Tuesday, 13 Dec 2022

Hospital Appointments Status

Questions (527)

Sorca Clarke

Question:

527. Deputy Sorca Clarke asked the Minister for Health when an appointment will issue to a person (details supplied). [62157/22]

View answer

Written answers

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Healthcare Infrastructure Provision

Questions (528, 532)

Michael Lowry

Question:

528. Deputy Michael Lowry asked the Minister for Health his views on a matter (details supplied); and if he will make a statement on the matter. [61633/22]

View answer

Michael Lowry

Question:

532. Deputy Michael Lowry asked the Minister for Health his views on a matter (details supplied) in relation to palliative care; and if he will make a statement on the matter. [61661/22]

View answer

Written answers

Minister for Health

I propose to take Questions Nos. 528 and 532 together.

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 Staff

Questions (529)

David Cullinane

Question:

529. Deputy David Cullinane asked the Minister for Health if the consultant psychiatrist post for the south east in CHO 5 has been filled; the basis and tenure on which it has been filled; the length of time that the post was vacant; the number of times that the post was advertised; and if he will make a statement on the matter. [61634/22]

View answer

Written answers

Minister of State at the Department of Health

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

Medicinal Products

Questions (530, 538)

Neale Richmond

Question:

530. Deputy Neale Richmond asked the Minister for Health his views on whether it is appropriate that pregnant women suffering from hyperemesis should have to see a consultant before receiving their reimbursement for Cariban; his views on whether this will introduce an additional barrier to treatment for women in this position and is appropriate given that the HSE recommends Cariban as the first line treatment for hyperemesis, nausea and vomiting in pregnancy; if he will include a prescription from a GP to allow for the reimbursement; and if he will make a statement on the matter. [61639/22]

View answer

Richard Boyd Barrett

Question:

538. Deputy Richard Boyd Barrett asked the Minister for Health the rationale for the reimbursement of pyridoxine/doxylamine, whose brand name is Cariban in Ireland, for women with hyperemesis gravidarum to require a prescription from a consultant obstetrician, rather than a GP; and if he will make a statement on the matter. [61689/22]

View answer

Written answers

Minister for Health

I propose to take Questions Nos. 530 and 538 together.

As part of Budget 2023, I announced €32.2 million in funding for Women’s Health Initiatives in 2023, to include dedicated funding for Cariban® (doxylamine/pyridoxine). Cariban® is an Exempt Medicinal Product i.e. not licensed with the Health Products Regulatory Authority (HPRA) in Ireland. Following the recommendations of the HSE Medicines Management Programme, this product will be made available on an individual patient basis for those patients who meet the criteria under Community Drug Schemes (GMS, DPS) from January 2023 where Consultant Obstetrician initiated.

Under Community Drug Schemes, Exempt Medicinal Products must be Consultant initiated. However, whilst the original prescriber is a Consultant and specialist in the relevant field, the HSE will accept a GP prescription further to the initial hospital prescription for approved patients.

Departmental Policies

Questions (531)

Jim O'Callaghan

Question:

531. Deputy Jim O'Callaghan asked the Minister for Health the main policy achievements of his Department since 27 June 2020; and if he will make a statement on the matter. [61652/22]

View answer

Written answers

Minister for Health (Deputy Stephen Donnelly)

My Department is engaged in policy development and implementation across the full spectrum of issues that impact health and wellbeing in Ireland. To support the Deputy, I have listed below the main policy achievements and initiatives undertaken by my Department since I took post as Minister for Health in June 2020 which mark significant milestones in the development of health policy for Ireland. Relevant policy documents are available in detail on gov.ie/health.

Further details of the main achievements made are and will continue to be documented in the Department of Health Annual Reports. These documents will detail the achievements of my Department over the period of a year, in particular our achievements as they relate our commitments in the Programme for Government: Our Shared Future .

Since March 2020, officials from my Department continue to provide ongoing advice in relation to the overall response to COVID -19 . Further to this, in 2020, my Department was successful in:

- Establishing the CervicalCheck Tribunal in line with Justice Meenan recommendations for an alternative system for dealing with claims arising from CervicalCheck.

- Publishing the Final Report of the Expert Group to review the law of torts and the current systems for the management of clinical negligence claims.

- Continuing implementation of the National Maternity Strategy with the expansion of the supported care pathway across maternity services.

- Ensuring all 19 maternity services in the country have at least one Advanced Midwife Practitioners by funding 12 additional Advanced Midwife Practitioners were funded to support the further roll-out of the Model of Care .

