David Cullinane (Waterford, Sinn Fein)
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251. To ask the Minister for Health the status of the single national health fund promised under Sláintecare; and if he will make a statement on the matter. [17845/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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As committed to in the Action Plan for 2019, Sláintecare has developed proposals for multi-annual capital and current funding, including a transition fund, to support health care reform. Following Budget 2020, the Sláintecare Programme Implementation Office have been resourced with a total of €45.5 million in 2020 (with an additional €50 million in 2021) in order to progress the resourcing of enhanced community care under the capacity planning framework, and in supporting care redesign initiatives.

There is a commitment to provide €10 million in 2020, with a further committed total of €60 million in 2021, to support the development of enhanced community care that will effect a shift in care from the acute sector to the community. The additional full-year funding will provide for up to 1,000 therapists, nurses, dementia advisors and other professionals in the community. There will be also be resources of €12 million to support care redesign initiatives, along with the existing €23.5 million provided to the SPIO in 2019.

David Cullinane (Waterford, Sinn Fein)
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252. To ask the Minister for Health the number of reports produced by the Sláintecare implementation office; and if he will make a statement on the matter. [17846/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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In response to the Sláintecare Report, the government approved the Sláintecare Implementation Strategy in July 2018. The Strategy sets out the actions to be taken in the first three years of the Sláintecare implementation process. The Sláintecare Programme Implementation Office was established in September 2018 with the initial task of reviewing and refining the strategy into a detailed Action Plan for 2019. This Action Plan outlines the project management structures and governance approach for the 10-year implementation of Sláintecare, as well as detailed timeframes for 138 projects to be progressed in 2019.

The Sláintecare Programme Implementation Office was established in September 2018 and has had one full year in operation.A series of important Sláintecare reform Government decisions have been made in this time, including the agreement:

1. on the geographies for the six new Regional Health Areas which is a first major step towards restructuring our health services in line with recommendation in the Oireachtas Committee report, which is informing the development of a detailed business case for consideration by Government;

2. on revised GP contractual arrangements in April 2019, which will see a €210 million investment (40% increase) in General Practice over the next four years of which €80 million will be available for the management of chronic diseases, like diabetes and COPD, through family doctors. This is expected to benefit more than 400,000 patients; and

3. on the strengthening of the HSE with the formal appointment of the Health Service Executive (HSE) Board in June 2019 and the introduction of a new HSE Chief Executive Officer.

A Sláintecare Action Plan Year-end Report 2019 was approved by government in April and subsequently published. Including the milestones set out above, 112 actions of 138 were successfully implemented during 2019. This work has been carried out by many stakeholders, including from the Department of Health, the Health Service Executive (HSE) and the voluntary and community bodies and key partners.

Including the Sláintecare Implementation Strategy, the Sláintecare Action Plan 2019 and four quarterly reports on progress, a total of six reports have been published by the Sláintecare Programme Implementation Office since establishment.

All the publications relating to Sláintecare can be found at the following link:

David Cullinane (Waterford, Sinn Fein)
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253. To ask the Minister for Health the number of times the Cabinet committee on Sláintecare met; the dates of the meetings; and if he will make a statement on the matter. [17847/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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There is no specific Cabinet Committee in relation to Sláintecare. Discussions of Sláintecare formed part of the Social Policy and Public Services Cabinet Committee B. Sláintecare was the topic of these meetings on two occasions on 11 April 2018 and 22 November 2018.

In addition, updates on Sláintecare progress were provided to Cabinet Committee B throughout 2019. There were health specific meetings of this committee on the following dates 21 February 2019, 01 April 2019, 11 July 2019, 10 September 2019, 21 October 2019, 30 October 2019 and 09 December 2019.

