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 Header Item Written Answers Nos. 104-123
 Header Item Healthcare Policy
 Header Item Hospital Staff
 Header Item Hospital Staff
 Header Item Cannabis for Medicinal Use
 Header Item Cannabis for Medicinal Use
 Header Item Cannabis for Medicinal Use
 Header Item Cannabis for Medicinal Use
 Header Item Cannabis for Medicinal Use
 Header Item Cannabis for Medicinal Use
 Header Item Vaccination Programme
 Header Item Covid-19 Pandemic
 Header Item Vaccination Programme
 Header Item Covid-19 Pandemic
 Header Item Health Services
 Header Item Mental Health Policy
 Header Item Medical Cards
 Header Item Hospital Waiting Lists
 Header Item Covid-19 Pandemic

Thursday, 29 April 2021

Dáil Éireann Debate
Vol. 1006 No. 3
Unrevised

First Page Previous Page Page of 77 Next Page Last Page

Written Answers Nos. 104-123

Healthcare Policy

 104. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly his plans for the review and revision of Breastfeeding in a Healthy Ireland: the HSE Breastfeeding Action Plan 2016 – 2021; if a new plan will be developed for the period from 2011; and if he will make a statement on the matter. [22369/21]

Minister of State at the Department of Health (Deputy Frankie Feighan): Information on Frankie Feighan Zoom on Frankie Feighan Breastfeeding is a priority for Healthy Ireland in my Department and we work closely with the HSE National Breast Feeding Co-ordinator on the Breastfeeding in a Healthy Ireland Action Plan 2016-2021. This is the framework for progressing supports for breastfeeding in Ireland and the HSE has established the National Breastfeeding Implementation Group to progress a range of actions to:

  - improve governance and health service structures, 

  - develop new breastfeeding training programmes, 

  - develop evidenced based policies and practices

  - communicate the importance of breastfeeding through social marketing, support and advocacy and 

  - monitor and evaluate breastfeeding services.

  The National Breastfeeding Implementation Group is partnering with key divisions to provide the supports that mothers require at all stages of the breastfeeding continuum. 

   Due to the impact of the COVID-19 pandemic on the delivery of some actions, the HSE will extend the implementation of the Breastfeeding Action Plan into 2022 and continue to work on priority outstanding actions.

Hospital Staff

 105. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly if clinical midwife and nurse specialist lactation consultants have been appointed within all Irish maternity and paediatric hospitals, according to a determined births to support staff ratio, with dedicated CMS / CNS lactation in NICUs; the proportion of CMS / CNS whole-time equivalent per births in maternity units and per admissions currently; the cost of ensuring the appointment of these according to a determined births to support staff ratio; and if he will make a statement on the matter. [22370/21]

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

Hospital Staff

 106. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the number of full-time lactation consultant posts in each CHO; the cost of meeting the deficits; and if he will make a statement on the matter. [22371/21]

Minister of State at the Department of Health (Deputy Frankie Feighan): Information on Frankie Feighan Zoom on Frankie Feighan The question relates to a service matter and has been referred to the HSE for direct reply to the Deputy.

Cannabis for Medicinal Use

 107. Deputy David Cullinane Information on David Cullinane Zoom on David Cullinane asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly if an application has been received to add the PCBD110 product to the medical cannabis access programme; if so, when he expects a decision to be made on the addition of the product to the programme; and if he will make a statement on the matter. [22373/21]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly I have been informed by the Health Products Regulatory Authority that no application has been made from any prospective supplier looking to add PCBD110 to the Medical Cannabis Access Programme (MCAP).

Prospective suppliers of products to the Medical Cannabis Access Programme (MCAP) can apply to the Health Products Regulatory Authority (HPRA), acting on behalf of the Minister for Health, to have a cannabis product considered for inclusion in the schedule to the Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) Regulations 2019.

Applicants must provide evidence to demonstrate that the proposed cannabis product meets the requirements of a ‘specified controlled drug’ as defined in the MCAP legislation. The onus is on prospective suppliers to submit applications to the HPRA.