- Publishing Ireland’s first ever Maternity Experience Survey with the results being very positive overall and all hospitals having developed Quality Improvement Plans.

- Healthy Ireland Communications managed the cross-sectoral Keep Well campaign, which provided supports for population resilience in the context of Covid-19, from October 2020 to June 2021. Healthy Ireland has since partnered with Sport Ireland for a citizen engagement campaign called Let’s Get Back to encourage people to return to sport and physical activity, in late 2021 and early 2022.

- Under the Public Health (Alcohol) Act 2018 the following measures on alcohol pricing, advertising and public health input into licensing came into operation. From 12 November 2020, in mixed retail outlets alcohol products and advertising are confined to one of the following:

- an area separated by a 1.2m high barrier, or

- units in which alcohol products are not visible up to 1.5m height, or

- up to three units that can be a maximum of 1m wide by 2.2m high.

- In addition, alcohol products can be contained but not be visible in a unit behind the counter. (Section 22)

- Publishing two National Clinical Effectiveness Committee (NCEC) National Clinical Guidelines ; No. 24. Diagnosis, Staging and Treatment of Patients with Colon Cancer and No. 25. Diagnosis, Staging and Treatment of Patients with Rectal Cancer.

- Publishing Version 2 of NCEC National Clinical Guideline No. 1. Irish National Early Warning System (INEWS).

- Publishing the Report of the Expert Review Body on Nursing and Midwifery .

- Completing and publishing the Framework for Safe Nurse Staffing and Skill Mix in Adult Emergency Care Settings in Ireland.

- Completion of the testing and publication of the results of an integrated nurse-led community virtual ward proof-of-concept.

- Developments in mental health services continue in line with the national mental health policy, Sharing the Vision, as does work on Connecting for Life, the national suicide reduction strategy, which both align to the Programme for Government commitment. Connecting for Life was extended for a further 4 years from 2020 to 2024 .

- Sharing the Vision was published, and the National Implementation and Monitoring Committee (NIMC) was established to drive the policy recommendations forward and ensure robust policy implementation oversight and governance.

- 5 Early Intervention in Psychosis Teams are in place out of 20 Early Intervention in Psychosis teams required. 48 Whole Time Equivalents have been funded via National Clinical Programme for Early Intervention in Psychosis since 2019. Of which 17.1 Whole Time Equivalents were funded since 2020. 556 service users have accessed the 5 teams since 2020.

- Introduction of the paid induction week for Interns – previously this was an unpaid week.

- The Strategic Plan for Critical Care was brought to Government in December 2020. 297 permanent adult critical care beds are now open, an increase of 42 over the 2020 baseline of 255. Funding is in place to increase this to 340 beds by late 2022/early 2023.

- Significant progress was made toward operationalising the Medical Cannabis Access Programme and consultants can now register patients with the HSE.

In 2021, some of my Department’s main policy achievements were, as follows:

- Developed key legislative work, including the preparation of over 50 Statutory Instruments under the Health Act 1947, in order to provide for the public health measures required by Government in response to COVID-19. Officials in my Department also oversaw the development of national legislation and infrastructure to implement the EU Digital COVID Certificate Regulation during the COVID-19 pandemic, to facilitate ease of movement within the European Union.

- An overall improvement in compliance among approved mental health centres in recent years. In 2021, 59 approved centres (89%) achieved at least an 80% rate of compliance (in 2020, 82% of approved centres achieved this). Of these, two-thirds achieved at least 90%.

- The Sláintecare Implementation Strategy & Action Plan 2021-2023 was approved by Government in May 2021. The new Strategy builds on the progress of Sláintecare reform to date and on the lessons learned from COVID-19. A mid-year progress report on implementation of the Strategy & Action Plan was published on 10 September 2021.

- The HSE Winter Preparedness Plan for 2021/2022 was published on 15 November 2021. The Plan aims to ensure that the health service is prepared for the challenges of winter 21/22 in the context of the ongoing Covid-19 pandemic.

- The opening of the CHI Tallaght Outpatient and Emergency Care Unit on 15 November 2021 was a major milestone in the new children’s hospital project. The new facility delivers services in a modern, fit for purpose environment and significantly expands acute paediatric capacity in the Greater Dublin Area with 2022 full-year activity projected to reach 7,000 outpatient appointments and 30,000 emergency care attendances.

