Holly Cairns (Cork South West, Social Democrats)
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3258. To ask the Minister for Health the steps he is taking to fulfil the Programme for Government commitment to provide free contraception over a phased period, starting with women aged 17 to 25 years of age. [41100/21]

Frank Feighan (Sligo-Leitrim, Fine Gael)
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Following the recommendations of the Joint Committee on the Eighth Amendment of the Constitution, a Working Group was established in April 2019 to consider the range of policy, regulatory and legislative issues arising in relation to improving access to contraception in Ireland.

The Group’s high-level report, published in October 2019, identified the barriers that exist to accessing contraception and the mechanisms available to overcome those barriers, noting that any policy proposal must focus on accessibility, education, and workforce capacity as well as cost.

A sizable body of work remains to be addressed in order to develop and finalise the policy approach, bring forward the necessary legislative proposals and ensure the implementation of service delivery arrangements.

It is however important to stress that my Department and this Government remain committed to providing free contraception over a phased basis, starting with women aged 17 – 25, as set out in the Programme for Government.

Progress on these issues has unfortunately been delayed until recently, given the need to focus on and prioritise the response to the ongoing Covid-19 pandemic. However, the Department is currently assembling a Contraception Implementation Group, which will commence work imminently.

Some access to free contraception is already enabled, through the National Condom Distribution Service (NCDS), which was established by the HSE Sexual Health and Crisis Pregnancy Programme (SHCPP) in October 2015.The NCDS functions as a central point for distributing free condoms and lubricant sachets to HSE services and other organisations working with individuals and groups at increased risk of negative sexual health outcomes.

These include migrants; young people; gay, bisexual and other MSM; sex workers; people living with addiction issues and people living with HIV. From 2017 to the end of 2019, the number of organisations ordering from the NCDS has doubled.

The service was extended to 3rd level institutions in late 2019. Third-level institutions can now order condom dispensers from the HSE, which enable the provision of free condoms and sexual health information to students on campuses nationwide. The SHCPP advises that 3rd level institutions will be contacted, prior to the commencement of on-campus attendance in September, with regard to their engagement with the NCDS.

Information leaflets are provided with the condom dispensers, which outline to students how to use condoms correctly, and emphasise the importance of using condoms consistently and every time sex happens. The information leaflets direct students to HSE - led and HSE-funded websites for further information about sexual health and wellbeing; www.sexualwellbeing.ie and www.man2man.ie.

It should be noted that, while oral contraception and various forms of long-acting reversible contraception can be more effective at preventing pregnancy, condoms provide protection against STIs that is not provided by non-barrier forms of contraception.

It is envisaged that continued expansion of the NCDS will be facilitated in line with demand, in order to support the STI prevention and sexual health promotion needs of people living in Ireland.

Holly Cairns (Cork South West, Social Democrats)
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3259. To ask the Minister for Health the steps he is taking to fulfil the Programme for Government commitment to introduce a publicly funded model of care for fertility treatment. [41101/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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As the Deputy is aware, a commitment to introduce the model of care for infertility, which was developed by officials in my Department in conjunction with the HSE’s National Women & Infants Health Programme, is included in the Programme for Government, “Our Shared Future”. This model of care will ensure that infertility issues will be addressed through the public health system at the lowest level of clinical intervention necessary as part of the full range of services available in obstetrics and gynaecology.

Phase One of the roll-out of the model of care has commenced and involves the establishment, at secondary care level, of Regional Fertility Hubs in maternity networks, which will facilitate the management of a significant proportion of patients presenting with infertility issues.

Funding of €2m was provided to the HSE to commence Phase One of the roll-out of the model of care in 2020. This was utilised specifically in respect of the development of the first four Regional Fertility Hubs – namely, Cork Maternity University Hospital, the Rotunda Hospital, the National Maternity Hospital and the Coombe Women & Infants University Hospital.

Additional funding of just over €1m has been made available to enable the continuation of Phase One of the roll-out in 2021, including through the setting-up of the final two Regional Fertility Hubs, one located within the Saolta Hospital Group, at University Hospital Galway, and one within the University of Limerick Hospital Group, at Nenagh General Hospital. Therefore, the completion of Phase One of the roll-out will result in fully operational Regional Fertility Hubs in each of the six Hospital Groups across the country.

