Written Answers Nos. 346-367
346. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to develop a plan aimed at tackling loneliness and isolation, particularly among older people, as outlined in the Roadmap for Social Inclusion, across each of the CHO areas since the establishment of the current Government; and if he will make a statement on the matter. [33320/23]
View answerEvidence shows loneliness is a significant issue for population health and a number of different studies have linked loneliness to multiple chronic health conditions. Loneliness levels in Ireland are rising, and the pandemic was a major contributory factor.
Loneliness can be detrimental for our physical and mental health, while reconnecting with others post-COVID-19 pandemic has numerous physical and mental health benefits.
In response to the increase in loneliness which particularly impacts older people, the Ministers for Health and the Chief Medical Officer, supported by Healthy Ireland, developed a nationwide campaign, aimed at older people to encourage them to rebuild their social connections and re-integrate into their communities. Post-pandemic, with vaccines and sensible precautions, it is safe for older people to reconnect with the world, to say “Hello Again World”, make up for lost time and re-establish important connections with their community.
Mental health of older people is a priority in Sharing the Vision, Ireland's national mental health policy, with actions including improving access to Mental Health Services for Older People, promoting evidence-based digital mental health interventions in the general population and with older persons, and linking recommendations with the National Positive Ageing Strategy.
To this end, the Age Friendly Homes Programme began in 2021 as a two-year pilot project, with the overall objectives to prevent early or premature admission to long-term residential care; enable older people to continue living in their homes or in a home more suited to their needs; help older people to live with a sense of independence and autonomy and support older people to be and feel part of their communities. Funding of €5.2 million has been allocated in Budget 2023 to roll-out the Healthy Age Friendly Homes Programme nationally in 2023.
The HSE, in conjunction with ALONE, is also continuing the roll out of a Support Coordination Service across the country. This service will support older people to live well at home independently, and for as long as possible, through support coordination and access to services such as, but not limited to; practical supports, befriending, social prescribing, assistive technology, and coordinated linkages to local community groups in their area. This service is being led out under the Enhanced Community Care (ECC) Programme, a strategic reform programme in line with Sláintecare proposals and priorities which seeks to deliver new and enhanced services and support the move toward a more community-centric model of healthcare.
As part of the ECC programme, the Integrated Care Programme for Older Persons (ICPOP) model aims to shift the delivery of care for older people away from acute hospitals towards a community based, planned and coordinated care model which is closely aligned to Primary Care and Acute sector partners. The objective of the programme is to improve the quality of life for older people by providing access to integrated care and support that is planned around their needs and choices. This supports them to live well in their own homes and communities without the need to access acute care settings. As of Q2 2023, 23 ICPOP teams have been established across Ireland, with 30 expected to be established in total by year end.
The Government is committed to ensuring that those living with dementia have access to the right services and supports to help them to live well in their communities, and has prioritised much-needed investment in dementia over the past three budgets.
We have invested €12.16 in dementia services and supports in 2023: €4.86 million has been provided for the National Dementia Strategy and €2.1 million for the full resumption of dementia-specific day care services. We have also prioritized investment valued at €5.2 million to allocate a minimum of 15% of 5 million new home support hours to people with dementia, up from 5% in 2021 and 11% in 2022. This investment is in addition to €5.9 million provided for the implementation of the National Dementia Strategy in 2021, and a further €7.3 million in 2022.
Work has also commenced on establishing the remit of the Commission on Care. It is anticipated that the Commission will examine various care and supports for older people in a modular fashion.
At a local level, Mental Health Day Services provided by the HSE are available to those who may require them, which provide mental health and medication supports, as well as wider assistances associated with daily living. In addition, in May this year I announced an additional €5.25 million funding for meals on wheels and day centres for older people to organisations across the country.
To the extent that this query relates to CHO-level services, I have referred this question to the HSE for a direct response.
347. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to further support the Nursing Homes Support Scheme (The Fair Deal) to provide assistance when staying at home may no longer be an option since the establishment of the current Government; and if he will make a statement on the matter. [33323/23]
View answerFair Deal was designed to protect and support vulnerable older people, to ensure equal access to nursing home care based on what they could afford. This gives certainty to people and families. Government funding for Fair Deal is to support vulnerable older people at a time in their lives where full-time care is essential.