Quarterly updates on Sláintecare implementation were also provided to the Cabinet throughout 2019 and 2020 through Memorandum for the Information of Government, which included the quarterly reports that were subsequently published at the following link:

David Cullinane (Waterford, Sinn Fein)
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254. To ask the Minister for Health the increase in the health and well-being budget since the adoption of Sláintecare; and if he will make a statement on the matter. [17848/20]

David Cullinane (Waterford, Sinn Fein)
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255. To ask the Minister for Health the funding allocated to resourcing and developing a universal child health and well-being service since the adoption of Sláintecare; and if he will make a statement on the matter. [17849/20]

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I propose to take Questions Nos. 254 and 255 together.

It is not possible to identify in totality how much funding is currently spent on improving health and wellbeing across all Government Departments and agencies and in wider society.

Whilst there was little change to the Health and Wellbeing budget following the immediate adoption of the Sláintecare programme, the budget for the Healthy Ireland Fund was increased from € 5million in 2017/2018 to €6 million in 2019 and 2020.

In 2019, the Department of Health launched the €20m Sláintecare Integration Fund to support successful service delivery projects that will clearly demonstrate how citizens can be offered the right care, in the right place and at the right time. These projects are offering new approaches to sickness prevention, hospital avoidance, and the delivery of care in the community.

In total 122 successful projects were selected, of which 38 related to ‘promoting the engagement and empowerment of citizens in the care of their own health’. There is a total of €6 million allocated to health and wellbeing projects which includes support for Chronic Disease Self-Management, Sexual Health Services, Smoking Cessation, Mens’ Sheds and Social Prescribing among others. This will help deliver care as close to home as possible and prevent avoidable illness at an early stage.

As the Health Service Executive may also have relevant information on this matter I have also referred the Deputy's questions to the Executive for attention and direct response to him.

David Cullinane (Waterford, Sinn Fein)
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256. To ask the Minister for Health the amount spent on removing inpatient charges for public hospital care since the adoption of Sláintecare; and if he will make a statement on the matter. [17850/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Health (Amendment) Act 2013, provided for the current public hospital statutory in-patient charge is €80 per night, subject to a maximum of €800 in any twelve consecutive months.

There has be no change to the rate or application of the in-patient charge since its introduction from 1 January 2017.

Removal of the current inpatient charge would cost approximately €30m per annum.

David Cullinane (Waterford, Sinn Fein)
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257. To ask the Minister for Health the reductions made for prescription charges for medical card holders since the adoption of Sláintecare; and if he will make a statement on the matter. [17851/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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Prescription charges were introduced to address the rising costs in the General Medical Services (GMS) scheme. The charge, which is set by regulation, has been varied on a number of occasions.

The Health Services (Prescription charges) Regulations 2017 (SI 553/2017) reduced the charge to €2 per item for all eligible persons with a monthly limit of €20.

A further amendment in 2018 under the Health Services (Prescription Charges) (Over 70s) Regulations 2018 (S.I. No. 639 of 2018) reduced the charge to €1.50 per item for persons over 70 years, with a cap of €15 per person or family per month.

David Cullinane (Waterford, Sinn Fein)
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258. To ask the Minister for Health the reductions in the threshold for the drugs payments scheme made since the adoption of Sláintecare; his plans to reduce the threshold further in Budget 2021; and if he will make a statement on the matter. [17852/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Drugs Payment Scheme (DPS) monthly threshold has been varied a number of times over the years.

The DPS threshold was last reduced by S.I. No. 59 of 2019 Health Services (Amendment) Regulations 2019 which came into effect on 1 April 2019 which reduced the monthly threshold to €124.

S.I. No. 577 of 2017 Health Services (Drug Payment Scheme) Regulations 2017 which came into effect on 1 January 2018 reduced the monthly threshold to €134.

As part of Budget 2020 the previous Government announced that the DPS threshold would be reduced to €114 from 1 September 2020.

I am now consulting with government colleagues on this proposal.

David Cullinane (Waterford, Sinn Fein)
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259. To ask the Minister for Health the changes that have been made to the drugs payment scheme threshold for singe households since the adoption of Sláintecare; the further moves being considered in relation to same; and if he will make a statement on the matter. [17853/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Drug Payment Scheme (DPS), is aimed at individuals and families who do not have a medical card and normally would have to pay the full cost of their medication. It also applies to those who have a GP visit card. Anyone ordinarily resident in Ireland may apply to join this non means tested scheme.