Cannabis for Medicinal Use

 108. Deputy David Cullinane Information on David Cullinane Zoom on David Cullinane asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the criteria which prospective products for the medical cannabis access programme must meet in order to be recommended for use in the programme; if trace-THC products may be considered for inclusion; and if he will make a statement on the matter. [22374/21]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly The Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) Regulations 2019 outline the legal framework for the Medical Cannabis Access Programme (MCAP) in Ireland.

  Products that meet the definition of ‘specified controlled drugs’ as per the Regulations can be assessed for inclusion in Schedule 1 of the Regulations by the HPRA.

  Products containing THC at trace levels are still subject to control under the Misuse of Drugs Act and are eligible for inclusion in the MCAP provided they meet the definition of “specified controlled drugs” in the regulations.  

  The application forms can be found on the ‘Publications and Forms’ section of www.hpra.ie or by contacting controlleddrugs@hpra.ie.

Cannabis for Medicinal Use

 109. Deputy David Cullinane Information on David Cullinane Zoom on David Cullinane asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the reason none of the four products currently recommended for use in the medical cannabis access programme meet the criteria of less than 2% THC for use in the treatment of resistant epilepsy established in the clinical guidance on cannabis for medical use of his Department; his plans to address same; and if he will make a statement on the matter. [22375/21]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly Cannabis products that can be used in the Medical Cannabis Access Programme are defined as ‘specified controlled drugs’ in legislation and the definition outlines the specific requirements for those products.

  Only products included in the schedule of specified controlled drugs can be prescribed by medical consultants under the Medical Cannabis Access Programme.

  The criteria cannabis products must meet in order to be considered by the Minister for inclusion on the schedule are set out in the legislation and can be found in the operator guidance issued by the HPRA

  Details on how to apply for a licence to possess, supply or import medical cannabis products for use under the Medical Cannabis Access Programme in accordance with the requirements for schedule 2 products in the Misuse of Drugs Regulations 2017 can be found in the operator guidance issued by the HPRA.

  It is open to any supplier or producer to apply to the HPRA to have their products assessed for inclusion in the programme.

Cannabis for Medicinal Use

 110. Deputy David Cullinane Information on David Cullinane Zoom on David Cullinane asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly when the medicinal cannabis access programme will be launched; and if he will make a statement on the matter. [22376/21]

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 the Deputy directly on this matter, as soon as possible.

Cannabis for Medicinal Use

 111. Deputy David Cullinane Information on David Cullinane Zoom on David Cullinane asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly if Brexit has had or will have implications on the supply and use of products approved for use under the medical cannabis access programme considering that products approved for use on the programme must be sold or supplied for medical purposes by the relevant public or state body of a member state other than the state and must be currently supplied to patients in the member state as outlined in the legislation; and if he will make a statement on the matter. [22377/21]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly Cannabis based products accepted for use in the medical cannabis access programme must meet the definition of a ‘specified controlled drug’ as set out in the Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) Regulations 2019. Conditions (d) and (e) of the definition stipulate that a cannabis based product must be permitted to be sold or supplied in another Member State and currently supplied to patients in that Member State.

(d) which is permitted to be sold or supplied for medical purposes by the relevant public or state body of a Member State other than the State,

(e) which is currently supplied to patients in the Member State referred to in sub-paragraph (d),

As the United Kingdom (UK) has left the European Union, it is no longer a Member State. Cannabis based products that are permitted to be sold or supplied in the UK only and/or are currently supplied to patients in the UK only do not meet the definition of a ‘specified controlled drug’. Accordingly,  applications to consider such cannabis based products for inclusion in the medical cannabis access programme cannot be accepted. 

Four cannabis based products have been accepted for use in the medical cannabis access programme to date, and a small number of applications are currently under review by the Health Products Regulatory Authority (HPRA).