The Department of Health acknowledges that there are variations in the cost of care across public centres as well as across private nursing homes, with HSE Community Nursing Units generally having a higher cost of care. It is important to note that the HSE is statutory provider of last resort and will always step in where a resident’s needs are sufficiently complex that they are not able to be cared for elsewhere in the community. The HSE needs to be equipped to deliver that kind of complex care.
In December 2021, the Department published the independently chaired Value for Money review on nursing home costs. The review found that the cost differential is largely driven by variances in staff-to-resident ratios and the skill mix in public and private nursing homes. The Value for Money Review made nine recommendations which the Department continues to take forward. It should be noted that many of the recommendations from the report were already in progress and overlap with existing reforms.Overall, €1.4 billion of the total Health Budget was allocated last year to support over 22,700 people under Fair Deal. This will increase to nearly €1.5 billion for 2023, and I am cognisant that the budget has to support all residents under the Nursing Home Support Scheme (NHSS) for the full calendar year.The Government is conscious of the financial challenges faced by the nursing home sector, especially smaller and voluntary nursing homes that may not have access to the same economies of scale as larger homes or groups. The Government has provided substantial support to the private and voluntary nursing home sector over the course of the pandemic. Over €150m of financial support has been provided to private and voluntary nursing homes through the COVID-19 Temporary Assistance Payment Scheme (TAPS) and the provision of free PPE and oxygen to private nursing homes continues, costing over €77 million to date.A new €10 million scheme (TIPS) was established last year to support private and voluntary nursing homes with increases in energy costs, covering 75% of year-on-year cost increases up to a monthly cap of €5,250 per nursing home. This scheme has been extended for a second time to the end of June 2023.The only mechanism for funding from the public purse for nursing home residents is Fair Deal and it is really important that private and voluntary providers continue to engage in the process as set out in the Nursing Home Support Scheme Act 2009. The long-established statutory mechanism through which private and voluntary nursing homes are funded was established by the Oireachtas under the Nursing Homes Support Scheme Act 2009. This legislation outlines the process for private and voluntary providers to negotiate the prices for their services with the designated State agency, the National Treatment Purchase Fund (NTPF).Maximum prices for individual nursing homes are agreed with the NTPF following these negotiations and are based on the NTPF’s cost criteria, such as costs reasonably incurred by the nursing home, local market prices, historic prices and overall budgetary capacity. Under the Nursing Homes Support Scheme Act Act 2009 the NTPF has statutory independence, and there is no role for Ministers or the Department of Health in negotiations with individual nursing homes. Overall, approximately 425 private nursing homes negotiate with the National Treatment Purchase Fund (NTPF). The Department of Health and I have regular interaction with the NTPF and met them recently to discuss ways to support the sector, where necessary and appropriate, to complement the normal process of negotiating rate increases when contracts are renewed. Budget 2023 saw over €40 million in additional funding for the Nursing Home Support Scheme (NHSS) which will provide for an uplift in the maximum prices chargeable by private and voluntary nursing homes, as negotiated. Anyone who has had a scheduled renegotiation of their Deed of Agreement this year with the NTPF has seen a significant uplift. In addition, other options to support nursing homes are also being explored, such as to help with the often costly nature of compliance for nursing homes under necessary HIQA regulations.I am conscious of private and voluntary nursing homes that are not scheduled to renegotiate their Deed of Agreement in 2023 and other options are being considered. One of the options under consideration is for nursing home providers to agree to a shorter contract duration with the NTPF.Important strands of reform to the nursing home sector are being, or have been, brought forward. In addition to that outlined above, the Government remains committed to delivering on:
•The 86 recommendations of COVID-19 Nursing Homes Expert Panel, especially those recommendations related to long-term sectoral reform
•The four recommendations of the NTPF Review of Pricing System for Long Term Residential Care Facilities
•The 16 recommendations of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care AssistantsWork continues within the Department of Health to deliver on all of these recommendations, as well as analysing the outcomes of the Skills Mix and Safe Staffing pilots which will serve to inform future policy.Given the size, complexity and cost of the NHSS, implementation is complex and any changes in policy direction need to be carefully assessed and kept under review. The Department of Health is consistently seeking to identify improvements and introduce enhancements to the scheme, where feasible, which aims to ensure that long-term nursing home care is sustainable, accessible and affordable for everyone and that people continue to be cared for in the most appropriate settings.
348. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to ensure that no nursing homes support scheme resident is charged for services they do not use, since the establishment of the current Government; and if he will make a statement on the matter. [33324/23]
View answerThe Nursing Homes Support Scheme (NHSS), commonly referred to as Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost.
The NHSS covers the cost of the standard components of long-term residential care which are:
• Nursing and personal care appropriate to the level of care needs of the person;
• Bed and board;
• Basic aids and appliances necessary to assist a person with the activities of daily living; and
• Laundry service.
Costs not covered by the NHSS include those individually incurred for items like social activities, newspapers and hairdressing. This may also include medical services such as therapies and some medical equipment. A person's eligibility for other schemes, such as the medical card scheme or the drugs payment scheme, is unaffected by participation in the NHSS or residence in a nursing home. In determining the services covered by the NHSS it was considered very important that the care recipient and the taxpayer would be protected and would not end up paying for the same services twice. For this reason, medications and aids that are already prescribed for individuals under an existing scheme are not included in the services covered by the NHSS, as this would involve effectively paying twice for the same service.
It is important to state that residents of nursing homes should enjoy the same levels of support and access to services for which they are eligible as when they lived in their own homes. It is acknowledged that the reason they require 24-hour levels of support is due to their level of dependency, which in turn may require access to clinical services including hospital and other outpatient appointments in the community.
The Department of Health does not currently hold data relating to additional charges in private nursing homes; these vary according to each individual nursing home depending on the services offered. It is important to note that it is private nursing homes who hold responsibility for delivering care to their residents in line with their terms of registration and the relevant regulations under the Health Act 2007. It is clear that under the terms of the NHSS Act 2009, private nursing homes should not levy additional charges on NHSS residents for services coming within scope of the Nursing Home Support Scheme.
Part 7 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 stipulates that the registered provider of the nursing home must agree a contract in writing with each resident on their admission to the nursing home. This contract must include details of the services to be provided to that resident and the fees to be charged. Residents should never be charged fees which are not set out in the contract. The Department of Health and the HSE are not a party to such contracts which are concluded between each resident and their nursing home.
The Competition and Consumer Protection Commission (CCPC) has published consumer protection guidelines for contracts of care in long-term residential care services for older people. The guidelines set out the obligations and responsibilities that providers must adhere to under consumer protection law and are aimed at providing greater transparency, clarity and certainty for consumers.
Concerns about additional charges should in the first instance be taken up with the nursing home provider. Where an individual is not satisfied with the response they receive, they may wish to take their complaint further by seeking a review from the Office of the Ombudsman.
The Department of Health is currently reviewing the available evidence and a focused piece of work to examine the issue in relation to additional charges is underway.
There are a number of separate factors driving this issue and potential actions to address each of these are being considered.
349. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to ensure that the best possible safeguards are in place to protect our friends and family in nursing homes since the establishment of the current Government; and if he will make a statement on the matter. [33325/23]
View answerSafeguarding adults who may be at risk of abuse, harm, and neglect by others in the context of their interactions with the health and social care sector, including in nursing homes, is a key objective of the Department of Health, every statutory body under its aegis and every relevant service that interacts with such adults.
In the health and social care sector, a framework of standards, policies and procedures for safeguarding adults who may be at risk of abuse, harm, neglect, and exploitation within the sector, including in nursing homes, is in place, and further measures are being developed to strengthen this framework.
Cross-sectoral legislative provisions relevant to adult safeguarding are also applied throughout the health and social care sector, including, for example, legislation on vetting and on the mandatory reporting to An Garda Síochána of information about the commission or suspected commission of certain offences against vulnerable adults or against children.
Existing governance measures
Key governance provisions currently in place include:
• The significant inspection and other regulatory powers of the Health Information and Quality Authority (HIQA) and the Mental Health Commission (MHC) in relation to the quality and safety of healthcare and social care provision generally (under the Health Act 2007 and the Mental Health Acts).
• The roles of health and social care professional regulatory bodies (including CORU, the Irish Medical Council, the Nursing and Midwifery Board of Ireland, the Dental Council of Ireland and the Pharmaceutical Society of Ireland) in relation to, inter alia, professional registration requirements and professional codes of conduct.
