFreagraí scríofa
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 establishment in July 2023 of the Expert Taskforce to support the expansion of the role of pharmacists in Ireland is evidence of my commitment to that aim. I have accepted the first recommendation of the Taskforce and work to implement that recommendation has commenced with the relevant stakeholders. The Taskforce has now moved on to the second phase of its work.There has been constructive engagement between Department officials and the Irish Pharmacy Union especially in recent months to advance consideration of the range of initiatives to support an enhanced role of pharmacy.
As the Taskforce progresses its work this close engagement needs to continue with my Department and the HSE, with a view to identifying the key enablers to support realisation of the objectives of an expanded scope of pharmacy practice.
Departmental Reports
Ceisteanna (215)
Colm Burke
Ceist:215. Deputy Colm Burke asked the Minister for Health to provide an anticipated completion date for the Department of Health Evaluation Report of the Impact of the 2018 Sugar Sweetened Drinks Tax; and if he will make a statement on the matter. [51486/23]
Amharc ar fhreagraFreagraí scríofa
A Healthy Weight for Ireland, the Obesity Policy and Action Plan (OPAP), was launched 2016 under the auspices of the Healthy Ireland Framework (Healthy Ireland: A Framework for Improved Health and Wellbeing 2013-2025). It was developed in recognition of the growing need for a co-ordinated policy response to the increasing prevalence of obesity in Ireland. OPAP covers a 10-year period up to 2025 and aims to reverse obesity trends, prevent health complications, and reduce the overall burden for individuals, families, the health system, and the wider society and economy. It recognises that obesity is a complex, multi-faceted problem and needs a multi-pronged solution, with every sector of society playing its part.
OPAP includes a suite of prevention measures which were identified by the World Health Organisation (WHO, 2008) as cost-effective interventions, ranging from education and schools-based programmes to reformulation and fiscal policies with the aim of gradually changing Ireland’s obesogenic environment to facilitate consumption of healthier foods and drinks.
The introduction of an Irish Sugar-Sweetened Drinks (SSD) tax was first announced in the Programme for Government in May 2016 and was included in the suite of commitments under the Obesity Policy and Action Plan. The SSD tax was announced in Budget 2018, setting out the applicable tax rate structure, and the tax came into effect on the 1st of May in 2018.
The aim of the Irish SSD tax is to reduce rates of childhood and adult obesity in Ireland by reducing the consumption of sugar sweetened drinks as a contributor to health and dental deterioration, particularly among young people. The desired outcomes are twofold: (1) that individuals reduce consumption of sugar sweetened drinks by reducing amount consumed or switching to healthier choices; (2) that industry reformulates products to reduce (not necessarily remove) levels of added sugar in the drinks products.
The SSD tax is the first such fiscal measure in Ireland and a commitment was given to undertake an evaluation of the sugar sweetened drinks tax against the stated aims of the tax. Following an internal scoping review, the Department went to tender for an external evaluation of the SSD Tax in August 2023.
Outcomes of interest from the study are primarily around the impact of the tax on the consumption of SSDs and on reformulation of SSD products. The contract for the evaluation was awarded in October and the evaluation is expected to be complete in Q1 of 2024. The results will be published in due course.
Legislative Measures
Ceisteanna (216)
Colm Burke
Ceist:216. Deputy Colm Burke asked the Minister for Health if he will take the necessary steps to initiate a Public Health (Obesity) Bill to include restricting the marketing of unhealthy foods to children; and if he will make a statement on the matter. [51487/23]
Amharc ar fhreagraFreagraí scríofa
The policy instrument for addressing obesity in Ireland is “A Healthy Weight for Ireland’, the Obesity Policy and Action Plan (OPAP), which was launched in September 2016, under the umbrella of the Healthy Ireland Framework, our national policy for health and wellbeing in Ireland.
The OPAP covers a 10-year period, up to 2025, and aims to reverse obesity trends, prevent health complications and reduce the overall burden for individuals, families, the health system, and the wider society and economy. Implementation of the OPAP is overseen by a cross-sectoral and cross-Departmental group, the Obesity Policy Implementation Oversight Group (OPIOG), chaired by the Department of Health. Deliverables under the OPAP are also reflected in a number of key policy documents, including the Sláintecare Implementation Strategy and Action Plan and the Healthy Ireland Strategic Action Plan (HI SAP).
