Written Answers Nos. 127-149
127. Deputy Richard Bruton asked the Minister for Health if his Department has developed funding templates to promote cross-agency and cross-Department collaboration, particularly in the context of positive ageing; and if he will make a statement on the matter. [19864/24]
Amharc ar fhreagraWith the aim of supporting healthy, active, and autonomous ageing throughout the life-course, the National Positive Ageing Strategy (2013) provides a framework for whole-of-government policy-making and service-delivery in partnership with the community and voluntary sector. Envisioning a society in which the equality, independence, participation, care, self-fulfilment, and dignity of older persons are pursued at all times, the Strategy aims to address the range of social, economic, and environmental factors that affect people as they age.
The cost-neutral National Positive Ageing Strategy does not contain specific actions. Rather it is a high-level strategic document that outlines a number of national goals, objectives, and action areas to provide direction in relation to the issues that need to be addressed to promote positive ageing. Accordingly, my Department has not developed the type of funding templates referred to by the Deputy.
However, as the Deputy will be aware, in fulfilment of the commitment in the Programme for Government, the Government has established an independent Commission on Care for Older People, which is being supported by a secretariat from my Department. The Commission, which met for the first time on 21st March 2024, is chaired by Professor Alan Barrett (Chief Executive Officer, Economic and Social Research Institute) and is comprised of independent experts.
The Commission is charged with examining the provision of health and social care services and supports for older people and with making recommendations to the Government for their strategic development. Subsequently a cross-departmental group will be established under the auspices of the Commission to consider whether the supports for positive ageing across the life course are fit-for-purpose and to develop a costed implementation plan for options to optimise these supports.
Engagement and collaboration with stakeholders will be a central component of the work of the Commission. To support the work of the Commission, a Reference Group of non-governmental and civil society organisations and other key stakeholders working in the area, including those with lived experience is being formed. The Reference Group will engage in an advisory capacity with the Commission and subsequently with the cross-department group which will be established under its auspices. The inaugural meeting of the Reference Group will be held on 18 June 2024.
128. Deputy Michael Healy-Rae asked the Minister for Health to expedite a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [25790/24]
Amharc ar fhreagra“As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.”
129. Deputy Pádraig Mac Lochlainn asked the Minister for Health if he will commence the process of upgrading Letterkenny University Hospital to a Model 4 hospital, considering the very large number of inpatients that the hospital caters for each year and the distances that patients from Donegal have to travel to avail of appointments and procedures that are only available from the nearest Model 4 hospitals, hundreds of miles away. [25795/24]
Amharc ar fhreagraAs Minister for Health, I am committed to the ongoing development of Letterkenny University Hospital. This Government has allocated significant resources to Letterkenny which will benefit patients:
• The hospital budget has increased from €157 million in 2020 to €196 million in 2024, this is a 25% increase in 4 years.
• Staffing at the hospital has grown by 437 since January 2020, an increase of 25%. This includes 30 more medical staff and 137 more nurses and midwives.
• Under our hospital bed expansion plan a total of 122 beds will be delivered at Letterkenny University Hospital by 2031. This includes 50 beds delivered between 2021-2024 and 72 beds between 2029-2031.
• The Report of the National Acute Medicine Programme (2010) defined four generic hospital models and delineated which services would be expected in each model and how patients would move between them. Letterkenny University Hospital is defined as a Model 3 hospital and it has a 24-hour Emergency Department, an Intensive Care Unit and additional speciality units.
• Model 4 Hospitals provide the same as Model 3 hospitals however would also be expected to have tertiary care for specialised services and these typically serve the population at a national level. University Hospital Galway (UHG) is designated as the Model 4 Tertiary Referral Hospital for the Saolta University Health Care Group.
• Models of care are in the first instance determined by the HSE including service delivery and design. Any amendments to the provision of care in Letterkenny University Hospital, including any expansion that would change the Model of Hospital, should be led by hospital group, based on service need.
