Written Answers Nos. 368-394
368. Deputy Colm Burke asked the Minister for Health what action his Department is taking to ensure that the authorisation scheme 2023 is enough of an incentive to persuade more individuals to become homecare providers; and if he will make a statement on the matter. [11305/24]
Amharc ar fhreagraAs this is an operational 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 recently ended the industrial action which commenced on 6 October 2023. As a consequence, members in these grades were not engaging with political forums or processes. As a result of the accumulated backlog, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
369. Deputy Colm Burke asked the Minister for Health what action his Department is taking to ensure that the authorisation scheme 2023 continues to provide the necessary support to homecare workers in view that the scheme is successful in the sense that it funds the homecare workers travel time, however it fails to fund the necessary milage that is completed by the homecare worker; and if he will make a statement on the matter. [11306/24]
Amharc ar fhreagraAs this is an operational 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 recently ended the industrial action which commenced on 6 October 2023. As a consequence, members in these grades were not engaging with political forums or processes. As a result of the accumulated backlog, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
370. Deputy Colm Burke asked the Minister for Health to provide details on any ongoing efforts being made by his Department to incorporate technology and innovation into home and community care services to improve efficiency and effectiveness; and if he will make a statement on the matter. [11307/24]
Amharc ar fhreagraTechnology and innovation offer some unique opportunities to support and improve home and community care services in keeping people well, and provide support for them in their communities and homes whenever they may require health and social care assistance.
Peoples willingness to adopt solutions that are enabled through technology was demonstrated throughout the pandemic, which required many people to use telehealth solutions to maintain social distancing, and use online solutions to register for tests, vaccination appointments and to receive their digital covid certificate. Ireland also witnessed the most rapid adoption of a covid tacker app in the world. Numerous surveys by patient representative organisations also demonstrate an appetite for technology enabled solutions, provided these are not to the exclusion of traditional ways of accessing health services.
Following on from the learnings from COVID-19, the National Telehealth Steering Committee was established and now governs the HSE’s Telehealth Programme. In April 2023, it set up a dedicated Telehealth Working Group with the mandate to develop a Telehealth Roadmap for Ireland. The HSE published ‘HSE Telehealth Roadmap 2024-2027: Building Blocks for the Embedding & Expansion of Telehealth’ – to guide future developments in this area- on the 1st December 2023.
The telehealth programme is also developing acute virtual wards which are defined as a safe and efficient alternative to bedded care that is enabled by technology. Virtual Wards support patients who would otherwise be in hospital to receive acute care, monitoring, and treatment in their own home, thus preventing avoidable hospital admissions, or supporting early discharge. This programme of work has significant potential to deliver efficiency and effectiveness across services in both community and homecare settings. Foundational work for this has been completed and the HSE will progress two significant virtual ward projects in Limerick and Dublin in 2024.
In terms of homecare specifically, the HSE has deployed InterRai as a system that brings consistency and transparency to the assessment of need for homecare supports.
The HSE are also running two programmes to trial the use of ‘Digital Supportive Technologies to enable increased service user independence and enhanced Home Care’, including increased independence and enhanced homecare for older persons. This is particularly important, as a Statutory Homecare scheme is developed, in order to offer people choice and ensure that this service design is optimised through the adoption of enabling digital technologies.
The procurement of an IT system for home support by the HSE is also underway. This system will facilitate, manage and streamline the application process from receipt of application to decision on service entitlement and make it easier for people to make these applications online. It will also link with InterRAI and include case management and eRostering capabilities for staff.
371. Deputy Colm Burke asked the Minister for Health what action his Department is taking to ensure a standardised rate of pay for the different types of home and community care providers, in view that disability home support is not operated under an authorisation scheme, which indicates that providers of disability support are paid less than those who are providers of elderly home support, wherein these providers are not guaranteed the living wage or travel time; and if he will make a statement on the matter. [11308/24]
Amharc ar fhreagraI wish to advise the Deputy that this is a matter for the Department of Children, Equality, Disability, Integration and Youth.
372. Deputy Colm Burke asked the Minister for Health what initiatives are in place to enhance the coordination and integration of home and community care services with other healthcare providers to create a seamless patient experience; and if he will make a statement on the matter. [11310/24]
Amharc ar fhreagraThe Government is committed to the delivery of health and social care services that enable older people to live and age well in their homes and communities. The provision of Meals on wheels services, Day centre's, Respite services and Home support services provides a valuable support to people in their communities.