- The establishment of two Major Trauma Centres is one of the major commitments of the Trauma System for Ireland. In April Government approved the designation of the Mater Misericordiae Hospital in Dublin as the Major Trauma Centre (MTC) for the Central Trauma Network. Recruitment in 2021 enabled the commencement of phase one of the development of the MTC at the Mater and facilitated the development of Planned Trauma Care in the MTC for the South Trauma Network, Cork University Hospital.

- In 2021 the National Ambulance Service (NAS) invested €10m development funding into strategic goals outlined in its five-year strategic plan, Vision 2020. The NAS is currently finalising a new strategic plan to build on the progress made under Vision 2020.

- Significantly increased funding of €7.3m in 2021 ensured implementation of the National Maternity Strategy was further progressed. 96.5 additional WTEs were approved for maternity services in 2021, resulting in further development of community-based midwifery services, increased choice for women and improved access to specialist services, including obstetric, endocrinology, perinatal pathology, neonatology and perineal services.

- Funding in 2021 ensured that all 19 maternity hospitals/units now offer the Strategy’s midwifery led Supported Care Pathway.

- On 11th May 2021, funding of €1.58m was announced to provide an additional 24 Lactation Consultants across hospital and community settings, which are required to implement the National Breastfeeding Action Plan and ensure timely skilled assistance for mothers who wish to breastfeed.

- Healthy Ireland published the Healthy Ireland Strategic Action Plan in May 2021, setting out the actions and priorities for the next 5 years of Healthy Ireland implementation.

- RTE’s Operation Transformation was sponsored by Healthy Ireland in 2021 and 2022. Healthy Ireland also ran it’s Let’s Get Set public engagement campaign and is running a Healthy Weight Campaign currently. Healthy Ireland and the Women’s Health Taskforce are working with Sport Ireland on the current It’s My Time campaign to promote participation in sport and physical activity amongst women over 40, which was funded by the Women’s Health Fund.

- Healthy Ireland, through Sport Ireland, supports and funds national strategies on promoting walking, cycling, running and swimming.

- Sláintecare and Healthy Ireland, working with the HSE and local authorities and community agencies, launched the Sláintecare Healthy Communities Programme to provide increased health and wellbeing services in 19 community areas across Ireland where health and wellbeing risk factors may be particularly concentrated.

- Healthy Ireland’s National Healthy Campus Framework was launched in July 2021. The Framework will help higher education institutions across Ireland to embed health and wellbeing into campus life for staff and students.

-A Roadmap for Food Product Reformulation in Ireland was launched in December 2021 This fulfils a key objective of the Obesity Policy and Action Plan by setting targets for the reduction of the levels of saturated fats, sugar and salt in processed foods. Healthy Ireland funding has been provided for a dedicated Food Reformulation Task Force, situated in the FSAI, to implement the Roadmap. The Task Force is to operate until the end of 2025. Engagement with industry is a key element of the work of the Task Force.

- The National Cancer Strategy Implementation Report and Key Performance Indicators for 2020 was published on 5 May 2021. Progress on implementation of the National Cancer Strategy has continued throughout 2021, with investment of €20m having a significant impact on access to cancer diagnostics, treatment and supports.

- The National Screening Advisory Committee (NSAC) launched the first ‘Annual Call’ for proposals from the public on new population-based screening programmes that may be adopted in Ireland, as well as submissions on proposed changes to existing screening programmes.

- Publication of the mid-term review of the national drugs strategy Reducing Harm, Supporting Recovery and the six strategic priorities for the remaining four years of the strategy, 2021-2025. The strategic priorities will strengthen the health-led approach to drug use and align with the EU Drugs Strategy and Action Plan. The mid-term review of the strategy shows significant progress in implementing the action plan for the period 2017 to 2020, with only a small number of the 50 actions outstanding.

- Tobacco Free Ireland 2020 Annual Report was published on 9 September 2021. Tobacco Free Ireland is Ireland’s national tobacco control policy. It sets a target for Ireland to be tobacco free by 2025.

- The 3rd Progress Report on implementation of the COVID-19 Nursing Homes Expert Panel’s (NHEP) recommendations was published in September 2021. Many of the short- and medium-term recommendations have already been implemented. The third progress report highlights the achievements in implementing nationally focused recommendations as well as detailing the ongoing supports under NHEP to the Nursing Home Sector.

From 11 January 2021 the Public Health (Alcohol) Act 2018 (Sale and Supply of Alcohol Products) Regulations 2020 came into operation. The Regulations prohibit:

- the use of bonus or loyalty card points in relation to alcohol products

the sale of alcohol products at a reduced price when sold with another product or service, and

- the sale of alcohol products at a reduced price for a period of 3 days or less.