130. Deputy Pádraig Mac Lochlainn asked the Minister for Health if he will ensure that an elective surgical hub is also located at Letterkenny, County Donegal, now that the HSE plans to locate one at Sligo, adjacent to another Model 3 hospital (Sligo University Hospital) with much lower number of inpatients per annum than Letterkenny University Hospital. [25796/24]
Amharc ar fhreagraIn December 2022, the locations of 6 new Surgical Hubs were announced, following the success of the Reeves Day Surgery Unit at Tallaght University Hospital. The HSE is currently considering the feasibility of developing an additional Surgical Hub for the Northwest, and any decisions on this will be announced in due course. No further locations for Surgical Hubs are under consideration at this time.
131. Deputy Thomas Pringle asked the Minister for Health if his Department has engaged with or offered support to the health services in Cuba in light of the severe impact of the embargo on its healthcare system; and if he will make a statement on the matter. [25797/24]
Amharc ar fhreagraThe Department of Health has not had any engagement with nor offered support to the Cuban health services. In principle, there would no issues in exploring potential collaboration between Ireland and Cuba health services.
132. Deputy Pádraig O'Sullivan asked the Minister for Health further to Parliamentary Question No. 158 of 22 May 2024, when the HSE executive management team will be in a position to approve or make a decision on the reimbursement application for dostarlimab (jemperli) indicated as monotherapy for the treatment of adult patients with recurrent or advance endometrial cancer; and if he will make a statement on the matter. [25807/24]
Amharc ar fhreagraUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for decisions on the pricing and reimbursement of medicines; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
133. Deputy Darren O'Rourke asked the Minister for Health when a person in County Meath (details supplied) will get a hospital appointment; and if he will make a statement on the matter. [25811/24]
Amharc ar fhreagra“As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.”
134. Deputy Michael Lowry asked the Minister for Health further to Parliamentary Question No. 567 of 8 May 2024, if he is aware that the person has not yet received a response and is not satisfied with the timelines or the delay in receiving a response; if he will seek further clarification from the HSE on this matter; when a response will be issued to this person; and if he will make a statement on the matter. [25813/24]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
135. Deputy Róisín Shortall asked the Minister for Health the steps that he is taking to progress nurse prescribing of opioid substitution therapy; the status of the working group set up to examine this issue; the timeline that he is working towards for introduction of nurse prescribing of opioid substitution therapy; the reason for the delay in progressing this policy; and if he will make a statement on the matter. [25814/24]
Amharc ar fhreagraNurses play an key role in providing treatment interventions to clients with problematic drug use. Their work forms an important element of the addiction services response to the problem of substance use in our society.
HSE Addiction services across the country employ nurses and a comprehensive governance structure for these staff is currently being put in place. This includes the recent appointment of a Director of Nursing for HSE Addiction services.
Nurses also have a key role to play in implementing the six strategic priorities identified in the midterm review of the national drug strategy.
Based on the HSE report on action 2.1.14, of the National Drug Strategy in examining potential mechanisms to increase access to Opioid Substitution Therapies, there is currently no objective need for the introduction of nurse prescribing of OST/OAT.
The focus on Strategic Implementation Group 3 (SIG 3) is to develop integrated care pathways for high-risk drug users to achieve better health outcomes. The HSE Director of Nursing sits on SIG 3 to provide advice on harm reduction responses and integrated pathways for high risk drug users.
I am assured that the contribution of nurses will be kept to the fore in the provision of services for this vulnerable cohort.
136. Deputy Thomas Gould asked the Minister for Health if he is aware that the map of drug and alcohol services shows a gap in provision in large areas of the State; and his plans to remedy this. [25824/24]
Amharc ar fhreagraThe publication of an interactive map of drug services is phase one of the audit of drug services being undertaken by the Dept of Health and the HRB. The audit is an action to support the implementation of the strategic action plan 2023-2024 for the national drugs strategy.
Phase two involves an analysis of current funding of drug treatment and drug related family support services and demand for same, based on
• Analysis of NDTRS, NDRDI and NDAS data to assess service demand.
• Data merge with Pobal depravation index as a proxy predictor of service demand.
• Geomapping of data to provide funding offices with information to plan service delivery.
