Written Answers Nos. 1211-1233
1212. Deputy Pauline Tully asked the Minister for Health the reason that Statutory Instrument number 237 of 2023 does not reflect the fact that the THC content in the EU hemp crop is legally regulated under the EU Common Agricultural Policy; and if he will make a statement on the matter. [36073/23]
View answerHemp is a plant of the genus Cannabis Sativa L. Cannabis is a Schedule 1 controlled drug and is subject to the strictest levels of control. Possession is only permitted by licence.
Statutory Instrument 237/2023, the Misuse of Drugs Act 1977 (Controlled Drugs) (Designation) (Amendment) Order 2023 amends Statutory Instrument 211/2022, the Misuse of Drugs Act 1977 (Controlled Drugs) (Designation) Order 2022. The Designation Order correctly does not reflect that the THC content in the EU hemp crop is legally regulated under the EU Common Agricultural Policy.
In Ireland, the Misuse of Drugs framework is the only legislative framework for the regulation of controlled drugs, not Common Agricultural Policy Regulations. THC is a cannabinol derivative, and is a schedule 1 controlled drug under the Misuse of Drugs Regulations 2017 and is subject to the strictest control measures.
Schedule 2(b) of the Designation Order, states that subject to the licensing provisions of the Misuse of Drugs framework, the growing of hemp shall be permitted from seed varieties specified by the Commission of the European Communities, as being eligible for the purposes of Regulation (EU) 2021/2115 of the European Parliament and of the Council of 2 December 2021 (establishing rules on support for strategic plans to be drawn up by Member States under the common agricultural policy (CAP Strategic Plans) and financed by the European Agricultural Guarantee Fund (EAGF) and by the European Agricultural Fund for Rural Development (EAFRD) and repealing Regulations (EU) No 1305/2013 and (EU) No 1307/2013) , as supplemented by Commission Delegated Regulation (EU) 2022/126 (supplementing Regulation (EU) 2021/2115 of the European Parliament and of the Council with additional requirements for certain types of intervention specified by Member States in their CAP Strategic Plans for the period 2023 to 2027 under that Regulation as well as rules on the ratio for the good agricultural and environmental condition (GAEC) standard 1).
THC is a cannabinoid derived from the flowering top of the hemp plant. These agricultural Regulations specify that hemp may only be cultivated using certain seed varieties which produce a hemp plant containing up to 0.3% tetrahydrocannabinol (THC). This does not mean that cultivators have legal access to the flowering tops of the plant i.e. THC .
In Ireland, before a licence will issue, applicants for a licence to grow hemp for fibre must sign an undertaking that the flowering top of the hemp plant will not be further processed and must be destroyed on harvesting. The hemp for fibre cultivation licence, issued pursuant to Section 14 of the Misuse of Drugs Act 1977 permits the cultivation of the hemp plant for fibre purposes only, it does not permit the possession of a schedule 1 controlled drug such as THC.
1214. Deputy Paul Kehoe asked the Minister for Health when the renal support centre (details supplied) will resume its facility in Beaumont, given the Covid-19 emergency has ended; and if he will make a statement on the matter. [36080/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1215. Deputy Robert Troy asked the Minister for Health when a person (details supplied) will be called for hip replacement surgery in the Regional Hospital Tullamore. [36088/23]
View answerUnder 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.
1216. Deputy Violet-Anne Wynne asked the Minister for Health further to Parliamentary Question No. 736 of 20 June 2023, if he will provide an update with respect to HSE safety net service and the need for the rollout of an awareness campaign to make people aware as many people are going without care; and if he will make a statement on the matter. [36089/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1217. Deputy Violet-Anne Wynne asked the Minister for Health his views on a service level agreement (details supplied); and if he will make a statement on the matter. [36098/23]
View answerGeneral Practitioners that hold GMS contracts for the provision of services to medical card and GP visit card holders, are required under their contract to make suitable arrangements for emergencies outside normal practice hours.
