Written Answers Nos. 65-84
67. Deputy Neasa Hourigan asked the Minister for Health the organisations that are now providing services previously provided by the North Inner City Drugs and Alcohol Task Force given his that Department has suspended the activities of the task force; and if he will make a statement on the matter. [7692/22]
Amharc ar fhreagraThe Department of Health provides €2.249m per annum to community-based drug and alcohol services under the remit of the North Inner City Drug and Alcohol Task Force. The City of Dublin Youth Services Board, and the HSE act as channels of funding for the administration of this funding to front line drug and alcohol projects. The Dept of Health has not suspended funding to any organisation providing drug and alcohol services under the remit of the North Inner City Drugs and Alcohol Task Force.
The task force has informed local services that it is no longer in a position to function. The Department has asked the HSE (CHO Dublin North City and County) and the City of Dublin Youth Services Board, to provide reassurance to the frontline services that funding will continue in 2022.
I understand that the HSE has met with each of the funded organisations over the past three weeks as part of the annual Service Level/Grant Aid Agreement process and has not been made aware of any reduction, interruption in or impact to service delivery.
I understand that the HSE met with the company associated with the North Inner City Drugs and Alcohol Task Force on 13th January in relation to service delivery issues, including the parameters of funding in 2022 that could be provided to the company. I would advise the company to engage directly with the HSE to discuss its proposed programme of drug and alcohol activities in 2022.
68. Deputy Willie O'Dea asked the Minister for Health the status of the implementation of the affordability measures in healthcare pledged in Budget 2022. [7911/22]
Amharc ar fhreagraThe Programme for Government set out the pathway for expanded access to health care in keeping with the vision and ideals of Sláintecare.
We promised to expand universal access to healthcare in a manner that is fair and affordable.
We have delivered and are continuing to deliver on that commitment.
The funding allocated to Health in Budget 2022 is the biggest ever investment package in Ireland’s health and social care services and demonstrates the Government’s commitment in the Programme for Government to deliver Universal Healthcare in a number of important areas.
€11.5 million was provided to fund the reduction in the Drugs Payment Scheme monthly threshold for an individual or family household from €114 to €100 on 1 January this year. Last week the Government announced a further reduction to €80 which will be effective from 1 March this year.
The combined effect of those two reductions in the DPS threshold will be an annual saving of €408, or 30%, for any individual or household that regularly exceeded the 2021 threshold of €114.
Budget 2022 also included provision for the expansion of free GP care to all children aged 6 and 7. My officials and the HSE are already engaged in preparatory work, and I expect to be in a position to bring forward proposals to the IMO later this quarter.
A sum of €10 million was provided on top of the 2022 Estimate allocation of €56 million to improve the viability and sustainability of the Dental Treatment Services Scheme (DTSS).
Funding of €4.5m has been provided for measures to alleviate the financial burden associated with hospital charges for children accessing care in a public hospital. My Department is currently working on preparing the necessary legislative amendments, and it is my intention to introduce the legislation in the Oireachtas later this year.
The roll out of a free contraception programme for women and girls aged 17-25 is expected to commence in August 2022, at a cost of approximately €9 million.
69. Deputy Bríd Smith asked the Minister for Health the number of children who needed hospital treatment as a result of contracting Covid-19; the measures he is taking to deal with the long-term effects on children form the virus specifically, the research and long-term studies of effects and numbers affected and so on; and if he will make a statement on the matter. [7962/22]
Amharc ar fhreagraCOVID-19 is a new disease so information on it, its features, incidence and course are still emerging. My Department, and the HSE, continue to review new evidence, research and data as it emerges, internationally and nationally, to ensure care is in place for all adults and children who need it.
As of midnight 8th Feb, 1,745 children with a confirmed case of COVID19 have been recorded on the national Computerised Infectious Disease Reporting system as having been hospitalised since the start of the pandemic. However, it would not be accurate to say definitively that this is the number of children hospitalised due to COVID19 – some may have been admitted to hospital for conditions other than COVID19.
Fortunately, most children with COVID19 infection have asymptomatic or mild disease. The incidence of severe disease and hospitalisation of children with COVID19 is low. The international evidence to date is that the incidence of Long COVID in children is rare and mainly of short duration.