The OPAP recognises that obesity is a complex, multi-faceted issue and needs a multi-pronged solution, with every sector of society playing its part. This is also emphasised by the 2022 WHO European Regional Report. The OPAP also includes most of the recommended policy actions in the WHO 2022 report.
Many initiatives and policies which address different aspects of the complexity of obesity have been developed and progressed over the last number of years. An internal review and an external evaluation of the OPAP was published at the end of 2022 which highlighted the progress that had been made to deliver on the OPAP and also highlighted key actions remaining to be fully implemented.
The Programme for Government, 2022 includes a commitment to introduce a Public Health Obesity Bill, including examining restrictions on promotion and advertising aimed at children. In relation to the issues around advertising and marketing of unhealthy foods aimed at children, work has been progressing at both EU and national levels to examine restricting marketing of unhealthy foods and beverages to children through other channels and the need to introduce a Public Health Obesity Bill needs to be considered in this context.
At an EU level, the EU Joint Action “Best ReMaP” (Best practices in Reformulation, Marketing and public Procurement), has just completed its work and a suite of resources has now been published under the Work Package on Restricting the marketing of unhealthy foods to children and adolescents. Ireland worked with 15 other Member States on this suite of resources which includes an EU coordinated approach using the WHO nutrient profile model for the identification of foods not permitted for marketing to children, guidance for Codes of Practice to reduce unhealthy food marketing and a report on a pilot EU-wide harmonised and comprehensive monitoring protocol for unhealthy food marketing. Intersectoral Working Groups have been established to facilitate the implementation of the food marketing tools developed by the Joint Action Best-ReMaP and the integration of policies into national legislation after the end of the Joint Action.
With regard to current rules in Ireland regarding advertising, sponsorship, product placement and other forms of commercial promotion aimed at children or broadcast in or around children’s programming, these are contained in the Childrens’ Commercial Communications Code (CCCC). This is a statutory broadcasting code issued by the Broadcasting Authority of Ireland pursuant to section 42 of the Broadcasting Act 2009.
The establishment of “an Coimisiún na Meán” under the Online Safety and Media Regulation Act 2023 provides for the creation of codes and rules which “may prohibit or restrict… the inclusion in programmes of commercial communications relating to foods or beverages considered by the Commission to be the subject of public concern in respect of the general public health interests of children… those foods or beverages which contain fat, trans-fatty acids, salts or sugars.”
As the Department responsible for public health policy, the Department of Health will contribute to, and be consulted on, the making of any codes by Coimisiún na Meán relating to the advertisement of food or beverages at children. The Department of Health is engaging with the Commission with a view to identifying how we will progress the development of such codes. We anticipate that this complex policy issue will require a high level of consultation across Government, with experts and other key stakeholders as and when appropriate.
The Online Safety and Media Regulation Act provides for the making of online safety codes which may restrict the marketing of certain foods and beverages to children, thus providing the means to deliver on this particular policy objective within the PfG. The necessity to bring forward a Public Health Obesity Bill will continue to be assessed as objectives are met by other means.
Health Strategies
Ceisteanna (217)
Colm Burke
Ceist:217. Deputy Colm Burke asked the Minister for Health if he will take the necessary steps in relation to implementing mandatory upper limits relating to salt in bread and other major sources of salt in the Irish diet, in tandem with linked initiatives addressing food labelling, public service procurements and mass media campaigns; and if he will make a statement on the matter. [51488/23]
Amharc ar fhreagraFreagraí scríofa
I would like to thank the Deputy for raising a number of important issues, many of which are relevant to addressing the risk factors associated with overweight and obesity and the many different diseases that can be caused or exacerbated by overweight and obesity, including cardiovascular disease, diabetes and many cancers.
“A Healthy Weight for Ireland”, our national Obesity Policy and Action Plan (OPAP) recognises that not only are individual-focused measures needed to address overweight and obesity which is a key risk factor for CVD, but that a wide range of policies, many structural, are needed to address the obesogenic environment that we live in.
The Obesity Policy and Action Plan (OPAP) was launched in September 2016 as part of the Healthy Ireland Framework and covers a 10-year period up to 2025. It aims to reverse obesity trends, prevent health complications and reduce the overall burden for individuals, families, the health system, and the wider society and economy.?