Cannabis for Medicinal Use

 112. Deputy David Cullinane Information on David Cullinane Zoom on David Cullinane asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly further to Parliamentary Question No. 2152 of 21 April 2021, the exact matters which he has requested officials to examine; the barriers identified; the possible measures to rectify this problem; and if he will make a statement on the matter. [22378/21]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly Officials were asked to examine the reimbursement process. I was informed that pursuant to Section 10B of the Health Act 2004 the Minister for Health shall not give a direction under section 10, or specify a priority or performance target under section 10A, as respects:-

  (a) any function of the Executive relating to the provision of treatment or a health or personal social service to any particular person,

  (b) any function of the Executive relating to a decision concerning—

  (i) whether or not a particular person is eligible for a particular health or personal social service (including the payment of a grant or allowance),

  (ii) the extent to which and the manner in which a person is eligible for any such service.

Vaccination Programme

 113. Deputy Peadar Tóibín Information on Peadar Tóibín Zoom on Peadar Tóibín asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly when those under 16 years of age with complex medical needs including their in-home caregivers will receive the vaccine in circumstances in which it has been medically supported by a consultant such as in the case of a person (details supplied). [22380/21]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly The COVID-19 Vaccine Allocation Strategy sets out a provisional list of groups for vaccination. The Strategy was developed by the National Immunisation Advisory Committee (NIAC) and the Department of Health, endorsed by the National Public Health Emergency Team (NPHET), and approved by Government on 8 December 2020. 

  On the 23rd of February, the Minister for Health announced an update to Ireland’s COVID-19 Vaccine Allocation Strategy. In comprising the initial Vaccine Allocation Strategy, the NIAC listed several conditions associated with increased risk of severe disease and death. In the intervening period, national and international evidence has become available which has enabled a more detailed analysis of underlying conditions that may increase the risk of developing severe disease or death. The NIAC has now been able to more comprehensively identify those medical conditions and to distinguish between those which place a person at very high or high risk of severe disease if they contract the virus. Medical conditions and the magnitude of the risk they pose will continue to be monitored and periodically reviewed.  

  On the 30th of March, the Government approved a further update to the COVID-19 Vaccination Allocation Strategy. Based on clinical, scientific and ethical frameworks produced by the National Immunisation Advisory Committee and the Department of Health, following the vaccination of those most at risk, future groups will be vaccinated by age, in cohorts of 10 years (i.e., 64-55; 54-45, etc.). 

  The move to an age-based model better supports the programme objectives by: 

  - protecting those at highest risk of severe disease first, which benefits everyone most; 

  - facilitating planning and execution of the programme across the entire country; 

  - improving transparency and fairness. 

  Further details are available here: 

  https://www.gov.ie/en/press-release/93f8f-minister-donnelly-announces-update-to-irelands-vaccination-prioritisation-list/

  No vaccine has currently been approved for ages younger than 16 years.

Covid-19 Pandemic

 114. 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 his attention has been drawn to a situation whereby under S.I. No. 183 of 2021 a person entering the State who is fully vaccinated but has not completed the mandatory wait time post-vaccination (details supplied) is required to complete the full two week mandatory hotel quarantine despite becoming fully vaccinated during this time period. [22382/21]

 115. 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 his attention has been drawn to the case of a person (details supplied). [22383/21]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly I propose to take Questions Nos. 114 and 115 together.

Mandatory hotel quarantine has been introduced as one element of Ireland’s public health measures to combat the transmission of COVID-19 variants of concern.

  The Health Act 1947, as amended, provides that all persons arriving in Ireland from a designated state, or having travelled through a designated state in the previous 14 days, are required to undergo mandatory quarantine in a designated facility unless they are an exempted traveller under the Act. All applicable travellers must reserve and pay for a place in mandatory hotel quarantine. 

  Mandatory hotel quarantine is also necessary in circumstances where passengers coming from non-designated states, do not provide evidence that they have a negative or ‘not detected’ result from a COVID-19 Reverse Transcription Polymerase Chain Reaction (RT-PCR) test carried out no more than 72 hours before arrival into Ireland.   