• Joint National Standards for Adult Safeguarding developed by HIQA and the MHC and approved by the Minister for Health, that apply to all regulated health and social care centres, including nursing homes.
Existing operational safeguarding measures
The existing framework also includes a range of operational structures and procedures, including in particular the HSE’s national operational adult safeguarding policy Safeguarding Vulnerable People at Risk of Abuse – Policy and Procedures (2014) , which is in place primarily in all HSE and HSE-funded social care settings.
The HSE has put in place a range of structures and processes to support and further develop its national operational adult safeguarding policy, including:
• A HSE National Safeguarding Office leading policy development and oversight.
• Clear guidelines set out in the existing policy for HSE and HSE-funded staff to follow in cases of suspected abuse or neglect of adults at risk (including a “zero tolerance” approach to abuse, meaning that abuse must be reported by staff in all instances).
• An adult safeguarding policy and procedures training programme, and a requirement that staff must attend training (the training is also accessible to non-HSE and HSE-funded services).
• Social work teams ("Safeguarding and Protection Teams") in each of the 9 HSE Community Healthcare Organisation areas.
• Over 2,000 designated safeguarding officers nominated by service providers and provided with additional training.
• Implementation planning for a revision by the HSE of its operational adult safeguarding policy which is expected to extend the policy beyond the social care pillar and to all HSE and HSE-funded services.
Policy and legislation development – health and social care sector
The Department of Health remains committed to ensuring that the best possible safeguards are in place to protect any of our service users who may be at risk of abuse, including such services users in any setting (including nursing homes) where health or social care services are provided to them.
Work to develop an overarching health and social care sector adult safeguarding policy, building on the robust structures already in place, is at an advanced stage and will be the subject of a public consultation planned for September 2023. The intention is that the policy will apply to all public, voluntary and private healthcare and social care settings.
Significant policy development work has been undertaken to date, including completion of the stakeholder consultation and primary evidence development phases of this major and complex policy project:
• A high-level inter-sectoral Steering Group was established to assist the Department in its development of the policy.
• The Department commissioned the Institute of Public Health (IPH) to undertake focus groups with cohorts of health and social care service users who may be affected by the national adult safeguarding policy for the health and social care sector, to ensure their voices are heard during policy development. A total of 12 focus groups were held, with 82 participants in 4 cohorts (including nursing home residents), between November 2019 and March 2020. The report was published in February 2021.
• The Department engaged with other key stakeholders in relation to the development of the national sectoral policy and the resulting output pack detailing stakeholders’ feedback is posted on the Department’s website.
• An independent international research evidence review to inform the policy for the sector was commissioned by the Department and published in February 2021.
• These reports, together with updates and related papers such as presentations to the Steering Group and discussion papers on the policy content, are published on the Department's website and can be accessed at www.gov.ie/en/publication/2861af-adult-safeguarding/.
The Department is now preparing for a public consultation in September and a costing study on a draft health sector policy on adult safeguarding, prior to submitting a costed draft policy to Government for its approval. Subject to Government approval of this national sectoral policy, legislation as required to underpin the approved policy will thereafter be prepared. The introduction of safeguarding legislation remains a priority for me.
350. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to Increase the number of specialist palliative care beds countrywide over the five years of government, ensuring that there will be a hospice serving every region in the country since the establishment of the current Government; and if he will make a statement on the matter. [33326/23]
View answerWith the openings of specialist inpatient palliative care units in Wicklow, Mayo, and Waterford in 2020/2021, CHO8 is now the only community healthcare organisation without at least one specialist palliative care inpatient unit. The HSE in CHO8 has been working on plans for two inpatient units, one in Tullamore, Co. Offaly and one in Drogheda, Co. Louth.
The HSE’s 2017-2019 Palliative Care Development Framework identifies Tullamore, Cavan, and Drogheda as regions where additional hospices are required. With regard to Drogheda, the HSE continues to work on the planning and development of the Drogheda Hospice. This work involves HSE Estates, CHO8, and a 3rd party philanthropist.
Regarding the development of a hospice in the Midlands, a tender competition took place earlier this year to secure the services of a design team for this project. A design team was appointed at the end of May with initial meetings taking place on 20th June and 5th July 2023. The design process is ongoing.