Phase Two of the roll-out will see the introduction of advanced infertility interventions including IVF, in the public health system. Phase Two will not commence until such time as infertility services at secondary level have been developed across the country, required resources have been allocated, and the assisted human reproduction (AHR) legislation is commenced. Drafting of the AHR legislation is ongoing, in conjunction with the Office of the Attorney General.

It is intended that, in line with available resources, this model of care for infertility will be rolled out on a phased basis over the course of the coming years. The underlying aim of the policy to provide a model of funding for AHR, within the broader AHR regulatory framework, is to improve accessibility to AHR treatments, while at the same time embedding safe and appropriate clinical practice and ensuring the cost-effective use of public resources.

Holly Cairns (Cork South West, Social Democrats)
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3260. To ask the Minister for Health the steps he is taking to fulfil the Programme for Government commitment to promote an increase in the number of new mothers breastfeeding by increasing support in maternity hospitals and primary care centres through access to lactation specialists and public health nurses. [41102/21]

Frank Feighan (Sligo-Leitrim, Fine Gael)
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This year, Healthy Ireland and Sláintecare have made a significant investment towards implementing the National Breastfeeding Action Plan. We all know how important it is that our children get the best possible start in life and this is something all Government partners have prioritised in the Programme for Government.

Ireland has a culture of bottle feeding and in order to improve child and maternal health, as well as reducing childhood obesity we need to improve our breastfeeding rates. On 11th May, I announced funding of €1.58m euros to provide the additional 24 Lactation Consultants across hospital and community settings, that are required to ensure timely skilled assistance for mothers who wish to breastfeed. It will also support enhanced training, skills and knowledge to frontline staff.

Holly Cairns (Cork South West, Social Democrats)
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3261. To ask the Minister for Health the steps he is taking to fulfil the Programme for Government commitment to fully implement the recommendations contained in the reports of the scoping inquiry and all other reports into CervicalCheck. [41103/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Programme for Government commits to fully implement the recommendations contained in Dr Scally’s Report of the Scoping Inquiry, and all other reports into CervicalCheck.

Significant progress has been made in implementing the recommendations and associated actions from Dr Scally's report, across all themes and areas of work, by the Department of Health, the HSE and the National Cancer Registry Ireland. In addition, the CervicalCheck Steering Committee, chaired by Professor Anne Scott, and which includes representatives from 221+ Group and patient advocates in its membership have a role in oversight of the implementation of the remaining recommendations.

At the end of Quarter 2 2021, 164 of the 170 actions, arising from 58 recommendations, are completed. Work is well underway in completing the 6 remaining actions. Since Quarter 1 2019, the Department of Health has been publishing quarterly progress reports on the implementation of the recommendations made in Dr Scally’s 2018 report and the full archive and previous quarterly progress reports is available on the Department of Health website.

It is important to acknowledge, as well as the ongoing developments in the CervicalCheck programme and the National Screening Service, the implementation of many recommendations continues to have a wider impact on many areas of health policy and programme delivery. This includes the ongoing work of the National Screening Advisory Committee and the Women’s Health Taskforce, for example, as well as ongoing policy development around issues such as open disclosure, and patient and public participation in health policy development and implementation.

Holly Cairns (Cork South West, Social Democrats)
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3262. To ask the Minister for Health the steps he is taking to fulfil the Programme for Government commitment to support the CervicalCheck screening programme and promote the uptake of the HPV vaccine. [41104/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Programme for Government commits to supporting the CervicalCheck Screening Programme and promoting the uptake of the HPV vaccine. To achieve this requires a well organised screening programme, combined with HPV vaccination for boys and girls, so that Ireland can look forward to a significant reduction in the incidence of cervical cancer cases over the next 10-20 years.

The Programme for Government commits to fully implement the recommendations contained in Dr Scally’s Report of the Scoping Inquiry, and all other reports into CervicalCheck. In this regard, significant progress has been made in implementing the recommendations and associated actions from Dr Scally's report, across all themes and areas of work, by the Department of Health, the HSE and the National Cancer Registry Ireland. In addition, the CervicalCheck Steering Committee, chaired by Professor Anne Scott, and which includes representatives from 221+ Group and patient advocates in its membership have a role in oversight of the implementation of the remaining recommendations. At the end of Quarter 2 2021, 164 of the 170 actions, arising from 58 recommendations, are completed. Work is well underway in completing the 6 remaining actions. Since Quarter 1 2019, the Department of Health has been publishing quarterly progress reports on the implementation of the recommendations made in Dr Scally’s 2018 report and the full archive and previous quarterly progress reports is available on the Department of Health website. The Government approved €10 million in funding for Cancer Screening in 2021, this investment represents a real commitment to improving healthcare for the women of Ireland. Details of the specific service improvements and investments are set out in the HSE National Service Plan 2021.