Significant work has been achieved to date in implementing the OPAP. The FSAI, Safefood and in particular, the HSE have worked with the Department in developing and delivering initiatives to address overweight and obesity from prevention measures right through to clinical treatment, at all life stages. The Department has also supported other Government Departments in the development of policies to address overweight and obesity, including guidelines for school meals and early learning centres.
I would like to address the particular initiatives raised by the Deputy.
In 2021, the Department of Health published A Roadmap for Food Product Reformulation in Ireland. The Food Reformulation Task Force, a strategic partnership between the Food Safety Authority of Ireland (FSAI) and Healthy Ireland, was formed to implement the Roadmap.
One of the aims of the Roadmap is to reduce the salt content of 25 food categories identified as being in high priority need of salt reformulation. These include both bread and processed meats. Food retailers, manufacturers, ingredient suppliers and food service outlets are requested to reduce salt in the 25 priority food categories by 10%. This will build on the work of the Salt and Health programme led by the FSAI between 2003 - 2014. To drive reformulation in these priority food categories the Food Reformulation Task Force is engaging with food manufacturers, food retailers, ingredient suppliers and food service outlets with regards to the reduction of nutrients of public health concern, including salt in the Irish food supply.
The Food Reformulation Task Force will continue to drive food reformulation to achieve the ambitions not only for salt reduction set out in the Roadmap, but also for sugar and saturated fat content, and will publish annual progress reports outlining progress made. Food reformulation is currently done on a voluntary basis in Ireland, with the engagement, encouragement and support of the Task Force. The outcome of the work of the Task Force, which runs to 2025, and consideration of best practices across Europe will help to inform future policy direction with regard to food reformulation in Ireland.
With regard to food labelling, as part of the Farm-to-Fork Strategy published in 2020, the European Commission announced the revision of EU rules on the information provided to consumers. The aim of revising Regulation (EU) 1169/2011, known as the Food Information to Consumers (FIC) Regulation, is to ensure better labelling information, to help consumers make healthier and more sustainable food choices, and to tackle food waste. The Department of Health has legislative responsibility for the FIC Regulation and is coordinating the Irish cross-government approach. The Commission had committed to releasing a legislative proposal, including an impact assessment in Q4, 2022 but this has been delayed. The Commission has yet to indicate when the labelling aspect of the FIC revision will be progressed and has yet to confirm a date on when the impact assessment is likely to be published. Once these are progressed, they will then be considered by the Department of Health-led Inter-Departmental Group, with a view to achieving an agreed Ireland position for submission to the Commission for negotiation by the Member States.
Public awareness and engagement campaigns are an important part of the health promotion and prevention actions under OPAP. The Healthy Ireland social media platforms are used to convey healthy eating messages and to disseminate healthy eating guidelines. The HSE and safefood also run awareness campaigns and health promotion initiatives. A number of targeted campaigns have been run under the guise of OPAP.
START is a public health campaign from safefood, the Departments of Health in Northern Ireland and the Republic of Ireland, Healthy Ireland, the Health Service Executive and the Public Health Agency. The START campaign aimed to support families to take small steps to eating healthier food and becoming more active. A successor to the Safefood Start campaign is currently under development.
Under the guidance of the Obesity Policy Implementation Oversight Group, a targeted social media campaign was developed by Healthy Ireland in partnership with stakeholders in 2022 called the Healthy Weight campaign. Based on analysis of trends in overweight and obesity, the campaign targets men and women aged 24 to 34 years, with a focus on lower socio-economic groups. Research with Young Adults led to the development of a creative concept based around 4 pillars - healthy habits that help individuals maintain a healthy weight: Eat Well, Be Active, Sleep and Stress. The initial burst of this campaign ran in Sep-Nov 2022. The campaign is currently in it’s second implementation phase across social media and radio channels, and once again focuses on the 4 pillars identified in initial research to help individuals aged 24 to 34 maintain a healthy weight.
The Department of Health has also been actively engaging in the Best ReMaP project which has just concluded its work. Best-ReMaP is a Europe-wide Joint Action that seeks to contribute to an improved quality of food supplied to citizens of Europe by facilitating the exchange and testing of good practices concerning food reformulation, marketing of food and beverages to children and the procurement of food by public bodies for educational institutions, social care facilities, etc. The outcomes from BestReMaP will assist the Department and other Government bodies to identify best practices for driving structural changes that are needed to progress OPAP and reduce the impact of the wider environment on overweight and obesity levels in Ireland.
