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 Header Item Written Answers Nos. 329-344
 Header Item Hospital Waiting Lists
 Header Item Hospital Waiting Lists
 Header Item Hospital Staff
 Header Item Hospital Waiting Lists
 Header Item Respite Care Services
 Header Item Disability Services Provision
 Header Item Disability Services Funding
 Header Item Health Services
 Header Item Health Services
 Header Item Addiction Treatment Services
 Header Item Medicinal Products
 Header Item Addiction Treatment Services
 Header Item Nursing Home Accommodation
 Header Item Dental Services

Wednesday, 29 July 2020

Dáil Éireann Debate
Vol. 996 No. 2
Unrevised

First Page Previous Page Page of 101 Next Page Last Page

Written Answers Nos. 329-344

Hospital Waiting Lists

 329. Deputy Thomas Gould Information on Thomas Gould Zoom on Thomas Gould asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the number of persons awaiting a colonoscopy in the Mercy Hospital; the number waiting up to 30 days, 30 to 60 days, 60 to 90 days and more than 90 days, in tabular form; and if he will make a statement on the matter. [19469/20]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly In response to the Covid-19 pandemic the HSE had to take measures to pause most elective scheduled care activity with effect from the end March 2020. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by National Public Health Emergency Team (NPHET) and in accordance with World Health Organisation guidelines, and the National Action Plan.

  The trajectory of the disease means there is now an opportunity for increasing the provision of non-covid care including more routine care. NPHET has since revised its recommendation on the pausing of all non-essential health services, with a recommendation that the delivery of acute care be determined by appropriate clinical and operational decision making.

  Application of the essential risk mitigating steps set out in the guidance developed under the auspices of the NPHET Expert Advisory group will have operational implications, which will impact on throughput. 

  Where possible, hospitals are working to find innovative ways to enable service provision, which include virtual clinics for some outpatient department appointments. The HSE website provides details on services currently available and operational in each hospital on its website. This information is reviewed frequently and provides up-to-date announcements on services available at each site (www2.hse.ie/services/hospital-service-disruptions/hospital-service-disruptions-covid19.html).

  To ensure services are re-introduced in a safe, clinically-aligned and prioritised way, the HSE launched its Strategic Framework for ‘Service Continuity in a Covid Environment’ on 24 June.  Its implementation will ensure service resumption is done in an integrated way. This will involve a phased approach to ensure community services are strengthened. The Framework will also consolidate new ways of working and build on international knowledge. Further detail regarding the phases of service resumption are contained in the HSE’s ‘A Safe Return to Health Services’ document, published on their website on 22 July.

  As the system continues to deliver Covid-19 and non-Covid 19 care side-by-side over a more prolonged period, my Department and the HSE will continue to work closely together to protect essential non-Covid 19 acute care and progress the provision of more routine non Covid-19 care.

  In relation to the particular query raised by the Deputy concerning colonoscopies, as this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Hospital Waiting Lists

 330. Deputy Thomas Gould Information on Thomas Gould Zoom on Thomas Gould asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the number of persons awaiting an endoscopy in the Mercy Hospital; the number waiting up to 30 days, 30 to 60 days, 60 to 90 days and more than 90 days, in tabular form; and if he will make a statement on the matter. [19470/20]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly In response to the Covid-19 pandemic the HSE had to take measures to pause most elective scheduled care activity with effect from the end March 2020. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by National Public Health Emergency Team (NPHET) and in accordance with World Health Organisation guidelines, and the National Action Plan.

  The trajectory of the disease means there is now an opportunity for increasing the provision of non-covid care including more routine care. NPHET has since revised its recommendation on the pausing of all non-essential health services, with a recommendation that the delivery of acute care be determined by appropriate clinical and operational decision making.

  Application of the essential risk mitigating steps set out in the guidance developed under the auspices of the NPHET Expert Advisory group will have operational implications, which will impact on throughput. 

  Where possible, hospitals are working to find innovative ways to enable service provision, which include virtual clinics for some outpatient department appointments. The HSE website provides details on services currently available and operational in each hospital on its website. This information is reviewed frequently and provides up-to-date announcements on services available at each site (https://www2.hse.ie/services/hospital-service-disruptions/hospital-service-disruptions-covid19.html).

  To ensure services are re-introduced in a safe, clinically-aligned and prioritised way, the HSE launched its Strategic Framework for ‘Service Continuity in a Covid Environment’ on 24 June.  Its implementation will ensure service resumption is done in an integrated way. This will involve a phased approach to ensure community services are strengthened. The Framework will also consolidate new ways of working and build on international knowledge. In addition, the HSE published 'A Safe Return to Health Services' last week, which is a Service Continuity Roadmap for the resumption of services across the health system. 

