Seán Canney
Question:752. Deputy Seán Canney asked the Minister for Health if dental care can be provided to a person (details supplied); and if he will make a statement on the matter. [29589/24]
View answerHealth Services
Questions (752)
Written answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
Health Services
Questions (753)
Richard Boyd Barrett
Question:753. Deputy Richard Boyd Barrett asked the Minister for Health if respiratory syncytial virus immunisation pathfinder programme does not include children born between 1 July and September 2024; if not, the rational for this; and if he will make a statement on the matter. [29590/24]
View answerWritten answers
As you are aware, the Government recently provided approval for an infant Respiratory Syncytial Virus (RSV) Immunisation Pathfinder Programme which will run between September 2024 and February 2025. All newborn infants born during the programme will be offered immunisation against RSV after birth on site in Irish maternity hospitals. This immunisation will protect newborn infants when they are most vulnerable to the complications of RSV during the winter period when infection rates are at their highest. The risk is highest in children less than six months of age.
As well as protecting newborn infants, this programme will help maintain health service capacity during this coming winter season. The programme is based on NIAC advice and is a temporary programme put in place as an interim measure pending the outcome of Health Technology Assessments on RSV immunisation currently being undertaken by the Health Information and Quality Authority (HIQA).
A HTA is a multidisciplinary research process that collects and summarises information about a health technology. The information can cover a range of fields, including clinical effectiveness and safety, cost-effectiveness and budget impact, organisational and social aspects, and ethical and legal issues. The information is collected and presented in a systematic, unbiased and transparent manner. As well as protecting infants against serious illness, this pathfinder programme also offers the HSE an opportunity to establish working mechanisms and to evaluate the programme.
It is a strategic initiative designed to explore innovative approaches to improving health outcomes within a community or population. Such programmes often serve as pilots or models that, if successful, can be scaled up and replicated in other settings.
The outcome of the HTAs, and learnings from the pathfinder programme once complete, will inform the development of any longer-term programme and future decision making on this matter.
Healthcare Infrastructure Provision
Questions (754)
Pearse Doherty
Question:754. Deputy Pearse Doherty asked the Minister for Health the total number of staff carpark spaces available at University Hospital Limerick for each year from 2014 to 2024 to date, in tabular form; and if he will make a statement on the matter. [29591/24]
View answerWritten answers
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 (755)
Pearse Doherty
Question:755. Deputy Pearse Doherty asked the Minister for Health to provide details of the total number of formal complaints made by HSE employees and agency staff which have been received by HSE complaints officers and or other competent authorities about car parking facilities at University Hospital Limerick for each year from 2014 to 2024 to date, in tabular form; and if he will make a statement on the matter. [29592/24]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Health Services Staff
Questions (756)
Pearse Doherty
Question:756. Deputy Pearse Doherty asked the Minister for Health to provide details of the total number of WTE staff, by job title and grade, employed at University Hospital Limerick for each of the years from 2014 to 2024 to date, in tabular form; and if he will make a statement on the matter. [29593/24]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Ambulance Service
Questions (757)
Cathal Crowe
Question:757. Deputy Cathal Crowe asked the Minister for Health the progress made in improving access to urgent and emergency care, including critical care, trauma services and the national ambulance service since 27 June 2020; the additional funding provided in successive budgets; his plans for 2024; and if he will make a statement on the matter. [29607/24]
View answerWritten answers
Urgent and Emergency Care
A significant improvement in Urgent and Emergency Care Performance is being seen across Emergency Departments nationally. This is driven by the ongoing implementation of the Urgent and Emergency Care Operational Plan. In the first 5 months of the year, despite a 10% increase in ED attendances, the 8am Trolley count has reduced by 14% compared to the same period last year. In addition, there has been a 20% reduction of the number of patients aged 75 and over waiting more than 24 hours in EDs nationally, representing a total of 1,947 patients.
The 2024 UEC Operational Plan, presented to government this week, includes targeted actions and reform initiatives such as:
o The delivery of a 10-bedded Virtual Ward in University Hospital Limerick (UHL) and in St Vincent's University Hospital (SVUH), scaling to 25 virtual beds for each site by year end to deliver 50 virtual beds in total.o Providing additional and extended hours for senior decision makers and staff integral to supporting 7/7 operations.o Standardising the opening hours of all Injury Units (IUs) to provide a 7-day service, 8am to 8pm including Bank Holidays. o Working with GP Out of Hours Services to maintain and increase GP Out Of Hours contacts and reduce the level of GP Out of Hours referrals to EDs.o Delivering high levels of streaming in the emergency departments, e.g. to: Medical Assessment Units; Injury Units; and other appropriate services.o Ensuring all sites adhere to weekly long stay reviews of patients with a length of stay greater than 14 days, to ensure efficient patient flow.o Transferring all clinically appropriate non-acute patients in models 3 and 4 hospitals to appropriate alternative settings, including model 2 hospitals and transitional care beds.o Putting in place additional National Ambulance Service private capacity through voluntary and private ambulances to improve egress and patient flow.o Delivering national and local media communications campaigns to provide information on appropriate and alternative pathways of care and to encourage vaccine uptake.
