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Tuesday, 13 Dec 2022

Written Answers Nos. 620-634

Mental Health Services

Questions (620)

Paul Murphy

Question:

620. Deputy Paul Murphy asked the Minister for Health if he will ensure the treatment needed is provided for a child (details supplied) urgently within the inpatient care services. [62165/22]

View answer

Written answers

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

Dental Services

Questions (621)

Fergus O'Dowd

Question:

621. Deputy Fergus O'Dowd asked the Minister for Health the total number of dentists who are registered to provide services to patients with medical cards in counties Louth and Meath over the years 2019 to date in 2022, in tabular form; and if he will make a statement on the matter. [62168/22]

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.

Public Inquiries

Questions (622)

Pat Buckley

Question:

622. Deputy Pat Buckley asked the Minister for Health if he intends to establish an independent public inquiry into the high numbers of deaths at a nursing home (details supplied) in east Cork; and if he will make a statement on the matter. [62172/22]

View answer

Written answers

I would like to again express my sympathy to all those who lost loved ones during the pandemic.

Since the start of the pandemic, the national response has continuously evolved to take account of emerging evidence and learnings both nationally and internationally. Throughout, this has included a specific focus on older people, in particular, those resident in nursing homes.

Significant supports were put in place for nursing homes, and the situation at both a local and a national level was kept under ongoing and active review. An independent Nursing Homes Expert Panel was established early in the pandemic to examine the management of COVID-19 in nursing homes and provide real-time learnings and recommendations to inform the ongoing response. The Expert Panel reported in August 2020 and significant progress has been made in implementing its recommendations.

The Taoiseach has indicated that a comprehensive evaluation of how the country managed COVID-19 will be undertaken which will provide an opportunity to learn lessons from our experiences in dealing with a pandemic over the past 2 years. This will help ensure that we are in a better, stronger position if another pandemic or another similar type of emergency arrives. Consideration is being given as to what the best model for this evaluation will be.

Separately, the Minister for Health has stated that he believes that a review of the management and impact of COVID-19 in nursing homes is warranted. He has asked the Department of Health to consider the options available for undertaking such a review, taking account of the experience of, and learnings, from other review processes undertaken in recent years.

Hospital Staff

Questions (623)

Paul Donnelly

Question:

623. Deputy Paul Donnelly asked the Minister for Health the number of vacant whole-time equivalent, WTE, consultant posts by speciality in each hospital part of the Children's Health Ireland, CHI, group; and when each of these vacancies will be filled in tabular form. [62178/22]

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.

Medical Aids and Appliances

Questions (624)

Paul Donnelly

Question:

624. Deputy Paul Donnelly asked the Minister for Health the current waiting times for aids and appliances in community healthcare organisation, CHO7. [62179/22]

View answer

Written answers

As the Health Service Executive (HSE) has responsibility for the provision of aids and appliances, I have asked the HSE to reply to the Deputy directly, as soon as possible.

Departmental Data

Questions (625)

Paul Donnelly

Question:

625. Deputy Paul Donnelly asked the Minister for Health the number of WTE respiratory consultant posts at Connolly Hospital, Blanchardstown in the years of 2020, 2021 and to date in 2022, in tabular form. [62180/22]

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.

Hospital Services

Questions (626)

Paul Donnelly

Question:

626. Deputy Paul Donnelly asked the Minister for Health the additional resources that Connolly Hospital, Blanchardstown are receiving as part of the HSE 2022-2023 winter plan. [62181/22]

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.

Mental Health Services

Questions (627)

Cormac Devlin

Question:

627. Deputy Cormac Devlin asked the Minister for Health the main initiatives that he has taken to develop and expand mental health services since 27 June 2020; the additional funding provided in successive budgets; his plans for 2023; and if he will make a statement on the matter. [62214/22]

View answer

Written answers

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

Care of the Elderly

Questions (628)

Cormac Devlin

Question:

628. Deputy Cormac Devlin asked the Minister for Health the main initiatives that he has taken to develop and expand health services for older persons since 27 June 2020; the additional funding provided in successive budgets; his plans for 2023; and if he will make a statement on the matter. [62215/22]

View answer

Written answers

Next year the overall funding available to the HSE for Older Persons will exceed €2.4 billion. This includes nearly €1.1 billion for Fair Deal. This represents an overall increase of 25% since 2020. A wide range of core services will be provided for older persons including home support, day care, community supports in partnership with voluntary groups and intermediate care as well as long-stay residential care when remaining at home is no longer feasible.