  The Government continues to evaluate wider policy on international travel as informed by the epidemiological situation and public health advice.  

As of 17th   April, passengers who are fully vaccinated and have the documents to confirm this are no longer required to complete mandatory hotel quarantine on arrival in Ireland. Dependents, including children, will also be exempted from the requirement to complete mandatory hotel quarantine in this instance.  

  Please note that the 4 EMA approved vaccines currently accepted have specific definitions for when a person would be considered fully vaccinated. 

  The following table sets out the definition of ‘fully vaccinated’;

Type of Vaccine You are regarded as fully vaccinated after
Pfizer-BioNtech 7 days after 2nd dose
Moderna 14 days after 2nd dose
Oxford-AstraZeneca 15 days after 2nd dose
Johnson & Johnson/Janssen 14 days after single dose


  Passengers who are fully vaccinated and exempt from hotel quarantine are still subject to other travel restrictions, such as the need to provide a negative pre-departure PCR test and complete a period of self-quarantine at home or wherever specified in their passenger locator form. 

  Neither I as Minister for Health nor my Department have a role in decisions relating to whether individual persons must enter mandatory quarantine or whether individual persons are exempted travellers. All such decisions are to be determined in accordance with the provisions of the Act.

  The Government continues to advise against all non-essential international travel.

Vaccination Programme

 116. Deputy Michael Ring Information on Michael Ring Zoom on Michael Ring asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly if NIAC recommendations overrule general practitioner recommendations (details supplied); and if he will make a statement on the matter. [22384/21]

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 the deputy directly, as soon as possible.

Covid-19 Pandemic

 117. Deputy David Cullinane Information on David Cullinane Zoom on David Cullinane asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly his views on easing visiting restrictions in hospitals for patients with dementia; if the guidance will be reviewed to allow at least one family member to visit those patients; and if he will make a statement on the matter. [22389/21]

 118. Deputy David Cullinane Information on David Cullinane Zoom on David Cullinane asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly if a primary carer or family member will be allowed in hospitals to take care of persons with dementia in addition to nurses and hospital carers; and if he will make a statement on the matter. [22390/21]

Minister of State at the Department of Health (Deputy Mary Butler): Information on Mary Butler Zoom on Mary Butler I propose to take Questions Nos. 117 and 118 together.

The Health Protection Surveillance Centre has published new visiting guidance on 23rd April, which comes into effect on 4th May, and will provide additional opportunities to visit residents in long-term residential care facilities. Residents may now be facilitated to receive four routine visits per week. This will be possible following two weeks after the full vaccination of approximately 8 out of 10 of all residents in the nursing home. Otherwise, two visits per week should be facilitated. The duration of visits should be appropriate to the needs of the resident and should not be less than one hour. Where there is high vaccine coverage, 2 people may visit at a time but there is no requirement to limit the number of nominated visitors.

If a visitor is fully vaccinated and is visiting in a room with a resident who is fully vaccinated with no other person present, they do not need to wear masks or avoid physical contact.

A copy of the latest guidance can be accessed at www.hpsc.ie.

Although the situation in nursing homes has greatly improved, the risk associated with COVID-19 remains very real. There is still a risk of introduction of infection, including the possibility of a new variant of COVID-19, against which the vaccine may be less effective. Therefore, caution remains appropriate. At all times vigilance on the general infection prevention and control measures must be maintained and public health advice must continue to be followed, including when visiting, to reduce the spread of COVID-19 and protect those living in our communities. 

I have written to HIQA and all nursing home providers to emphasise the need to ensure visits take place to the greatest extent possible in line with the new guidance. I have also encouraged providers to communicate frequently and clearly with residents and families on the matter of visiting.

The guidance will be kept under continuing review as new evidence and data emerges. I have asked the HSE to reply directly to the Deputy on this matter.