Drug services are provided by the HSE and community and voluntary organisations. Many services have developed as a response to local demand, often under the auspices of drug and alcohol task forces. As a result, the model of service provision is fragmented and uneven. Access to services can often depend on geographical factors.
The intention is to engage statutory agencies that fund drug treatment services to (i) provide a snapshot of current funding levels and activities, and (b) to assist with gathering more detailed data on what is being provided in relation to the funding. NDTRS figures will also provide a measurement of activity levels.
The audit will map existing service provision against predicted treatment demand based on the Pobal depravation indices and NDTRS figures. Statistics from the National Drug & Alcohol Survey and the National Drug-Related Deaths Index will also inform this work. This information can then by used to inform the planning and funding of drug treatment and family support services in the HSE health regions.
I am committed to enhancing access to and delivery of drugs services in the community under the national drug strategy. Considerable resources have been invested in increasing provision of drug services in recent years. The audit of services will help to plan services in the new HSE health regions to meet population demand and to ensure equitable access across regions and communities.
137. Deputy Thomas Gould asked the Minister for Health if he is aware that the service transfer plan for the transfer of paediatric oncology services from MUH to CUH includes the potential use of adult beds, with no plan to replace these beds. [25825/24]
Amharc ar fhreagraAs this is a service matter, I have forwarded your query to the HSE and asked that they respond to you directly, as soon as possible.
138. Deputy Maurice Quinlivan asked the Minister for Health to examine the case of a person (details supplied) who, having been referred to the ENT clinic at University Hospital Limerick 2.5 years ago to address gromets, has yet to receive an appointment; and if he will make a statement on the matter. [25842/24]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible
139. Deputy Fergus O'Dowd asked the Minister for Health to outline his Department's response and proposed actions in relation to a report (details supplied) published on 6 June 2024 into xylitol as prothrombotic and associated with cardiovascular risk; and if he will make a statement on the matter. [25845/24]
Amharc ar fhreagraThe Report referred to by the Deputy relates to xylitol, which is a member of a group of sugar alcohols known as polyols. Polyols are food additives most often used as sweeteners but can also be used for other technological functions (e.g. flavour enhancer, humectant) in foods.
The use of food additives such as xylitol in food is regulated in the European Union (EU) in accordance with Regulation (EC) No 1333/2008 of the European Parliament and of the Council on food additives. A food additive may only be authorised, if it is considered to present no hazard to the health of the consumer at the level of use proposed.
The safety of sweeteners, including xylitol, which were permitted for use in foods before 20 January 2009, are being re-evaluated by the European Food Safety Authority (EFSA). Once EFSA has completed its re-evaluation of xylitol, the European Commission and the EU Member States will consider whether to continue its authorisation as a food additive.
The Food Safety Authority of Ireland (FSAI) actively participate in discussions on food additives at EU level on behalf of the Department of Health. Officials in my Department have requested that the FSAI bring this Report to the attention of the European Commission so that it can be raised with EFSA.
140. Deputy Bernard J. Durkan asked the Minister for Health his views on a matter (details supplied); and if he will make a statement on the matter. [25862/24]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
141. Deputy Bernard J. Durkan asked the Minister for Health the extent to which it is expected to improve the mental health facilities available in CHO 7 for each category of patient over the next twelve months; and if he will make a statement on the matter. [25873/24]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
142. Deputy Bernard J. Durkan asked the Minister for Health the extent to which backlogs in school health examinations are being addressed, including dental and ophthalmic; the extent of progress in addressing these backlogs over the past twelve months to date; and if he will make a statement on the matter. [25874/24]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
143. Deputy Bernard J. Durkan asked the Minister for Health the extent to which plans are in hand to ensure an adequate GP service throughout County Kildare, an area of expanding population; if all efforts can be made to ensure seamless access to quick service; and if he will make a statement on the matter. [25875/24]
Amharc ar fhreagraGPs are private practitioners, most of whom hold a GMS contract with the HSE for the provision of GP services without charge to medical card and GP visit card holders. As self-employed practitioners, GPs may establish practices at a place of their own choosing. There is no prescribed ratio of GPs to patients and the State does not regulate the number of GPs that can set up in a town or community.