Home Support

The Programme for Government commits the Government to ‘Introduce a statutory scheme to support people to live in their own homes, which will provide equitable access to high quality, regulated home care’. Over the last three Budgets I have secured over €200 million in additional funding for home support: a 42% increase since 2020.

Over that time, targets have increased by 5 million hours. Delivering this enhanced capacity requires substantial recruitment. This has been affected due to strategic workforce challenges. To examine, and formulate recommendations to address, these challenges, I established a cross-departmental Strategic Workforce Advisory Group in March 2022. The Report of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Healthcare Assistants was published on 15 October 2022, and it presents a suite of 16 recommendations spanning the areas of areas of recruitment, pay and conditions of employment, barriers to employment, training and professional development, sectoral reform, and monitoring and implementation.

I have strongly endorsed all of the Advisory Group's recommendations, the implementation of which has commenced and will be closely monitored by the Department of Health against agreed timelines. At a joint press conference on 30 November 2022, the Minister of State for Business, Employment and Retail, Damien English, T.D. and I announced that, as recommended by the Advisory Group, 1,000 General Employment Permits will be made available for home support workers from January 2023. This will enable the employment within Ireland of non-EU/EEA citizens as home support workers and promises to significantly reduce the shortage of workers that we are currently experiencing.

In line with our Programme for Government commitment the continued expansion of home care hours and progressing development of a statutory scheme for the regulation and financing of home support services is a key priority in 2023.

The Department of Health is currently developing a regulatory framework for home support providers with the aim of ensuring that all service users are provided with high quality care. This will comprise of primary legislation for the licensing of home support providers, regulations for home support which will set out the minimum requirements that a provider must meet to obtain a licence, and HIQA national standards.

The Heads of Bill are currently being drafted by the Department with a view to bringing it through the Houses of the Oireachtas at the earliest opportunity. The Department is engaging with key stakeholders in relation to the legislation. A Regulatory Impact Analysis is also being progressed by the Department. The draft regulations are at an advanced stage and are informed by a public consultation which concluded on 4 August. The analysis of submissions has been carried out by the Institute of Public Health (IPH) and it demonstrates strong agreement in relation to the regulation of home support service provision. A report on the findings of the public consultation is being finalised with a view to publication in due course. Legal advice and engagement with key stakeholders (HIQA, HSE, private and voluntary providers, and service user representative groups) will assist with final revisions to regulations for providers of home support services in 2023. In addition to this, HIQA are in the process of developing standards for home care and home support services which will be the focus of a public consultation early next year.

Testing of a reformed model of service delivery for home support is in progress in four pilot sites. The evaluation phase has commenced, and a final report is expected by Q1 2023. The HSE has begun the recruitment process for 128 interRAI Care Needs Facilitators to progress the national rollout of interRAI as the standard assessment tool for care-needs in the community. Inter RAI standardised outputs will be used to determine prioritisation and levels of care required. This will facilitate effective, efficient, fair and transparent care needs assessment and planning and appropriate service delivery. The HSE is undertaking a recruitment process for a number of key posts to support and enable the establishment of a National Home Support Office. Funding is provided for 15 full time jobs including 9 Community Healthcare Organisation home support manager/coordinator posts. A Head of Service has been appointed to the new National Home support Office.

Day centres

Day centres are fundamental to the health and wellbeing of our older population and play a key role in enabling older people to live independently in their own communities and the reopening of these centres are a priority for me. The re-opening of day care centres following their necessary closure in 2020 began in the second half of 2021 and continues into 2022. Approximately 85% of Day Care Services for Older People are open and have resumed service and by the end of 2022 it is expected that 92% of Day Care Centres will have resumed the service.