Over 2,500 GPs currently hold a GMS contract, and while they are not obliged to, most GPs participate in GP Out of Hours cooperatives to meet their outside of practice hours service requirements. A robust GP Out of Hours services ensures that, as much as possible, urgent care needs are met in the community and not in a hospital setting.
The ShannonDoc cooperative provides GP out of hours services for Limerick, North Tipperary and Clare. As with the other GP out of hours cooperatives, Shannondoc is a private organisation. However, the HSE provides significant funding to support out of hours co-operative services through service level agreements, with ShannonDoc having received almost exactly €5 million in HSE funding in 2022.
The HSE is in regular contact with all Out of Hours service providers to ensure that these services continue to meet the needs of their local communities.
1218. Deputy Violet-Anne Wynne asked the Minister for Health to outline all of the functions and associated finances transferred to the Department of Children, Equality, Disability, Integration and Youth since 1 January 2023 to date; and if he will make a statement on the matter. [36099/23]
View answerAbout one in seven people in Ireland, circa 650,000, self-reported as having a disability in Census 2016. In line with the ‘mainstream first’ approach of the Disability Act 2005, over 90% of people with a disability are supported through general community health and social services. Health Service Executive funded specialist community-based disability services are delivered to an estimated 80,000 people with a disability.
Policy functions and funding responsibility for approximately 2.647 billion euro relating to specialist community-based disability services transferred to the Minister for Children, Equality, Disability, Integration and Youth on the 1st of March 2023.
Specialist community-based disability services include the services provided by, or on behalf of, the HSE to children and adults with physical, sensory, intellectual disability and/or autism, including:
• Specialist children’s and adults’ multi-disciplinary supports
• Day services
• Respite services
• Personal Assistant and Home Support Services and
• Residential services.
The responsibility for the delivery of these services is retained within the Health Service Executive.
1219. Deputy Violet-Anne Wynne asked the Minister for Health further to Parliamentary Question No. 627 of 24 January 2023, the reason that the number of HSE health care support assistants in County Clare is significantly lower than every other county in CHO3; and if he will make a statement on the matter. [36106/23]
View answerReferred to HSE National HR to respond to the Deputy directly.
1220. Deputy Violet-Anne Wynne asked the Minister for Health his views on the success or otherwise of the Ennis Hospital ambulance transfer pathway since it was established in January 2023; and if he will make a statement on the matter. [36107/23]
View answerThe Medical Assessment Unit (MAU) pathway for 112/999 patients commenced operations in Ennis Hospital on January 9th and in Nenagh Hospital on February 7th. The pathway will commence operations at St. John’s Hospital on Thursday 27th July 2023.
The development of this pathway allows patients that meet agreed clinical criteria to be transferred by ambulance and treated in a Model 2 hospital. Its implementation is resulting in patients receiving medical treatment in a hospital closer to their home, is reducing patient presentations to Emergency Departments (EDs) and is helping to release ambulances more quickly to respond to other emergency calls. The MAUs in Ennis and Nenagh Hospitals treat patients referred by GPs, ShannonDoc, and now National Ambulance Service paramedics. 112/999 patients that do not meet these clinical criteria will continue to be transported to EDs for assessment and treatment.
To date, 119 patients have been referred to Ennis and Nenagh MAUs through this pathway, playing in important role in ED avoidance.
In addition, to increase activity at MAUs in the region, the University of Limerick Hospitals Group (ULHG) has had funding of €5.2m approved by the HSE’s National Acute Division. This funding has secured the already extended weekend service at Ennis MAU and allows for St. John’s and Nenagh MAU to open seven days per week.
Recruitment is ongoing for an additional 51.45 Whole Time Equivalents for the ULHG MAUs across a number of specialties including medical doctors, nurses, allied health professionals, health and social care professionals and administrative staff. As more of these staff take up post, the number of additional slots available for medical assessment will gradually increase. Once all staff are in post, the overall effect of this investment will be the creation of an additional 7,176 slots per annum across the three sites.