- From 12 November 2021 the Act provided for:

- A prohibition on alcohol advertising on a sports area during a sporting event, at events aimed at children or at events in which the majority of participants or competitors are children. (Section 15)

- Alcohol sponsorship of events aimed at children, events which the majority of participants or competitors are children and events involving driving or racing motor vehicles is prohibited. (Section 16)

- Significant progress was undertaken to update the Mental Health Act 2001. Draft Heads of Bill were approved and published by Government in July 2021.

- Proof of concept of the Community Virtual Ward (CVW) model is complete and published.

- The Disability Capacity Review to 2032 was published in July 2021. In order to drive the process of implementing the recommendations of the report, a Disability Action Plan Framework was also published which sets out key priorities over the period to 2025.

- The development, publication and commencement of implementation of Ireland's second One Health National Action Plan on Antimicrobial Resistance 2021-2025, known as iNAP2 (published Nov 2021).

- In November, 15 applications submitted from Ireland’s Rare Disease / Highly Specialised Care Centres of Expertise, were approved to join the European Reference Networks (ERNs). This achievement will be pivotal to drive innovation, training and clinical research for highly specialised care in collaboration with the established momentum of the ERN model which incorporates the most talented clinicians and investigators in the European Community and also for individuals and families affected with rare diseases.

- Introduction of two agreements for 2021-2025 pertaining to drug pricing and supplies, the Framework Agreement on the Supply and Pricing of Generic, Biosimilar, and Hybrid Medicines with Medicines for Ireland and the Framework Agreement on the Supply and Pricing of Medicines with The Irish Pharmaceutical Healthcare Association.

- The Review of the Health (Regulation of Termination of Pregnancy) Act 2018 commenced in line with statutory and Government commitments in December 2021. The Review will assess the effectiveness of the operation of the legislation and is being conducted in a fair and transparent manner. Ms Marie O’Shea, B.L. was appointed as the independent Chair of the Review and a final report will be made available no later than 7 February 2023 for consideration.

- Publication of the NCEC National Clinical Guideline No. 26. Sepsis Management for Adults (including maternity

- Publication of the NCEC National Clinical Guideline No. 27. Management of Chronic Obstructive Pulmonary Disease (COPD)

- By the end of December, 93.7% of urgent referrals to CAMHS were responded to within three working days, above the 90% target.

- An additional CAMHS Community Mental Health team was set up in 2021 bringing the total to 73 CAMHS teams today with 72 acute in-patient beds.

- An extra 120 intern posts were permanently established in 2021. This represents an increase of 16% to standard Intern intake and an investment of approximately €5.5 million annually (excluding overtime costs).

- We introduced the permanent establishment of 40 Post CSCT (Certificate of Satisfactory Completion of Specialist Training) Fellowships. Not only do these Fellowships offer opportunities for graduates of our training programmes to stay in Ireland to continue to build on their expertise, but our health service is also seeing the benefit of these highly trained graduates working in Ireland.

This year, 2022, officials in my Department have successfully achieved:

- The 2022 Waiting List Action Plan, published on 25 February 2022, allocated €350 million to stabilise and reduce waiting lists and times, while also bringing forward longer-term reforms such as care pathways and enhancing capacity in hospitals and specialties. The Plan is part of a multi-annual approach to reduce and reform waiting lists and times, which were exacerbated during the Pandemic.

- Development and opening of COVID-19 Healthcare Worker Death in Service Scheme in September 2022.

- The Chronic Disease Management Programme in general practice commenced operation in 2020. It engages with patients to encourage a pro-active management of four chronic conditions: COPD; diabetes; asthma; and cardiac failure. The Programme has been progressively extended to include all GMS patients suffering from the four conditions, and in 2023 final roll-out, to include opportunistic case-finding for all aged above 45, will commence. To the end of October this year, GPs conducted 333,000 consultations under the Chronic Disease Management Programme, with over 284,000 patients now registered. This figure includes over 30,000 consultations with high-risk patients and patients identified through the Opportunistic Case Finding element of the Programme. 2022

- The Women’s Health Action Plan 2022-23 was published on 8 March 2022, to mark International Women’s Day and commits to improving health outcomes and experiences for women.

- To date, significant investment has been made in areas expressed as a priority for women including endometriosis, menopause, gynaecology, maternity, contraception, mental health, HPV vaccines, period poverty, health and wellbeing, post-natal care.

- Budget 2023 commits €69.2 million for women’s health initiatives.