The HSE has developed an interim model of care for Long Covid and this includes paediatrics. I am informed by the HSE that they are establishing post-acute and Long Covid services across the country and that they will continue to monitor cases of COVID19 to assess and plan for associated needs.
People who have had Covid-19 and are in need of further care are being followed up by their GP or in hospital settings as clinically appropriate. Adults and children with concerns regarding Long COVID are advised to consult with their GP in the first instance.
71. Deputy Duncan Smith asked the Minister for Health his interaction with an association (details supplied) to date; and the steps that he plans to take to address the particular healthcare needs of those affected by the failure to withdraw thalidomide from the Irish market in a timely manner. [7728/22]
Amharc ar fhreagraThere are a number of cases concerning thalidomide before the High Court at present and it is not possible to comment on matters that are sub judice.
However, the Government recognises that thalidomide survivors face challenges in everyday life related to their injuries. I am anxious to assure thalidomide survivors of the Government’s ongoing commitment to provide them with the necessary health supports to meet their related needs. I have directed my office to set up a meeting with thalidomide survivors at the end of this month, strictly without prejudice to the ongoing litigation.
In addition to an ex-gratia lump sum and an ex-gratia monthly allowance for life, the supports provided by the Irish State to each Irish survivor include a medical card on an administrative basis regardless of means. This includes access to a full range of primary care, hospital and personal social services, provision of appliances, artificial limbs, equipment and housing adaptations.
There is a designated senior manager in the Health Service Executive who liaises with Irish thalidomide survivors and assists them to access supports towards their ongoing health and personal social service needs.
At the meeting with survivors I will listen to their healthcare needs. I will also talk with them about the work underway in the Department to provide these health and personal social supports on an ex-gratia basis on a statutory footing, as committed to by the Government. However, as outlined above, matters which are before the High Court will not form part of the agenda for discussion.
72. Deputy Brendan Smith asked the Minister for Health if he will ensure that the necessary provision of additional capacity at the National Orthopaedic Hospital, Cappagh is given urgent consideration; when the proposed project will proceed to the next stage; and if he will make a statement on the matter. [7900/22]
Amharc ar fhreagraNTPF data shows that Orthopaedics is the speciality with the largest number of patients waiting for in-patient/day case treatment.
I have always advocated that Cappagh can be part of the solution to tackle waiting lists for adults and paediatrics.
The HSE has advised that a proposal for a project to develop additional capacity at the National Orthopaedic Hospital Cappagh is currently being considered.
Just last Friday I went out to visit Cappagh Orthopaedic Hospital and discussed this major proposal with management and clinicians at the hospital.
The proposed project will involve the provision of an additional 10 bed High Dependency Unit, 75 bed ward, 3 theatres & radiology refurbishments.
A Strategic Assessment Report will be undertaken in relation to this proposal.
The final decision to proceed with this project cannot be made until it progresses through a number of approval stages, in line with the Public Spending Code.
I would also like to point to a €1.65m initiative introduced under the Access to Care Programme in 2021. It enables the NOHC to undertake non-complex surgery for paediatric patients aged 2 years and over, addressing the waiting lists at CHI (Temple Street). NOHC estimates that they will complete 640 non-complex in-patient surgeries for CHI in 2022.
73. Deputy Michael Collins asked the Minister for Health if the good work that staff in settings caring for children have undertaken throughout the pandemic will be acknowledged (details supplied); and if they will be included in the €1,000 recognition payment. [5718/22]
Amharc ar fhreagraI thank the Deputy for raising this important question about workers, including those who work in childcare, who supported the national effort over the past two years to meet the challenges of COVID-19.
In recognition of the efforts of the general public, volunteers and all workers during the COVID-19 pandemic and in remembrance of people who lost their lives due to the COVID-19 pandemic, on Wednesday 19 January, the Government announced a once-off public holiday will take place on Friday 18 March 2022.
Also, noting the unique additional challenges and risks in the health sector during this period, the Government announced COVID-19 recognition payment for frontline public sector healthcare workers. Importantly and distinctly from other workers, those eligible are, in general, frontline public sector healthcare workers who are directly employed and worked or trained in COVID-19 exposed healthcare environments / clinical settings.