ULHG's MAUs provide diagnosis and treatment for patients referred with medical conditions including chest infections, Chronic Obstructive Pulmonary Disease (COPD), pneumonia, urinary tract infections, fainting episodes, clots in the leg, anaemia or non-acute cardiac problems. In 2022, 12,737 patients were referred to the MAUs in Ennis, Nenagh and St. John's hospitals.
1221. Deputy Violet-Anne Wynne asked the Minister for Health if he has confidence in an entity (details supplied); and if he will make a statement on the matter. [36108/23]
View answerI fully recognise the effects that issues such as overcrowding at the Emergency Department (ED) at University Hospital Limerick (UHL) and delays to treatment as a result of the Covid-19 pandemic have had on patients, their families and staff working in the University of Limerick Hospital Group (ULHG). Following interventions made last year, there has been ongoing intensive engagement with ULHG in response to concerns about the ED at UHL. As a result, significant supports were provided to the hospitals and community services to help drive a programme of work to respond more effectively to the pressures at the hospital.
Because of those supports, and additional investment provided, ULHG has been implementing important measures which include a renewed focus on hospital avoidance, patient flow and discharge planning, and regular and frequent assessment of patients with long stays in hospital. ULHG has also recruited additional staff over the last year, including emergency medicine consultants and non-consultant hospital doctors. In tandem with these measures, initiatives commenced as part of the last Winter Plan have continued beyond the end of the winter period, to build sustainable improvements. These include actions such as the expansion of the OPTIMEND service provision to ensure timely assessment and intervention among people aged 75 years and older, and the recruitment of additional ED registrars and physiotherapists for Community Intervention Teams.
ULHG has also invested significantly in their Model 2 hospitals to enhance non-acute patient care. In April 2022, the new purpose-built €2m Injury Unit at Ennis Hospital opened, replacing the existing unit that had operated out of the main hospital building since 2013. The new Unit, which I formally opened last month, has brought an immediate improvement in the clinical environment and experience for healthcare staff and the thousands of patients who use this service every year. There has also been investment in equipping the Outpatient Department, including provision of X-Ray Room and other diagnostics, in Phase 1b of the redevelopment of Ennis General Hospital and in redevelopment works to provide two replacement theatres and supporting facilities.
In addition, ULHG has confirmed that, through funding of €5.2m secured from the HSE, the Medical Assessment Units (MAUs) at Ennis Hospital, Nenagh, and St John’s now all operate seven days per week. This funding will see 51 additional Whole-Time Equivalents recruited across a number of specialties for the MAU services.
Another important development implemented by ULHG is the introduction of the MAU pathway for 112/999 patients at Ennis and Nenagh Hospitals. This allows patients that meet agreed clinical criteria to be transferred by ambulance and treated in a Model 2 hospital. This pathway is resulting in patients receiving medical treatment in a hospital closer to their home, is reducing patient presentations to EDs and is helping to release ambulances more quickly to respond to other emergency calls. The MAUs in Ennis and Nenagh Hospitals treat patients referred by GPs, ShannonDoc, and now National Ambulance Service paramedics. In addition to Ennis and Nenagh, it is envisaged that the MAU pathway for 112/999 patients will commence operations at St John's Hospital, Limerick by the end of July 2023.
In addition to this work, UHL has received significant infrastructural investment in recent years. For example, in October 2022, I broke ground on the new 96-bed inpatient block project at UHL. This project represents a total capital investment of just over €90 million, and will deliver a 4-storey, 96 single bed acute inpatient ward block and will go some way toward addressing capacity issues in the region. In 2021, a new 60-bed modular ward block opened. This follows the completion of two separate rapid-build projects, constructed in response to the Covid-19 emergency, which provided an additional 38 inpatient beds on site at UHL. In total, 150 additional beds have been opened in the ULHG since 1st January 2020 and 98 of these beds are in UHL.
Following these and other investments across the wider ULHG, consideration is also being given to future capacity requirements. It is noted that ULHG has developed proposals in this regard. These proposals will be considered by the hospital group and the HSE in line with their governance processes.