In relation to the delivery of a specialist palliative care unit at St Christopher’s Hospice in Cavan, I have been informed by the HSE that the design for the unit has been agreed by all parties involved and is in the process of being submitted to the County Council for planning permission. It is anticipated that construction works would commence at the earliest Q4 of 2023 or Q1 2024.
Once these planned hospices are open, there will be an inpatient unit in every region of the country, providing specialist palliative care inpatient services for people with complex needs, a hub for the existing specialist palliative community homecare teams and supporting the discharge of patients from acute hospitals.
The Department of Health is currently developing a new palliative care policy for adults to replace the 2001 report. The new policy will reflect the changes in end-of-life care including increased demand for adult palliative care, the shift towards care in the community, the emphasis in Sláintecare on addressing geographic variations in the provision of both community and hospital palliative care services, and developments in international best practice.
I trust this clarifies the matter.
351. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to support community specialist palliative homecare teams in all HSE areas, fund designated home care packages, and resource specialist palliative care provided in hospices since the establishment of the current Government; and if he will make a statement on the matter. [33327/23]
View answerSpecialist palliative care services are provided by the HSE in conjunction with the voluntary sector. Specialist palliative care multidisciplinary teams deliver integrated care in acute hospitals, specialist palliative care inpatient units (hospices) and in community settings including a person’s home. Specialist palliative care reduces acute hospital admissions and facilitates earlier discharge from hospitals to the community where care is delivered by the palliative care team in accordance with the patient and family’s needs.
Key objectives of the National Service Plan 2023 are to facilitate earlier discharge from hospital of patients who wish to receive end-of-life care in the community in line with their needs and to increase the number of patients receiving night support at home in collaboration with the Irish Cancer Society and Irish Hospice Foundation. The Palliative Care Budget increased to a total national service plan allocation in 2022 of €121.9 million from a national service plan allocation of €119m in 2021. In 2023, the budget is €130.1m.
Budget 2023 has an allocation of €3.7million to be provided for new measures in palliative care. The new measures will enhance the provision of adult and children’s specialist palliative care services across the country and will include funding to support bereavement services for parents and families who have experienced the death of a child.
The HSE’s 2017-2019 Palliative Care Development Framework identifies Tullamore, Cavan, and Drogheda as regions where additional hospices are required. The HSE continues to work with the planning and development of Drogheda Hospice. This work involves HSE Estates, CHO8, and the 3rd party philanthropist.
Regarding the development of a hospice in the Midlands, the HSE is working on developing a costed time lined plan for the hospice. In September 2022, Taoiseach Micheál Martin announced €20m in capital funding for a new specialist palliative care inpatient unit for the Midlands. The Midlands hospice development is expected to be completed by the end of 2025.
In relation to the delivery of a specialist palliative care unit at St Christopher’s Hospice in Cavan, I have been informed by the HSE that the design for the unit has been agreed by all parties involved and is in the process of being submitted to the County Council for planning permission. It is anticipated that construction works would commence at the earliest Q4 of 2023 or Q1 2024.
Once these planned hospices are open, there will be an inpatient unit in every region of the country, providing specialist palliative care inpatient services for people with complex needs, a hub for the existing specialist palliative community homecare teams and supporting the discharge of patients from acute hospitals.
The Department of Health is currently developing a new palliative care policy for adults to replace the 2001 report. The new policy will reflect the changes in end-of-life care including increased demand for adult palliative care, the shift towards care in the community, the emphasis in Sláintecare on addressing geographic variations in the provision of both community and hospital palliative care services, and developments in international best practice.
With regard to an update on community specialist palliative homecare teams in all HSE areas and designated home care packages, this has been referred to the HSE as it is a service matter. I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
352. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to increase resources for the children's palliative care programme; and if he will make a statement on the matter. [33328/23]
View answerThe Programme for Government 2020 is committed to increasing resources for the Children’s Palliative Care Programme. This will be supported by consultants with a special interest in children’s palliative care and children’s outreach nurses to coordinate care for children with life-limiting conditions and their families. When children are at end of life, they and their families deserve the best possible care. It is vital that such care is available when needed either in their home or in a hospital setting. A priority for 2023 is to implement the recommendations from the HSE 2020 report for supporting a model of care for children with life-limiting conditions in the community in Ireland.