Health Services

 119. Deputy Michael Healy-Rae Information on Michael Healy-Rae Zoom on Michael Healy-Rae asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly if he will address a matter regarding the case of a person (details supplied); and if he will make a statement on the matter. [22402/21]

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 the Deputy directly, as soon as possible.

Mental Health Policy

 120. Deputy Neasa Hourigan Information on Neasa Hourigan Zoom on Neasa Hourigan asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly his plans to address concerns raised in correspondence (details supplied) in relation to mental health reform; and if he will make a statement on the matter. [22413/21]

Minister of State at the Department of Health (Deputy Mary Butler): Information on Mary Butler Zoom on Mary Butler I recently received the correspondence referred to by the Deputy. I am giving detailed consideration to the concerns raised, in consultation as appropriate with other relevant areas within the Department and with the HSE. I will revert to the organisation in question at an early date.

Medical Cards

 121. Deputy Robert Troy Information on Robert Troy Zoom on Robert Troy asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly if a medical card will be awarded to a person (details supplied). [22423/21]

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 the Deputy directly, as soon as possible.

Hospital Waiting Lists

 122. Deputy Richard O'Donoghue Information on Richard O'Donoghue Zoom on Richard O'Donoghue asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the position regarding the increasing waitlists across all departments within the HSE; his plans to resolve the issue of backlogs; and if he will make a statement on the matter. [22425/21]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly It is recognised that waiting times for scheduled appointments and procedures have been impacted in the last year as a direct result of the COVID-19 pandemic.

Elective hospital care was curtailed for the first quarter of 2021, in line with the rapid increase in Covid -19 hospital admissions, with only critical time dependent elective procedures undertaken.

On 23 March the HSE published the “Safe Return to Health Services Plan”. This plan outlines a three phased approach for the proposed restoration of services across Community Services, Acute Hospital Operations, Cancer Services and Screening Services. It sets target times for their safe return and details the conditions and challenges that will have to be met. Every phase of the plan has been informed by clinical guidance and putting patient and staff safety first. Decisions in relation to the type and volume of activity will be made at site level based on local COVID-19 numbers, available capacity and guidance from national clinical leads.

The schedule outlined in the plan for resumption of services will be regularly monitored by the HSE and updated as appropriate, dependant on public health advice and healthcare capacity.

Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.

€240 million has been provided in Budget 2021 for access to care, €210m of which has been allocated to the HSE and a further €30m to the National Treatment Purchase Fund. This will be used to fund additional capacity to address the shortfall arising as a result of measures taken in the context of COVID-19, as well as to address waiting lists.

The National Treatment Purchase Fund is working closely with Public Hospitals to arrange treatment for clinically suitable patients and as of the end of March, almost 6,000 Inpatient and Day cases, and 4,000 G.I. Scopes offers of treatment had been accepted year-to-date. In terms of Outpatients, the National Treatment Purchase Fund had arranged almost 7,000 appointments by the end of March.

The HSE has advised that as of the end of March 2021, more than 6,700 patients had been seen at City West Convention Centre across a range of outpatient and daycase clinics since the site started to be used for HSE activity in August 2020. There are currently a number of initiatives taking place in conjunction with Children’s Heath Ireland, Ireland East, and Dublin Midlands Hospital Groups.

In response to the COVID-19 pandemic, and in order to continue to provide outpatient access for patients, there has been substantial development in virtual outpatient consultations across acute hospital services. The use of telemedicine has allowed Outpatient activity to continue for clinically suitable patients, reducing the footfall in hospitals and facilitating infection control and social distancing requirements. The HSE has advised that a total of 657,415 virtual outpatient consultations took place in 2020 from March to December (when reporting process commenced). This represents over 27% of the OPD activity during this period. The HSE has further advised that at the end of March 2021 a total of 227,122 patients had been seen virtually year to date.

Covid-19 Pandemic

 123. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly if persons working in the Covid-19 testing centres as volunteers or paid have access to high-quality masks of a similar grade to that used in a clinical setting; and if he will make a statement on the matter. [22434/21]

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 the deputy directly, as soon as possible.


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