Health Promotion
Ceisteanna (218)
Colm Burke
Ceist:218. Deputy Colm Burke asked the Minister for Health if he will launch a public awareness campaign addressing the risks associated with the use of e-cigarettes and related nicotine products during pregnancy; and if he will make a statement on the matter. [51489/23]
Amharc ar fhreagraFreagraí scríofa
The current focusis to reduce smoking and second-hand smoke (SHS) exposure in pregnancy as the medical evidence shows that smoking complicates pregnancy and leads to poor outcomes including impaired foetal growth and development, pre-term delivery, birth defects and sudden infant death. Health impacts continue past childhood and into later life, since children born to mothers who smoke have an increased likelihood of developing chronic disease as adults. Smoking rates in pregnancy, and therefore the burden of negative outcomes, are highest in the poorest socioeconomic groups.
Policy and action is guided primarily by the National Stop Smoking Clinical Guideline which contains specific and evidence-based guidance on best practice in supporting pregnant women to stop smoking. This includes recommending Nicotine Replacement Therapy during pregnancy and breastfeeding, following discussion with a healthcare provider in order to assist in preventing smoking. The Guideline does not recommend e-cigarettes for smoking cessation in either the general population or in pregnancy however it does include a framework for discussing the use of e-cigarettes in this context.
There is not sufficient evidence in relation to the risks of e-cigarettes or other nicotine products during pregnancy to warrant a targeted policy response beyond the framework of the Stop Smoking Clinical Guideline. My Department continues to monitor any emerging research in this regard.
Tobacco Control Measures
Ceisteanna (219)
Colm Burke
Ceist:219. Deputy Colm Burke asked the Minister for Health if he will allocate additional funding in respect of Ireland's tobacco control budget; and if he will make a statement on the matter. [51490/23]
Amharc ar fhreagraFreagraí scríofa
Funding for cessation services provided by the HSE has increased from €11.8 million in 2017 to €15.7 million in 2022. In Budget 2024, €1.1m. additional funding was allocated for the Tobacco Free Ireland Programme for the provision of free NRT through the HSE Quit Service, bringing the total funding to €1.8 million in 2024. €1.1m additional funding was also allocated for the development and implementation of a tobacco and e-cigarette retailer licencing and inspection system for the Public Health (Tobacco Products and Nicotine Inhaling Products) Bill, which is currently under review by the HSE.
The Public Health (Tobacco Products and Nicotine Inhaling Products) Bill, which I expect to be enacted by the end of this year, will create a licencing system for the retailers of tobacco and nicotine inhaling products such as e-cigarettes, prohibit the sale of e-cigarettes to minors, and restrict the sale of both tobacco and nicotine inhaling products from temporary or moveable premises, self-service vending machines and events aimed at children.
Other cessation measures have been implemented in addition to those available from the HSE in recent times. As part of Budget 2023, Government removed VAT on all nicotine replacement therapies thus reducing the cost of these products to people who wish to stop smoking. I have also agreed that nicotine replacement therapies should be included in the Drug Payment Scheme and to remove the two week limit that applied to first prescriptions of these therapies.
It should also be noted that as part of Budget 2024 Nicotine Replacement Therapies (NRT) are included in the Drug Payment Scheme, and existing prescription limits on NRT in the Community Drug Schemes have been removed.
Health Services
Ceisteanna (220)
Colm Burke
Ceist:220. Deputy Colm Burke asked the Minister for Health if he will set aside funding to undertake a Healthy Ireland Study to ascertain levels of hypertension awareness, treatment and control in the population; and if he will make a statement on the matter. [51493/23]
Amharc ar fhreagraFreagraí scríofa
The Healthy Ireland Survey is conducted annually, with a representative sample of the population aged 15 and older living in Ireland. The sample size is typically in the region of 7,400 - 7,500 people. Fieldwork to date has been conducted on behalf of the Department of Health by Ipsos B&A.