  As the system continues to deliver Covid-19 and non-Covid 19 care side-by-side over a more prolonged period, my Department and the HSE will continue to work closely together to protect essential non-Covid 19 acute care and progress the provision of more routine non Covid-19 care.

  In relation to endoscopy services, a national programme was established in mid-2016 to coordinate several activities to improve endoscopy services. The Endoscopy Programme is housed within the Acute Operations Division of the HSE and the programme is overseen by the National Endoscopy Steering Group. The programme team consists of a Clinical Lead, Training Lead, Nurse Lead and Programme Manager. The team are supported by the National Endoscopy Working Group.

  The aim of the programme is to improve the delivery of endoscopy services across all Hospital Groups.

  The Endoscopy data requested by the Deputy is outlined in the following table.

Mercy University Hospital GI Scopes Waiting List June 2020  
0-1 Mth 85
1-2 Mths 44
2 Mths- 3 Mths 40
+3 Mths 481
Total  650

Hospital Staff

 331. Deputy Thomas Gould Information on Thomas Gould Zoom on Thomas Gould asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the number of vacancies at the Mercy Hospital; the grade of each vacancy; the length of time of the vacancy in tabular form; and if he will make a statement on the matter. [19471/20]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly As this is a service matter, I have asked the Health Service Executive to respond to you directly as soon as possible.

Hospital Waiting Lists

 332. Deputy Thomas Gould Information on Thomas Gould Zoom on Thomas Gould asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the number of persons awaiting a needs assessment in the Mercy Hospital; the number waiting less than three months, three months to six months, six months to 12 months and more than 12 months, respectively in tabular form; and if he will make a statement on the matter. [19472/20]

 333. Deputy Thomas Gould Information on Thomas Gould Zoom on Thomas Gould asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the number of persons awaiting a speech and language appointment in CHO4; the number waiting less than three months, three months to six months, six months to 12 months and more than 12 months, respectively in tabular form; and if he will make a statement on the matter. [19473/20]

 334. Deputy Thomas Gould Information on Thomas Gould Zoom on Thomas Gould asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the number of persons awaiting an occupational therapy appointment in CHO4; the number waiting less than three months, three months to six months, six months to 12 months and more than 12 months, respectively in tabular form; and if he will make a statement on the matter. [19474/20]

Minister of State at the Department of Health (Deputy Anne Rabbitte): Information on Anne Rabbitte Zoom on Anne Rabbitte I propose to take Questions Nos. 332 to 334, inclusive, together.

The recently published Programme for Government document "Our Shared Future" recognises the need to improve services for both children and adults with disabilities through better implementation and by working together across Government in a better way. 

  The  Government commits to prioritising early diagnosis and access to services for children and ensuring that the most effective interventions are provided for each child, to guarantee the best outcomes.

  As the Deputy's questions relate to service issues, they have been referred to the HSE for direct reply. 

Respite Care Services

 335. Deputy Thomas Gould Information on Thomas Gould Zoom on Thomas Gould asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the number of respite hours provided to families in north central areas of County Cork over each of the past 12 months; the number provided in each month since March 2020; and if he will make a statement on the matter. [19476/20]

Minister of State at the Department of Health (Deputy Anne Rabbitte): Information on Anne Rabbitte Zoom on Anne Rabbitte The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives.

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.  

Disability Services Provision

 336. Deputy Thomas Gould Information on Thomas Gould Zoom on Thomas Gould asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the number of day-care centres in north central areas of County Cork that have now reopened; the number that will be reopened by September 2020; the number that will not be in a position to reopen by September 2020; and if he will make a statement on the matter. [19477/20]

Minister of State at the Department of Health (Deputy Anne Rabbitte): Information on Anne Rabbitte Zoom on Anne Rabbitte As part of the overall effort to contain the spread of COVID-19 and in line with public health advice, day service locations closed in March.

Since then, HSE Disability Services have been working to develop national guidance on the part of the disability sector to direct how all day services can be delivered. The Guidance to support the Framework for the Resumption of Adult Disability Day Services was published by the HSE on 8 July 2020.

In developing the guidance document to guide providers, the HSE worked closely with service providers through representative organisations such as the National Federation of Voluntary Service Providers, Disability Federation of Ireland and the Not for Profit Association, in addition to Inclusion Ireland, who represent people with intellectual disabilities and their families.