The Department of Health will also introduce a measure for making a similar payment to staff in private sector nursing homes and hospices that were affected by Covid-19.
I note that the Deputy has asked about two particular organisations - my Department is working together with the HSE to provide additional details on this measure including full eligibility criteria, particulars and terms and conditions that apply.
I am mindful of other workers outside of frontline healthcare who played their own important part during this difficult period but did not work in such exposed areas. It is tough to draw a line on this matter, but the Government based its decision on the specific additional risks which these frontline healthcare workers faced.
74. Deputy Thomas Pringle asked the Minister for Health the number of referrals that have made to National Incident Review Panel since publication of its last annual report in 2018, by year of referral, the CHO area in which the incident took place and if the service was a HSE service or a HSE funded service; and if he will make a statement on the matter. [5194/22]
Amharc ar fhreagraThe National Independent Review Panel, NIRP, which is fully operational since 2018, is managed and directed by an independent chairperson and consists of independent panel members who have been appointed through a public appointment process.
The NIRP has been established to enable the HSE to undertake independent reviews when things go seriously wrong involving people within the community health and social care sector within HSE or HSE funded services. Although the NIRP is part of the HSE, it is independent of all HSE operations at both national and community level.
Since 2018 the NIRP have received four referrals. One in 2018, one in 2019, and two in 2020.
As per the NIRP’s Operational Guidelines 2021, all reports produced by the NIRP will be pseudonymised with all identifying information removed. In this context the NIRP cannot identify the CHO area that each review pertains to, nor can it identify whether the reviews pertain to a HSE or HSE funded service.
The NIRP will seek to determine what the relevant services and individuals involved in the case might have done differently that could have prevented the significant harm or improved the quality of life for the person/s concerned. It is important to remember, therefore, that the aim of the NIRP review process is to promote learning from cases where there have been extreme concerns about the safety and wellbeing of individuals who use a community health and social care service within a HSE or HSE funded service.
75. Deputy Dara Calleary asked the Minister for Health if the HSE Capital Plan for 2022 includes developments in Ballina District Hospital and Belmullet Community Hospital. [7826/22]
Amharc ar fhreagraI would like to thank the Deputy for raising this question and to acknowledge the tremendous work of staff in the provision of services in these hospitals over the years.
The HSE Capital Plan 2022 is based on funding of €1.02bn, an increase of 4% on 2021. The plan provides for progression of projects across sector and across the country.
In developing the Plan, the number of projects competing for inclusion invariably exceeds the funding available. It is therefore necessary to carry out a robust appraisal and then prioritisation exercise to ensure that best value is achieved from the available capital budget. This is in line with the Public Spending Code requirements.
In the conduct of initial appraisal of proposed projects, submissions must be considered by the HSE’s National Capital & Property Steering Committee. If a project submission is approved by this Committee, it can then be included for consideration for inclusion in the Capital Plan.
Regarding these projects, submissions have been made and are being considered by the National Capital & Property Steering Committee. A site inspection and meeting was to be organised, however due to COVID -19 this was not possible. An on-site meeting has been arranged between the Services, Estates and local Community Healthcare Organisation to review these projects on the 16th February 2022.
76. Deputy Joan Collins asked the Minister for Health if he will report on the cross-Departmental strategic workforce advisory group in relation to capacity issues in home care provision. [61937/21]
Amharc ar fhreagraAs I have stated previously, I am committed to establishing a cross-Departmental Strategic Workforce Advisory Group to examine strategic workforce challenges in front-line carer roles in home support and nursing homes.
The work of this Group will centre on engagement with the relevant stakeholders in the sector. To this end, a 'Call for Submissions' was issued by my Department to relevant stakeholders in December. Following receipt of these completed submissions in January, my Department undertook a short-life scoping exercise to gather initial data and evidence on the nature and extent of the challenges in the sector to inform the structure and membership of this cross-departmental Group.
This scoping exercise is now complete and invitations to join the Group, along with its draft Terms of Reference, have been issued to all relevant government departments and agencies. The inaugural meeting of the Group will be held in the week beginning February 28th, 2022.
At this meeting the Terms of Reference for the Group will be finalised and action timelines agreed.