The Survey, first published in 2015, gives an up-to-date, annual picture of the health of the nation, reporting on many health-related lifestyle behaviours. With the exception of the 2020 Survey, which was not completed as a result of the sudden onset of the Covid-19 pandemic, the Survey has been published in Q3-4 each year since 2015. Interviewing for the Survey was conducted by personal interview up to and including 2019; the Survey was switched to telephone interviewing in 2021. The 2023 Healthy Ireland Survey launch is scheduled for Wednesday, 22nd November.
The data from Healthy Ireland Surveys is used to underpin policy development and implementation, to monitor, measure and evaluate progress in implementing various elements of the Healthy Ireland Framework, as well as to meet international reporting obligations, including to the OECD, the EU and the WHO, and to provide information to researchers.
The Survey asks about long-term health conditions every year, including hypertension, which is also known as high blood pressure.
The latest results from the Healthy Ireland Survey, published on 22 November 2023 shows that 9% of the population aged 15 years and over have “high blood pressure or hypertension” lasting 6 months or longer and confirmed by a medical diagnosis. This is the most prevalent long-term condition reported in 2023. This current figure represents an increase from the 7% reported in 2022 and 6% in 2021.
In 2023, 8% of men and 9% of women report having high blood pressure or hypertension. By age group, 15% of those aged 45 and over report having this condition compared to 2% of those aged 15 to 44. The highest rates of hypertension are reported by 19% of men and 24% of women over the age of 65.
Previous waves conducted from 2015, the first year of the Healthy Ireland Survey, to 2019, did not stipulate whether reported conditions must be lasting for six months or more, nor whether they were confirmed by a medical diagnosis. These criteria have the effect of filtering the less severe cases, and, in their absence, earlier survey waves report higher levels of hypertension in the population, of approximately 12%.
In 2018, more detailed questions were asked regarding blood pressure checks, with 66% of those surveyed having had their blood pressure measured during the previous 12 months, rising to 87% of people aged over 55. This is a high proportion, suggesting that awareness of the need to check blood pressure is good, particularly in older age cohorts.
The Survey also includes detailed questions on self-perceived health, and health service utilisation including visits to GPs, every year. In 2023, 76% of respondents report visit the GP each year with an average of 4 visits per person. This average rises to 90% in people aged over 65.
The Survey will continue to estimate the prevalence of high blood pressure every year; there is scope to include a more detailed module on awareness of hypertension risk and access to treatment, should this be submitted for consideration.
A more detailed breakdown of Healthy Ireland Survey results by gender and age is available at www.gov.ie/en/collection/231c02-healthy-ireland-survey-wave/.
Pharmacy Services
Ceisteanna (221)
Colm Burke
Ceist:221. Deputy Colm Burke asked the Minister for Health to give due consideration to conducting cardiovascular disease screening and management within the pharmacy setting; and if he will make a statement on the matter. [51494/23]
Amharc ar fhreagraFreagraí scríofa
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 establishment in July 2023 of the Expert Taskforce to support the expansion of the role of pharmacists in Ireland is evidence of my commitment to that aim. I have accepted the first recommendation of the Taskforce and work to implement that recommendation has commenced with the relevant stakeholders.
There has been constructive engagement between Department officials and the Irish Pharmacy Union especially in recent months to advance consideration of the range of initiatives to support an enhanced role of pharmacy. As the Taskforce progresses its work this close engagement needs to continue with my Department and the HSE, with a view to identifying the key enablers to support realisation of the objectives of an expanded scope of pharmacy practice.
The General Practitioner (GP) Chronic Disease Management (CDM) Programme commenced in 2020 and has been rolled out on a phased basis to adult GMS (Medical Card and GP Visit Card) patients over a 4-year period as planned. The specified chronic conditions included in the Programme are Type 2 Diabetes; Asthma; Chronic Obstructive Pulmonary Disease (COPD) and cardiovascular disease (including Heart Failure, Ischaemic Heart Disease, Cerebrovascular Disease (Stroke/Transient Ischemic Attack (TIA), Atrial Fibrillation).
The CDM programme is an entirely new healthcare service in Ireland that has brought the care for chronic disease further into the community and it aims to reduce hospital attendance by patients with one or more of these specified conditions.