The guidance document seeks to support the safe return of services in the context of ongoing public health guidance. It also recognises that the impact of public health guidance will result in services being provided at a reduced level and will require changes in how people are supported, increased use of technology where appropriate and more use of outreach supports.

Day services will gradually resume during the month of August. Service providers are already working to get day services ready to reopen safely, and in line with public health guidance. Service providers will be in touch with all families and service users during the month of July to discuss when they may expect the resumption of their service and what that service will consist of.

I want to acknowledge the many challenges experienced by individuals and their families over this difficult time. Families across the country have had their routines upended due to the impact of COVID-19 and I hope that this will be the first step towards returning to some sense of normalcy.

The Guidance to support the Framework for Resumption of Adult Disability Day Services is available on the New Directions website: www.hse.ie/newdirections. The HSE have also issued monthly communications updates for service users and their families, the latest leaflet “Adult Disability Day Services and COVID-19 - What’s Happening? July 2020” is available at the above link.  

An information portal that will contain the dates on which the 966 disability day service locations will reopen around the country is being developed. After August 4th service users and families will be able to access this information on www.hse.ie/newdirections.

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Disability Services Funding

 337. Deputy Thomas Gould Information on Thomas Gould Zoom on Thomas Gould asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the number of day care centres for persons with intellectual disabilities in north central areas of County Cork that have submitted applications for funding in order to reopen; the amount required; the amount allocated to date by his Department; the amount that will be allocated; and if he will make a statement on the matter. [19478/20]

Minister of State at the Department of Health (Deputy Anne Rabbitte): Information on Anne Rabbitte Zoom on Anne Rabbitte As part of the overall effort to contain the spread of COVID-19 and in line with public health advice, day service locations closed in March.

  Since then, HSE Disability Services have been working to develop national guidance on the part of the disability sector to direct how all day services can be delivered. The Guidance to support the Framework for the Resumption of Adult Disability Day Services was published by the HSE on 8 July 2020.

  In developing the guidance document to guide providers, the HSE worked closely with service providers through representative organisations such as the National Federation of Voluntary Service Providers, Disability Federation of Ireland and the Not for Profit Association, in addition to Inclusion Ireland, who represent people with intellectual disabilities and their families.

  The guidance document seeks to support the safe return of services in the context of ongoing public health guidance. It also recognises that the impact of public health guidance will result in services being provided at a reduced level and will require changes in how people are supported, increased use of technology where appropriate and more use of outreach supports.

  Day services will gradually resume during the month of August. Service providers are already working to get day services ready to reopen safely, and in line with public health guidance. Service providers will be in touch with all families and service users during the month of July to discuss when they may expect the resumption of their service and what that service will consist of.

  I want to acknowledge the many challenges experienced by individuals and their families over this difficult time. Families across the country have had their routines upended due to the impact of COVID-19 and I hope that this will be the first step towards returning to some sense of normalcy.

The Guidance to support the Framework for Resumption of Adult Disability Day Services is available on the New Directions website: www.hse.ie/newdirections  . The HSE have also issued monthly communications updates for service users and their families, the latest leaflet “Adult Disability Day Services and COVID-19 - What’s Happening? July 2020” is available at the above link.  

An information portal that will contain the dates on which the 966 disability day service locations will reopen around the country is being developed. After August 4th service users and families will be able to access this information on www.hse.ie/newdirections  

  It has been recognised that additional costs may arise for service providers in providing safe services. To date, Government has approved COVID 19 Pandemic Health service funding of €2bn. The aim of this funding is to support investment necessary to address COVID 19, to mitigate risk of the spread of COVID 19 and to facilitate the provision of health and social care services against the backdrop of COVID 19. The HSE is in the process of reviewing and validating business cases from disability services providers for additional funding to support the reopening of services

  As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.   

Health Services

 338. Deputy Thomas Gould Information on Thomas Gould Zoom on Thomas Gould asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the number of persons on the waiting list for ophthalmology in north central areas of County Cork; the average waiting time for an appointment; and if he will make a statement on the matter. [19479/20]

: Information on Stephen Donnelly Zoom on Stephen Donnelly Reducing waiting time for patients for hospital operations and procedures is a key priority for Government. In recent years, my Department has worked with the HSE and the National Treatment Purchase Fund (NTPF) and made considerable improvements to access for patients waiting for high volume procedures including cataracts. At the end of July 2017, the number of people waiting for a cataract procedure was 10,024. As of the end of June 2020, there were 6,023 patients waiting for a cataract procedure. Of these, 1,039 are waiting over 9 months which represents a reduction of 76% when compared to July 2017, when there were 4,249 waiting over 9 months.