Complementary to the development of the new Elective Hospitals, the HSE also plans to work with Hospital Groups and forthcoming Regional Health Areas to progress proposals for a shorter-term measure by developing ‘Surgical Hubs’ in Cork, Galway, Limerick, Waterford and Dublin with a narrower scope of procedures. Regarding the Surgical Hub for Limerick, planning is at an early stage, and I have asked the HSE to expedite the development, so it is operational as soon as possible.
My Department continues to work with the HSE to ensure the improvement of services for all patients in the Midwest region continues. While I recognise that there is more to be done, particularly in relation to the ED, improvements are being made. This was acknowledged in the context of HIQA’s recent inspection report of UHL against the National Standards, in comparison to their previous report from March 2022. In that regard, I am confident that the measures being taken as a result of the additional investment and support provided to ULHG will help to further improve services at UHL and across the group.
1222. Deputy Peter Burke asked the Minister for Health the reason Section 39 workers did not get the pandemic bonus; and if they can be treated the same as Section 38 workers who did get the bonus. [36117/23]
View answerLast year the Government announced a once-off, ex-gratia COVID-19 pandemic recognition payment for certain frontline public sector healthcare workers, to recognise their unique role during the pandemic. Eligibility criteria for the payment were set following significant consideration and consultation.
While the Department does not comment on individual cases, I can confirm that in order to receive the recognition payment, staff must have:
• Been in COVID vaccination cohorts 1 or 2, and
• Worked ordinarily onsite in a COVID-19 exposed healthcare environment, and
• Worked for at least 4 weeks in the 1/3/2020 – 30/6/2021 period, and
• Worked in a HSE/Section 38 organisation, or one of the following:
Private Sector Nursing Homes and Hospices (e.g. Private, Voluntary,Section 39 etc.);
Section 39 long-term residential care facilities for people with disabilities, working on-site;
Agency roles working in the HSE;
Health Care Support Assistants (also known as home help / home care / home support) contracted to the HSE;
Members of the Defence Forces redeployed to work in frontline Covid-19 exposed environments in the HSE;
Paramedic staff employed by Dublin Fire Brigade to deliver services on behalf of the HSE.
Only those staff who meet all of the above eligibility criteria are covered for this payment. I appreciate that many other workers, volunteers, and other citizens, provided important services during this most difficult time. While this is not questioned, it is important to recognise that this in itself is not sufficient to be considered eligible for this payment.
The Government appreciates that those organisations and staff who are not encompassed for this particular payment may feel disappointed. It was tough to draw a line on this matter, but the Government based its decision on the risks which eligible frontline workers faced, following careful consideration. While undoubtedly immense efforts have been made by other healthcare staff since the onset of this pandemic, it is right that the Government pursue this course to recognise those at greatest risk in the performance of their duties throughout the pandemic, including those who worked in the very acutely affected environments above.
In recognition of the efforts of all workers, volunteers, and the general public during the COVID-19 pandemic, and in remembrance of people who lost their lives due to the COVID-19 pandemic, the Government announced a public holiday which took place on 18 March 2022. As of February this year there is also a new permanent public holiday established to mark Imbolc/St Brigid’s Day.
Finally I want to again express my sincere gratitude to all healthcare workers for their efforts during what has been a challenging period for our health services.
1223. Deputy Ged Nash asked the Minister for Health to consider correspondence from a disability sector provider (details supplied) whose staff have been incorrectly excluded from accessing the pandemic recognition payment; if he agrees that a direct and objective comparison can be made between the status of workers in private nursing homes who have received the payment and workers at the facility referred to in the correspondence who have been excluded from the scheme; if he will have this matter addressed in the interests of the equitable and consistent application of the scheme; and if he will make a statement on the matter. [36149/23]
View answerLast year the Government announced a once-off, ex-gratia COVID-19 pandemic recognition payment for certain front-line public sector healthcare workers, to recognise their unique role during the pandemic. Eligibility criteria for the payment were set following significant consideration and consultation.