To support patients in managing their chronic condition(s), under the CDM Treatment Programme each patient receives two scheduled reviews with the GP in a 12-month period, each preceded by a practice nurse visit. These reviews include patient education, preventative care, medication review, physical examinations, scheduled investigations and individual care planning.
The Opportunistic Case Finding Programme identifies those at high risk of cardiovascular disease or diabetes for entry to the Preventive Programme. Under the Preventive Programme, patients identified at high risk of cardiovascular disease agree a self-management plan with their GP/practice nurse, setting goals for improvement. Referrals to support services for smoking cessation, harmful alcohol treatment and weight management are made as appropriate.
I am fully committed to supporting our population screening programmes which are a valuable part of our health service, enabling early treatment and care for many people, and improving the overall health of our population.
Any decisions about further changes or expansion of cancer screening, including the introduction of cardiovascular disease (CVD) screening programme, will be made on the advice of the National Screening Advisory Committee (NSAC). This independent expert group considers and assesses evidence in a robust and transparent manner, and against internationally accepted criteria. It is important we have rigorous processes in place to ensure our screening programmes are effective, quality assured and operating to safe standards, and that the benefits of screening outweigh the harms.
Furthermore, the National Review of Specialist Cardiac Services commenced in January 2018 under the Chairmanship of Professor Phillip Nolan and a Steering Group formed from nominations of interested stakeholders representing medical, professional/technical staff, nursing, and patient representatives.
The aim of the Cardiac Services Review is to recommend configuration for a national adult cardiac service to achieve optimal patient outcomes at population level with particular emphasis on the safety, quality and sustainability of the services that patients receive. This aligns with the Sláintecare reform programme. In terms of scope, the National Review covers scheduled and unscheduled hospital-based services for the diagnosis and treatment of cardiac disease in adults, which includes screening.
The Review is finalised and has been presented to my office, where it is under my consideration. The recommendations of the review will inform the future provision of cardiac services nationally.
Health Promotion
Ceisteanna (222)
Colm Burke
Ceist:222. Deputy Colm Burke asked the Minister for Health to examine action that can be taken to highlight the importance of physical movement in the workplace environment; and if he will make a statement on the matter. [51498/23]
Amharc ar fhreagraFreagraí scríofa
Improving the health and wellbeing of the people of Ireland is central to the work of Government. The vision for Healthy Ireland in the Department of Health is where everyone can enjoy physical and mental health and wellbeing to their full potential and where wellbeing is valued and supported at every level in society.
To achieve this, a whole of society approach is required and it is widely acknowledged at international level that the workplace is an ideal setting to promote employee health and wellbeing, providing multiple benefits to employees and employers, as well as broader social and economic gains.
Given the dimension and complexity of workplace health, a multi-agency and multi-disciplinary approach was required. The National Framework for Healthy Workplaces was developed by a sub-group co-chaired by the Department of Health and the Department of Business, Enterprise and Innovation with the support of the Institute of Public Health and key stakeholders and was launched in December 2021.
The Framework is underpinned by robust evidence and consultation, and provides strategic direction and flexible guidance that can be adapted to any workplace to help create and sustain health and wellbeing among the workforce. It integrates existing laws and policies and aligns with other government strategies on issues like reducing injuries and ill-health, promoting active travel and positive mental health.
The Healthy Workplace website, launched in May 2023 provides content on workplace related health and wellbeing as well as interactive tools to support workplaces to deliver and evaluate wellbeing interventions in their organisations. Specific universal information for workplaces in relation to increasing opportunities for physical activity in the workplace is included in a dedicated “physical” wellbeing area. This includes initiatives to support both employers and employees at both organisational and individual levels. The website is available at healthyworkplace.ie/.
Health Promotion
Ceisteanna (223)
Colm Burke
Ceist:223. Deputy Colm Burke asked the Minister for Health to set out a revised national food pyramid, designed to promote both human and planetary health; and if he will make a statement on the matter. [51499/23]
Amharc ar fhreagraFreagraí scríofa
Healthy Ireland, A Framework for Improved Health and Wellbeing 2013-2025, was launched in March 2013 and is the national Framework supporting the health and wellbeing of the country. It takes a “whole of Government” and “whole of society” approach to improving health and wellbeing. The Framework is based on international research, experience and thinking in addressing the broad social determinants of health.