Meals on Wheels

Over the years the Meals on Wheels service has proven to be an important component of the community services offered to older people, particularly in rural communities. I have secured an additional €1.8m with a view to expanding the service.

Enhanced Community Care

In 2021 the HSE commenced the implementation of the Enhanced Community Care (ECC) Programme which aims to deliver increased levels of healthcare with service delivery reoriented towards general practice, primary care, and community-based services. Work continues on the roll-out and establishment of community healthcare networks and community specialist teams for older people and for chronic disease management. The National Integrated Care Programme for Older Persons (ICPOP) forms part of the ECC Programme and seeks to ensure older people with complex care needs can access care quickly, at or near home, through care pathways specifically designed for older people and targeting Frailty, Falls, and Dementia. As of November 2022, 21 ICPOP teams have been established.

ALONE and the HSE Support Coordination Service

The HSE, in conjunction with ALONE, is continuing the roll out of a Support Coordination Service across the country. This supports older people to live well at home as 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 also coordinate linkages to local community groups in their area. This service is being led out under the ECC Programme.

Healthy Age Friendly Homes Programme

The Healthy Age Friendly Homes Programme is an innovative partnership between the local government sector (through Age Friendly Ireland) and Sláintecare in the Department of Health that commenced at the beginning of 2021 and saw the introduction of a new person-centric, robust, support coordination service. This new initiative aims to support older people to remain living in their own homes and communities for as long as possible and reduce the rate of older people transferring to long-term residential care. The interim report of phase 1 of the Healthy Age Friendly Homes programme was published in June 2022 and details the significant progress of the programme over its first 12 months pilot phase.

I was delighted to announce in Budget 2023 that funding of €5.2 million has been allocated to roll-out the initiative nationally. Age Friendly Ireland will deliver this programme in partnership with Sláintecare. This two year pilot project represents an innovative approach by operating between housing services in local government, the health service, and community and voluntary supports. The overall objectives of the programme are 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.

Community Nursing Unit Programme Update

One of this Government’s key priorities is to support older people to age in place and live in dignity and independence in their own homes and communities for as long as possible. HSE Community Nursing Units (CNUs) are an essential and valued part of our social care infrastructure. For those who avail of long-term residential care, it is essential that public investment in this infrastructure is maintained at a level which supports the highest standard of care.

The CNU Programme was launched in 2016 to ensure that public community nursing units would be refurbished or replaced so that they would be fully compliant with Regulations made under the Health Act 2007 and in line with National Standards. There are currently 89 different projects at various stages and phases of development. 43 full projects are complete. Construction is underway on several more facilities, while the remainder are at various stages of appraisal, planning and/or design. On 7 December I was delighted to announce that the awarding of the contract to deliver seven Community Nursing Units (CNUs) under the HIQA compliance programme through the Public Private Partnership (CNU PPP Project). The CNU PPP Project will deliver the residential care facilities comprising of both short and long stay beds for older persons at facilities across the country. Some 530 beds will be delivered overall in sites at Ardee (50 beds), Athlone (50 beds), Clonmel (50 beds), Killarney (130 beds), Midleton (50 beds), St. Finbarr’s, Cork (105 beds), and Thomastown (95 beds).

Community Beds

A critical component of the Winter Plan 2020-2021 was the provision of sufficient Intermediate Care capacity in the community to reduce hospital admissions and facilitate timely discharges from acute settings for older persons. It included expanding Intermediate Care capacity through the addition of rehabilitation beds in public facilities, repurposed public beds and privately purchased bed capacity for transitional care. Delivery has been significantly impacted by a number of factors, including but not limited to: COVID-19 Outbreaks, Recruitment Challenges, Minor Works, HIQA Fire and Safety Works. Beds have been reprofiled to new facilities to combat challenges to service delivery and to more appropriately address client needs.

As of November 2022, 365 public Community beds have been delivered over the last two years. A further 127 beds are planned to come on stream by March 2023. At the end of 2021, 521 beds were on stream. At present 643 private short stay beds are now on stream in 34 facilities supporting discharges from Acute Hospitals and hospital avoidance in the community. A further 44 beds are scheduled meaning we should have up to 687 beds on stream by the end of 2022.