- Funding of €8.66m has been allocated to the National Maternity Strategy in 2022 for its continued implementation. This is facilitating the recruitment of an additional 94.7 WTEs to support the Strategy’s vision of a new model of integrated, team-based care that provides increased choice to women. The posts cover a variety of disciplines including, obstetrics, neonatology, endocrinology, anaesthetics, dietetics, midwifery, physiotherapy and occupational therapy.

- The funding is also providing additional home-from-home birthing suites, upgrades to theatres and wards, as well as additional training/supports for our maternity staff to increase choice and improve outcomes and experiences for women and babies accessing maternity services .

- Significant progress has been made in implementing a range of gynaecology service reforms, which is continuing.

- My Department is responsible for establishing a network of 20 “see-and treat” ambulatory gynaecology clinics; 12 clinics are open with 8 more in development.

- To date, I have put in place 5 specialist menopause clinics in the NMH, Nenagh General Hospital, Rotunda, Galway and the Coombe and a 6th clinic in Cork expected to open in 2023.

- Furthermore, my Department is establishing 2 supra-regional specialist centres for complex endometriosis care and developing 6 additional interdisciplinary teams to support holistic treatment of endometriosis within each of the maternity networks.

- We have opened 5 Regional Fertility Hubs, which are facilitating the management of certain patients presenting with infertility issues at secondary care level. A 6th Regional Fertility Hub is expected to open early in 2023.

- The HSE’s National Women & Infants Health Programme has developed a draft Framework for the establishment of a National Perinatal Genomics Service, which it is intended will be located in Dublin, across two sites.

- With effect from 21 September 2022, acute public in-patient charges for children under 16 years have been abolished in all public hospitals.

- The Health (Miscellaneous Provisions) (No.2) Act 2022 removes the acute public in-patient charge of €80 per day (including day-case charges) for children under 16 years of age in all public hospitals. Following enactment of the legislation in July 2022, the measure came into effect from 21 September 2022.

- On 17 May 2022, the Government approved the legal framework that will underpin the ownership and governance arrangements for the new National Maternity Hospital (NMH) at the Elm Park campus.

- Healthy Ireland, in partnership with the Dept. of Sport and Dept. of Transport, funded and supported the hosting of a major international conference on walking, Walk21, held in Dublin in September 2022.

- Waves 7 and 8 of the Healthy Ireland Survey were published on 7 December 2021 and 5 December 2022 respectively, providing valuable data with regard to the health behaviours of people living in Ireland, in the context of COVID-19.

- The Healthy Ireland Outcomes Framework First Report and the Review of the National Physical Activity Plan were published in Q3, 2022 and are available on the Healthy Ireland website.

- The Healthy Ireland Healthy Workplaces Framework was launched in December 2021. The Framework provides strategic direction and flexible guidance for workplaces to promote health and wellbeing among Ireland's workforce. An Implementation Group for the Framework was established in May 2022 and the development of a website to support workplaces will be launched in early 2023.

- The development of the National Mental Health Promotion Plan commenced in early 2022 and to date an Evidence Review and consultation with key stakeholders has been completed. The National Mental Health Promotion Oversight Group was established in September and the drafting of the plan is underway.

- A Review of the Obesity Policy Action Plan is due to be published the week beginning 12 December 2022.

- The free contraception scheme for women aged 17-25 was launched on 14 September 2022.

- A nationwide home STI testing service was launched on 4 October 2022.

- The Department of Health and HSE have provided supports for period poverty, through CHOs, local authorities and NGOs, to those most at risk of same; those living with homelessness, addiction, consistent poverty, minorities including Travellers and Roma and lone parents, in line with recommendations in the Period Poverty in Ireland Discussion Paper, which were supported by Government.

- Under the Public Health (Alcohol) Act 2018 the following measures on alcohol pricing, advertising and public health input into licensing came into operation:

- From 4 January 2022. a prohibition on selling alcohol below a minimum unit price of 10c per gram of alcohol came into operation (Section 11)

- From 24 November 2022, an applicant for an intoxicating liquor licence must notify the Environmental Health Service in advance of an application and the Environmental Health Service may appear and give evidence at the court hearing on an application (Section 4).

- The health system has deployed the use of electronic health records at 4 of our maternity hospitals (~50% of births) and at the largest acute hospital in the country (St. James). My Department is in the process of delivering EHR /CMS systems at the National Rehab and National Forensics hospitals. Earlier this year, Government gave approval for CHI to enter into contracts for an enterprise level EHR for the new children’s hospital, and work is now progressing on that programme of work.