In 2009, the National Immunisation Advisory Committee (NIAC) recommended HPV (human papillomavirus) vaccination for all 12 to 13 year old girls to reduce their risk of developing cervical cancer when they are adults. In September 2010, the HPV vaccination programme was introduced for all girls in the first year of secondary school. The NIAC recommended that the HPV vaccine should also be given to boys. On foot of NIAC’s recommendation, my Department asked the Health Information and Quality Authority (HIQA) to undertake a health technology assessment (HTA) to establish the clinical and cost-effectiveness of extending the current immunisation programme to include boys in the first year of secondary school. HIQA completed the HTA in December 2018, recommending that the HPV immunisation programme be extended to include boys. A policy decision was made to extend the HPV immunisation programme to include boys. This started in September 2019 with the introduction of a 9-valent HPV vaccine.

It is important to note that the schools-based immunisation programme for the 2019/2020 academic year has been completed and the uptake rates for the HPV vaccine in that academic year are 82% for the first dose of the vaccine and 77% for the second dose. This is the highest uptake for the HPV vaccination programme since 2015/2016 and is particularly encouraging because it was the first year that boys were included in the programme and it shows that the provision of vaccine in community clinics did not adversely affect the uptake.

The programme for the academic year 2020/2021 was paused during the first few months of 2021 due to school closures and redeployment of staff to the COVID-19 immunisation programme. The inputting of uptake information for the schools-based programme has also been delayed due to redeployment of administrative staff. However, Community Healthcare Organisations have reported that the vast majority of second level schools had their first dose of HPV vaccine delivered between October and December 2020.

The uptake rate for the first dose of the HPV vaccine, in the 2020/2021 academic year, is 67% as of the 12th May 2021, and this figure is expected to increase because data input on vaccine uptake is ongoing. The HSE expects the HPV vaccination programme for 2020/21 to be substantially complete before the start of the 2021/22 academic year.

Holly Cairns (Cork South West, Social Democrats)
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3263. To ask the Minister for Health the steps he is taking to fulfil the Programme for Government commitment to ensure that community services assign a case manager for older people with chronic conditions to assist them with accessing the care they need. [41105/21]

Mary Butler (Waterford, Fianna Fail)
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The HSE's Integrated Care Programme for Older People seeks to design systems that recognise and meet the complex healthcare needs of older people across the care journey. The Programme aims to ensure that older persons with long-term complex care needs will have access to a single point of contact, when needed.

As this Parliamentary Question relates to an operational issue, it is a matter for the HSE. However, members of the Oireachtas are advised that the HSE is currently unable to access the information to answer Parliamentary Questions due to the recent cyber-attack, which has required a temporary shut-down of HSE IT systems. The disruption to service is ongoing, and the HSE is working hard to restore its IT capacity and resume normal services. Members of the Oireachtas will be advised as soon as the HSE is again in a position to provide responses to PQs and are encouraged to resubmit their Parliamentary Questions at that point.

Holly Cairns (Cork South West, Social Democrats)
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3264. To ask the Minister for Health the steps he is taking to fulfil the Programme for Government commitment to develop the role of advanced nurse practitioners in older person services and chronic disease management. [41106/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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The development of advanced nurse practitioner and advanced midwife practitioner roles has continued in line with the Policy on the Development of Graduate to Advanced Nursing and Midwifery Practice and with Sláintecare.

I can confirm that there are now 58 Registered Advanced Nurse Practitioners (RANP) working in Older Persons Services, with a further 17 undertaking the education programme, Masters in Advanced Practice. 21 of these posts have been approved in the last year.

As the Deputy will be aware, Chronic Disease Management covers a broad range of services and I have included the following conditions: Respiratory, Diabetes, Cardiovascular, Rheumatology, Tissue viability, Chronic pain and MND. There are 82 RANP’s working across these services with an additional 29 candidates undertaking the education programme. 25 of these posts have been approved in the last year.