Written Answers Nos. 1100-1119
1100. Deputy Richard Bruton asked the Minister for Health if, given the absence of a diabetes registry and clinical audits, he can outline how his Department plans to identify gaps and issues in diabetes care more effectively; the steps being taken to establish a national diabetes register; the timeline for its implementation; and how is it envisaged to enhance diabetes management across Ireland. [44288/24]
View answerIn June I published the Terms of Reference for a Review of Diabetes Policy and Services. The Steering Group leading that process includes representatives from the Department of Health, the Health Service Executive (HSE), and Diabetes Ireland.
The Steering Group is engaged in developing its report at the moment, and will submit a report within six months of the commencement of its work. This report will include key findings, recommendations, and a set of actions to improve service delivery and patient outcomes. Its proposals will be costed and those costings will take a relevant cost-benefit analysis into account.
The development of a National Diabetes Registry will have a long-term benefit on patient care by facilitating benchmarking of individual care against guideline recommendations and QI feedback to practitioners, and on the provision of appropriate health services by providing reliable information to healthcare planners and policymakers.
I have asked the Health Service Executive to respond to the Deputy directly as soon as possible in relation to the implementation of the National Diabetes Registry.
1101. Deputy Richard Bruton asked the Minister for Health the number of insulin pumps allocated to children and adults by the HSE between 2020 and 2024, in tabular form, including the make and model and the cost associated with the purchase of the units per annum; and if he will make a statement on the matter. [44289/24]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for decisions on the pricing and reimbursement of medical products; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
1102. Deputy Richard Bruton asked the Minister for Health to outline the products and services provided to the HSE by its various contracted manufacturers for patients with type 1 diabetes; and if he will make a statement on the matter. [44291/24]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for decisions on the pricing and reimbursement of medical products; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
1103. Deputy Richard Bruton asked the Minister for Health how his Department and the HSE plans to widen access to continuous glucose monitoring technology for people with Type 1 diabetes to improve their diabetes management and quality of life; and if he will make a statement on the matter. [44292/24]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for decisions on the pricing and reimbursement of medical products; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
1104. Deputy Richard Bruton asked the Minister for Health if he will provide details on the establishment of multidisciplinary diabetes teams, and the integrated model of care for diabetes patients, between hospitals and primary care providers; how this will ensure safe, high-quality, person-centred care for all individuals living with diabetes; and if he will make a statement on the matter. [44293/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1105. Deputy Carol Nolan asked the Minister for Health the number of civil servants, by grade, in his Department who were on a career break in 2023 and 2024; the number of those who in 2023 and 2024 were on a career break of five years or more; and if he will make a statement on the matter. [44305/24]
View answerThe Number of officers on Career Break in 2023 and 2024 in the Department of Health by grade are as follows:
AP - 2023 7, 2024 6
AO - 2023 6, 2024 7
HEO - 2023 4, 2024 2
EO - 2023 4, 2024 2
CO - 2023 1, 2024 2
In 2023 we had one person who had a career break of 5 years who resigned in 2023.
In 2024 we had two officers who had a career break of 5 years, one of them resigned and one returned to work in 2024.
1106. Deputy David Cullinane asked the Minister for Health the additional responsibilities and roles taken on or assigned to consultants in public health following the creation of this grade; the number of doctors that have moved into this grade, and the additional responsibilities which came with this new role; the impact of this new post in real terms on work practices; if any analysis has been conducted on the difference which these posts have made, as judged against the initial rationale for introducing these posts; and if he will make a statement on the matter. [44343/24]
View answerIn Q2 2021, my Department, the Irish Medical Organisation and the Health Service Executive reached agreement on implementation of a fundamentally reformed and strengthened model for public health service delivery in Ireland, in line with international best practice and the recommendations set out in a report prepared by Crowe Horwath. To enable the delivery of this model, the agreement included the establishment of 84 Consultant in Public Health Medicine posts through open recruitment on a phased basis ( 3 phases ), with subsequent phases contingent on the completion of a review process, completed in February 2022 and February 2023, demonstrating clear evidence that the desired outcomes were being delivered.
The HSE is currently in the third and final phase of recruitment, having recruited 72 out of the 84 positions with the remainder in various stages of the process, in line with the HSE Pay and Numbers Strategy.
Prior to the introduction of Consultants in Public Health Medicine, work primarily focused on Health Protection, including infectious disease control, as well as the investigation and the management of environment and health issues. Public Health reform has introduced specific posts for the pillars of Health Service Improvement, Health Improvement, Health Intelligence and Child Health. Additionally, Consultants are now embedded in Cancer Control, the National Screening Service, Quality and Patient Safety and Global Health.