In addition to these services there has been ongoing work on foot of the recommendation of the Health Service Capacity Review 2018 to shift care out of acute hospitals into the community and closer to a person’s home, where safely possible. In pursuit of this goal, the Health Service Executive (HSE) commenced the implementation of the Enhanced Community Care Programme in 2021.
The Enhanced Community Care (ECC) Programme objective is to deliver increased levels of health care with service delivery reoriented towards general practice, primary care and community-based services.
This Programme aims to implement an end-to-end care pathway that will care for people at home, and over time prevent referrals and admissions to acute hospitals where it is safe and appropriate to do so, and enable a “home first” approach.
The Integrated Care Programme for Older Persons (ICPOP) also seeks to ensure older people with complex care needs can access care quickly, at or near home through care pathways specifically designed for older people and targeting Frailty, Falls, and Dementia.
To date, 28 ICPOP community specialist teams have been established across the country.
373. Deputy Colm Burke asked the Minister for Health what action his Department is taking to recruit new home support providers, in view that the authorisation scheme has been proven to increase staff retention for home support providers but it has had no impact on the recruitment of new home support providers; and if he will make a statement on the matter. [11311/24]
Amharc ar fhreagraAs this is an operational 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 recently ended the industrial action which commenced on 6 October 2023. As a consequence, members in these grades were not engaging with political forums or processes. As a result of the accumulated backlog, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
375. Deputy Colm Burke asked the Minister for Health to outline in detail the steps being taken by his Department to prioritise and support informal caregivers who play a crucial role in home and community care; and if he will make a statement on the matter. [11313/24]
Amharc ar fhreagraFamily carers are key enablers for Government policy to support people to live with dignity and independence in homes and communities of their choosing for as long as possible by providing vital care to some of our most vulnerable citizens. The essential role that family carers play in the provision of care in Ireland is fully recognised and appreciated by me and my Department. Every day, family carers through their selfless hard work, knowledge and compassion enhance the quality of life of the most vulnerable in our society. In the area of health there are multiple programmes to support family carers.
National Carers' Strategy
Government policy on family carers is set out in the 2012 National Carers' Strategy which provides the strategic direction for future policies, services and supports provided by Government departments and agencies for carers. The Strategy is designed around a core vision which recognises and respects carers as key care partners who are supported to maintain their own health and well-being, care with confidence and participate as fully as possible in economic and social life. Oversight of the Strategy is led by my Department, with individual Government Departments leading on action areas that fall within their remit.
Carers’ Guarantee
Annually recurring funding of €2 million was provided in Budget 2021 under the National Carers’ Strategy to improve equity of access to supports for carers across the country. This funding is an important step towards delivering on the Programme for Government commitment to develop a Carers’ Guarantee, providing a more standard package of supports to family carers in every region, in tandem with the community and voluntary sector. €1.9 million of this funding is being provided to Family Carers Ireland to deliver a mix of community and individual supports across five areas of activity: community carer supports; intensive and emergency supports; education and training FCI’s freephone careline; and psychosocial support.
The remaining €100,000 funds Care Alliance Ireland to deliver a professionally moderated online support group for Family Carers. The service promotes supports to assist family carers in carrying out their caring roles, thus allowing care recipients to be maintained in their own homes and communities.
In addition to these supports, to address the health-specific needs of family carers themselves, the HSE has developed a family carers’ support page on its website at www.hse.ie/eng/services/list/3/carerssupport/.
Respite
Respite care is a vital part of the toolkit to support carers. €62 million in funding is provided annually to provide respite beds in older people’s services. Respite may be provided in the community within the person’s own home, in HSE residential care settings, by agreement with voluntary organisations or by contracted private facilities.
In addition, in June 2021 the HSE, in partnership with Family Carers Ireland, launched the Home Support Emergency Respite Scheme, with funding of €600,000, to provide a total of 27,000 hours of respite care to unpaid carers who require additional emergency respite. The HSE has committed to continuing to provide emergency respite supports in 2024.
In 2023 the Government allocated €2.1 million to allow dementia day care centres to reopen to full capacity. In budget 2024, a further €500,000 was allocated to increase the provision of in-home dementia day care.