The Government is working to increase the number of GPs practicing in the State and thereby improve access to GP services across the country.
Under the 2019 GP Agreement additional annual expenditure provided for general practice was increased by €211.6m. This provided for significant increases in capitation fees for participating GMS GPs, and new fees for additional services and increased practice supports. The GP Agreement 2023 further increased GP capitation fees, increased the existing subsidy rates for practice staff, and introduced a grant support for additional staff capacity as well a practice staff maternity leave support. These measures make general practice in Ireland a more attractive career choice for doctors.
The number of doctors entering GP training has been increased significantly in recent years, with 286 new entrants in 2023 and 350 places made available for new entrants for this year. Annual intake to the GP training scheme has been increased by over 80% from 2015 to 2023, and the number of new entrant places to be available this year is a 22% increase on last year's intake.
Furthermore, GP recruitment is ongoing under the joint International Medical Graduate Rural GP Programme between the HSE and the Irish College of General Practitioners (ICGP). 121 non-EU GPs were enrolled under the training programme last year and it is planned to recruit up to 250 more GPs from outside Ireland this year. The placement of GPs under the programme is targeted to rural and underserviced areas.
Lastly, a Strategic Review of General Practice is underway. The review, with input from key stakeholders, is examining the broad range of issues affecting general practice including issues related to GP capacity. When completed, the review will set out the measures necessary to deliver a more sustainable general practice into the future.
144. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he and his Department continue to accelerate the programme of assessment for children with or without special needs who may be in need of counselling, psychiatric or medical attention; if he will ensure a rapid processing of such cases; and if he will make a statement on the matter. [25876/24]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond Directly to the Deputy as soon as possible.
145. Deputy Bernard J. Durkan asked the Minister for Health by how much it is intended to reduce the numbers on hospital waiting lists by whatever means over the next twelve months; and if he will make a statement on the matter. [25877/24]
Amharc ar fhreagraThe challenge facing our acute hospital waiting lists is well recognised, and both the Government and I have acknowledged that waiting lists are too long and many patients on those lists are waiting too long to receive the care they need. In response to this, the first Waiting List Action Plan (WLAP) was implemented in late 2021, as part of a multi-annual approach encompassing short-term actions to increase capacity and activity in the immediate term, and longer-term reform measures to sustainably reduce and reform hospital waiting lists and waiting times.
The aim of the WLAP is to ensure that patients have more timely access to high-quality scheduled care in our acute hospitals and will improve patient outcomes and patient experiences of our healthcare service. It should be noted that each of the WLAPs to-date, beginning with 2021, have achieved reductions in overall waiting lists and the 2024 WLAP aims to build on this progress.
The 2024 WLAP– published in March - builds on the work done in previous plans and is targeting long waiters and a further 10% reduction in the number of patients breaching the Sláintecare Time Targets (as of year-end 2023). This year’s WLAP also has a target of reducing the overall waiting list volume by 6% by year end, to a closing position of 632,086. This would continue the trend of annual reductions in waiting lists in recent years and would represent a significantly larger reduction than the 2.7% achieved in 2023.
The WLAP 2024 is focused on a tighter set of 19 targeted actions aimed at maximising impact on our waiting lists, under the following three pillars:
• Delivering Capacity,
• Reforming Scheduled Care,
• Enabling Scheduled Care Reform.
• Under the 2024 WLAP, the HSE and National Treatment Purchase Fund (NTPF) are aiming to remove c. 1.81 million patients from active waiting lists. These activity targets are c. 5% above the 2023 out-turn, with a further 3% in outpatient (OPD) core and additional activity planned.
• In addition, the 2024 WLAP includes a number of actions and initiatives aimed at reforming scheduled care, including the further rollout of Modernised Care Pathways; continued focus in addressing waiting lists for paediatric orthopaedics (spina bifida/scoliosis) and gynaecology; enhancing theatre optimisation; as well as implementing a number of enhanced productivity and efficiency measures for waiting list management, including the broader rollout of Patient Initiated Reviews (PIR) and Central Referrals.