The following have already been led and delivered by these new consultant roles, which would be additional to roles and responsibilities prior to the introduction of the new Consultant roles:
Established all cross-domain leadership and governance structures, with the appointment of a National Director of Public Health, five National leads and six Area Directors of Public Health, and the mobilisation of National Public Health Senior Leadership and Management Teams.
Structural reconfiguration of Public Health from the former Health Board Structure to six new Public Health Areas aligned to Sláintecare areas, led by Area Directors of Public Health and delivering a Consultant-led Public Health service in line with the Hub-and-Spoke model.
Progressed detailed specification of requirements, completed market soundings and received official Permission to Tender from the Digital Governance Oversight Unit to support the procurement of an Outbreak Case and Incident Management IT System, a key enabler of a National Health Protection Service.
Via the introduction of additional resources, Consultants have led and implemented enhancements to existing infectious disease surveillance systems in the Health Protection Surveillance Centre (HPSC). This will ensure effective monitoring and signalling of what is happening at population level, leading to a greater understanding of disease transmission and severity along with population immunity and risk.
Engaged key stakeholders in Public Health, the wider Health Service and an International Subject Matter Expert to define key functions of the new domains of practice at National and Area level within Public Health i.e., Health Protection, Health Intelligence, Health Improvement and Health Service Improvement in line with international best practice.
Developed a Health Protection Strategy 2022–2027 led by the National Clinical Director of Health Protection and published in October 2022. Two annual reports inclusive of what has been achieved have also been published.
Developed a National Immunisation Office Strategy 2024 – 2027
Delivered enhanced multidisciplinary teams, in line with the HSE pay and numbers strategy
Delivered first phase Regional Population Profiles with a national comparative report.
Delivered a Health Needs Assessment Framework
Developed a National Tuberculosis Strategy
In 2025, HSE will focus on the following key areas:
Children and parents: Provide support to children, parents and child healthcare providers through the Child Health Public Health function and the National Healthy Childhood Programme, commence development of a Child Health Public Health strategy and expand the HSE Newborn Bloodspot Screening Programme.
Immunisation: Deliver a high-level of prevention and control of vaccine preventable diseases, including COVID-19 and seasonal flu vaccinations and through the Primary Childhood Immunisation Schedule
Health protection: Deliver the HSE Health Protection Strategy 2022-2027 including:
• Preparing for and responding to public health threats and major incidents
• Ensuring consistent, high-quality public health approaches to prevention, investigation, surveillance, and response to notifiable infectious diseases
• Enhancing preparation for new emergent global health threats
Information and management systems: Advance first phase implementation of the Outbreak Case and Incident Management System and procure implementation and support services for the development of a National Immunisation Information System
New strategy and programmes: Develop a new Public Health Strategy and a new population-based planning approach. Build capacity and capability across the system including for research and partnership (with a focus on health inequalities) and commence delivery of a programme of heath intelligence products and services (including Health Atlas Ireland).
All of the above will further embed the population health approach to working with colleagues across the HSE and other Agencies.
As the HSE continues towards the full implementation of the new consultant model, further monitoring and evaluation of the impact of the new consultants in Public Health Medicine will occur against the implementation of the service plans and over the longer term by the impact of the population health approach on the health outcomes of the population.
1107. Deputy Michael Moynihan asked the Minister for Health what action is being taken to address the extremely long waiting times for orthodontic treatment; if he would accept that these long waiting times place an enormous burden on the patients affected; and if he will make a statement on the matter. [44347/24]
View answerThere are challenges in the provision of oral healthcare services, including orthodontics, and patients are waiting longer than they should have to, to access care. Therefore, in addition to the over €200m that the Government invests in public oral healthcare services annually, an additional €17m in one-off funding has been invested since 2019/2020 to address orthodontics treatment waiting lists. This funding has supported a reduction in the total number waiting to commence orthodontic treatment, by 43% between end-March 2019 and end-June 2024.
However, I acknowledge that we need to do more. From 2025, €8.4 million is being provided on an ongoing basis to continue initiatives aimed at addressing primary care waiting lists for children. This ongoing funding will provide an opportunity to drive innovative solutions built on the learnings from previous successful Waiting List Action Plan initiatives to address the increasing level of demand for primary care services.
Once the allocation of this funding across primary care is finalised for 2025, the proportion assigned to orthodontics will be applied across the various available orthodontics waiting list initiatives in a manner that best addresses the current waiting lists, in terms of both specific clinical need and geographic spread.
Implementation of the National Oral Health Policy is proceeding and a plan for the first phase of implementation is being finalised between my Department and the HSE. The plan will set out a phased approach to the reform of public oral healthcare services, including orthodontics, along with the associated strategic workforce planning elements.