Extension of GP Visit Cards to carers in receipt of the Carer’s Support Grant
Since September 2018, individuals in receipt of either a full or half-rate Carer's Allowance or Carer's Benefit are automatically eligible for a GP visit card. On foot of this measure, as of December 2023, 7,098 people in receipt of either full or half-rate Carer's Allowance or Carer's Benefit have gained GP Visit Card eligibility. It is also noted that many carers may have already held a medical card or GP visit card prior to this policy change.
A range of other measures have also been introduced in recent years to expand access to GP Care including the automatic awarding of a GP visit card to all people over 70 in 2015 and as provided for in Budget 2023, eligibility for GP visit cards was extended to people who earn up to the median household income (€46,000 or less). Over 400,000 additional people, who otherwise would have attended their GP on a private basis, are expected to become eligible for free GP care under this expansion. It is envisaged that these measures will be supported by a significant package of additional capacity supports to GP practices.
It is likely that many of those currently in receipt of the Carer Support Grant will be among those positively affected by this expansion, although an estimate of the exact number is not currently available.
In addition to these direct supports for family carers, my Department is also engaged in the following workstreams that help support family carers.
Statutory Home Support Scheme
My Department is currently developing a regulatory framework for home-support providers with the aim of ensuring that all service-users are provided with high-quality care. This will comprise of primary legislation for the licensing of home support providers, regulations for home support which will set out the minimum requirements that a provider must meet to obtain a licence, and Health Information and Quality Authority (HIQA) national standards.
The Heads of Bill are currently being drafted by my Department with a view to bringing the Heads of Bill to Government for approval in 2024.
Engagement with stakeholder groups and experts have shaped regulations which now await legal drafters. The informed perspective of the Chief Inspector and HIQA team influenced changes in areas such as training requirements in order to future proof regulations. HIQA standards, decision-making framework and the inspection process will ensure that quality home support services are provided by adequately prepared workers to better informed service users. The scope of regulation has now been confirmed and HIQA standards for home care and home support will go out for public consultation early 2024.
Mental Health Services
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. This will enhance the delivery of vital services to as many people as possible over 2024.
As part of the funding allocated to mental health services, new development funding has been secured to advance initiatives on youth mental health, and around priority groups identified within the national suicide prevention strategy Connecting for Life. This new development funding will be focused on increased CAMHS staffing, a new Youth Mental Health app, a referral pilot for children's community services including CAMHS (piloting an approach to service referrals known as ‘No Wrong Door’), the expansion of Suicide Bereavement Liaison Services, and expanding the Traveller Counselling Service. A priority for the HSE under its annual Service Plans is to improve access to the HSE Childcare Psychology service, and to the specialist CAMHS service, and to reduce waiting lists for both.
Commission on Care for Older People
On 3rd October 2023 the Government approved my proposal, in collaboration with the Minister of State for Older People, to establish an independent Commission on Care for Older People. The Commission will examine the provision of health and social care services and supports for older people and make recommendations to the Government for their strategic development. Subsequently, a cross-departmental group will be established under the auspices of the Commission to consider whether the supports for positive ageing across the life course are fit-for-purpose and to develop a costed implementation plan for options to optimise these supports. €1.243 million was secured in Budget 2024 to support the work of the Commission, which is due to be formally established in the coming weeks.
376. Deputy Colm Burke asked the Minister for Health to confirm what impact if any the Independent Commission which is due to be formally established early this year will have on policy changes to the role of home and community care providers, in view that this Commission will examine the provision of health and social care services and supports for older people and make recommendations to the Government for their strategic development; and if he will make a statement on the matter. [11314/24]
Amharc ar fhreagraThe independent Commission on Care for Older People will examine the health and social care services and supports for older people across the continuum of care and make recommendations for their strategic developments. It will be cognisant of the national policy landscape within which they are being delivered and developed.
Accordingly, there will be recognition that there are already a range of initiatives in train which promise to have a significant impact on the status quo in respect of the provision of care to the older age cohort. These include the development of the statutory home support scheme; the national roll-out of community specialist teams for older persons and for chronic disease management; the regulatory reform of long-term residential care; the development of policies in the areas of palliative care and adult safeguarding; Housing Options for our Ageing Population joint policy statement and more broadly the implementation of the recommendations of the COVID-19 Nursing Homes Expert Panel and the Report of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Healthcare Assistants.