This Group will then progress a structured programme of ongoing consultative engagements with key sectoral stakeholders to further explore and define the issues, listen to stakeholder views, and identify approaches to respond to the strategic workforce challenges.
The Group will provide a forum for agreement on strategic approaches to address the workforce challenges in the sector and develop a report for my consideration outlining the Group’s key findings; recommendations; and a proposed action plan to support implementation of these recommendations to include periodic monitoring of progress.
77. Deputy Neale Richmond asked the Minister for Health if he plans to add hyperemesis treatment to the drug repayment scheme; and if he will make a statement on the matter. [7762/22]
Amharc ar fhreagraI fully appreciate that hyperemesis, or severe sickness during pregnancy, is a debilitating condition for some women, and I am anxious that our health service should support women with this condition in every way possible.
Improving women’s health outcomes is a key priority for me and this Government. We made a strong commitment to Promoting Women’s Health in the Programme for Government and are fully committed to the development and improvement of Women’s Health services and to working with women and girls to improve their health across the whole life cycle.
In coming weeks I will be bringing a Women’s Health Action Plan to Government. It sets forward a wide range of positive initiatives to support women’s health, including maternal health, and provides a framework for further prioritisation as issues and needs arise.
In relation to the issue of hyperemesis, my officials are engaged with the HSE on this. The HSE are currently considering options intended to make products which treat this issue more widely available, and I am requesting an urgent consideration of this matter. I have also asked the Women’s Health Taskforce, the Department of Health group established in 2019 to improve women’s health outcomes and experiences of healthcare, to examine options with a view to achieving the best possible outcome for women suffering with this condition.
The commitment to Women’s Health has been reflected within Budget 2022, in the allocation of €31 million for new development funding to specifically support women’s health.
Budget 2022 will:
- Invest almost €9 million additional funding to ensure continued implementation of the National Maternity Strategy into 2022 and beyond, building on the significant investment in 2021
- Continue improvements in our gynaecology services by establishing a further 6 ambulatory gynaecology "see and treat" clinics, bringing the total to 20 clinics nationally
- Invest in funding access to contraception for women aged 17-25
- Support further developments in menopause care by increasing the number of specialist menopause clinics from 1 clinic to 4 clinics nationally
- Increase investment in sexual assault treatment units
- Invest in tackling period poverty for the first time
- Provide funding for the establishment of a new Obstetric Event Support Team
- Provide funding to establish a perinatal genetics service
- Build on initiatives started in 2021, by further expanding specialist endometriosis services for more complex cases across two centres;
and
- Invest an additional €5 million into the Women’s Health Fund to fund innovative new approaches to women’s health services nationwide
In addition, a further €16m in other measures to support women's health has been embedded within other new measures for 2022 within the Health Vote in areas such as cancer, mental health and social inclusion budgets, bringing the overall investment in women's health to €47m in additional funding provided for 2022.
79. Deputy Thomas Pringle asked the Minister for Health the number of reviews that have been commissioned by the HSE for each of the three categories identified in its Incident Management Framework since the inception of the framework in 2018, by year of referral, the CHO area in which the incident took place and if the service was a HSE service or a HSE funded service; and if he will make a statement on the matter. [5195/22]
Amharc ar fhreagraThe deputy will be aware, that in January 2018 the HSE launched a new Incident Management Framework (IMF). An incident is defined in the IMF as an event or circumstance which could have, or did lead to unintended and/or unnecessary harm. This includes clinical or non-clinical incidents which occur in health services. The IMF is designed to provide health and social care services with a practical and proportionate approach to the management of incidents.
The focus of the Framework is on understanding how and why an incident occurred and using this knowledge to improve safety.
In parallel to the IMF, information regarding the number and nature of incidents occurring in the HSE and HSE funded services are recorded on the National Incident Management System (NIMS) which is maintained by the State Claims Agency.
With regards the Deputy’s specific parliamentary question of the number of reviews commissioned by the HSE across all CHOs in HSE and HSE funded services, the HSE have advised that this detailed breakdown of information will require validation. The HSE will provide this information directly to the Deputy in due course.
The HSE launched an updated IMF in 2020 following a review they conducted in 2019 to enhance its operation and to continue to place emphasis on the need, in the aftermath of an incident, to adopt an empathetic, person centred and practical response to persons affected by an incident.