Critical Care
The Strategic Plan for Critical Care that was brought to Government in 2020 is successfully addressing historical deficiencies in critical care capacity. Significant funding of €78.2 million has been provided by Government since 2021 under Phase 1 of the Strategic Plan. This funding provides for an additional 94 beds over the 2020 baseline figure of 258 beds and will bring capacity to 352. Today, a total of 334 adult critical care beds in place, an increase of 76 beds, or 29.5% since 2021. To put the increase into perspective, there had been an increase of just 21 beds in the previous eight years (2013 -2020 inclusive). Where necessary, the number of critical care beds can surge beyond the baseline of 334 as part of an emergency response.
The development of critical care capacity involves much more than simply sourcing a bed and putting it in a hospital. It requires trained available nurses and doctors, who are in demand around the world, as well as appropriate equipment, such as ventilators, to deliver effective patient care. Since 2021, we have invested in education and training initiatives to increase the critical care workforce.
In addition to an increase in critical care beds, this investment has also increased workforce supply and resulted in other initiatives such as the NAS Critical Care Retrieval Service, work on the Critical Care Information System and Critical Care Outreach Teams.
Phase 2 of the Strategic Plan will provide a further 106 beds, increasing capacity to 458 beds. This will exceed the recommendation of the 2018 Health Service Capacity Review, which had recommended 430 beds by 2031.
Capital funding of €5m in the HSE Capital Plan 2021 was allocated to commence the planning for the five prioritised Phase 2 developments. These capital builds will be delivered over a number of years and this reflects the scale of these buildings, decant of existing accommodation, design, relevant approval processes, construction, equipping and commissioning.
Trauma Services
Implementation of the National Trauma Strategy continues to progress. The establishment of two Major Trauma Centres was one of the major commitments of the Trauma Strategy. In April 2021, the 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 services at Cork University Hospital, the MTC for the South Trauma Network.
On 20th April 2023 the Minister and Taoiseach launched Major Trauma Services at the Mater Misericordiae University Hospital (the Central Trauma Network) and Cork University Hospital (the South Trauma Network). This event marked the successful completion of the first steps in the development of a trauma system for Ireland.
In addition to the development of major trauma services at the two MTCs, a number of key recommendations of the Trauma Strategy have been progressed, including:
• The establishment of the trauma desk at the National Emergency Operations Centre (NEOC) to streamline and coordinate inter-hospital referrals through the centralised system, 1800-Trauma. This service is available to hospitals in the Central Trauma Network to refer patients to the Major Trauma Centre at the Mater Hospital, and Beaumont Hospital for patients with Traumatic Brain Injury (TBI).
• The development of Pre-Hospital Trauma Triage Tool and Bypass Protocols to ensure patients are brought to the most appropriate place for treatment.
• The development of a standardised Rehabilitation Needs Assessment (RNA) and Rehabilitation Prescription (RP), which have been implemented at the two MTCs.
• The development of a Trauma Transfer of Care and Egress policy to provide a standardised process for referral and transfer of care for trauma patients.
• The development of a Clinical Guidance Document for the Management of Major Trauma in Older Adults, which aims to improve trauma care for older adults.
National Ambulance Service (NAS)
The NAS has been engaged in a continuous process of strategic reform to transform the service from a traditional emergency response and conveyance service to a clinically led and agile mobile medical service with an increasing capacity to treat patients at the most appropriate level of clinical need, including in home and community settings in line with the overall aims of Sláintecare.
Specifically, these reform measures include the development, roll-out and expansion of both "Hear and Treat" and "See and Treat" alternative care pathways, including the NEOC Clinical Hub and Pathfinder, which mean that circa 1,000 patients each week are now being treated in home and community settings of which approximately 40% avoid clinically unnecessary conveyance to a hospital ED leading to both a better care experience for the patient as well as significant acute hospital savings.
The NAS also continues to address identified front-line capacity requirements. The current staffing includes 196 Student Paramedics who were enrolled at the NAS college in 2023 and 144 newly qualified Paramedics who successfully graduated from the NAS college in 2023 to add additional front-line capacity. A total of 410 students are currently in training at the NAS College with further recruitment ongoing this year following recent campaigns.
The total NAS budget this year of over €230 million represents a rise of €63million or 37% from the 2019 allocation, and continuous year-on-year increases in government funding has allowed the NAS to grow its staff to 2,360 full time equivalent employees, of which well over 2,100 staff are deployed in the provision of direct patient care.
Cancer Services
Questions (758)
Cathal Crowe
Question:758. Deputy Cathal Crowe asked the Minister for Health the progress made in improving access to cancer services since 27 June 2020; the additional funding provided in successive budgets; his plans for 2024; and if he will make a statement on the matter. [29608/24]
View answerWritten answers
My Department is engaged in policy development and implementation across the full spectrum of issues that impact health and wellbeing in Ireland. 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.
Progress made to improve access to cancer services is as follows:
• This Government has allocated substantial funding of €50m for national cancer treatment and screening services over 2021 to 2023. In the same period, this Government has allocated an additional €98m for new medicines, which has facilitated the introduction of 61 new cancer medicines.
• The Health Research Board has allocated €37.6m to cancer research since 2020, including €21.6m to support improved cancer clinical trials infrastructure.
• In 2024, €3m has been allocated on a once-off basis to the Alliance of Community Cancer Support Centres, which provide counselling and other services to cancer patients in the local community.
• Funding over the course of the Strategy has enabled the recruitment of more than 670 staff to our national cancer services since 2017, including an additional 200 nursing staff, 100 consultants, and 180 health and social care professionals in designated cancer centres.