The Commission members provide expertise across the areas of geriatrics, gerontology, health economics, health policy and management, primary care, health ethics, health technologies, and ageing and disability. With their breadth of expertise and experience, the members of the Commission will ensure that the Commission’s recommendations are informed by emerging good practice and lessons learnt nationally and internationally. Most importantly, I am confident that the Commission and the Reference Group of stakeholders will ensure the voice of older people themselves is heard.
377. Deputy Alan Dillon asked the Minister for Health in relation to the current status of Parliamentary Questions within the Health Service Executive; if the HSE can quantify the accumulated backlog of unanswered Parliamentary Questions; the anticipated processing time for addressing outstanding responses; when the HSE expects to resume normal representative activities; and the expected waiting period for a Deputy to receive a response to their query. [11323/24]
Amharc ar fhreagraThe time frame as set down by the Standing Orders of the Dail for answering PQs is 10 working days.
Up to the commencement of the FORSA industrial action the HSE ‘on time’ average response was 75% for the 10 day (PQ) time frame and 81% within 15 days (Jan. - Sept 2023). Note some PQs are more complex and require the gathering of information from across different sections of the HSE e.g. Community Health Organisations (CHOs) and Hospital Groups, hence it is not always possible to respond within the 10 day time frame.
The FORSA industrial action commenced on 6th October and was suspended on 7th February 2024 and at that point there was a backlog of 1,385 PQs for 2023 received for reply from the Department of Health and the Department of Children, Equality, Disability, Integration & Youth.
Since the lifting of the Industrial Action on the 7th February, the HSE has responded to 774 of the backlog of PQs from 2023, with as of today’s date 611 PQs remaining of the backlog to be responded to.
The HSE at the same time has received 1,314 PQs in 2024 for processing and reply. The HSE has responded to 660 of these PQs to date (5th March 2024).
The HSE is working as quickly as it can to clear the back log while at the same time dealing with the daily volume of new PQs. For example in the week commencing 26th February alone the HSE responded to 302 PQs (119 from 2023 & 183 PQs from 2024) and processed a further 275 new PQs for reply.
378. Deputy Patrick Costello asked the Minister for Health if he will meet with the families of those affected by the Cherry Orchard Hospital move; and if he will make a statement on the matter. [11327/24]
Amharc ar fhreagra381. Deputy Patrick Costello asked the Minister for Health how many vacant units there are within the Cherry Orchard Hospital facility; how many of these could have been used to house residents whilst works were ongoing; what is the current state of repair of any vacant units onsite; how long have these units been vacant; how much would it cost to bring these units back into use and whether this is being considered; and if he will make a statement on the matter. [11330/24]
Amharc ar fhreagra382. Deputy Patrick Costello asked the Minister for Health to outline the other plans considered by the HSE to address the works required which would have allowed residents to remain on-site during completion of works in the Sycamore and Willow Units at Cherry Orchard Hospital; why these plans were deemed to be unworkable; when these decisions were made; and if he will make a statement on the matter. [11331/24]
Amharc ar fhreagra383. Deputy Patrick Costello asked the Minister for Health to outline what will happen to the staff members assigned to the Sycamore and Willow Units at Cherry Orchard Hospital for the duration of the move; and if he will make a statement on the matter. [11332/24]
Amharc ar fhreagra384. Deputy Patrick Costello asked the Minister for Health for an update on the Covid outbreak in Cherry Orchard Hospital; and if he will make a statement on the matter. [11333/24]
Amharc ar fhreagra385. Deputy Patrick Costello asked the Minister for Health how many of the residents from the Sycamore and Willow Units Cherry Orchard Hospital have passed away since residents were given notice of the move in November 2023; and if he will make a statement on the matter. [11334/24]
Amharc ar fhreagraI propose to take Questions Nos. 378, 381, 382, 383, 384 and 385 together.
As these are operational matters, 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 recently ended the industrial action which commenced on 6 October 2023. As a consequence, members in these grades were not engaging with political forums or processes. As a result of the accumulated backlog, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
379. Deputy Patrick Costello asked the Minister for Health his views on the scope and significance of the structural problems identified by HIQA within Cherry Orchard Hospital; and to outline timeline on when and how they will be addressed. [11328/24]
Amharc ar fhreagraAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
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.