  A key development in improving access to Ophthalmology services was the opening of a stand-alone high-volume consultant-led cataract theatre by the University of Limerick Hospital Group in Nenagh Hospital in 2018, with the intention that it would facilitate patients from surrounding geographical areas to avail of their treatment there.

  In response to the Covid-19 pandemic the HSE had to take measures to pause most elective scheduled care activity with effect from the end March 2020. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by National Public Health Emergency Team (NPHET) and in accordance with World Health Organisation guidelines, and the National Action Plan.

  NPHET has since revised its recommendation on the pausing of all non-urgent health services, with a recommendation that the delivery of acute care be determined by appropriate clinical and operational decision making. Application of the essential risk mitigating steps set out in the guidance developed under the auspices of the NPHET Expert Advisory group will have operational implications, which will impact on throughput.

  To ensure services are re-introduced in a safe, clinically-aligned and prioritised way, the HSE launched its Strategic Framework for ‘Service Continuity in a Covid Environment’ on 24 June.  Its implementation will ensure service resumption is done in an integrated way. This will involve a phased approach to ensure community services are strengthened. The Framework will also consolidate new ways of working and build on international knowledge.  In addition, the HSE published 'A Safe Return to Health Services' last week, which is a Service Continuity Roadmap for the resumption of services across the health system.

  Where possible, hospitals are working to find innovative ways to enable service provision, which include virtual clinics for some outpatient department appointments. The HSE website provides details on services currently available and operational in each hospital on its website. This information is reviewed frequently and provides up-to-date announcements on services available at each site (https://www2.hse.ie/services/hospital-service-disruptions/hospital-service-disruptions-covid19.html).

  As the system continues to deliver Covid-19 and non-Covid 19 care side-by-side over a more prolonged period, my Department and the HSE will continue to work closely together to protect essential non-Covid 19 acute care and progress the provision of more routine non Covid-19 care.

  The data requested by the Deputy concerning ophthalmology, is outlined in the attached document. The NTPF advised that Area of Residence coding cannot differentiate between North/South Cork. This information is instead presented by City/County instead.

Specialty Name Area Of Residence Amount Average Num Days
Ophthalmology Cork (City)
129
170
Ophthalmology Cork (County)
312
186

Health Services

 339. Deputy Thomas Gould Information on Thomas Gould Zoom on Thomas Gould asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the number of persons in north central areas of County Cork who are waiting for an appointment for early intervention by therapy; the number who are waiting less than six months, six months to 12 months and more than 12 months, in tabular form; and if he will make a statement on the matter. [19480/20]

Minister of State at the Department of Health (Deputy Mary Butler): Information on Mary Butler Zoom on Mary Butler As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Addiction Treatment Services

 340. Deputy Thomas Gould Information on Thomas Gould Zoom on Thomas Gould asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the number of detoxification and rehabilitation treatment beds by region in each of the years 2010 to 2019 and to date in 2020, in tabular form. [19507/20]

Minister of State at the Department of Health (Deputy Frankie Feighan): Information on Frankie Feighan Zoom on Frankie Feighan As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Medicinal Products

 341. Deputy Thomas Gould Information on Thomas Gould Zoom on Thomas Gould asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly if a drugs-monitoring scheme for distribution of prescribed medicines has been implemented. [19508/20]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly Medicines which have a high potential to be misused are subject to stricter controls under the Misuse of Drugs Acts 1977 to 2016 and the Misuse of Drugs Regulations and Orders 2017. The legislation imposes restrictions on the possession, production, supply, importation and exportation of controlled drugs.

In 2017, the Misuse of Drugs Regulations were updated and additional controls on benzodiazepines and so-called 'z-drug' sedatives were introduced, including import and export controls, stricter prescribing and dispensing controls, as well as an offence of possession, thereby assisting Customs and An Garda Síochána in protecting public health and local communities.

The amendments to the Regulations also afforded practitioners an opportunity to review patients receiving such medications and allow them to make brief interventions with these patients. Brief interventions have been shown to be of value in reducing prescription usage of these potent medicines.

In October 2017 the Medical Council of Ireland and the Pharmaceutical Society of Ireland launched joint guidance on the Safe Prescribing and Dispensing of Controlled drugs. The aim of this resource was to facilitate safer prescribing and dispensing of controlled drugs. It should be used by all prescribers and pharmacists in the collaborative, safe and effective care of patients.  