There have been significant increases in funding to enhance the provision of children’s palliative care services across Ireland in recent years. Across 2021 and 2022, funding has been allocated for the recruitment of 12.5 additional whole-time equivalents to enhance the provision of children’s palliative care services across acute and community settings. These posts will support the provision of specialist palliative care to children as close to home as possible. Budget 2023 has an allocation of €3.7million to be provided for new measures in palliative care. The new measures will enhance the provision of adult and children’s specialist palliative care services across the country and will include funding to support bereavement services for parents and families who have experienced the death of a child. The Palliative Care Budget increased to a total national service plan allocation in 2022 of €121.9 million from a national service plan allocation of €119m in 2021. In 2023, the budget is €130.1m.
Additional resourcing was provided in 2021/2022 to support the Childrens Palliative Care Programme. This included:
• €2.3 million in funding to enhance and develop Laura Lynn’s Children’s Hospice and outreach services. This funding has been used to increase Laura Lynn’s Hospice in the Home Service across Leinster and supported the opening of a new Laura Lynn Hub in Munster.
• 6.5 additional Clinical Nurse Coordinators (CNC’s) were provided to take the total number of CNC’s nationally to 18.5. This will ensure there are two CNC’s in each Community Health Organisation. Currently there are 16 CNC’s in place with 2.5 vacancies.
• 1 Consultant in Paediatric Palliative Medicine and 1 Clinical Nurse Specialist for the Specialist team in Childrens Health Ireland Crumlin. These posts have been recruited.
• The creation of 4 Regional Paediatricians with a Special Interest in Palliative Medicine for Waterford, Cork, Limerick and Galway to enhance regional leadership and support professionals delivering palliative care to children in their home. It’s expected these posts will be recruited in 2023.
The new HSE Service Plan 2023 will underpin further improvements in children’s palliative care services. A multiagency approach is adopted to provide palliative care to children in their homes. This approach involves: collaboration between primary care, regional paediatricians, and adult community palliative care services - coordinated by the Clinical Nurse Coordinator (CNC) - and supported by paediatric palliative care team located in CHI Crumlin/Temple St. One of the cornerstones of children’s palliative care is to facilitate a fully integrated approach to care.
The Department and HSE will continue to progress developments for children’s palliative care services in Ireland, working towards the highest possible quality of end-of-life care and support for children with life limiting illnesses across the country.
353. Deputy Fergus O'Dowd asked the Minister for Health to outline the total budget for homecare provision over the years 2020 to date, in tabular form, by CHO, county, number of hours requested by homecare management, number of hours provided and the total expenditure per county; and if he will make a statement on the matter. [33330/23]
View answerAs these are operational matters, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible
354. Deputy Charles Flanagan asked the Minister for Health to outline the services that are available under the dental treatment services scheme in counties Laois and Offaly; the action being taken to ensure that medical card holders can access dental care in counties Laois and Offaly; and if he will make a statement on the matter. [33351/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
355. Deputy Charles Flanagan asked the Minister for Health if there have been any developments in the extension of the dental treatment services scheme; and if he will make a statement on the matter. [33352/23]
View answerThe Dental Treatment Services Scheme (DTSS) provides dental care, free of charge, to medical card holders aged 16 and over. In May 2022, the Scheme was extended to include Scale and Polish for all medical card patients along with an expansion of the oral examination to include provision of preventative advice, using €10 million awarded in Budget 2022. In addition, the fees paid to contractors were increased by 40-60% across most treatment items. Both the numbers of patients and treatments have been increasing since the measures were introduced in May 2022.
The Government recognises that substantive reform of the DTSS is required, as set out in the National Oral Health Policy, Smile agus Sláinte. My Department is working closely with the HSE to ensure the establishment of focused structures to drive implementation of the Policy. These implementation structures will include establishment of leadership functions in the HSE. In that context, the design and establishment of the necessary leadership and implementation structures is a key objective in the HSE’s National Service Plan for 2023.