The monthly threshold has never been reduced exclusively for single households. It has however, been reduced for all holders of the card from a maximum of €144 a month to its current limit of €124.

As part of Budget 2020 the previous Government announced that the DPS threshold would be reduced to €114 from 1 September 2020.

I am now consulting with government colleagues on this proposal.

David Cullinane (Waterford, Sinn Fein)
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260. To ask the Minister for Health the expansion in community diagnostics that has taken place since the adoption of Sláintecare; and if he will make a statement on the matter. [17854/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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The HSE is currently rolling out a diagnostics plan that envisages a range of diagnostic/imaging services being provided across all Community Healthcare Organisations with the support of hospitals and private providers, with a particular focus on improving GP access to ultrasound. The Deputy may wish to note that in 2019, there were 67,000 ultrasound and 79,500 x-rays delivered via GP access to radiology services.

In terms of medium-term planning for additional diagnostic capacity, the National Development Plan states that, new dedicated ambulatory elective only hospital facilities will be introduced in Dublin, Galway and Cork. As per the Development plan, these facilities will provide high volume, low complexity procedures on a day and outpatient basis, together with a range of ambulatory diagnostic services.

As part of the wider Sláintecare implementation, the Elective Hospitals Oversight Group, established by the Department of Health, is currently developing a high-level facilities spatial brief and order of magnitude costs which details the elective clustering of appropriate activities for each of the three facilities in Dublin, Cork and Galway. This will also include an output and facility specification, based on efficient and effective service delivery, which will include diagnostic procedures. This is due to be completed in the Autumn of 2020.

David Cullinane (Waterford, Sinn Fein)
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261. To ask the Minister for Health the extension of counselling provided by private providers through general practitioner primary care referral since the adoption of Sláintecare; the cost of same; and if he will make a statement on the matter. [17855/20]

Mary Butler (Waterford, Fianna Fail)
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As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

David Cullinane (Waterford, Sinn Fein)
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262. To ask the Minister for Health the advances made in the development of public psychology services in primary care since the adoption of Sláintecare; the cost of additional expansion or advances; and if he will make a statement on the matter. [17856/20]

Mary Butler (Waterford, Fianna Fail)
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As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

David Cullinane (Waterford, Sinn Fein)
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263. To ask the Minister for Health the additional number of assistant and child psychologists provided as part of public psychology services since the publication of Sláintecare; and if he will make a statement on the matter. [17857/20]

Mary Butler (Waterford, Fianna Fail)
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As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

David Cullinane (Waterford, Sinn Fein)
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264. To ask the Minister for Health the estimated additional funding provided to ensure universal general practitioner care since the adoption of Sláintecare; and if he will make a statement on the matter. [17858/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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Progress continues to be made in implementing the Sláintecare plan to provide universal access to healthcare through the expansion of eligibility on a phased basis.

On 25 June, the Government gave approval for the publication of the Health (General Practitioner Service and Alteration of Criteria for Eligibility) Bill 2020. This Bill provides, amongst other things, for the phased expansion of GP care without fees to all children from 6 to 12 years of age inclusive. The Bill was published on July 01, 2020 and it is expected to proceed through the Houses of the Oireachtas in mid-July. Funding in respect of first phase of the expansion, the provision of GP care without charges to children aged 6 and 7, was provided for within the Budget 2020 package of family friendly measures, which amounts to €45m in total.

David Cullinane (Waterford, Sinn Fein)
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265. To ask the Minister for Health the estimated additional funding provided to ensure universal primary care since the adoption of Sláintecare; and if he will make a statement on the matter. [17859/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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There has been no specific allocation of funding to ensure universal primary care since the publication of the Sláintecare Implementation Strategy. However, funding for the provision of primary care services was increased in Budget 2020 in order to help deliver on the vision of Sláintecare.