Nursing Homes Expert Panel

Throughout the pandemic, as part of the overall national response to COVID-19, there has been a specific and sustained focus on older persons, and in particular, those resident in nursing homes. This included the establishment of a structured nursing home support system, in line with National Public Health Emergency Team (NPHET) recommendations, to provide enhanced supports to public and private nursing homes. A comprehensive package of direct and indirect supports was established in early 2020 and many of these remain active across the country to support nursing homes on a proactive basis and to respond in the event of a COVID-19 outbreak. Furthermore, an independent COVID-19 Nursing Homes Expert Panel was established in May 2020 to examine the complex issues surrounding the management of COVID-19 in nursing homes.

The Expert Panel recommendations have provided a guiding framework not only for the pandemic response in nursing homes over the last two years but also more broadly for a wide-ranging programme of improvement and reform for older persons’ care, in particular in residential care settings.

Four Expert Panel Progress Reports have been published to date, the latest published on the 21 June 2022. This progress report sets out the progress achieved across the 86 recommendations in the Nursing Homes Expert Panel’s report and outlines the plans and structures in place to continue implementation along with details of next steps and timelines. It is available here - gov.ie/en/publication/c7f5b-covid-19-nursing-homes-expert-panel-report-implementation-oversight-team/#progress-report. Significant progress has already been made in implementing the recommendations of the Expert Panel, particularly those recommendations requiring a priority focus in the response to COVID-19, and work to progress medium and longer-term reform recommendations is on-going.

In October 2022, the Government approved the publication of the General Scheme for a Bill to provide a broader suite of enforcement tools for the Chief Inspector of HIQA and allow for the collection, sharing and publication of key date on nursing homes. Pre-legislative scrutiny has been undertaken and engagement with the Office of the Attorney General on the drafting of the provisions will commence shortly. The Patient Advocacy Service commenced a phased rollout to private nursing homes in November 2022. The findings of the first National Nursing Home Experience Survey, which is the first national survey on the experience of residents and their families of nursing home care in Ireland, were also published in November 2022. A new end-of-life palliative care programme, the Carú Programme, for the nursing home sector was also launched. This programme is a partnership between the HSE, Irish Hospice Foundation and the All Ireland Institute of Hospice and Palliative Care.

Funding is also being provided to establish regional HSE Community Support Teams for nursing homes. Recruitment is underway to replace the temporary COVID Response Teams (CRTs), which were set up as a response to COVID-19 with permanent multi-disciplinary Community Support Teams (CSTs) in each CHO.

Nursing Home Support Scheme

The Nursing Homes Support Scheme (NHSS or ‘Fair Deal’) currently supports over 22,500 residents in approx. 550 nursing homes across the State. Long-term residential care is supported through additional funding for the Nursing Homes Support Scheme (NHSS) to maintain services and manage inflationary increases. 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.

The Nursing Homes Support Scheme (Amendment) Act 2021 introduced further safeguards into the NHSS, to further protect the viability and sustainability of family farms and businesses. It also introduced a change which extends the three-year cap on contributions to the sale of a personal residence, removing a disincentive against the sale of a property. My Department has also developed an amendment to reduce the rate of at which rental income is assessed under the NHSS, to remove a disincentive to the rental of vacant homes owned by residents in long-term care. This change will be enacted imminently and the legislation will be commenced once appropriate preparations have been made within the HSE to ensure it can be operated effectively and in a way that addresses concerns I have raised in relation to safeguarding, consent and capacity.

Nursing Home Supports

The Government has provided substantial support to the private and voluntary nursing home sector over the course of the pandemic, with over €145 million in funding delivered through the Temporary Assistance Payment Scheme (TAPS). The Temporary Assistance Payment Scheme will continue to support Nursing Homes with the cost of COVID-19 outbreaks until the end of the year. Since the start of the pandemic, private and voluntary nursing homes have also received a wide range of non-financial supports, including over €72m in free PPE and oxygen,

A new €10 million scheme – the Temporary Inflation Payment Scheme - has been established to support private and voluntary nursing homes with increases in energy costs. The scheme covers 75% of year-on-year cost increases in energy and heating, up to a monthly cap of €5,250 per nursing home, over the period of July to December 2022. Nursing homes can claim three-quarters of €7,000 of vouched expenses overall.