While the Department does not comment on individual cases, I can confirm that in order to receive the recognition payment, staff must have:
• Been in COVID vaccination cohorts 1 or 2, and
• Worked ordinarily onsite in a COVID-19 exposed healthcare environment, and
• Worked for at least 4 weeks in the 1/3/2020 – 30/6/2021 period, and
• Worked in a HSE/Section 38 organisation, or one of the following:
Private Sector Nursing Homes and Hospices (e.g. Private, Voluntary,Section 39 etc.);
Section 39 long-term residential care facilities for people with disabilities, working on-site;
Agency roles working in the HSE;
Health Care Support Assistants (also known as home help / home care / home support) contracted to the HSE;
Members of the Defence Forces redeployed to work in frontline Covid-19 exposed environments in the HSE;
Paramedic staff employed by Dublin Fire Brigade to deliver services on behalf of the HSE.
Only those staff who meet all of the above eligibility criteria are covered for this payment. I appreciate that many other workers, volunteers, and other citizens, provided important services during this most difficult time. While this is not questioned, it is important to recognise that this in itself is not sufficient to be considered eligible for this payment.
The Government appreciates that those organisations and staff who are not encompassed for this particular payment may feel disappointed. It was tough to draw a line on this matter, but the Government based its decision on the risks which eligible frontline workers faced, following careful consideration. While undoubtedly immense efforts have been made by other healthcare staff since the onset of this pandemic, it is right that the Government pursue this course to recognise those at greatest risk in the performance of their duties throughout the pandemic, including those who worked in the very acutely affected environments above.
In recognition of the efforts of all workers, volunteers, and the general public during the COVID-19 pandemic, and in remembrance of people who lost their lives due to the COVID-19 pandemic, the Government announced a public holiday which took place on 18 March 2022. As of February this year there will also be a new permanent public holiday established to mark Imbolc/St Brigid’s Day.
Finally I want to again express my sincere gratitude to all healthcare workers for their efforts during what has been a challenging period for our health services.
1224. Deputy Ged Nash asked the Minister for Health the reason a child (details supplied) has not been accepted as a client of CAMHS in Louth despite presenting with severe behavioural problems for some time; and if he will make a statement on the matter. [36152/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1226. Deputy Colm Burke asked the Minister for Health if he will provide immediate financial relief to parents and family carers who have been forced to pay privately for assessment costs either through reimbursement, or payment through the National Treatment Purchase Fund; and if he will make a statement on the matter. [36172/23]
View answer1227. Deputy Colm Burke asked the Minister for Health if he will ringfence dedicated funding to finance an urgent review of open cases across all Child and Adult Mental Health Services; and if he will make a statement on the matter. [36173/23]
View answerAs this is a service matter, I have asked the Health Service Executive to reply directly to the Deputy as soon as possible.
1228. Deputy Colm Burke asked the Minister for Health if he will give due consideration to extending the National Treatment Purchase Fund to include occupational therapy, speech and language therapy and physiotherapy to enable backlogs to be cleared; and if he will make a statement on the matter. [36179/23]
View answerThe National Treatment Purchase Fund was established under the Health (Corporate Bodies) Act 1961, with the function of providing hospital treatment for citizens and the collection and validation of information in relation to waiting lists. Its role was extended in 2009, via the Nursing Home Support Scheme Act 2009, to provide for negotiations with private nursing homes in the context of fees payable under the Nursing Home Support Scheme.
As noted above the NTPF’s statutory remit is in respect of the provision of hospital treatment and does not extend to arranging or funding any non-hospital services, including occupational therapy, speech and language therapy and physiotherapy.
Notwithstanding the fact that Primary Legislation would be required to expand the NTPF’s role there are other core factors that may militate against a role for the NTPF in the acquisition of the type of community services referred to in the Deputies question in the short to medium term.
