Cathal Crowe
Ceist:1059. Deputy Cathal Crowe asked the Minister for Health the estimated average full-year cost to the health service of employing one health and social care professional. [44152/24]
Amharc ar fhreagraWritten Answers Nos. 1059-1078
1059. Deputy Cathal Crowe asked the Minister for Health the estimated average full-year cost to the health service of employing one health and social care professional. [44152/24]
Amharc ar fhreagraAs this is an operational matter, I have asked the HSE to respond to the Deputy Directly.
1060. Deputy Cathal Crowe asked the Minister for Health the estimated total full-year cost to the Exchequer to open 3,000 more hospital beds. [44153/24]
Amharc ar fhreagraAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
1061. Deputy Cathal Crowe asked the Minister for Health the estimated total full-year cost to the Exchequer to halve the drugs payment scheme monthly maximum payment from €80 to €40. [44154/24]
Amharc ar fhreagraThe Drugs Payment Scheme (DPS) provides for the refund of the amount by which expenditure on approved prescribed medicines or medical and surgical appliances exceeds a named threshold in any calendar month. The DPS is not means tested and is available to anyone ordinarily resident in Ireland.
The DPS threshold was reduced twice in 2022:
• From €114 to €100 per month on 1 January 2022.
• From €100 to €80 per month on 1 March 2022.
Therefore, currently, under the DPS, no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS significantly reduces the cost burden for people with ongoing expenditure on medicines.
The estimated full year cost of reducing the DPS threshold to €40 is €95m.
This costing does not take account of demographic changes, changes in eligibility (e.g., loss of medical cards), or how a reduction in the DPS threshold may impact claimant behaviour.
1062. Deputy Cathal Crowe asked the Minister for Health the estimated total full-year cost to the Exchequer to fund one sexual assault treatment unit under the HSE. [44155/24]
Amharc ar fhreagraAs this is an operational matter for the Health Service Executive, the HSE has been asked to reply directly to the Deputy.
1063. Deputy Ged Nash asked the Minister for Health when he expects the counsellors and psychotherapists registration board of CORU to have completed its review of the submissions received regarding the draft standards of proficiency for counsellors and psychotherapists, and publish the outcome of this review; the projected timeline envisaged by CORU leading to the opening of the counsellors and psychotherapists register; and if he will make a statement on the matter. [44163/24]
Amharc ar fhreagraCORU is Ireland’s multi-profession health and social care regulator. CORU’s role is to protect the public by regulating the health and social care professions designated under the Health and Social Care Professionals Act 2005 (as amended), including setting the standards that health and social care professionals must meet to be eligible for registration and maintaining registers of persons who meet those standards.
Seventeen health and social care professions are designated for regulation by CORU. There are currently registers open for twelve professions and CORU is continuing the substantial work required to open the registers for the remaining designated professions of psychologists; counsellors and psychotherapists; clinical biochemists; and orthoptists.
The Counsellors and Psychotherapists Registration Board (the board) was established in 2019, tasked with establishing regulation for the two professions of “counsellor” and “psychotherapist”.
Since its establishment the board has carried out extensive work to advance the introduction of regulation for both professions. Most recently a public consultation was held on the Standards of Proficiency and Criteria for Education and Training Programmes for both professions. This was open for twelve-weeks from September until December 2023.
There was an extremely high level of engagement with this consultation process. 689 responses were received with extensive engagement from stakeholders including members of the professions, education providers, employers, professional bodies, and members of the public.
The consultation submissions highlighted that there remains significant disagreement within and between the professions, that they are distinct and separate, and there are diverse opinions as to the competences required for entry to the professions required for safe practice.
In this context, it's crucial to carefully consider the risks to the public. The criteria for education and training programmes, especially regarding practice placements, must balance protecting vulnerable service users with ensuring that students are supported in becoming proficient, independent and safe practitioners through completing their training.