• The substantial funding provided to cancer services in 2021 and 2022 has facilitated cancer services to recover to above 2019 service levels following the pandemic, and increased staffing in all areas to strengthen multidisciplinary teams. Funding of €3.4m supported increased patient attendances at Rapid Access Clinics (RACs) and improved performance against national Key Performance Indicators (KPIs).
• Ground-breaking therapies such as CAR-T cell therapy have been rolled out in Ireland for the first time (to adults in 2021 and children in 2022).
• Peptide Receptor Radionuclide Therapy (PRRT) was made available in Ireland to patients with neuroendocrine tumours for the first time in 2023.
• Medical oncology services have been strengthened and have become one of the main types of cancer treatment with over 10,000 patients receiving services each month, helping patients to avoid hospital attendance.
• The National Cancer Research Group was established in June 2019 and was refreshed in 2023. The Group includes representatives of the Department, National Cancer Control Programme (NCCP), Health Research Board, and the Irish Cancer Society. Membership of the group also includes academia, the charity sector, a patient representative, and other relevant stakeholders.
• The NCCP supported the development of nursing/allied health professional research through the Cancer Nursing Research Award 2021 in collaboration with the Irish Cancer Society.
• The National Cancer Information System (NCIS) is a single national computerised system that records and stores information relevant to a patient’s health care. NCIS is currently being introduced on a phased basis to all public hospitals providing cancer services. The roll-out will take a number of years and remains a key objective for the NCCP. Additional sites have been identified for roll-out of NCIS in 2024. NCIS is now live in nineteen sites nationwide.
• The NCCP has led in the development of Best Practice Guidance for Community Cancer Support Centres, and an Alliance, recognising the important role cancer support centres play in the provision of community psychosocial support for cancer patients and their families, has been established.
• Survivorship programmes including ‘Cancer Thriving and Surviving’ and ‘Life and Cancer – Enhancing Survivorship (LACES) have been delivered.
• New models of care for cancer and national clinical guidelines for 8 tumour types have been developed, e.g. Psycho-oncology Model of Care in 2022, CAYA Psycho-oncology Model of Care in 2023, Hereditary Cancer Model of Care in 2023, Systemic Anti-Cancer Therapy (SACT) Model of Care in 2022, and national breast cancer clinical guidelines in 2020, with radiation oncology update in 2023.
• €2.07m was provided for enhancing radiotherapy services, including 25 additional staff and the continued roll-out of new and innovative forms of radiotherapy.
• Construction of a new €70m radiation oncology facility at University Hospital Galway was completed in 2022, with first patients seen in Q2 2023.
• National Cervical Screening Laboratory has been scaling up operations after receiving full accreditation by the Irish National Accreditation Board (INAB).
• Under commitments in the Programme for Government, from October 2023 the age range of people eligible for Bowel Screen, was lowered to now include women and men aged 59 years.
• In November 2023, I announced that Ireland is on target to eliminate cervical cancer by 2040. This places Ireland as one of the leading countries in the world in this regard. A roadmap has been published, charting Ireland’s next steps to elimination.
Community Care
Questions (759)
Cathal Crowe
Question:759. Deputy Cathal Crowe asked the Minister for Health the progress made in improving access to primary care and enhanced community care since 27 June 2020; the additional funding provided in successive budgets; his plans for 2024; and if he will make a statement on the matter. [29609/24]
View answerWritten answers
The development of primary care services – alongside social and community care more broadly – is central to this Government's determination to deliver a high-quality, integrated and cost-effective health care system.
In Budget 2022, the Minister secured recurring annual investment of €195m to enable the continued expansion of primary care services through the Enhanced Community Care (ECC) programme.
The ECC programme forms part of wider efforts to deliver on Sláintecare and the promise of care being delivered in the right place at the right time and as close to home as possible. The ECC programme includes a number of different elements that enhance primary care services across the country. Amongst other initiatives, the funding has allowed for the full roll-out of 96 Community Healthcare Networks (CHNs) and enables the continued development of 30 Community Specialist Teams for Older Persons, and 30 Community Specialist Teams for the Management of Chronic Diseases.
All 96 CHNs are now operational, servicing local populations of 50,000 people per network, and supporting GP’s in providing integrated care. 27 Community Specialist Teams for Older Persons are operational, working in an integrated way with acute services to support older patients.
26 Community Specialist teams for Chronic Disease management are operational and are working in an integrated way with acute services, supporting patients across areas of diabetes, respiratory and cardiology, and full nationwide coverage by the Community Intervention Teams has been achieved with 21 now operational across the country.
The ECC programme represents a significant expansion in primary care capacity, and will see some 3,500 additional staff recruited overall, with a particular focus on nursing and health and social care professionals. Over 2800 staff have been onboarded or are at an advanced stage of recruitment, which represents 81% of the full recruitment target.
Since January 2021, GP’s now have increased direct access to MRI, DEXA and CT scans and X-ray via the GP Access to Community Diagnostics initiative. This structured pathway for GPs to directly access diagnostic tests enables a greater level of care to be delivered in the community, supporting patient-centred care, early diagnosis, and early intervention.
We also continue to develop new, state of the art Primary Care Centres (PCCs) to support the provision of the very highest standards of primary care. Primary Care Centres are modern, purpose-designed buildings that provide a single location for a primary care team to work from. They have a key role in delivering a reformed health service. As of end-March 2024 there were 174 Primary Care Centres operational nationally. In total, 45 Primary Care Centres have become operational since end-June 2020. There are a further 10 currently in construction.
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.