There is a major difference in the nature of private capacity in the context of hospitals versus community. NTPF treatments are purchased from hospitals (institutions) through panel agreements with the relevant providers, community services are predominately provided via individual practitioners.
People using HSE primary care therapies are likely to have more complex needs and, therefore, require several services at the same time, provided through a multidisciplinary team. In essence, they have a longer-term relationship with health services rather than an episodic relationship such as that provided in a hospital.
Any changes would need to be widely consulted upon, analysed, and planned prior to enactment. An NTPF style approach could potentially play a role in the future, but there are foundational issues as outlined above that need systematic reform and development.
It should also be noted that the Government's Waiting List Action Plan 2023 allocated a total of €22.7 million in funding for the provision community and primary care waiting list initiatives. €3.5 million of this has been allocated to address primary care therapy service waiting lists, and the HSE has advised that the roll-out of associated initiatives is anticipated to commence shortly. Progress on the roll out of these initiatives will be monitored and reported over the coming months.”
1229. Deputy Colm Burke asked the Minister for Health to confirm the up-to-date position in respect of the proposed building of a helicopter pad in Cork University Hospital, for which planning permission has been granted; if further public consultation is planned with immediate residents to alleviate concerns during construction; and if he will make a statement on the matter. [36180/23]
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.
1230. Deputy Colm Burke asked the Minister for Health when a child (details supplied) will be provided with a date for a surgical procedure to alleviate the challenges they have arising out of scoliosis; and if he will make a statement on the matter. [36181/23]
View answerI sincerely regret that children can experience a long waiting time for scoliosis treatment, and remain conscious of the burden that this places on them and their families.
Last year I approved an ambitious plan from Children’s Health Ireland to reduce the number of children waiting for spinal orthopaedic procedures (scoliosis/spina bifida), and significant current and capital funding was committed to implement the plan. CHI has developed a plan for 2023 to continue and build on the work done in 2022.
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.
1231. Deputy Kathleen Funchion asked the Minister for Health if there is an alternative way for a person (details supplied) to get a medical card. [36185/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1232. Deputy Sean Sherlock asked the Minister for Health if, further to an announcement by HIQA (details supplied), he will commit to funding the introduction of a vaccine to the routine vaccine schedule for children. [36186/23]
View answer1366. Deputy John Brady asked the Minister for Health if consideration has been given to providing the chicken pox varicella vaccine to all children through the infant and children’s immunisation programme; and if he will make a statement on the matter. [36740/23]
View answer1409. Deputy Duncan Smith asked the Minister for Health the projected cost of providing two doses of the chicken pox varicella vaccine free to all children through the primary or school child immunisation programme; the estimated annual cost of providing this in 2024; the estimated five-year cost; and if he will make a statement on the matter. [37096/23]
View answerI propose to take Questions Nos. 1232, 1366 and 1409 together.
Varicella (chickenpox) is a common, highly infectious disease mainly affecting children under ten years of age caused by varicella-zoster virus (VZV). The Varicella vaccine is not currently included as part of the routine childhood immunisation schedule.
My Department asked the Health Information and Quality Authority (HIQA) to carry out a Health Technology Assessment (HTA) on the Varicella Zoster Vaccine which was published on July 13th 2023.
HIQA found that there is clear and consistent evidence that the chickenpox vaccine is both safe and effective in preventing chickenpox and its complications. It also found that adding the chickenpox vaccine to the childhood immunisation programme is likely to be cost effective.
The HTA found that adding the vaccine to the childhood immunisation schedule would cost between €13 million and €28 million over the first five years, depending on whether one or two doses are given.
The HTA findings will be considered and will inform a decision in relation to the inclusion of the chickenpox vaccine in the childhood immunisation programme.
I have asked the HSE to respond directly in relation to the costing aspect of the question.
1233. Deputy Sean Sherlock asked the Minister for Health the individuals appointed to his Department’s task force savings and efficiencies steering group; the timelines laid out for a report to be made to him; and if he will publish the report when received. [36189/23]
View answerReferred to HSE National HR to respond to the Deputy directly.