The board is carefully considering the submissions to its public consultation as it works to set the threshold standards required for public protection and following this extensive review activity, the board will communicate the next steps in the process towards introducing statutory regulation for counsellors and psychotherapists.
Owing to the significant amount of work to establish and implement the standards required for public protection, it is not possible at this time to confirm the timelines for registers opening for the professions of counselling and psychotherapy.
1064. Deputy John McGuinness asked the Minister for Health if an early appointment for assessment for a hip operation will be arranged in the case of a person (details supplied), as their GP considers the case to be urgent. [44172/24]
Amharc ar fhreagraAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1065. Deputy Matt Shanahan asked the Minister for Health the status of redress to patients of psychiatric hospitals who feel they have an historic claim; and if he will make a statement on the matter. [44188/24]
Amharc ar fhreagraThe involuntary admission of persons to a psychiatric hospital or unit prior to the introduction of the Mental Health Act 2001 was governed by statute, in this case the Mental Treatment Act 1945. The 1945 Act specifically allowed for the admission and detention without their consent, of a person as a ‘temporary patient' or a 'person of unsound mind'. Such admissions took place following an application made in this regard and required a medical certificate signed by a doctor and also a reception order signed by a consultant psychiatrist.
The Act also provided patients with the right to contact the Minister for Health, the Inspector of Mental Hospitals or the President of the High Court in relation to their detention. In addition, it also required the Inspector of Mental Hospitals, in the course of his inspections, to visit any patient "the propriety of whose detention he had reason to doubt".
If any person considers that they may have a claim of the nature raised by the Deputy, it is open to them to raise such concerns in the first instance either with the HSE or to perhaps seek legal advice, as appropriate.
I have asked the Health Service Executive to respond to the Deputy directly as soon as possible to outline its views on the matter raised.
1066. Deputy Matt Shanahan asked the Minister for Health to report on any professional understanding that exists around the treatment options of ‘multiple monitored ECT’, the use of sodium amytal in such treatments, and any likely adverse events in such use; and if he will make a statement on the matter. [44189/24]
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.
1067. Deputy Matt Shanahan asked the Minister for Health in regard to patients who have suffered trauma as a result of psychiatric institutional sectioning and treatment, what supports exist in the health system to support them in terms of counselling, and so on; and if he will make a statement on the matter. [44190/24]
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.
1068. Deputy Cathal Crowe asked the Minister for Health if the panel that the HSE set up for the role of MWCG 23.021 senior dental nurse still exists; if the role in question is subject to the HSE recruitment embargo; and if he will make a statement on the matter. [44207/24]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
1069. Deputy Gary Gannon asked the Minister for Health the measures in place to ensure that the financial assessments and contributions required of individuals in nursing homes under the fair deal scheme are fair and just, given the concerning financial situation faced by some elderly residents in nursing homes availing of the scheme; and if he will make a statement on the matter. [44214/24]
Amharc ar fhreagraIntroduced in 2009, The Nursing Homes Support Scheme (NHSS), commonly referred to as ‘Fair Deal’, is a system of financial support for people who require long-term residential care. It is unique in Europe in that it is a fair, single, unified system for funding and making long-term residential care more accessible.
Fair Deal is specifically designed to support residents, based on an individual’s means, and that people are cared for in the most appropriate settings. By making nursing home care more affordable, the scheme has increased access to necessary care for many older adults.
NHSS participants contribute to the cost of their care according to their means while the State pays the balance of the cost. Since the scheme was introduced over 300,000 people have availed of Fair Deal.