Mental Health Services
Questions (760)
Cathal Crowe
Question:760. Deputy Cathal Crowe asked the Minister for Health the progress made in improving access to mental health services since 27 June 2020; the additional funding provided in successive budgets; his plans for 2024; and if he will make a statement on the matter. [29610/24]
View answerWritten answers
The provision of mental health services are in the main a matter for the Health Service Executive and I have requested the executive to respond to the Deputy directly in this regard. From a policy and budgetary point of view the Deputy may also be interested to note the following progress in areas such as enhancing all aspects of our mental health services and supports remains a key priority for Government. There have been significant improvements in the delivery of our mental health services over the past number of years and the Government is committed to ensuring their continued development throughout this year and into the future. I have outlined in my below response some of the key achievements in mental health in recent years.
The Government’s clear commitment to enhancing mental health services, is shown by significant mental health funding increases in recent years. The total allocation for mental health services in 2024 is over €1.3 billion, which is the fourth year in a row in which the mental health budget has been increased. This increase in funding for mental health services represents a significant investment which will enable continued policy implementation and service improvement in line with our national mental health policy, Sharing the Vision. This year’s budget allocation builds on the investment this Government has made over the last number of years to deliver the policy priorities of Sharing the Vision through the provision of mental health supports across a broad continuum from mental health promotion, prevention and early intervention, to acute and specialist mental health service delivery, and enabling us to continue to deliver our vital services to as many people as possible, as we move into 2024.
As part of the funding allocated to mental health services, new development funding has been secured to advance initiatives on youth mental health, and around priority groups identified within our national suicide prevention strategy Connecting for Life. This new development funding will be focused on increased CAMHS staffing, a new Youth Mental Health app, a referral pilot for children's community services including CAMHS (piloting an approach to service referrals known as ‘No Wrong Door’), the expansion of Suicide Bereavement Liaison Services, and expanding the Traveller Counselling Service to achieve national coverage for the first time.
An additional allocation of €10m in the Revised Estimates process is funding the expansion of CAMHS Hubs services, CAMHS Emergency Department Liaison, recruitment of staff to further expand specialist mental health services for young people in areas such as ADHD, Eating Disorders and Early Intervention in Psychosis; and funding for measures around online safety to support the digital literacy and protection of young people online.
Funding allocated to mental health services in recent years has allowed for the continued investment in the mental health national clinical programmes and models of care, which has led to significant service improvements, including the full implementation of specialist perinatal mental health network provided for and the on-going expansion of specialist mental health teams for eating disorders, ADHD in adults, and dual diagnosis.
Telehealth services are fully established including YourMentalHealth.ie; the information line 1800 111 888, the crisis textline, 50808, and NGO online supports. These include youth specific supports, such as those provided through Jigsaw, SpunOut, and Turn2Me. The majority of telehealth supports are available seven days per week, with some providing 24hour support. In addition, the HSE has partnered with SilverCloud, on a national roll out of digital cognitive behaviour therapy to address depression and anxiety and to make mental health support more widely available.
Importantly, as budgets increase, we need to ensure that we have plans and strategies in place so that those resources are used effectively and efficiently to the benefit of people using our mental health services. All aspects of mental health services are being improved and developed, through Sharing the Vision in the short to longer term. Sharing the Vision aims to enhance the provision of mental health services and supports across a broad continuum, from mental health promotion, prevention, and early intervention to acute and specialist mental health service delivery, during the period 2020-2030.
In terms of implementation and oversight, the National Implementation Monitoring Committee (NIMC) and implementation monitoring structures are well established, enabling policy implementation and governance. The NIMC is made up of the NIMC Steering Committee, supported by a NIMC Reference Group to provide the service user and family member perspective. The establishment of the Reference Group in March 2022 is a key development as it is absolutely vital that people who use our services and their families are at the heart of the design, development and delivery of the systems we build to serve them.
NIMC Specialist Groups, have been established in priority areas of development including Youth Mental Health Transitions, Acute Inpatient Bed Capacity, Women’s Mental Health, Primary Care Mental Health Services and Digital Mental Health.
Sharing the Vision Implementation Plan 2022 – 2024 was published on 23 March 2022. The Plan sets out individual programme pathways of implementation for each of the 100 policy recommendations for the next three years. Official reporting on the policy is on-going, with Status Implementation Reports published regularly on the Department of Health website. As of end 2023, 97 of the 100 recommendations are in implementation, with 79 marked on track or with a minor delivery issue.
The implementation of Sharing the Vision will build on existing initiatives already underway, for example in the provision of digital mental health services, the continued phased development and roll-out of our national clinical programmes, which are at the heart of service improvement, and the ongoing legislative reform through the review of the Mental Health Act.
In mid-2021, the Government approved a General Scheme of a Bill to amend the Mental Health Act. This General Scheme took into account the 165 recommendations of the Expert Group Review of the Act, the observations of key stakeholders such as the Mental Health Commission and the HSE, the results of a 2021 public consultation wherein 100 submissions were received, changes in domestic legislation, most significantly the Assisted Decision-Making (Capacity) Act 2015, and Ireland’s international commitments, including under the European Convention on Human Rights and the UN Convention on the Rights of Persons with Disabilities.