Further work is also being undertaken to address issues in the sector on foot of the recommendations of the NTPF Pricing Review, the Value for Money review of Nursing Home costs and the report of the Strategic Workforce Advisory Group.

Inflation Package/ Cost of Living Supports for Section 39 Organisations

In recognition of the challenges being faced by the community health and social sector in delivering and maintaining key health and social care services against a backdrop of increased inflationary pressures affecting energy, heating and related costs, the Government is providing an inflation support fund in Budget 2023. A significant fund of up to €100m has been allocated to support community based voluntary organisations who are such an essential pillar in the provision of Health services across country. €10m of this has been allocated for the Temporary Inflation Payments Scheme for Nursing Homes, with the remainder to be allocated to community and voluntary providers across the health sector. The exact scope and mechanism for distributions of these funds is currently being finalised by the Department of Health and will be announced shortly. It is proposed that the inflation support fund will be administered by the HSE utilising the mechanism in place for funding eligible organisations in receipt of Service Level Arrangements and Grant Aid Agreements.

Dementia Supports

I have long been an advocate for the development of services for people with dementia and their families and this is reflected in the focused investment in dementia services in recent years. A key commitment of the Programme for Government is to continue implementing the National Dementia Strategy with an aim of improving dementia supports and services so that people living with dementia can live well for as long as possible.

Funding of €12.9million for dementia specific supports and services in 2021 allowed for substantial advancements in areas including:

- Enhanced Memory Technology Resource Rooms in 9 sites across the country

- Dementia diagnostic services through a specialist regional memory clinic in Cork and four new memory assessment and support services in Mayo, Wexford, Waterford and Sligo

- Enhancement of acute care pathways for people with dementia through the recruitment of more clinical nurse specialists

- The implementation of a National Clinical Guideline on the appropriate prescribing of psychotropic medication for non-cognitive symptoms in people with dementia

- Access to in-home day care and support

- Dementia: Understand Together initiative

In addition, in November 2021 I officially launched an expansion of the National Dementia Advisor Service. The Dementia Adviser Service provides a key focal point to help people navigate the health and social care system, ensuring they receive the right support at the right time. I was delighted to secure funding for 11 new dementia advisers in 2021, to expand this vital service. This has brought the total number of dementia advisers to 28 nationally, plus a coordination post.

In 2022, funding of €7.3 million has been allocated for dementia services and supports to continue to improve care pathways for people with dementia across the country. This funding provides for: -

- 5 new memory assessment and support services and one new regional specialist memory clinic in Galway

- Specialist diagnostic services for people with an intellectual disability through the National Intellectual Disability Memory Service in Tallaght University Hospital

- Enhancement of memory technology resource rooms

- Implementation of a dementia minimum dataset across all care settings to standardise data collection and reporting

- 6 dementia assistant director of nursing posts (one in each hospital group) to improve quality and safety of care for people with dementia

- 4 additional dementia clinical nurse specialists to improve care pathways in acute care settings

- The third wave of the Irish National Audit of Dementia in acute hospitals

- A Brain health project manager to promote brain health and reduce the prevalence and delay the onset of dementia through collaboration with clinical programmes, the understand together campaign and dementia risk reduction group.

This year, the number of new home support hours allocated to people with a dementia or cognitive impairment has been raised from 5% to 11%, valued at €7.8 million.

Investment in the National Dementia Strategy will continue in 2023, with a continuing focus on diagnosis, post-diagnostic supports and care for people with dementia. The HSE intends to publish a Model of Care for dementia in Q1 2023. Some €2.1 million in additional funding will be provided for the restoration to full capacity of dementia-specific community day care services. Furthermore, the proportion of dementia-specific new home support hours will increase from 5% in 2021 to 15% in 2023, valued at €5.2 million.

National Carers' Strategy

New funding of €2 million was provided in Budget 2021 for the implementation of the National Carers’ Strategy. The funding delivers on the Programme for Government commitment to a Carers’ Guarantee by improving equity of access to supports for carers across the country. Some €1.9 million of this funding is being provided to Family Carers Ireland to improve its supports, while the remaining €100,000 is supporting an online support group operated by Care Alliance Ireland.