In further support of the legislative changes, in February 2018, the HSE Medicines Management Programme (MMP) published “Guidance on appropriate prescribing of benzodiazepines and z-drugs (BZRA) in the treatment of anxiety and insomnia”. It contains information on initiation and review of BZRA, highlighting the potential dangers associated with long-term use and provides examples of resource materials which may support prescribers and pharmacists to manage the withdrawal of patients from these medicines. 

More recently, officials in the Department of Health have been working with stakeholders, including prescribers, pharmacists and the HSE, facilitated by the Medical Council, to further examine the issue of the prescribing of benzodiazepines and other controlled drugs and to build on the changes introduced in 2017. This is providing a platform for key stakeholders to work together to develop initiatives, led by the respective stakeholders, to better address the difficulties associated with the prescribing of controlled drugs.

This group, via the HSE MMP, has prepared support materials, including posters for GP waiting rooms and community pharmacies, and patient guides to better inform both prescribers and patients of the potential risks associated with the prescribing of controlled drugs.  

Officials from the Department of Health are continuing to engage with and support the work of this group as it considers potential solutions to ensure greater visibility and governance around the prescribing and dispensing of controlled drugs in order to ensure the safe, appropriate and efficacious use of these important but potent medicines.

Addiction Treatment Services

 342. Deputy Thomas Gould Information on Thomas Gould Zoom on Thomas Gould asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the funding available to prevent gambling addiction; the amount available to treat gambling addiction; and the number of publicly funded treatment places for those specifically suffering from a gambling addiction.  [19509/20]

Minister of State at the Department of Health (Deputy Frankie Feighan): Information on Frankie Feighan Zoom on Frankie Feighan The Health Service Executive has responsibility for the provision of addiction treatment services.

  People who present to the HSE for addiction treatment for gambling are offered the same range of interventions as those who present with a drug and alcohol addiction, or a mental health concern, including an initial assessment, a comprehensive assessment, and individual counselling.

  Figures produced by the HSE show that the number of cases where people presented with problem gambling were 208 in 2015, 195 in 2016 and 219 in 2017.

  The HSE also provides funding to a number of voluntary sector providers who treat gambling addiction, along with drug and alcohol addictions.

  The Department of Justice and Equality has responsibility for gambling regulation. In March 2019, the Government published the Inter-Departmental Working Group Report on Future Licensing and Regulation of Gambling. This report refers to the introduction of a modern licensing approach to all gambling activities, including enhanced protection of consumers and vulnerable individuals.

  The report addresses the social impact of gambling, including the issue of problem gambling. It notes the social and health impacts of problem gambling and acknowledges that problem gambling can lead to social breakdown, with devastating financial losses and alienation of family and friends. Problem gambling can be associated with a range of harms including higher risk of psychiatric disorders, alcohol and drug misuse, physical and mental health issues, separation and divorce, unemployment and insolvency

  The 2014/15 Drug Prevalence Survey provides the first comprehensive set of data on the extent of gambling in Ireland. The results indicate that 64.5% of the population report some form of gambling in the 12 months prior to the survey, with 41.4% gambling on a monthly basis, or more often. The survey further found that prevalence of problem gambling in the general population was 0.8%.

  The survey is being repeated for 2018/2019 under the auspices of the Health Research Board (HRB) with initial findings expected to be published in 2020.

  The Working Group recommended that:

- funding be made available for research, training, and community interventions into treatment of gambling addiction.

- funding of public education and awareness raising programmes and the production of relevant information materials be supported.

- assistance be given in the provision of additional services to treat gambling addiction.

  In order to meet these objectives, the Group recommended that a Social Fund, managed by the gambling regulatory authority should be established.

  I support the recommendations of the working group report to address the social impact of gambling and to establish a social fund, managed by the gambling regulatory authority.

   

Nursing Home Accommodation

 343. Deputy Thomas Gould Information on Thomas Gould Zoom on Thomas Gould asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the number of publicly funded residential care homes for the elderly in Cork city in each of the years 2010 to 2019 and to date in 2020, in tabular form. [19510/20]

Minister of State at the Department of Health (Deputy Mary Butler): Information on Mary Butler Zoom on Mary Butler As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Dental Services

 344. Deputy Thomas Gould Information on Thomas Gould Zoom on Thomas Gould asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly if a replacement service in the community will be opened due to the closure of dental clinics (details supplied). [19511/20]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly As this is a service matter it has been referred to the HSE for attention and direct reply to the Deputy.

   


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