Participants within the NHSS contribute up to 80% of their income (40% if part of a couple) and 7.5% per annum of the value of their assets (3.75% if part of a couple). The first €36,000 (€72,000 if part of a couple) is excluded from assessment. The value of a person's principal residence is only assessed for contributions for their first three years on the scheme. This is known as the three-year cap, which is intended to protect the value of a principal private residence, along with the other safeguards built into the Financial Assessment which ensure that:
• Nobody will pay more than the actual cost of care;
• A participant will keep a personal allowance of 20% of their income or 20% of the maximum rate of the State Pension (Non-Contributory), whichever is the greater, and;
• If a participant has a spouse or partner remaining at home, they will be left with 50% of the couple’s income or the maximum rate of the State Pension (Non-Contributory), whichever is the greater
A participant will only pay contributions for the amount of time they actually spend in care. Data from HSE indicates that, on average, NHSS residents cover around 30% of their cost of care, with the state covering the remaining 70%. This proportion is based on the assessment of residents' assets and income, rather than on the cost of providing their care, and has remained stable over recent years.
This means that the same set of criteria is used to calculate the contribution to the cost of care, therefore the cost to the person will be the same regardless of whether a person resides in a private/voluntary nursing home or a publicly-run Community Nursing Unit, In circumstances where the calculated contribution to the cost of their own care exceeds the cost of care provision, the person is ineligible to receive funding under the scheme.
The NHSS covers the cost of the standard components of long-term residential care which are:
• Nursing and personal care appropriate to the level of care needs of the person;
• Bed and board;
• Basic aids and appliances necessary to assist a person with the activities of daily living; and
• Laundry service.
Although the NHSS covers core living expenses, residents can still incur some costs in a nursing home, such as social programmes, newspapers or hairdressing. In recognition of this, anyone in receipt of financial support under the NHSS retains at least 20% of their income. Under the terms of the NHSS Act 2009, private nursing homes should not levy additional charges on NHSS residents for services coming within scope of the Nursing Home Support Scheme.
A person's eligibility for other schemes, such as the medical card scheme or the drugs payment scheme, is unaffected by participation in the NHSS or residence in a nursing home.
Participants who own property/land-based assets in the State also have access to Ancillary State Support, or the Nursing Home Loan, an optional feature of the Fair Deal Scheme. It is a loan advanced by the HSE to help people meet the portion of their contribution to the cost of care that is based on property/land-based assets, most typically against the personal residence. If an individual secures ancillary state support, they will not need to contribute against the value of the relevant property during their time on the scheme, unless the property is sold during that time.
The NHSS currently supports about 23,500 people. Around 80% of those are supported in private nursing homes, with the remainder in public HSE-run facilities (both systems are funded through the NHSS). I have secured year-on-year funding increases for Fair Deal that has seen the budget increase from €968 million in 2019 to €1.223 billion for 2025.
Effective from 1 February 2024, nursing home residents can retain 100% of the income accrued from renting the principal private residence. In previous iterations of the scheme, rental income was assessed at the same rate as other income, and since November 2023 assessed at a reduced rate of 40%.
It should be noted that this provision will only apply to income generated from rental of the principal private residence; any rental income received from a property which is not from a principal residence will continue to be treated as general income and assessed at 80%.
In addition, the commencement of the Nursing Homes Support Scheme (Amendment) Act 2021 includes an amendment in relation to applying the 3-year cap to the proceeds of sale of a house while a resident is in long-term care.
This addresses the first relevant commitment in the Housing for All Strategy (action 19.7).
The 2021 Act now extends the 3-year cap to cover the proceeds of sale, so that a person will be able to sell their home without incurring additional fees from their fourth year in long-term residential care onwards. This applies even if the home is sold before 3 years in care; the proceeds of sale will be assessed up to the 3-year point, but excluded from assessment after that.
The Act also extended the three-year cap on contributions based on farm and business assets where certain conditions are met. The goal of this amendment is to assist in protecting the viability and sustainability of family farms and family-run businesses.