80. Deputy Bernard J. Durkan asked the Minister for Health the action being taken to ensure the availability of an adequate number of general practitioners to meet the demand at various practices throughout the county including in County Kildare which is set to experience a large number of general practitioner retirements that will need to be filled at the earliest possible date; and if he will make a statement on the matter. [7874/22]
Amharc ar fhreagraIt is imperative that general practice has the capacity necessary to deliver GP services, particularly as we move towards the provision of more care within the community. In that regard, I note that the number of GPs contracted to provide services to GMS patients has increased in the past 10 years from 2,258 to 2,539, an increase of 12%.
Nonetheless, I am very aware of the workforce issues facing general practice, including changing demographics, the number of GPs nearing retirement, the difficulties in filling a small number of GMS vacancies, and the impact of the shift towards care centred in the community on general practice. The Government has committed to providing significant additional resources to general practice to help to meet those challenges.
The 2019 Agreement with GPs will see investment in general practice increase by approximately 40%, or €210 million annually once the Agreement is fully implemented. We are on schedule in the delivery of those resources, with an increase of funding of €143.6 million provided between 2019 and 2021, and an additional €63 million provided in Budget 2022.
The 2019 Agreement provides for significant increases in capitation fees for participating GPs, and new fees and subsidies for additional services. The Agreement also provides for increased support for GPs in disadvantaged urban areas, and for improvements to maternity and paternity leave arrangements.
Previously, changes were made to the entry provisions to the GMS scheme to accommodate more flexible GMS GP contracts, and to the retirement provisions for GPs under the scheme, allowing GPs to hold GMS contracts until their 72nd birthday, while enhanced supports for rural GP practices were introduced, and since increased by the 2019 GP Agreement, to support rural GPs and make rural GMS panels more attractive.
The number of GPs entering training has increased steadily in recent years from 120 in 2009 to 233 trainees enrolled in 2021. Further increases are expected following the transfer of responsibility for training from the HSE to the Irish College of General Practitioners.
The vital role played by general practice and GPs individually throughout the COVID crisis is acknowledged. General practice has continued to operate, providing both Covid and non-Covid care to their patients. In return, the Government has provided substantial additional payments of over €300 million to general practice to enable GPs to provide: consultation services; assessments and referrals for Covid tests; Covid respiratory clinics; and Covid vaccinations. This is a demonstration of what general practice can do when properly resourced and is a positive indicator for the future.
81. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the steps he is taking to address the waiting lists of the children’s disability network teams in County Cork for access to assessments and therapies. [7931/22]
Amharc ar fhreagraThe implementation of the Progressing Disability Services for Children & Young People (PDS) programme is agreed Government and HSE policy. This policy supports the reconfiguration of children’s disability services to provide equitable, child and family centred services based on need rather than diagnosis. The PDS programme will ensure that services are provided for children with complex needs regardless of where they live or where they go to school and to facilitate this Children’s Disability Network Teams (CDNTs) have been established to provide services and supports for all children with complex needs with all 91 CDNTs established by December 2021.
As part of the HSE National Service Plan 2021, a total of 100 development posts were allocated for PDS and its implementation, from which Cork/Kerry Community Healthcare were allocated 7.5 additional posts. A further additional 5.8 posts were allocated under the Special School allocation.
At the end of December 2021, 6 additional posts from a total of 13.3 had been filled and HSE advise that efforts are ongoing to fill the remaining positions. Further additional posts for all CDNTs will also be announced as part of the HSE’s National Service Plan for 2022 to provide additional supports and therapy services for children throughout the country.
It is acknowledged that there are a number of vacancies in Network Teams in the Cork area, primarily due to difficulty with recruitment. This difficulty is being experienced in the majority of teams across the country. HSE Disability Services advise the backfilling of posts is challenging in the current environment due to lack of availability of appropriately qualified staff and demand for same across the health service. However, the Lead Agencies responsible for the management of the teams are prioritising the recruitment of such posts.
While efforts continue to ensure posts are filled as quickly as possible, the HSE advise that Network Teams in Cork operate according to a suite of national and regional standard operating policies, procedures and guidelines. There are prioritisation systems and caseload management systems (including assessment and intervention pathways) in place. This means that in practice children with the highest priority of need will have access to services in the first instance, while children with a lower priority of need are placed on the appropriate waitlists.