1108. Deputy John McGuinness asked the Minister for Health if an ambulance will be provided to take a seriously ill patient for treatment in a Dublin hospital (details supplied). [44356/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1109. Deputy Robert Troy asked the Minister for Health the average ambulance waiting times across each of the CHO regions. [44361/24]
View answerAs this is a service matter, I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
1110. Deputy Robert Troy asked the Minister for Health the reason a hospital has resisted using a charter medical service to clear waiting lists (details supplied) [44362/24]
View answerIn relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1111. Deputy Robert Troy asked the Minister for Health the current waiting times for cataract surgery in the Royal Victoria, Eye and Ear Hospital, Dublin. [44364/24]
View answerIt is acknowledged that many patients are still waiting too long for hospital appointments and treatments. I am conscious of the burden this places on patients and their families.
To address the issue, I adopted a multi-annual approach through a series of Waiting List Action Plans. Commencing in late 2021, these plans encompass short-term actions to increase capacity and activity in the short and immediate term, and longer-term reform measures to sustainably reduce both hospital waiting lists and waiting times.
The 2024 Plan with a budget of €360 million, builds on the work of previous plans which have achieved significant progress in overall waiting list reduction and in addressing long waiting times, against a backdrop of significantly increased demand for scheduled care services.
Funding of €420m is being allocated to the Waiting List Action Plan for 2025. This represents an almost 17% increase (€60m) above the significant funding allocated for the Action Plan this year.
The investment clearly demonstrates the Government’s ongoing commitment to sustainably reducing and reforming hospital waiting lists and waiting times. With this significant funding for 2025, we will continue to progress towards a having a public healthcare service in which everyone has timely and transparent access to high-quality scheduled care, where and when they need it.
The attached document containing information provided to my Department by the National Treatment Purchase Fund, sets out the number of patients waiting for cataract surgery in the Royal Victoria, Eye and Ear Hospital, Dublin, and how long those patients have been waiting.
1112. Deputy Robert Troy asked the Minister for Health when the Midlands Regional Hospital, Mullingar, will return to using charter medical for five days' rapid access; and if he will make a statement on the matter. [44365/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1113. Deputy Robert Troy asked the Minister for Health if he will introduce a vaccine for RSV virus. [44366/24]
View answerThe 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.
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 a Health Technology Assessment on RSV immunisation for infants and adults 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 HTA, and learnings from the pathfinder programme once complete, will inform the development of any longer-term programme and future decision making on the matter of RSV immunisation in Ireland.
1114. Deputy Robert Troy asked the Minister for Health if he will introduce a vaccine for the shingles virus. [44367/24]
View answerShingles vaccination is not currently provided as part of the national immunisation programme but it is open to any individual who is aged 50 years and older and who wishes to receive the vaccine to consult with their GP or pharmacist.
The shingles vaccine is not available through the medical card or drug payment schemes.
The ages at which vaccines are recommended in the national immunisation programme are chosen by NIAC in order to give each individual the best possible protection against vaccine preventable diseases.
The Health Information and Quality Authority (HIQA) recently carried out a Health Technology Assessment (HTA) on the herpes zoster vaccine which protects against shingles. 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.
HIQA published the HTA on 19 July 2024. The HTA found that adding the shingles vaccine to the schedule is not cost effective and is associated with a substantial budget impact. My Department has considered its findings and determined that the introduction of the vaccine can be reconsidered when cost effectiveness is more favourable.
1115. Deputy Carol Nolan asked the Minister for Health if he is satisfied that the provisions of the Department of Public Expenditure, National Development Plan Delivery and Reform Circular 4/2013 are being properly implemented by his Department; if he is satisfied that civil servants whose career breaks are coming to an end are being notified of appropriate vacancies; if he is concerned by instances where civil servants are having their career breaks extended unnecessarily where the Department has appropriate vacancies to fill; and if he will make a statement on the matter. [44378/24]
View answerThe Minister is satisfied that Circular 4/2013 is being properly implemented in the Department of Health and has no concerns that Civil Servants in his Department are having career breaks extended unnecessarily where the Department has appropriate vacancies to fill.
1116. Deputy John McGuinness asked the Minister for Health if a date for an assessment relative to the urgent need for a hip replacement will be expedited for a person (details supplied). [44387/24]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1117. Deputy Ged Nash asked the Minister for Health if the HSE has an ophthalmologist available at the Drogheda Primary Care Centre; and if he will make a statement on the matter. [44391/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1118. Deputy Ged Nash asked the Minister for Health the number of children awaiting an appointment to see an ophthalmologist under the Drogheda Primary Care Centre up to 1 October 2024; and if he will make a statement on the matter. [44392/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1119. Deputy Ged Nash asked the Minister for Health the number of positions currently filled at the south Louth CDNT under the following headings: dietitians, occupational therapists, physiotherapists, psychologists, social workers, and speech and language therapists; the number of posts under those headings that remain unfilled as of 23 October 2024; and if he will make a statement on the matter. [44393/24]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