1070. Deputy Gary Gannon asked the Minister for Health to provide an update on any reforms being considered to the fair deal scheme to address the financial challenges faced by families, particularly considering situations where miscommunication or administrative errors have led to financial distress; and if he will make a statement on the matter. [44215/24]
Amharc ar fhreagraAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1071. Deputy Richard Boyd Barrett asked the Minister for Health further to Parliamentary Question 256 of 2 October 2024, when a reply will issue from the HSE to the request to provide a report on the number of sanctioned whole-time posts in the Ireland East Hospital Group in September in 2020, September 2021, September 2022, September 2023 and September 2024; the details of whether these posts are filled or vacant and, broken down by hospital and discipline; and if he will make a statement on the matter. [44217/24]
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.
1072. Deputy Niamh Smyth asked the Minister for Health if the shingles vaccine will be provided free of charge to a person (details supplied) at high risk; and if he will make a statement on the matter. [44219/24]
Amharc ar fhreagraShingles 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.
1073. Deputy Ivana Bacik asked the Minister for Health to provide the details on the Women’s Health Action Plan on postnatal supports for mothers; to provide details of the funding and the progress on each of its action points, in tabular form; if he will specifically report on the establishment of new postnatal hubs targeted at supporting women for 14 days post birth, addressing areas of postnatal care, such as breastfeeding supports, physiotherapy, and emotional and physical supports; and if he will make a statement on the matter. [44221/24]
Amharc ar fhreagraThe 2022 Women's Health Action Plan and the National Maternity Strategy 2016-2026 call for a coordinated approach to support postnatal women and new babies in the community. The National Maternity Experience Survey has shown us that improving postnatal care is a priority for women. That is why, since 2022, I have directed significant investment into piloting and establishing a national network of Postnatal Hubs. Five Hubs are already running, with four more currently in development. Budget 2025 will provide four more Hubs, bringing the national network to 13.
These Hubs provide essential care for women in the community in the weeks after birth. I know from women who have attended this service how much they value the additional support, including hotlines, birth reflections, and physiotherapy.
To initiate the first two Postnatal Hubs, in 2022 €0.9 million was allocated through the Women's Health Fund. In the same year, this Government provided record funding of €8.7 million for the National Maternity Strategy, through which three further Postnatal Hubs were funded. A total of five Postnatal Hubs were open by the end of 2023 in Cork, Kerry, Portiuncula, Sligo and Carlow-Kilkenny.
I have allocated €0.4 million in 2024 to establish four more Postnatal Hubs, with a full year cost of €1.9 million in 2025.
This Government is investing an additional €2.0 million in the National Maternity Strategy in Budget 2025, which includes €0.9 million to open four further Postnatal Hubs.
These hubs will support women for up to 6 weeks post birth by addressing many gaps identified by women in postnatal care, including through provision of specialist bespoke lactation, perinatal mental health and birth reflective clinics alongside routine midwifery-led postnatal health promotion and education clinics.
To further enhance breastfeeding supports, this Government announced funding in Budget 2025 for five new lactation consultant posts, which will be allocated based on service demand within the HSE. Funding is also being allocated for the provision of additional breast pumps for mothers of critically ill and pre-term infants, enabling them to provide breastmilk for their babies while they stay in hospital for extended periods.
1074. Deputy Ivana Bacik asked the Minister for Health in respect of the 2022 Women’s Health Action Plan, if he will report on his Department’s achievement of the maternal health goal of fully funding the National Maternity Strategy. [44222/24]
Amharc ar fhreagraProgressing women's health continues to be a top priority for this Government.
A revised implementation plan for the National Maternity Strategy was published in November 2021. The revised Plan set out all remaining activity in relation to the implementation of the Strategy within the timeframe 2022-2026. The remainder of the Strategy’s implementation was then costed at approximately €43.7m.
€27.7m in new development funding has been directed through the Strategy from 2016-2025 with €16 million of this investment provided by this Government in 2021 and 2022. This investment has provided more than 500 whole time equivalent medical professionals, supporting our maternity services.