Healthy Ireland seeks to tackle the major lifestyle issues which lead to negative health outcomes, including smoking, alcohol, poor diet, physical inactivity, obesity. The Framework aims to shift the focus to prevention, seeks to reduce health inequalities, and emphasises the need to empower people and communities to better support their own health and wellbeing.
‘A Healthy Weight for Ireland’, the Obesity Policy and Action Plan (OPAP)’, was launched in September 2016 under the auspices of the Healthy Ireland Framework. The OPAP covers a ten-year period up to 2025 and aims to reverse obesity trends, prevent health complications and reduce the overall burden for individuals, families, the health system, and the wider society and economy.
The development of healthy eating guidelines is identified as an action in the OPAP. To date, a suite of age-specific guidelines have been produced in collaboration with the Scientific Nutrition Sub- Committee in the Food Standards Authority of Ireland (FSAI). The FSAI were commissioned by the Department of Health to review scientific evidence to inform the guidelines for each age group reflecting differences in nutritional requirements over the life- course.
Healthy Eating Guidelines for Adults, Teenagers and Children 5 years and older were published in 2016, followed by Healthy Eating Guidelines for 1- to 4-year-olds in 2020. Both resources use the food pyramid as a visual tool to demonstrate which food groups should be consumed in relevant quantities for good health. Healthy Eating Guidelines for over-65s were published in 2021 and corresponding resources across all age groups are available on the Healthy Ireland website.
The FSAI Scientific Committee are currently in the process of preparing Scientific Food-Based Dietary Guidelines for Teenagers, which includes a section on sustainability to promote human and planetary health, and they are expected to be published in 2024. Once these guidelines are available, they will inform the design of healthy eating resources for the public via Healthy Ireland and HSE websites.
Medical Aids and Appliances
Ceisteanna (224)
Denis Naughten
Ceist:224. Deputy Denis Naughten asked the Minister for Health further to Parliamentary Question No. 258 of 12 July 2023, and the ongoing cost of electricity, if he will review the current financial assistance to patients with home dialysis machines in light of the additional cost of their operation; and if he will make a statement on the matter. [51507/23]
Amharc ar fhreagraFreagraí scríofa
The Government is committed to providing accessible and affordable health care.
The Department of Social Protection administer the Supplementary Welfare Allowance (SWA) Scheme and the Fuel Allowance, which may assist individuals in meeting the costs associated with operating medical devices. Further information on these can be found, respectively, at:
www.gov.ie/en/collection/d5554-supplementary-welfare-allowance/
www.gov.ie/en/service/00aa38-fuel-allowance/.
In addition, energy suppliers are required to establish, maintain and regularly update a register of vulnerable customers. Vulnerable customers include:
• Those who are critically dependent on electrically powered equipment. This includes (but is not limited to) life protecting devices, assistive technologies to support independent living and medical equipment, or
• Those who are particularly vulnerable to disconnection during winter months for reasons of advanced age or physical, sensory, intellectual or mental health.
There are a range of additional protection measures in place for registered vulnerable customers. Energy suppliers are required to provide customers with a free and easy way to register as a vulnerable customer. Further information regarding this can be found at:
www.cru.ie/consumer-information/your-rights/vulnerable-customers/.
In Budget 2023, every household in Ireland received three €200 energy credits, totalling €600. These payments were made between November 2022 and April 2023.
Budget 2024 announced that three further energy credits of €150 each will be paid to households over the coming months.
There are also a range of Health Service Executive (HSE) administered schemes that assist individuals in meeting their medical costs.
People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. Medical card eligibility is primarily based on an assessment of means and is not granted on the basis of any particular condition.
In certain circumstances, the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. The HSE afford applicants the opportunity to furnish supporting documentation to determine whether undue hardship exists and to fully take account of all relevant circumstances that may benefit them in assessment, including medical evidence of costs and certain expenses.
In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
The Drug Payment Scheme (DPS) ensures that no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines who are not eligible for a medical card.
Individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
Mental Health Services
Ceisteanna (225)
Mark Ward
Ceist:225. Deputy Mark Ward asked the Minister for Health to outline the catchment areas for consultant psychiatrists in the Galway area; if an individual can be seen by these services outside of their catchment area; and to outline the options available to individuals who do not have a consultant psychiatrist in their catchment area. [51513/23]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday, 6 October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.