A Carers’ Needs Assessment is also being piloted in Community Healthcare West at present.

Commission on Care

The Government is committed to supporting healthy and positive ageing throughout the life-course as well as to ensuring that older persons can continue to live independently in their homes and communities for as long as possible. Acknowledging the disproportionately negative impact of the pandemic on older persons, the Programme for Government (2020) commits to the establishment of a commission on care that will ‘assess how we care for older people and examine alternatives to meet the diverse needs of our older citizens’, learning the lessons from COVID-19.

Desk research has been undertaken within the Department of Health in preparation for the establishment of a commission on care. The conclusions of this initial scoping exercise, along with an outline proposal for the commission, were presented to me earlier this year. It is envisaged that the commission will support a whole-of-government approach to examining existing policies and strategies which are of relevance to supporting positive and healthy ageing. Drawing on lessons learnt internationally as well as on stakeholder engagement, it is also anticipated that the commission will make recommendations to effectively address the gaps which currently exist in the policy landscape. It is anticipated that work on the commission will commence in the new year.

In 2023, our ambitious reform programme for older persons services will continue in 2023, building on work undertaken to date and with a focus on the development of new operational models and reform for Home Support and Residential Services.

Disability Services

Questions (629)

Cormac Devlin

Question:

629. Deputy Cormac Devlin asked the Minister for Health the main initiatives that he has taken to develop and expand disability health services since 27 June 2020; the additional funding provided in successive budgets; his plans for 2023; and if he will make a statement on the matter. [62216/22]

View answer

Written answers

In recent years, significant resources have been invested by the health sector in disability services, with the allocation of funding to disability services increasing year on year with €2 billion provided in 2020, €2.2 billion in 2021 and €2.3 billion in 2022. This year, the overall Budget for disability services in 2023 will be €2.4 billion, including a significant level of funding for specialist disability services. Building on the previous year, this is an unprecedented level of funding for Disability services. It follows substantial increases in the budget in 2021 and 2022; and reflects this Government’s commitment to strengthening the funding provided for the disability sector.

The HSE, in preparing its National Service Plan, will examine how services, including relevant KPIs, can be progressed in 2023 within the overall increased envelope of funding for disability services.

The Department of Health published the Disability Capacity Review in July 2021. This report set out the capacity requirements for health-funded disability services for the period up to 2032 and it is intended to address the capacity deficits in a phased approach over this period. This reflects the obligation under the UNCRPD for progressive implementation of social, cultural and economic rights.

In order to drive the process of implementing the recommendations of the Capacity Review, a Working Group was set up to develop an Action Plan for Disability Services. This group has now completed its work and the draft Action Plan, which will be an implantation plan for the first phase, is currently being finalised for approval.

So that further detail can be provided to the Deputy, I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.

Primary Care Services

Questions (630)

Cormac Devlin

Question:

630. Deputy Cormac Devlin asked the Minister for Health the main initiatives that he has taken to develop and expand primary care services since 27 June 2020; the additional funding provided in successive budgets; his plans for 2023; and if he will make a statement on the matter. [62217/22]

View answer

Written answers

Significant funding has been allocated to develop and expand primary care services in recent years, in order to provide greater and enhanced levels of care in the primary care setting, and to facilitate the reorientation of the health system from acute-focused service provision, enabling the shift to the left in line with Sláintecare reforms.

A key element of this is the implementation of the Enhanced Community Care Programme, a suite of reform initiatives, which includes significant recruitment of approximately 3,500 additional staff, mostly health and social care professional and nursing grades, and will include the implementation of 96 Community Healthcare Networks, 30 Community Specialist Teams for Older Persons and 30 Community Specialist Teams for Chronic Disease Management nationwide.

In Budget 2021, €175million in new measures funding was provided to primary care, with €150m of this allocated for the implementation of the Enhanced Community Care Programme, and €25m to the GP Access to Diagnostics initiative. This initiative provides GPs with a direct referral pathway for their patients to access radiology scans in convenient locations within the community and closer to home, preventing unnecessary referrals to acute based diagnostic services.