Investment of €2m announced for Budget 2025 (with a Full Year Cost of €4m in 2026) will ensure the continued implementation of the Strategy into 2025 and beyond. The priorities covered by Budget 2025 funding include:
• Additional Specialist Midwives to enhance women’s access to midwife-led care.
• Driving improvements in the safety of our maternity services through research, audit and new clinical guidelines.
• Recruiting more genetic counsellors and supporting staff to expand a new National Perinatal Genomics Service; evaluating, diagnosing, managing and treating anomalies before birth.
• Delivering 4 new Postnatal Hubs, to provide women with access to postnatal care in the community and away from a hospital environment.
Further funding of €0.45 million (€1.87 million Full Year Cost) has been provided in 2024 through the Women’s Health Taskforce for an additional 4 Postnatal Hubs. With five hubs operating, funding in 2025 will expand the national network to 13 Postnatal Hubs.
Combined investment through the Strategy and also through the eHealth Capital Plan is driving the roll-out of the Maternity and Newborn Clinical Management System (MN-CMS), which is a fully Electronic Health Record. The MN-CMS is currently live in 4 sites, covering 40% of births nationally. The system is being rolled out to the remaining standalone maternity hospitals to cover 70% of births nationally and 60.5% of Neonatal Intensive Care Activity. Additional funding of €4.4 million has been allocated for this expansion through the eHealth and ICT Capital Plan 2024.
Funding has also been directed through the Women's Health Taskforce and Women's Health Fund to support maternity initiatives, including €0.5 million to support the recruitment of Medical Social Workers in maternity units, over €1.3 million since 2022 to open Postnatal Hubs, and €1.3 million to establish a National Perinatal Genomics Service. Almost €1 million has been invested to develop community based Women's Health Hubs.
Funding has also been directed through the health and wellbeing programme throughout the Strategy period supporting progress against Strategy actions. In Budget 2025, almost €1 million is being invested to further enhance breastfeeding supports, including five new lactation consultant posts, and the provision of additional breast pumps for mothers of critically ill and pre-term infants, enabling them to provide breastmilk for their babies while they stay in hospital for extended periods.
This Government has invested in women's mental health services including perinatal mental health, for which funding has been directed through mental health services. To date this programme has received funding of €5.2m. We have also overseen unprecedented levels of investment across other supporting women's health services, including gynaecology, endometriosis services, and screening and menopause supports.
Following the implementation of the initiatives that have been funded in 2024-5, the HSE's National Women and Infants Health Programme (NWIHP) will assess any actions that may be outstanding as the Strategy enters its final two years. NWIHP have advised that to date 94% of actions are either completed or in progress. All of these developments, delivered under the Strategy, are supporting improved choice for women and driving safe, high quality, nationally consistent, woman-centred maternity care.
1075. Deputy Ivana Bacik asked the Minister for Health in respect of the 2022 Women’s Health Action Plan, if he will report on his Department’s achievement of the maternal health goal of embedding lactation consultants in all maternity units. [44223/24]
Amharc ar fhreagraEncouraging mothers to breastfeed is a priority, both for the Department of Health and for the HSE National health policy. The Healthy Ireland Framework, Healthy Ireland Strategic Action Plan, the National Maternity Strategy, the Obesity Policy and Action Plan, and the National Cancer Strategy, emphasise the importance of supporting mothers to breastfeed, as well as taking action to increase breastfeeding rates in Ireland.
The HSE Breastfeeding in a Healthy Ireland Action Plan 2016-2021 is the framework for progressing supports for breastfeeding in Ireland. A HSE Breastfeeding Action Plan Implementation Group was established to oversee delivery of the plan, and a national breastfeeding Co-Ordinator was appointed as lead. The Department of Health works closely with the HSE National Breast-Feeding Co-ordinator in the implementation of HSE Breastfeeding Action Plan 2016-2021, which has been extended out to 2025.