I wish to assure the Deputy that the caseload management systems are reviewed and updated regularly by the Network Team Managers and Cork Kerry Community Healthcare Disability Services have put in place additional waitlist initiatives with external agencies to support caseload management, using time related savings, including preliminary team assessments under the Assessment of Need process.
82. Deputy Barry Cowen asked the Minister for Health the number of home support hours that will be provided to older persons in counties Laois and Offaly during 2022. [7947/22]
Amharc ar fhreagraThe Government is committed to improving community-based services, shifting care to the home and offering greater choice for older people. In 2020, additional funding of €150 million was secured for home support to progress the development of a reformed model of service delivery to underpin the statutory scheme for the financing and regulation of home-support services and to provide for up to 5 million additional hours of home support last year. Preliminary information shows that about 2.9 million more hours were delivered by the end of December compared to the same period in 2020. I'm pleased to say that the funding to provide for up to 5 million additional hours has been maintained into 2022.
In CHO 8, the plan is to deliver over 2.3 million hours of home support this year, of which 580,542 hours is planned for counties Laois and Offaly.
83. Deputy John Lahart asked the Minister for Health when the 2022 HSE service plan will be published; and if he will make a statement on the matter. [7969/22]
Amharc ar fhreagraI have recently approved the 2022 National Service Plan, subject to a number of amendments on the 26th January 2022. Following submission by the HSE of the amended National Service 2022 on the 10th February 2022, I am currently giving consideration to this amended Plan and intend to revert to the HSE promptly.
Following this, the National Service Plan will be laid before the Houses of the Oireachtas within 21 days. Thereafter, the HSE will ensure it is published at the earliest possible time.
The plan sets out the type and volume of services the HSE will provide for within its financial allocation of €20.6 billion (current) which is the largest Health allocation in the history of the State. To put that in perspective, that is €6 billion higher than what was allocated in 2018 (€14.6 billion).
This shows our commitment to healthcare reform. €750 million is for Covid funding (PPE, Testing and Tracing, Vaccination, etc). The rest, €20 billion of current spend, is being used to maintain and reform existing services along with developing new clinical pathways; improving access; increasing bed numbers and capacity; and hiring more staff, including €350m to tackle the waiting lists through HSE and NTPF initiatives.
84. Deputy Paul Kehoe asked the Minister for Health if he will report on the implementation of the 2019 Agreement on Contractual Reform and Service Development for General Practice; the additional investment per annum this will enable by Government; and if he will make a statement on the matter. [7968/22]
Amharc ar fhreagraIn return for GPs’ cooperation with the service developments and reforms outlined in the 2019 Agreement on a reformed GP contract, the Government committed to increasing investment in general practice by approximately 40% (€210 million) between 2019 and 2023. To date, €206.6 million of this funding has been allocated: €27.3 million in 2019; €53.2 million in 2020; €63 million in 2021 and €63 million this year.
The Agreement provides for increases in capitation fees, new fees for additional services such as the chronic disease management (CDM) programme, improved maternity and paternity arrangements as well as enhanced supports for rural practices. In addition, targeted on-going funding of €2 million will also be set aside to provide additional support to practices in deprived urban areas. The Agreement requires that GPs cooperate with a wide-ranging set of modernisation measures in the areas of eHealth, medicines management and multidisciplinary working.
96% of GPs with GMS contracts have signed up to the reform and modernisation programme.
There has been considerable progress in the roll out of the CDM programme with 94% of eligible GPs providing the service to date. GPs have also rolled out therapeutic phlebotomy to patients with haemochromatosis, as set out in the Agreement. In addition, GPs have demonstrated their commitment to the eHealth agenda and hospital waiting list initiative and have also cooperated with the Streamlining and Coordination measures in the Agreement including the development of complaints policies and procedures, premises standards and practice profiles.
However, it is noted that there has been implementation delay in some areas due to the impact of Covid-19. Given the significant nature of the change programmes involved and the level of IT development required, it is reasonable to anticipate that there will be elements of the roll-out of these initiatives that will need to continue into 2023 to bring the programme to completion. This has been acknowledged by all the parties to the Agreement.