• In addition, through the work of the Productivity and Savings Task Force, further initiatives will be progressed to deliver additional care, which will also help to reduce waiting lists this year. For example, this will include considering opportunities for increased activity linked to the new public-only consultant contract, such as extra OPD clinics for new appointments.
146. Deputy Bernard J. Durkan asked the Minister for Health the extent to which dental patients can have their requirements met and progressed as quickly as possible, with particular reference to medical card holders; and if he will make a statement on the matter. [25878/24]
Amharc ar fhreagraThe Dental Treatment Services Scheme (DTSS) provides dental care, free of charge, to medical card holders aged 16 and over. Services available annually and on demand include an examination including preventative elements, two fillings, extractions, and a scale and polish. More complex care, such as dentures, and a broader range of treatments for patients with additional needs and high-risk patients, are available subject to the approval of the local HSE Principal Dental Surgeon.
Where access to a dentist is difficult, local HSE services assist patients who make enquiries and make lists of DTSS contractors available to medical card holders. In exceptional circumstances, the HSE assists patients to access emergency dental treatment by directly contacting private contractors or arranging treatment to be provided by HSE-employed dentists.
To support practitioners to provide care under the Scheme, I approved and funded a range of measures that were put in place on 1 May 2022 to introduce and reintroduce elements of preventative care and increase the fees paid to dental contractors for most treatment items by 40-60%. In 2023, 154,864 additional treatments were provided under the DTSS, with over 26,700 extra patients treated when compared with 2022.
In the longer term, the Government is committed to reforming dental services, including the DTSS, through the implementation of the National Oral Health Policy (NOHP), Smile agus Sláinte. An implementation plan for the 2024-2026 phase of rollout is being drafted by my Department and the HSE, for consultation and subsequent publication in the third quarter of this year. The HSE is committed to the design and development of packages of expanded preventative care, and will consult with the profession this year on this draft design, as the first phase of reform of the DTSS.
147. Deputy Bernard J. Durkan asked the Minister for Health how many applications for medical cards were granted in the past 12 months to date; the number who were refused or who are under investigation in the same period; and if he will make a statement on the matter. [25879/24]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
148. Deputy Bernard J. Durkan asked the Minister for Health the progress made in the last twelve months in countering ongoing difficulties of obtaining and retaining professional staff throughout the health services; the plans to increase staffing in the health service over the next 12 months to adequately address backlogs for service; and if he will make a statement on the matter. [25880/24]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
149. Deputy Bernard J. Durkan asked the Minister for Health the extent to which women’s health specifically remains central to the provision and delivery of a reliable level and quality of health services in all areas throughout Ireland; and if he will make a statement on the matter. [25881/24]
Amharc ar fhreagraWomen's Health remains a priority for both the Government and my Department and continues to be central to the provision and delivery of quality health services.
The Women's Health Action Plan 2024-2025 Phase 2: An Evolution in Women's Health was launched on the 18th April 2024 and represents the next phase of the Government's commitment to improving health outcomes and experiences for women and girls in Ireland. It builds on the progress achieved under the Women's Health Action Plan 2022-2023 and is an evolution of that plan. The new Women's Health Action Plan is the culmination of close collaboration with the Women's Health Taskforce, with colleagues across my Department, the HSE and most importantly, has as its foundations, what women are telling us about their health outcomes and their experiences of our health services.
Significant progress has been made in Women's Health in recent years which has improved the level and quality of health services available. This includes;
• The expansion of the Free Contraception Scheme, originally introduced in September 2022, to include all women aged between 17 and 31 years.
• Six Regional Fertility Hubs are now operational across the country and are providing access to publicly funded Assisted Human Reproduction treatment.
• Sixteen 'See and Treat' Ambulatory Gynaecology Clinics are fully operational with more opening in later this year.
• Six Specialist Menopause Clinics have opened.
• Two Specialist Endometriosis Centres for complex care have been established, along with five regional hubs.
• Five new postnatal hubs are now open, giving women access to postnatal care in community settings.
• A new National Perinatal Genomics Service has been 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 later this year.
• The new Women's Health Action Plan seeks to build on this progress and continue to work on new areas with the ultimate aim of improving health outcomes for women in Ireland.