380. Deputy Patrick Costello asked the Minister for Health if residents were afforded the opportunity to avail of the Assisted Decision Making Act, which became law in April 2023; if not, the reason this did not happen; and if he will make a statement on the matter. [11329/24]
Amharc ar fhreagraIn May 2023, a HIQA inspection identified concerns in relation to the flooring in both the Sycamore and Willow Units at Cherry Orchard Hospital. These presented a significant potential health and safety risk. A subsequent HSE review indicated that the flooring has underlying structural issues which require immediate remedial work.
The HSE has decided to close both Units and offer the residents a relocation to Clondalkin Lodge, which is a private nursing home, on a temporary basis while the necessary structural works are completed. It is expected that the works will take a minimum of 1 year to complete.
The residents of Cherry Orchard Hospital are being moved to more suitable accommodation on a phased basis. The phased move will have due regard to their needs, current proximity to each other and relationships within the unit.
The safety and wellbeing of residents and staff is the primary concern. All appropriate options were considered before committing to this move.
The HSE is working in consultation with residents, their families and staff while giving full consideration to health and safety concerns and regulatory compliance.
There is on-going monitoring and risk assessment to ensure that there is no immediate hazard to residents.
The HSE has reassured me that each care plan for this temporary move will include therapeutic input required and a review of charges to ensure that no one experiences adverse financial exposure. All additional charges will be covered by the HSE for the duration of the works.
There will be a medical social worker and an Assisted Decision Making lead available on site for the duration of this move. In addition, all residents have on site details for an independent advocate service should they wish to contact them.
I have been advised that there is no impact on other structures on the campus as the issues relate solely to the two modular buildings Willow and Sycamore units.
As of 27 February, 40 residents have been transferred from Cherry Orchard Campus. 22 residents currently remain on-site.
I have asked the HSE to respond to you directly in respect of the details of the Decision-Making services provided.
386. Deputy Denis Naughten asked the Minister for Health when a child will be called for an appointment with a paediatrician (details supplied); and if he will make a statement on the matter. [11355/24]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
387. Deputy Denis Naughten asked the Minister for Health when a child will be called for an appointment to UHG paediatric Department (details supplied); and if he will make a statement on the matter. [11356/24]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
388. Deputy Denis Naughten asked the Minister for Health when a person (details supplied) will receive a response to her appeal of the fair deal nursing home means assessment; the reason for the delay; and if he will make a statement on the matter. [11357/24]
Amharc ar fhreagraAs this is an operational 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 recently ended the industrial action which commenced on 6 October 2023. As a consequence, members in these grades were not engaging with political forums or processes. As a result of the accumulated backlog, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
389. Deputy Denis Naughten asked the Minister for Health when a person (details supplied) will be called for a BRAC2 gene test; the current waiting time for such tests; and if he will make a statement on the matter. [11358/24]
Amharc ar fhreagraAs this is a service matter, I have asked the HSE to respond to the Deputy directly, as soon as possible.
390. Deputy Róisín Shortall asked the Minister for Health if he intends to provide specialist long-Covid services for children; the steps he is taking to ensure that children with long-Covid have access to appropriate treatment and care; and if he will make a statement on the matter. [11360/24]
Amharc ar fhreagraAs the matter raised is a service delivery matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
391. Deputy Róisín Shortall asked the Minister for Health the status of the HSE FADA survey regarding the prevalence of long-Covid; the timeline for completion; the type of data being collected and measured; the reason children are not included in this survey; if this survey has been extended beyond HSE Public Health Area B; and if he will make a statement on the matter. [11361/24]
Amharc ar fhreagraAs the matter raised is a service delivery matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
392. Deputy Róisín Shortall asked the Minister for Health the number of persons on a waiting list for long-Covid and post-acute clinics, by clinic and time waiting, in tabular form. [11362/24]
Amharc ar fhreagraAs the matter raised is a service delivery matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
393. Deputy Róisín Shortall asked the Minister for Health the number of staff in each of the long-Covid and post-acute clinics, by clinic and grade, in tabular form. [11363/24]
Amharc ar fhreagraAs the matter raised is a service delivery matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
394. Deputy Róisín Shortall asked the Minister for Health if patient data is being collected and measured from long- Covid and post-acute clinics (details supplied); and if he will make a statement on the matter. [11364/24]
Amharc ar fhreagraAs the matter raised is a service delivery matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