The NSP 2020 allocated approximately €1.08bn for primary care services (including €160m for social inclusion), an increase of €37m on the 2019 closing budget. This allocation serves to meet a variety of costs associated with the delivery of primary care therapy services, dental services, orthodontic services, audiology services, ophthalmology, podiatry and so on. It also covers property management and lease costs associated with primary care facilities and a range of other services including paediatric homecare packages, immunisation services, GP training and GP Out of Hours Services. It does not however include expenditure associated with the Primary Care Reimbursement Service nor wider social care expenditure on services for older people, mental health or disabilities.

The primary care allocation for 2020 included €10m, building to an intended full-year investment of €60m in 2021, to provide for the enhancement of primary and community services as part of the implementation of Sláintecare. This funding will target the development of Community Healthcare Networks and the recruitment of up to 1,000 therapists, nurses and other professionals in the sector, thus further improving access to primary care services for those that need them.

David Cullinane (Waterford, Sinn Fein)
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266. To ask the Minister for Health the estimated additional funding provided to ensure universal palliative care since the adoption of Sláintecare; and if he will make a statement on the matter. [17860/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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As the Deputy will be aware, Sláintecare is the ten-year all-party Oireachtas policy, which was adopted by Government in 2017. It sets out the vision to deliver a healthcare system for the population of Ireland. The plan aims to deliver a universal health service that offers the right care, in the right place, at the right time, by the right team with a priority focus on keeping people well, developing primary and community services within a national policy context, and ensuring we have the right hospital capacity for the needs of our citizens. The Report recommended an additional investment of €10 million per annum into palliative care services over the first five years of the Report's lifespan.

A total of €100.6 million has been allocated in the National Service Plan 2020 for palliative care services this year. This represents an increase of more than 30% on provision for palliative care in 2017 when the Sláintecare Report was adopted by Government. The additional funding this year includes provision for 49 specialist palliative care inpatient beds in new hospices opening in Mayo, Waterford and Wicklow, and 6 new beds in an existing hospice unit in Kildare.

The Programme for Government identifies the north east (Cavan and Drogheda) and midlands as regions where additional hospices are required. The HSE is closely working with local hospice groups to progress these developments. Once these planned hospices are open, there will be an inpatient unit in every region of the country, providing a hub for the existing specialist palliative community homecare teams in every HSE area and supporting the discharge of patients from acute hospitals.

Since the publication of the Sláintecare report, a second paediatric consultant with a specialist interest in palliative care has been appointed. These consultants provide clinical support to parents and children in three children's hospitals in Dublin, while also providing support to paediatric units around the country. The Programme for Government commits to an increase in resources for the HSE's Children's Palliative Care Programme.

David Cullinane (Waterford, Sinn Fein)
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267. To ask the Minister for Health the estimated additional funding provided to increase homecare provision since the adoption of Sláintecare; and if he will make a statement on the matter. [17861/20]

Mary Butler (Waterford, Fianna Fail)
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As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

David Cullinane (Waterford, Sinn Fein)
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268. To ask the Minister for Health the estimated additional funding provided to ensure additional services for persons with disabilities since the adoption of Sláintecare; and if he will make a statement on the matter. [17862/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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As the Deputy will be aware, Sláintecare is the ten-year all-party Oireachtas policy setting out the vision to deliver a healthcare system for the population of Ireland. Sláintecare is about delivering a health and social care service that meets the needs of our population and attracts and retains the very best healthcare professionals, managers and staff. The plan is to deliver a universal health service that offers the right care, in the right place, at the right time, by the right team with a priority focus on keeping people well, developing primary and community services within a national policy context, and ensuring we have the right hospital capacity for the needs of our citizens.

