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Tuesday, 9 Apr 2024

Written Answers Nos. 1501-1521

Healthcare Policy

Questions (1501)

Colm Burke

Question:

1501. Deputy Colm Burke asked the Minister for Health if he will ring-fence dedicated funding to the relevant bodies to support the national Hidden Harm framework that recognises the adverse childhood experience of growing up with parental problem substance use; if he will take the necessary steps to ensure current funding for services for children and families who are impacted by parental drug and alcohol use is doubled for five years with a review of the services provided evaluated at the end of that time, as recommended by an organisation (details supplied); and if he will make a statement on the matter. [14860/24]

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Awaiting reply from Department.

Mental Health Services

Questions (1502)

Colm Burke

Question:

1502. Deputy Colm Burke asked the Minister for Health the steps he will take to ensure that the mental health allocation of 10% of the overall health budget is reached by 2030, as committed to in the Programme for Government; and if he will make a statement on the matter. [14861/24]

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Written answers

The Government is committed to enhancing mental health services, which will involve service improvement and reform, in addition to funding increases.

With regard to funding for 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 increase in funding for mental health services represents a significant investment which 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, and enabling us to continue to deliver our vital services to as many people as possible, as we move into 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 our 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 to achieve national coverage for the first time.

In addition to this, I have secured additional funding of €10m for mental health services in the revised estimates process, with details of additional allocations to be confirmed in the coming weeks.

It should be noted that funding for mental health supports is dispersed across many areas of Government, and there is no single headline funding figure which captures this important figure. For example, the figure of approximately €1.3bn above does not include funding for other parts of the health service that provide mental health services and supports, such as psychotropic medicines funded by the Primary Care Reimbursement Service, liaison mental health services in acute hospitals, some dual diagnosis (addiction and mental health) services, and mental health and well-being promotion.

It also does not include spending by other departments on services that incorporate psychological or mental health supports, such as the Prison and Probation Services, Social Protection, Defence Forces, or the Department of Education.

Departmental Funding

Questions (1503)

Colm Burke

Question:

1503. Deputy Colm Burke asked the Minister for Health if he will ring-fence dedicated funding of €2 million estimate to create a Commissioner for Ageing and Older Persons as part of a package of measures to counter ageism; and if he will make a statement on the matter. [14865/24]

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Written answers

In furtherance of the commitment in the Programme for Government, on 3rd October 2023 the Government approved the proposal, which the Minister for Health, Stephen Donnelly, and I brought forward, for the establishment of an independent Commission on Care for Older People. €1.243 million was allocated in Budget 2024 to support the Commission’s work.

On 14th December 2023 the Minister for Health and I announced the appointment of Professor Alan Barrett (Chief Executive Officer, Economic and Social Research Institute) as the Chairman of the Commission. On 29th February 2024 we announced the appointment of the other members of the Commission, all of whom are also independent experts. The inaugural meeting of the Commission was held on 21st March 2024.

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.

Accordingly, it is envisaged that consideration of matters such as whether there is a need to establish a commissioner for ageing and older people, and the fiscal viability of this, will fall within the Commission’s remit.

Public Procurement Contracts

Questions (1504)

Robert Troy

Question:

1504. Deputy Robert Troy asked the Minister for Health if he is confident that all contracts put to tender are awarded to companies who meet the tender criteria; and if it was to be identified where one clearly did not meet the stated criteria in the tender specs, what the recourse would be. [14868/24]

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Written answers

Public Procurement is governed by EU and National rules. The aim of these rules is to promote an open, competitive, and non-discriminatory public procurement regime which ultimately delivers the best value for money. My officials are responsible for ensuring that the Department's public procurement function is discharged in line with the standard accounting and procurement rules and procedures. Public procurement practices are subject to audit and scrutiny under the Comptroller and Auditor General (Amendment) Act 1993, and the Local Government Reform Act 2014.

My Department is fully committed to ensuring that it meets its obligations under the National Public Procurement Policy Framework including all national and EU procurement laws, guidelines, and Government circulars. All of these requirements are incorporated in the Department's Procurement Policy and officials who undertake procurement processes are required to ensure all are in compliance with this.

The EU Procurement and Remedies Directives govern the way public authorities and certain utility operators purchase goods, works and services. The rules are transposed into Irish law and apply to tenders for public contracts whose monetary value exceeds specified thresholds. Where an economic operator (with an interest in a public procurement process) believes that the process may have been run without proper application of the EU Public Procurement Directives, there are remedies available, such as taking a case to the High Court. The European Commission can also take action against a Member State if it considers that the Procurement Directives are not being applied correctly. For tenders of lower value, national rules apply which must respect the general principles of EU law, such as equal treatment and non-discrimination.