In 2021, Minister Donnelly announced additional funding to the HSE of €1.58 million to fund 24 additional lactation consultants to support more new mothers in maternity and primary care settings to breastfeed their infants. There are currently 59.1 WTE dedicated lactation posts employed in the HSE (34.5 maternity, 23.6 primary care and 1 in Children’s Health Ireland).
In the 2025 Budget, funding for an additional five lactation consultant posts was announced by the Minister of State, Colm Burke. These posts will be allocated based on service need identified in the HSE Breastfeeding Action Plan Progress report, published in September 2024.
The government recognises the invaluable role lactation consultants play in supporting new mothers to breastfeed and is committed to improving the rates of breastfeeding to promote health and wellbeing in Ireland.
1076. Deputy Ivana Bacik asked the Minister for Health in respect of the 2022 Women’s Health Action Plan, if he will report on his Department’s achievement of the maternal health goal of embedding perinatal mental health services in all maternity units. [44224/24]
Amharc ar fhreagra1077. Deputy Ivana Bacik asked the Minister for Health in respect of the 2022 Women’s Health Action Plan, if he will report on his Department’s achievement of the maternal health goal of progressing the first mother and baby unit for mothers who require inpatient mental health supports. [44225/24]
Amharc ar fhreagraI propose to take Questions Nos. 1076 and 1077 together.
Improving the outcomes and experiences of women in relation to perinatal mental health has been a priority for me and for the HSE since I became Minister. We have achieved great strides in Women’s Health since the launch of the first Women’s Health Action Plan in 2022 and the launch of the second Women’s Health Action Plan in April 2024.
In relation to perinatal mental health, these services are now available in all 19 maternity services nationwide.
The Specialist Perinatal Mental Health Services Model of Care, launched in 2017, is based on 6 Hub sites (multidisciplinary teams in Coombe, NMH, Rotunda, Galway, Cork, Limerick) and 13 spoke sites.
6 consultant-led Multi-Disciplinary teams are in place in the hub sites. Perinatal mental health midwife posts are now in place across all the 19 sites (hub and spoke).
A Steering Group has been established to refresh the Model of Care, and the Department of Health is currently considering issues raised separately in the National Women’s Council (NWC) report on Perinatal Mental Services. The Department of Health will work closely with the HSE to strengthen the Model of Care where required, to address the gaps highlighted by the report.
With regard to the development of a Mother and Baby Unit for Ireland, this is a key element of the Model of Care and progressing the Unit is a priority for me, the Department of Health and for the HSE. The HSE is currently preparing a feasibility study on building such a Unit on the Elm Park site at St. Vincent's University Hospital in Dublin. This is expected to be finalised in the near future. This would include all relevant estimated costs and timescales for the Unit, which will be then considered in due course under the HSE Capital Plan.
1078. Deputy Ivana Bacik asked the Minister for Health in respect of the 2022 Women’s Health Action Plan, if he will report on his Department’s achievement of the maternal health goal of establishing an obstetrics event support team to support families. [44226/24]
Amharc ar fhreagraThe HSE Obstetric Event Support Team (OEST) is a service provided by the HSE National Women & Infants Health Programme (NWIHP) to maternity hospitals/units to support the review process of a defined list of obstetric adverse events. The OEST provides a process for the sharing and implementation of learning and recommendations both locally and nationally. The OEST aims to support the maternity networks as they respond to the events in terms of overseeing and advising on appointment of the review panel, family engagement, conduct of the review, finalisation of the review report and follow up. In addition to assisting the health services in responding to severe maternity related incidents and in the provision of appropriate supports for patients and families, the OEST aims to ensure appropriate expert level support is available nationally by enabling learning from adverse maternity incidents to be actioned at a national level and by promoting engagement with relevant stakeholders across the maternity network.
Funding of €540,000 was provided to support the establishment and expansion of the OEST, within NWIHP, from Budget 2022 via the Women’s Health Action Plan 2022-2023. The OEST has been established and all maternity services nationally are engaging with OEST to share the learnings from events.