Following the publication of the all-party Oireachtas Sláintecare report, the Sláintecare Implementation Strategy was agreed by Government in August 2018 setting out an initial set of key actions for a three-year period. In line with the Strategy, a detailed Action Plan for 2019 was developed for implementation by the Sláintecare Programme Implementation Office. A Sláintecare Action Plan is being developed covering 2020-2021, factoring in the learnings from COVID-19, the new context within which the health system operates and the agreed Programme for Government.

As set out in the table below, spending on specialist disability services has significantly increased since the adoption of Sláintecare in 2017. This year, the Disability Services budget has increased to €2,054.5 billion, which represents an increase of 7.2% on 2019.

David Cullinane (Waterford, Sinn Fein)
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269. To ask the Minister for Health the estimated additional funding made available for child and adolescent mental health teams since the adoption of Sláintecare; and if he will make a statement on the matter. [17863/20]

Mary Butler (Waterford, Fianna Fail)
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As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

David Cullinane (Waterford, Sinn Fein)
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270. To ask the Minister for Health the estimated additional funding made available for adult community mental health teams since the adoption of Sláintecare; and if he will make a statement on the matter. [17864/20]

Mary Butler (Waterford, Fianna Fail)
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As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

David Cullinane (Waterford, Sinn Fein)
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271. To ask the Minister for Health the estimated additional funding made available for old age psychiatry since the adoption of Sláintecare; and if he will make a statement on the matter. [17865/20]

Mary Butler (Waterford, Fianna Fail)
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As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

David Cullinane (Waterford, Sinn Fein)
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272. To ask the Minister for Health the estimated additional funding made available for child and adolescent mental health liaison since the adoption of Sláintecare; and if he will make a statement on the matter. [17866/20]

Mary Butler (Waterford, Fianna Fail)
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As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

David Cullinane (Waterford, Sinn Fein)
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273. To ask the Minister for Health the number of adolescent mental health teams since the adoption of Sláintecare; and if he will make a statement on the matter. [17867/20]

Mary Butler (Waterford, Fianna Fail)
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As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

David Cullinane (Waterford, Sinn Fein)
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274. To ask the Minister for Health the estimated additional funding made available for intellectual disability and mental health services since the adoption of Sláintecare; and if he will make a statement on the matter. [17868/20]

Mary Butler (Waterford, Fianna Fail)
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As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

David Cullinane (Waterford, Sinn Fein)
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275. To ask the Minister for Health the progress that has been made in reinstating the budget for the Dental Treatment Services Scheme to pre-economic crisis levels since the adoption of Sláintecare; and if he will make a statement on the matter. [17869/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Dental Treatment Services Scheme (DTSS) provides dental treatments to medical card holders. In 2010, at the request of the Department of Health, the HSE introduced changes to the Scheme to cap expenditure at the 2008 level of €63 million. Theses changes still apply, although people considered high risk are provided with additional care. Expenditure on the DTSS is linked to demand.

Smile agus Sláinte, the National Oral Health Policy, published in April 2019, sets out the new model of care delivery for dental services. It includes proposals for the introduction of packages of oral healthcare for adult medical card holders at different intervals during their life course. The packages will focus on prevention and will include examinations, advice, and preventive therapies such as scale and polish. The timeframe for the delivery of the Policy is up to 2026 and the roll-out of these packages of care will take place incrementally over the next number of years. Routine care including fillings and complex care will continue to be available.

David Cullinane (Waterford, Sinn Fein)
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276. To ask the Minister for Health if he will provide details of the expansion of public activity in public hospitals that has occurred since the adoption of Sláintecare, by area, year and speciality; the total cost of such expansion; and if he will make a statement on the matter. [17870/20]

Stephen Donnelly (Wicklow, Fianna Fail)
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The HSE's Monthly Performance Reports provide an overall analysis of key performance data from Divisions, including Acute services. The activity data reported is based on Performance Activity and Key Performance Indicators outlined in the current National Service Plan. The Performance Reports also provides an update to the Department of Health on the delivery of the NSP. The 2019 reports are available at the following link:

As this is a service-related query, I have asked the HSE to respond directly to the Deputy.