356. Deputy Seán Crowe asked the Minister for Health how the additional €3.5 million announced in Budget 2023 for community and voluntary providers of drug and alcohol services is to be spent; the amount of that €3.5 million already allocated; a tabular breakdown of what organisations received a portion of that €3.5 million; and how much. [33384/23]
View answerIn Budget 2023, €3.5m in recurring funding was provided to support existing community and voluntary providers of drugs and inclusion health services (see attached fact sheet). Details and guidance on the administration of the €3.5 million are being finalised and I expect to make an announcement shortly.
This funding will be in addition to the inflation funding of €3.9m for drug and inclusion health projects recently announced. This once-off payment recognises the impact of inflation on the cost of delivering services for community and voluntary groups. Further information can be found at gov.ie - Health Ministers announce €81 million in once-off funding for voluntary and community providers (www.gov.ie).
357. Deputy Mairéad Farrell asked the Minister for Health to provide on update on outstanding recognition payments for front-line staff who worked at the height of the Covid-19 pandemic; and if he will make a statement on the matter. [33385/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
358. Deputy Pádraig O'Sullivan asked the Minister for Health if SouthDoc management is committed to providing a long-term service in Fermoy; and if he will make a statement on the matter. [33400/23]
View answer359. Deputy Pádraig O'Sullivan asked the Minister for Health if SouthDoc management is committed to providing a proper out-of-hours service in Fermoy; and if he will make a statement on the matter. [33403/23]
View answerI propose to take Questions Nos. 358 and 359 together.
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
360. Deputy Cathal Crowe asked the Minister for Health for an update on any capital works being carried out by his Department at this time in County Clare. [33412/23]
View answerAs 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.
361. Deputy Richard Bruton asked the Minister for Health if he has received a report from the HSE about waiting lists in Dublin for physiotherapy; and if he will make a statement on the matter. [33422/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
362. Deputy Robert Troy asked the Minister for Health if an application for home help support can be approved for a person (details supplied). [33426/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
363. Deputy Mairéad Farrell asked the Minister for Further and Higher Education, Research, Innovation and Science if, in relation the scaffolding construction training programme he launched in July 2022, he can confirm whether this course is currently recognised in accordance with Schedule 5 of the Safety, Health and Welfare at Work (Construction) Regulation 2013 (SI No 291 / 2013); and if he will make a statement on the matter. [33210/23]
View answerThe Safety, Health & Welfare at Work (Construction) Regulations 2013 require that certain construction workers carrying out safety critical tasks must complete Construction Skills Certification Scheme (CSCS) training. On successful completion, workers are issued with a CSCS Card which demonstrates their competency. Two scaffolding activities require CSCS training: Scaffolding – basic and Scaffolding – advanced.
Separately, for several years, it was recognised that there was a labour and skills gap in the scaffolding industry sector. I am delighted that we now have an apprenticeship on offer for this important skill-set. The programme is 2 years in length and the first apprentices are due to graduate later this year.
It has been identified that, under the current regulations, qualified scaffolding apprentices would be required to submit to a CSCS assessment in order to obtain the CSCS Card that will allow them to work on-site.
Currently, the existing arrangements for scheduled activities are being revised. The skills, training, and assessment for all construction activities currently covered by the existing 2013 regulations, and the Safety, Health and Welfare at Work (Quarries) Regulations 2008, will be updated under the Construction Safety Licensing Bill. The Bill is expected to be enacted at the end of 2023.
While the scaffolding apprenticeship is currently a recognised apprenticeship qualification, this Bill creates the potential for it to be included as a scheduled activity under this licensing model.
It has been noted that there is a time lag between the timing of the first apprenticeship graduates and the enactment of the Bill, and as a result, SOLAS has engaged extensively with the CIF, SIPTU, and the HSA to resolve this matter.
I am pleased to advise you that SOLAS, together with the LOETB, will take each apprentice through a Recognition of Prior Learning process in order to ensure that those scaffolding apprentices graduating in December 2023 obtain their CSCS card.
364. Deputy Catherine Murphy asked the Minister for Further and Higher Education, Research, Innovation and Science to clarify whether at any point over the past ten years the SSL certificates for his Department’s websites expired for a period of time; if so, the reason this occurred; and the duration they remained expired. [33274/23]
View answerMy Department has recorded no instances since its establishment in August 2020 to date, where SSL certs for public facing websites remained expired for a period of time.