Dental Services

Questions (1505)

Colm Burke

Question:

1505. Deputy Colm Burke asked the Minister for Health if he will grant an immediate allocation of €7 million to hire 76 HSE whole-time equivalent dentists to bring service levels back to 2007 levels, thereby cutting waiting lists for service and treatments in the public system that is, the children's school screening programme (details supplied); and if he will make a statement on the matter. [14869/24]

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Written answers

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

Dental Services

Questions (1506)

Colm Burke

Question:

1506. Deputy Colm Burke asked the Minister for Health if he will set aside funding to hire 30 specialist orthodontists to address the up to three-year waiting lists for orthodontic care; and if he will make a statement on the matter. [14870/24]

View answer

Written answers

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

Medical Cards

Questions (1507)

Colm Burke

Question:

1507. Deputy Colm Burke asked the Minister for Health if he will take the necessary steps to deliver a reformed medical card scheme through the provision of a voucher or credit towards dental care of between €100 to €500, respectively (details supplied); and if he will make a statement on the matter. [14871/24]

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Written answers

The Dental Treatment Services Scheme (DTSS) provides dental care, free of charge, to medical card holders aged 16 and over. The DTSS is not an emergency-only service and provides routine and preventive care, though I do acknowledge that the Scheme needs to be modernised.

I approved and funded a range of measures that were put in place on 1 May 2022 to introduce and reintroduce elements of preventative care and increase the fees paid to dental contractors for most treatment items by 40-60%. In 2023, 154,864 additional treatments were provided under the DTSS, with over 26,700 extra patients treated when compared with 2022.

Among the services available annually and on demand is an oral health examination, which includes:

- necessary x-rays and other supporting diagnostics;

- risk factor/health determinants (covering tobacco, alcohol, and diet) assessment, and provision of advice on these elements;

- Assessment for trauma, dental enamel defects and oral cancer;

- Provision of preventative advice.

A scale and polish (cleaning), two fillings and extractions are also provided without the need for prior approval. More complex care, such as dentures, additional fillings and a broader range of treatments for patients with additional needs and high-risk patients, are available subject to the approval of the local HSE Principal Dental Surgeon.

In the longer term, the Government is committed to reforming dental services, including the DTSS, through the implementation of the National Oral Health Policy (NOHP), Smile agus Sláinte. The HSE's Strategic Reform Lead is driving policy implementation across the organisation and moving forward with developing new services for both adults and children in line with the Policy.

Dental Services

Questions (1508)

Colm Burke

Question:

1508. Deputy Colm Burke asked the Minister for Health to set aside funding to reintroduce a foundation training scheme to facilitate new dental graduates to gain experience in a mentored environment; and if he will make a statement on the matter. [14873/24]

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Written answers

Mentoring is an important aspect of career development. It provides a structured environment for individuals to set and achieve goals and to develop skills. One of the key actions of the National Oral Health Policy, Smile agus Sláinte, is to evaluate graduate education and put lifelong postgraduate mentoring and supervisory networks in place to support dentists after study and throughout their professional career.

Smile agus Sláinte, sets out a new model of oral healthcare delivery. This policy focuses on a primary oral healthcare approach that will enable greater access to care by examining the training, roles and regulation of dental health professionals.

As part of this, undergraduate dental education will need to be realigned with the Policy by placing primary oral healthcare at its centre. The primary oral healthcare approach represents a significant change which requires an education system, both at undergraduate and graduate level, to ensure that the profession can respond to the oral healthcare needs of the entire population. In addition, ensuring that a sufficient breadth of skills is maintained in the profession will enable it to be flexible and responsive as the population’s oral health needs change.

In that context, while my Department is aware of the foundation training scheme that was previously in place, this would consist of additional training required after completion of undergraduate training to qualify a person to register and to provide care. It should be the case that graduates do not need to apply for and complete a separate qualification before they can practise. If a higher qualification is to be required, students should progress automatically, as is the case in other disciplines like pharmacy whereby a masters year is included, so that they are fully qualified to practise upon graduation.

The Foundation Training Scheme isn’t as broad as the policy approach of putting in place postgraduate mentoring and supervisory networks. The National Oral Health Policy approach seeks to develop a framework for postgraduate mentoring and supervisory networks to support oral healthcare professionals, throughout their careers.