In Budget 2022, €1.9 million in new measures funding was allocated to primary care, and, additionally €5.5 million funding was allocated through the Government’s Waiting list Action plan to implement an initiative in Primary Care Psychology services which targets clients under the age of 18 waiting longer than 52 weeks to access the service.

Budget 2023 has apportioned €18.8 million in funding for new measures in primary care, and of this €10 million has been allocated to provide access to IVF and AHR services from September 2023, €4.8M has been allocated to provide oral healthcare packages for 0 -7 year olds in 2023, with funding also provided to allow for the continued expansion of Community Intervention Teams nationwide, with 28 additional WTEs being recruited to these teams in 2023.

These investments and reforms are a demonstration of the commitment to shift the model of healthcare towards a more comprehensive and accessible primary care service in order to deliver better care closer to people’s home in communities across the country.

General Practitioner Services

Questions (631)

Cormac Devlin

Question:

631. Deputy Cormac Devlin asked the Minister for Health the main initiatives that he has taken to develop and expand general practitioner services since 27 June 2020; the additional funding provided in successive budgets; his plans for 2023; and if he will make a statement on the matter. [62218/22]

View answer

Written answers

The 2019 GP Agreement on contractual reform and service development is the largest development in general practice in recent times. The Agreement which is being rolled out from 2019 to 2023, provides for significant increases in capitation fees for participating GPs, the introduction of new fees and subsidies for additional services, and increased practice supports and allowances. Over €211 million in additional annual investment in general practice has been provided through successive budgets under the Agreement.

The Agreement also provided for the Chronic Disease Management Programme in general practice that 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 extend opportunistic case-finding to 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.

As announced in this year’s Budget, 2023 will see a large increase in eligibility of people for GP access cards. GP care without charges will be expanded to all children aged 6 and 7 as early as possible, and from 1 April 2023, GP care without charges will be expanded to those who earn the median household income of €46,000 or less. This will be supported by a significant package of additional capacity supports to GP practices.

The number of doctors entering GP training has been increased significantly in recent years, increasing to 208 in 2020, 233 in 2021 and 258 in 2022. The responsibility for GP training was transferred from the HSE to the Irish College of General Practitioners (ICGP) in 2021, this allows for the introduction of a new service model for GP training in Ireland and the further expansion GP training capacity in the years ahead. The ICGP aims to have 350 training places available for new entrants per year by 2026.

These measures will improve patient access to GP services, by increasing eligibility for GP care without charges while continuing to increase GP capacity, and improve the level of care provided.

Furthermore, due to commence shortly, a strategic review of GP services will be completed next year. The review, with input from key stakeholders, will examine the broad range of issues affecting general practice and will set out the measures necessary to deliver a sustainable general practice into the future.

Hospital Services

Questions (632)

Cormac Devlin

Question:

632. Deputy Cormac Devlin asked the Minister for Health the main initiatives that he has taken to develop and expand acute hospital services since 27 June 2020; the additional funding provided in successive budgets; his plans for 2023; and if he will make a statement on the matter. [62219/22]

View answer

Written answers

The information requested by the Deputy is being collated by Department officials and a deferred reply will be submitted within ten working days.

Health Services

Questions (633)

Jennifer Whitmore

Question:

633. Deputy Jennifer Whitmore asked the Minister for Health if he will define the term 'blue-light distance' when used in the context of maternity service, in particular the provision of home birth supports; if this is a term used by the National Ambulance Service; and if he will make a statement on the matter. [62224/22]

View answer

Written answers

As the National Women and Infants Health Programme leads on the management, organisation and delivery of maternity, gynaecological and neonatal services, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Departmental Reviews

Questions (634)

Jennifer Whitmore

Question:

634. Deputy Jennifer Whitmore asked the Minister for Health when the review and investigations into water births will be completed; the date that water births will be facilitated for those home-birthing; and if he will make a statement on the matter. [62225/22]

View answer

Written answers

As the National Women and Infants Health Programme leads on the management, organisation and delivery of maternity, gynaecological and neonatal services, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

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