A Mental Health Bill is now being prepared. The Bill will significantly update existing mental health legislation through, inter alia, the introduction of a set of guiding principles for adults and children receiving inpatient treatment, a revised set of criteria for detention, an overhauled approach to consent to admission and treatment, aligning capacity in mental health legislation with the provisions of the Assisted Decision-Making (Capacity) Act 2015, the introduction of a new, discrete Part on the care and treatment of children, and the introduction of additional safeguards for people receiving inpatient mental health treatment. The finalisation and introduction to the Oireachtas of a Mental Health Bill is a priority for the Government.
The General Scheme of Mental Health Bill was published in July 2021, followed by a pre-legislative scrutiny report published in October 2022. Parliamentary Drafters were initially assigned in January 2022 and new team assigned in January 2023. The Department of Health supporting OPC as it progresses the text of the Bill and is in regular contact with drafters and legal counsel. The Bill was on the priority for drafting list for all Dáil sessions in 2023 and the first in 2024 and was granted priority for publication in the summer Dáil session in 2024. The Bill will go to Government for approval to publish before the end of July.
I was very pleased to announce, in November 2020, the extension of Connecting for Life, our national suicide reduction strategy, by four years to 2024. This followed a recommendation from the independent strategy review conducted in 2018. It reflects the many achievements to date and the hard work and dedication of multiple stakeholders. The National Office for Suicide Prevention responsible for the implementation of Connecting for Life and overseen by the Department has a €14 million allocation. The extension and continued implementation of Connecting for Life demonstrates the government’s commitment to addressing suicide and self-harm in our communities.
Connecting for Life will reach the end of its life in 2024 and an evaluation of its implementation has commenced. Planning has also commenced for the successor strategy to Connecting for Life.
Following the Programme for Government commitment, the interdepartmental High-Level Taskforce was established by Government in 2021 to enhance links for those in contact with the criminal justice system accessing Mental Health, Addiction or Primary Care services. Final Report was approved by the Government on 20 September 2022 and was subsequently published. A joint Inter-Departmental Steering Committee has been established to monitor implementation the HTLF report over the next five years. The first annual progress report of this group was published in February.
Please see below table outlining the budget allocation to HSE Mental Health Services since 2020:
Mental Health Funding 2020 - 2024
|
Year |
Allocation (NSP) - €m |
|
2020 |
1,031.3 |
|
2021 |
1,114.1 |
|
2022 |
1,159.0 |
|
2023 |
1,226.7 |
|
2024 |
1,308.0 |
As the question also concerns operational matters, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Health Services
Questions (761)
Cathal Crowe
Question:761. Deputy Cathal Crowe asked the Minister for Health the progress made in improving access to children's health services since 27 June 2020; the additional funding provided in successive budgets; his plans for 2024; and if he will make a statement on the matter. [29611/24]
View answer
Awaiting reply from Department.
Health Services
Questions (762)
Cathal Crowe
Question:762. Deputy Cathal Crowe asked the Minister for Health the progress made in improving access to women's health services since 27 June 2020; the additional funding provided in successive budgets; his plans for 2024; and if he will make a statement on the matter. [29612/24]
View answerWritten answers
I remain committed to progressing women's health and it has been a priority for me in my role as Minister for Health since 2020. Significant progress has been made in the area of women's health in recent years including;
• A Free Contraception Scheme was first introduced in September 2022 for women aged between 17 and 25. The scheme was extended to 31 year-olds on 1st January 2024 and further extended to women aged 32 to 35 inclusive on 1st July 2024. The scheme is provided by approx. 2,400 GPs and 2,050 pharmacists nationwide.
• Referrals for publicly-funded Assisted Human Reproduction (AHR) treatments, such as IVF, commenced in September 2023. These services are being privately provided initially with eligible and clinically determined patients being referred from one of the 6 Regional Fertility Hubs located across the country.
• Sixteen ‘See-and-Treat’ Ambulatory Gynaecology (AG) Clinics are fully operational with 4 more in development. Approximately 16,000 patients were seen in these same day see-and-treat clinics in 2023.
• Six Specialist Menopause Clinics have opened nationwide, one in each maternity network, for women who require complex specialist care.
• My Department launched a National Menopause Awareness Campaign in 2 phases (October 2022 and March 2023) which included the development of a webpage. Overall, the campaign was positively received and 72% of survey respondents agreed that menopause is now being discussed more openly in Ireland.
• Two Specialist Endometriosis Centres for complex care have been established, along with 5 regional hubs. All hub and supra-regional sites are currently operational and receiving referrals.
• Since 2020 a total of €17.5 million in new development funding has been allocated to the delivery of the National Maternity Strategy 2016-2026. 186 additional staff have been employed, including consultants, midwives and social workers.
• Five new postnatal hubs are now open, giving women access to postnatal care in community settings.
• A new National Perinatal Genomics Service is being established to ensure women have access to critical testing both during pregnancy, and in planning for future pregnancies.
• 17 of our 19 maternity hospitals are providing full termination of pregnancy services, as prescribed in the 2018 Act, with services commencing in the final two hospital sites in 2024.
• Legislation providing for Safe Access Zones was signed into law by Uachtarán na hÉireann on 7th May 2024.
• An Inter-Departmental Period Poverty Implementation Group was established in 2021. Funding has been allocated over three budgets, starting with €714,000 in 2022, for period poverty mitigation in the community. The allocation has been increased by €100,000 each year with €914,000 allocated in 2024. A Procurement Framework was established to support the purchase of products, vending machines, equip facilities and distribute period products to those most in need.
• A Cervical Cancer Elimination target date of 2040 was announced in November 2023. There has been significant investment in the Cervical Cancer Elimination Strategy, as well as the HPV vaccination programme, including the expansion of the Laura Brennan HPV Vaccine Catch-Up Programme.