The intention is to support oral healthcare professionals by providing mentoring programmes as well as forms of Continuous Professional Development (CPD). Such CPD can include long distance and online courses which would be accessible to oral healthcare professionals.

Dental Services

Questions (1509)

Colm Burke

Question:

1509. Deputy Colm Burke asked the Minister for Health what new proposals will be put in place to assist in the delivery of the new dental hospital in UCC; and if he will make a statement on the matter. [14874/24]

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Written answers

The Deputy should note there are ongoing discussions around the National Development Plan (NDP) review between three departments including my Department and the Department of Public Expenditure, NDP Delivery and Reform given the significant capital costs involved in expansion. There are a range of potential projects which have been identified and can be pursued in Dentistry among other areas, including the delivery of the new dental school and hospital in UCC, which will support delivery of national objectives including Sláintecare. There are projects which would be possible to deliver at pace over the short-term period, as well as a number of other projects which could be delivered over the medium term.

At the conclusion of the NDP review, once updated department ceilings have been confirmed, successful applicants would be identified by the Higher Education Authority (HEA) based on assessment of objective criteria.

The funding and delivery of potential public capital projects is subject to the successful completion of the various approval stages, in line with the new lifecycle approach of the Public Spending Code (PSC), which was updated in 2019. The PSC is designed to ensure that investment decisions are underpinned by a clear policy rationale, and that costs are well understood.

These are defined processes which all Departments and agencies are subject to and must follow to ensure that Government, as the approving authority for all major projects, can be satisfied that the project is the best means to achieve a policy goal and that we achieve maximum value for money for the taxpayer. The specific requirements that must be included in a business case at the various stages of the PSC are detailed at www.gov.ie/en/publication/public-spending-code/.

The Cork Dental School and Hospital has two distinct remits: the Dental School for undergraduate and postgraduate education of future dental professionals and the hospital or service element which provides dental care both privately as well as under a HSE service level agreement.

The Dental School is under the direct remit of the HEA via University College Cork as the employment and governing body and the Department of Further and Higher Education, Research, Innovation and Science leads on and funds education-related activities.

Regarding the hospital function, the HSE is responsible for the planning and delivery of health services and management of healthcare infrastructure. Each year the HSE must develop a National Service Plan and Capital Plan upon receipt of notification from Department of Health of annual allocations set in the budget and priorities set out in the Letter of Determination. These plans must then be submitted for review and approval by the Minister for Health. Health capital investment decisions are informed by Programme for Government priorities, sectoral policies, strategies and reform initiatives as set out in Sláintecare.

Therefore, the Cork Dental School and Hospital must engage with the Higher Education Authority and the Department of Further and Higher Education, Research, Innovation and Science and the HSE, in the context of the requirements of the Public Spending Code, to explore the possible contribution of public funding to a new dental hospital building.

Work is ongoing through the appropriate processes to explore options to support the Cork University Dental School and Hospital to continue to deliver on its remit regarding both education and healthcare service provision.

Dental Services

Questions (1510)

Colm Burke

Question:

1510. Deputy Colm Burke asked the Minister for Health if he will set aside additional funding of €20 million for the two dental schools at UCC and TCD to increase the number of dental graduates that will practice in Ireland; and if he will make a statement on the matter. [14875/24]

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Written answers

One of the priorities of the National Oral Health Policy, Smile agus Sláinte, is to expand and maximise the oral healthcare workforce capacity in Ireland.

There are ongoing discussions around the National Development Plan (NDP) review between three departments including my Department and the Department of Public Expenditure, NDP Delivery and Reform given the significant capital costs involved in expansion. There are a range of potential projects which have been identified and can be pursued in Dentistry among other areas, which will support delivery of national objectives including Sláintecare. There are projects which would be possible to deliver at pace over the short-term period, as well as a number of other projects which could be delivered over the medium term.

At the conclusion of the NDP review, once updated department ceilings have been confirmed, successful applicants will be identified by the Higher Education Authority (HEA) based on assessment of objective criteria.

Aligned with Departmental policy regarding self-sufficiency and to address the current imbalance of domestic (including EU/UK) students vs non-EU students, dental schools need to have a 75:25 ratio of domestic vs non-EU students. Superimposed on this rebalancing there needs to be an additional 10-20% on the number of college places made available to dental students in the longer term.