365. Deputy Darren O'Rourke asked the Minister for Further and Higher Education, Research, Innovation and Science if he is aware of the concerns of an organisation (details supplied) regarding the Government’s recently published review of the PhDs in Ireland; if he has met or plans to meet them to discuss their concerns; and if he will make a statement on the matter. [33332/23]
View answer366. Deputy Darren O'Rourke asked the Minister for Further and Higher Education, Research, Innovation and Science whether PhD classified as non-EU will be provided with updated residency visas with a four-year duration; and if he will make a statement on the matter. [33333/23]
View answer367. Deputy Darren O'Rourke asked the Minister for Further and Higher Education, Research, Innovation and Science if there are plans to recommend that PhD researchers have access to PRSI; and if he will make a statement on the matter. [33334/23]
View answer368. Deputy Darren O'Rourke asked the Minister for Further and Higher Education, Research, Innovation and Science if there are plans to recommend that PhD researchers have access to sick leave and/or parental leave; and if he will make a statement on the matter. [33335/23]
View answer369. Deputy Darren O'Rourke asked the Minister for Further and Higher Education, Research, Innovation and Science if there are plans to recommend that PhDs to have access to the Workplace Relations Commission in order to resolve disputes with their university; and if he will make a statement on the matter. [33336/23]
View answer370. Deputy Darren O'Rourke asked the Minister for Further and Higher Education, Research, Innovation and Science if there are plans to recommend that minimum standards for the provision of funding for PhD researchers in Ireland, including minimum standards of pay, such as the national minimum wage; and if he will make a statement on the matter. [33337/23]
View answer371. Deputy Darren O'Rourke asked the Minister for Further and Higher Education, Research, Innovation and Science regarding the matter of employee status for PHDS; and if he will make a statement on the matter. [33338/23]
View answerI propose to take Questions Nos. 365 to 371, inclusive, together.
In November 2022, I appointed Dr Andrea Johnson and Mr David Cagney to undertake an independent National Review of State Supports for PhD Researchers. This reflects the objective, under the dedicated Talent Pillar of Impact 2030, Ireland’s national research and innovation strategy, for a consistent research student experience across research funders, higher education institutions and research disciplines.
The Review Terms of Reference comprise examination of:
• Current financial supports for PhD researchers,
• The adequacy, consistency and equity of current arrangements,
• The status of PhD researchers (employee/ student) including a review of international comparators,
• Impact on the funding of research programmes of any adjustments to current supports,
• Graduate outcomes, including return on investment,
• Visa requirements and duration for non-EU students.
As part of the review, the Co-Chairs held a comprehensive round of stakeholder consultations and online submissions, with 35 stakeholder meetings held and over 750 written submissions received. This included an all-day in-person workshop with a number of stakeholders which included the Postgraduate Workers Organisation (PWO).
The Co-Chairs recently submitted their first report to me which I brought to Cabinet on Tuesday 20 June for information. The report was subsequently published on my Department’s website on Wednesday 26 June and is available at the following address:
www.gov.ie/en/press-release/6ae92-minister-publishes-independent-report-on-supports-for-phd-researchers-in-ireland/
In this first report, based on extensive consultation and analysis, the Co-Chairs provide recommendations on the following:
• Financial supports for PhD researchers, with particular regard to stipend levels;
• Issues encountered by PhD researchers coming to Ireland from outside the European Union/ European Economic Area;
• Improving PhD graduate outcomes.
Within this, they recommend an increased stipend level, with an optimum target of €25,000. They acknowledge the potential ramifications of any such change on public finances and recognise that significant additional work will be needed in order give effect to such a recommendation.
Because of their particular complexity, the following elements of the terms of reference will require deeper analysis prior to final recommendations being made:
• Consistency and equity of approaches in how PhD researchers are supported, for example, those coming from under-represented groups;
• The status of a PhD researcher, i.e. classification as either a student or an employee.
My officials will meet the Co-Chairs shortly to determine the preparation of the final report which will consider these outstanding issues. The status issue in particular will require significant examination – especially in terms of any consequences for the Employment Control Framework.
Also, my officials will engage with their counterparts in the Department of Justice to discuss the issue around the updated residency visas for non-EU PhD students.
This first report provides a rich picture, at a point in time, of a range of important issues that now need to be considered by all stakeholders. Any budgetary implications of recommendations will be dealt with through the normal budgetary processes.