• Over €10 million was allocated to new developments in women's health screening services (breast, bowel, cervical and diabetic retina screening) from March 2022 to December 2023.
• A National Cervical Screening Laboratory was opened in December 2022. Over time, it is anticipated that the new laboratory will become the principal provider of cervical screening for the National Screening Service and become a National Centre of Excellence for cervical screening, as well as education, training and research.
• 6 multidisciplinary teams have been put in place for pregnant women and women with a baby up to one year old who may have an existing or new mental health problem. Women with severe mental health problems who are planning a pregnancy can also avail of this service. In addition, perinatal mental health midwife posts are now in place across 13 sites.
• The Women's Health Fund provided investment in 2021, 2022, and 2023 to support a range of mental health services for women and girls, including digital mental health service access, improving perinatal mental health supports, enhancing specialist eating disorder supports, providing targeted mental health supports for marginalised women and women in addiction and responding to the needs of young girls at risk of developing psychosis.
• There are now 11 multidisciplinary Eating Disorder teams in place across the country, with 100 people working across them, including 80 Eating Disorder Clinicians with 10 Consultant Psychiatrists. 6 of these teams started in 2023. Funding was recently announced for an additional Eating Disorder team which, when established, will bring the number of teams to 12.
The Women's Health Action Plan 2024-2025 Phase 2: An Evolution in Women's Health was launched on 18th April 2024. This plan represents the next phase or evolution in women's health. It continues to build on the invaluable undertaken over the previous Women's Health Action Plan 2022-2023, as well as having a focus on new and innovative developments. The services and initiatives will be embedded across the new HSE health regions. 2024 sees the allocation of over €11 million in new development funding to support the implementation of this plan, bringing the total additional funding allocated towards women's health to over €140 million since 2020. Further details relation to the Women's Health Action Plan 2024-2025 can be found here - assets.gov.ie/290734/0397244b-af0b-4dda-9b84-0da40897c723.pdf
Health Services
Questions (763)
Cathal Crowe
Question:763. Deputy Cathal Crowe asked the Minister for Health the progress made in improving access to older person's health services since 27 June 2020; the additional funding provided in successive budgets; his plans for 2024; and if he will make a statement on the matter. [29613/24]
View answerWritten answers
In 2020 the overall funding available to the HSE for Older Persons was €1.97 billion, in 2024 that has increased to nearly €2.62 billion. A wide range of core services is provided throughout the country 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.
Investment in social care services has been a substantial priority for this Government. In 2024, the HSE is funded to support 23,280 people in long-term residential care and to deliver 22 million hours of home support to 54,100 people at any one time, which represents over 70,000 people receiving home support across the year. Through its own services and through commissioning services from private and voluntary providers, the HSE exceeded the 22 million hour target in 2023 and will exceed it again in 2024. This also means that more people are receiving home support than projected, with over 56,000 people receiving home support in April.
The delivery of home support hours has increased every year since 2019, when under 18 million hours were delivered. The waiting list has also reduced from over 9,000 people at the start of 2020 to under 6,000 people today. At the same time, numbers of people in long-term residential care have stabilised, the average length of stay has reduced and the 4-week waiting time for funding approval has remained consistent throughout. Funding for transitional care has also increased, with €22 million being provided in 2024 to ensure that people are not delayed in being discharged from hospital, either to residential care, rehabilitation or home with supports.
The triangle of supports that help people to stay at home is made up of home support, day care and the meals on wheels service. Day care and meals on wheels have proven to be important components of the community services offered to older people, particularly in rural communities where these services can be essential in addressing loneliness and isolation. In 2024, we are investing an additional €3.7 million in over 300 day care services, in-home dementia day care and meals on wheels across the country. Meals on wheels are delivered from over 300 locations and are expected to deliver nearly 3 million meals this year.
In 2019, 3.4% of people over 65 were in long-term residential care. In 2024, the HSE is meeting its target to have less than 2.9% of people over 65 in long-term residential care. This indicates that our investment in the community is working to keep people at home, in line with the principles of Sláintecare: right care, right place, right time.
Dementia
I have also continued to champion services for people with dementia. Through successive budgets, I have worked to prioritise Government funding for the development of dementia diagnostic and post-diagnostic services, in line with the Dementia Model of Care.
Through Budget 2024, I provided an additional €500,000 to increase the provision of in-home dementia day care, for people who cannot, or do not wish to, attend centre-based day care. This was first introduced during the COVID-19 pandemic and is universally viewed as beneficial, improving both the quality of life of clients and providing a break for family carers. 52 dementia-specific day centres have also opened.
Alongside this, I allocated €300,000 in funding to the Alzheimer Society of Ireland to provide weekend activity clubs for people with young onset dementia. This new service will have the benefit of also providing respite to the family carer. Up to 120 people with dementia and their families are expected to benefit from this weekend service.
During my time as Minister I have also introduced ringfencing for new home support hours for people with dementia. This proportion of ringfenced hours has increased each year since 2021 and this year a minimum of 18% of all new home support hours is ringfenced for people with dementia.
Going forward there will be a strong focus on dementia-specific services, which have developed in recent years, like the Memory Technology Resource Rooms and National Dementia Adviser Service which provide invaluable information and supports to people with dementia and their family carers to help them adapt to a dementia diagnosis and continue to live as well as possible.