According to figures obtained in 2022 out of the 50 Dentistry graduates produced from UCC 20 were domestic students while of the 40 graduates produced from TCD 25 were domestic students. The HEA had requested both dental schools at UCC and TCD to submit proposals to expand capacity.

The Department of Health is fully supportive of the opportunities to expand capacity in both UCC and TCD and would be in favour of any proposal to increase the number of dental graduates that will practice in Ireland.

Disease Management

Questions (1511)

Thomas Pringle

Question:

1511. Deputy Thomas Pringle asked the Minister for Health the number of patients with type 1 diabetes who transitioned from the paediatric diabetes service to adult diabetes services in Letterkenny University Hospital in 2023 and 2024; how many of those use CGM technology; how many of those are using insulin pumps; how many of them have had one OPD diabetes review appointment in the adult service; how many of them had more than one appointment; how many are still awaiting their first appointment; and if he will make a statement on the matter. [14891/24]

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Written answers

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

Disease Management

Questions (1512)

Thomas Pringle

Question:

1512. Deputy Thomas Pringle asked the Minister for Health the number of adults with type 1 diabetes attending Letterkenny University Hospital (LUH); the number of those patients awaiting an annual OPD diabetes review appointment for less than 6, 6-12, 12-24 and over 24 months; and the longest patient waiting time for an appointment to see an endocrinologist in LUH; and if he will make a statement on the matter. [14892/24]

View answer

Written answers

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

Disease Management

Questions (1513)

Thomas Pringle

Question:

1513. Deputy Thomas Pringle asked the Minister for Health how many people living with type 2 diabetes have been treated in the HSE ECC specialist ambulatory care hub in Letterkenny to date; the number of appointments provided in 2023 and 2024; and if he will make a statement on the matter. [14893/24]

View answer

Written answers

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

Health Services

Questions (1514)

Paul Murphy

Question:

1514. Deputy Paul Murphy asked the Minister for Health further to Parliamentary Question No. 1334 of 20 March 2024, if the National Gender Service does not follow the 2017 "Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society* Clinical Practice Guideline" when considering dosages and hormone levels. [14898/24]

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Written answers

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

Health Services

Questions (1515)

Paul Murphy

Question:

1515. Deputy Paul Murphy asked the Minister for Health further to Parliamentary Question No. 1334 of 20 March 2024, if the National Gender Service does not use any biochemical reference ranges for hormones for patients in their care. [14899/24]

View answer

Written answers

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

Health Services

Questions (1516)

Paul Murphy

Question:

1516. Deputy Paul Murphy asked the Minister for Health further to Parliamentary Question No. 1334 of 20 March 2024, if there are any circumstances where National Gender Service would consider oestradiol levels in a trans woman below 100 pmol/L or above 600 pmol/L to be of any concern. [14900/24]

View answer

Written answers

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

Health Services

Questions (1517)

Paul Murphy

Question:

1517. Deputy Paul Murphy asked the Minister for Health further to Parliamentary Question No. 1334 of 20 March 2024, if the National Gender Service can provide an example scenario, including specific hormone levels, where "hormone levels can be measure to guide treatment decisions in some scenarios, such as requests to increase hormone doses. [14901/24]

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Written answers

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

Health Services

Questions (1518)

Paul Murphy

Question:

1518. Deputy Paul Murphy asked the Minister for Health further to Parliamentary Question No. 1334 of 20 March 2024, if the National Gender Service agrees that advising GPs not to provide hormone blood tests will prevent other medical teams from having information they might need for dosage increases. [14902/24]

View answer

Written answers

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

Health Services

Questions (1519)

Paul Murphy

Question:

1519. Deputy Paul Murphy asked the Minister for Health further to Parliamentary Question No. 1334 of 20 March 2024, if the National Gender Service agrees that clinicians outside their services can use their own clinical judgement when it comes to target to treat approaches and biochemical reference ranges. [14903/24]

View answer

Written answers

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

Health Services

Questions (1520)

Paul Murphy

Question:

1520. Deputy Paul Murphy asked the Minister for Health further to Parliamentary Question No. 1334 of 20 March 2024, what the National Gender Service advises for trans patients on hormones with other services who are unable to access hormone level blood tests. [14904/24]

View answer

Written answers

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

Health Services

Questions (1521)

Paul Murphy

Question:

1521. Deputy Paul Murphy asked the Minister for Health further to Parliamentary Question No. 560 of 20 February 2024, to ask the National Gender Service if the referenced paper underlies their model of care. [14905/24]

View answer

Written answers

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

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