COVID-19 and other pressures
The Government has provided substantial support to the private and voluntary nursing home sector over the pandemic and to address cost pressures.
• Over €151m of financial support was provided to private and voluntary nursing homes through the COVID-19 Temporary Assistance Payment Scheme (TAPS).
• The provision of free PPE and oxygen to private nursing homes.
• A €10 million Temporary Inflation Payment Scheme (TIPS) was established to support private and voluntary nursing homes with increases in energy costs, covering 75% of year-on-year cost increases up to a monthly cap of €5,250 per nursing home.
• I introduced a new €10m Resident Safety Improvement (RSI) scheme in 2024 to support private and voluntary nursing homes with HIQA regulation and compliance measures.
Strategic Workforce Advisory Group on Home Carers and Nursing Home Healthcare Assistants
Delivering all the services that we have funded is reliant on the availability of carers to work in the sector. There is a shortage of care workers in Ireland, which is seen in many other countries with similar models of care. Addressing this shortage is an urgent priority for the Government.
To this end, the cross departmental Strategic Workforce Advisory Group on Home Carers and Nursing Home Healthcare Assistants was established in March 2022 to examine and formulate recommendations to address the challenges in front-line carer roles in the home support and long-term residential care sectors. The Report of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Healthcare Assistants was published on 15 October 2022, and it contains 16 recommendations. Implementation of these recommendations is underway and is being overseen by a cross-departmental Implementation Group, chaired by the Department of Health. The group meets regularly, with its next meeting schedule in July. Progress updates are published and are available at:
www.gov.ie/en/publication/66dd1-strategic-workforce-advisory-group-on-home-carers-and-nursing-home-healthcare-assistants/
Significant progress has been made in implementing these recommendations. A new HSE Authorisation Scheme, which governs the payments to providers, and terms and conditions, was agreed in August 2023. This delivers on commitments for sectoral reform such as payment for travel time for home support providers, paying carers the National Living Wage at a minimum, and bringing legacy rates in line with the new revised rates of funding, ensuring fairness in the sector. This is the first time that all home support workers delivering care are entitled to receive payment for their travel time.
The Advisory Group’s ninth recommendation has also been fully implemented. The statutory instrument authorising the issuance of 1,000 employment permits for home support workers was signed in December 2022. These permits will be for full-time positions with a minimum salary of €27,000 per year. 917 permits have been availed of to date.
Healthy Age Friendly Homes
On 10 July 2024, I will launch the national roll-out of the ‘Healthy Age Friendly Homes’ (HAFH) programme, which is aimed at enabling access to services in the community.
HAFH is a support coordination programme that aims to enable older people to age in place and reduce the need to transfer to long-term residential care. HAFH is an innovative collaboration operating at the interface between health, housing, local government and climate action to address these wider determinants of health through the Age Friendly Ireland Shared Service.
On referral into the programme, a local co-ordinator carries out a home visit and conducts a holistic needs assessment for the older person in the areas of health, housing, community and social supports, assistive technologies, climate and finance. The co-ordinator agrees a personal plan with each individual older participant and supports them to access a range of services such as housing adaptation grants, home energy improvements, health appointments, befriending or other community services, or technology supports.
During the course of the piloting of the programme across nine sites between 2021 and 2023, local coordinators carried out over 4,600 home visits and provided over 9,000 supports to older people. In Budget 2023, I secured €5.2m in annual recurring funding to roll the programme out across the country.
As part of the national roll-out, using a population-based approach, each of the country’s 31 local authorities will host a local coordinator, with some areas receiving more based on their population's needs. Regional managers will be aligned to HSE Health Regions, to ensure alignment with health and social care services. Once launched the programme will support approximately 10,500 older people each year.
Telehealth
Finally, I am committed to improving access through the innovative use of technology. A telehealth project in CHO5 and Ireland East Hospital Group was approved for 1.5 million euro of funding under Sláintecare Integration Innovation Fund.
CHO5 will run a pilot project of 70 clients awaiting home support and the Hospital Group pilot is for 25 clients on the Delayed Transfer Of Care list. The project will run for two years with appropriate governance and oversight. It will include smart wireless devices which are integrated into homes. These devices ensure both personal and environmental safety, and home monitoring.
There is a 24/7 expert care, phone-based team, which oversees the safety and wellness service. This team provides “comfort calls”, where prompts can be given regarding medication, nutrition and activity. There is a digitally inclusive adapted tablet to support social interaction and family members have access to an app, where the complete day story is available. They will receive calls from the team if there are unexplained changes to the normal day. The aim of the fund is to test innovative models of care and provide a ‘proof of concept’ with a view to mainstreaming successful projects through the annual budget.
Health Services
Questions (764)
Holly Cairns
Question:764. Deputy Holly Cairns asked the Minister for Health further to Parliamentary Question No. 1357 of 9 April 2024, the timeline for a response to issue. [29620/24]
View answerWritten 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 (765)
Holly Cairns
Question:765. Deputy Holly Cairns asked the Minister for Health further to Parliamentary Question No. 364 of 18 June 2024, if the information sought will be provided (details supplied); the exact breakdown of psychology posts, per grade, advertised for the north Lee, south Lee, west Cork and north Cork primary care child/adolescent psychology services in 2020, 2021, 2022 and 2023; the dates that these recruitment drives commenced and their outcomes, that is, the number of posts filled and the number of posts that remained vacant in each instance; the form of recruitment used; and the grade of psychologist recruited or not recruited, in tabular form. [29621/24]
View answerWritten 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 (766)
Holly Cairns
Question:766. Deputy Holly Cairns asked the Minister for Health the number of psychologists, per grade, employed in the north Lee, south Lee, west Cork, north Cork and Kerry primary care child/adolescent psychology services at year end for 2020 to 2023, in tabular form. [29622/24]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
National Treatment Purchase Fund
Questions (767)
Bernard Durkan
Question:767. Deputy Bernard J. Durkan asked the Minister for Health when the necessary funds via the national treatment purchase scheme will be made available to facilitate urgent spinal fusion surgery in the case of a person (details suppled); and if he will make a statement on the matter. [29629/24]
View answerWritten answers
The National Treatment Purchase Fund (NTPF) works with public hospitals, as opposed to with patients directly, to offer and provide the funding for treatment to clinically suitable patients who are on an inpatient/day case waiting list for surgery, having been referred on to such a list following clinical assessment by a consultant at an outpatient clinic.
While the NTPF identifies patients eligible for NTPF treatment, the clinical suitability of the patient to avail of NTPF funded treatment is determined by the public hospital.
National Children's Hospital
Questions (768)
Peadar Tóibín
Question:768. Deputy Peadar Tóibín asked the Minister for Health if his Department sought to curtail spending in order to meet the rising construction costs of the national children’s hospital; and if he will make a statement on the matter. [29258/24]
View answerWritten answers
Annual capital ceilings are set out in the National Development Plan 2021-2030 (NDP); on a Departmental basis for the period to 2026 and on an aggregate basis out to 2030. Following the Estimates process each year, the Health Capital allocation is set out in the overall Health vote. In 2024 total funding available for the Health Building and Equipment Capital Plan is €1.138bn.
It is on the basis of this annual funding envelope that the HSE Capital Plan is developed, including capital funding for the New Children’s Hospital (NCH).
The HSE is required to prepare and submit to the me for review and approval an annual Capital Plan. In compiling the Capital Plan, first order priority is given to:
• Existing contractual commitments, i.e. the completion and equipping of all projects in construction. The NCH is one such project.
• Other contractual commitments e.g. Public Private Partnership unitary charges.
Following the allocation of funding to meet contractual commitments, priority is given to infrastructural risk projects, equipment replacement programme and the ambulance replacement programme.
Any remaining available funding is allocated to projects prioritised by the HSE National Capital and Property Steering Committee (NCPSC) in line with criteria agreed with my Department, which recognise Government and Ministerial priorities.
Inevitably there are more projects available to progress than there is funding available. Therefore, prioritisation of projects is necessary in the development of the annual capital plan. This is undertaken as set out above.
Progress of the capital programme and budget through the year must then be actively managed to ensure optimum usage of funding and resources in progression of the capital programme.
The NCH has been a contractually committed project in the Capital Plan for a number of years. On 13 February 2024, Government approved an enhanced capital budget sanction of €406m, bringing the total approved capital budget to €1.88bn (noting that in December 2023, Government had approved an interim increase of €40m to the capital budget). The approved increase in the capital budget was to address long-standing budget requirements identified in the 2019 PwC report, costs due to the extension of time to building completion, inflation, contractor claims, and to safeguard project and programme delivery to enable the hospital to open as soon as possible.
The approved HSE Capital Plan 2024 provides for the HSE to progress projects and programmes including the completion of the New Children's Hospital, advancement of the National Maternity Hospital, the Elective Hospitals, the development of Surgical Hubs, additional acute hospital capacity projects, progressing initiatives including primary care centres to bring about the delivery of care closer to home, investment in mental health facilities through the country, maintaining investment in minor capital initiatives, the delivery of the equipment and ambulance replacement programmes and to progress the Infrastructure and Decarbonisation Strategy and Implementation roadmap.
Based on the on-going review of progress, I expect the overall 2024 programme to be progressed in line with plan. I, and officials in my Department, continue to monitor progress and work with the HSE in the implementation of the plan.
Health Services
Questions (769)
Brian Stanley
Question:769. Deputy Brian Stanley asked the Minister for Health further to Parliamentary Question No. 374 of 18 June 2024, to provide an update on Graiguecullen health centre and the restoration of services that were available pre-Covid such as eye tests, speech and language, mental health services and community welfare officer visitations (details supplied); and if he will make a statement on the matter. [29673/24]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Health Service Executive
Questions (770)
Bernard Durkan
Question:770. Deputy Bernard J. Durkan asked the Minister for Health if the current HSE inspection regime for vaping products entering the Irish market is adequately resourced to track all potential instances of non-compliant product entering the market; and if he will make a statement on the matter. [29674/24]
View answerWritten answers
As this is a service matter I have referred this to the HSE.
Legislative Measures
Questions (771)
Bernard Durkan
Question:771. Deputy Bernard J. Durkan asked the Minister for Health for an update on the progress of the Public Health (Tobacco and Nicotine Inhaling Products) Bill 2024; when the general scheme will be referred to the Oireachtas Health Committee for pre-legislative scrutiny; for an update on his plans to publish a regulatory impact assessment with regard to the planned legislation; and if he will make a statement on the matter. [29675/24]
View answerWritten answers
The report of the public consultation on the further regulation of nicotine inhaling products and tobacco products will be published in the coming weeks. The results of that consultation, along with evidence reviews and legal advice, are informing the General Scheme for a Bill which I am currently developing and which I will bring to Government early in the next term.