Pauline Tully (Cavan-Monaghan, Sinn Fein)
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169. To ask the Minister for Health if the funding model for prosthetics and orthotics is on a national basis or is it different in each CHO; if this consists of a risk assessment to be completed by the referrer for each new application (details supplied); if so, the person or body that informs the referrer; and if he will make a statement on the matter. [34661/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Health Service Executive (HSE) provides a wide range of medical and surgical aids and appliances, including prostheses and orthoses, free of charge to eligible persons (such as medical card holders and people on the Long-Term Illness scheme) following assessment by a relevant health professional.

These are provided through community services known as Community Funded Schemes and play a key role in assisting and supporting people to maintain everyday functioning, and to remain living in their homes and local community.

Each Community Health Organisation (CHO) operates processes for the allocation of funding for medical and surgical aids and appliances. Each application within a CHO is assessed by the local Resource Allocation Group and a determination is made regarding approval based on clinical priority and the funding availability within local budgets.

However, HSE National Service Improvement Programme has the aim of improving the equity of access, value for money, and functional processes of the Community Funded Schemes through the establishment of national guidelines for the provision of medical and surgical aids and appliances.

While this work was delayed due to the Covid-19 pandemic, the Programme has recommenced. A review of the current prosthetics service is underway – under the Orthotics, Prosthetics and Specialist Footwear Work Stream – and is due to be completed by early 2023.

Pauline Tully (Cavan-Monaghan, Sinn Fein)
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170. To ask the Minister for Health the average waiting period for an authorised purchase order for a prosthesis or orthosis; the number of persons currently waiting on a prosthesis or orthosis who have been waiting less than 1, 1 to 3, 3 to 6 and longer than 6 months; and if he will make a statement on the matter. [34662/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible. 

Pauline Tully (Cavan-Monaghan, Sinn Fein)
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171. To ask the Minister for Health if there is a training budget for prosthetic and orthotic professionals; if so, the amount of same; and if he will make a statement on the matter. [34663/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible. 

Pauline Tully (Cavan-Monaghan, Sinn Fein)
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172. To ask the Minister for Health if engagement takes place between rehabilitation consultants employed by the National Rehabilitation Hospital with suppliers of prosthetics and orthotics; if so, the extent of this engagement; and if he will make a statement on the matter. [34664/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible. 

Pauline Tully (Cavan-Monaghan, Sinn Fein)
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173. To ask the Minister for Health if outcome measures in relation to the funding of prosthetics and orthotics are used to evaluate and direct funding on an audited outcome measure basis; and if he will make a statement on the matter. [34665/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible. 

Pauline Tully (Cavan-Monaghan, Sinn Fein)
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174. To ask the Minister for Health the ratio of clinicians working in prosthetics and orthotics to their clerical administrative staff; and if he will make a statement on the matter. [34666/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible. 

Pauline Tully (Cavan-Monaghan, Sinn Fein)
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175. To ask the Minister for Health the details of all national policies and plans that are in place regarding prosthetics and orthotics; and if he will make a statement on the matter. [34667/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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Prosthetics is the manufacture and fitting of artificial limbs (prostheses). Orthotics is the manufacture and fitting of devises (orthoses) designed to correct a patient’s physical posture and function, for example, specialised footwear, ankle and knee supports. 

The Health Service Executive (HSE) provides a wide range of medical and surgical aids and appliances, including prostheses and orthoses, free of charge to eligible persons (such as medical card holders and people on the Long-Term Illness scheme) following assessment by a relevant health professional.

These are provided through community services known as Community Funded Schemes and play a key role in assisting and supporting people to maintain everyday functioning, and to remain living in their homes and local community. Prosthetic services are currently provided by private providers and the cost is charged to the HSE.

Amputees, whose amputation arose from either a traumatic or elective event, usually have their primary prosthesis fitted at the hospital where the surgery was undertaken. Subsequent prostheses are provided to eligible patients through the Community Funded Schemes.

Rehabilitation services are provided by the National Rehabilitation Hospital (NRH) primarily at their site in Dun Laoghaire and augmented by a number of satellite clinics that they operate throughout the country. There are also a number of smaller services operated at regional level that provide assessment and fitting clinics along with prostheses at a local level.

The NRH does operate the Prosthetic, Orthotic and Limb Absence Rehabilitation (POLAR) Programme, which provides specialised, interdisciplinary limb absence rehabilitation for patients who have experienced amputation. This comprehensive rehabilitation service is offered to patients whether or not prosthesis is appropriate.

A HSE National Service Improvement Programme has the aim of improving the equity of access, value for money, and functional processes of the Community Funded Schemes through the establishment of national guidelines for the provision of medical and surgical aids and appliances.

While this work was delayed due to the Covid-19 pandemic, the Programme has recommenced. A review of the current prosthetics service is underway – under the Orthotics, Prosthetics and Specialist Footwear Work Stream – and is due to be completed by early 2023.

Pauline Tully (Cavan-Monaghan, Sinn Fein)
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176. To ask the Minister for Health if he will report on the effect the energy crisis and Brexit have had on the cost of prosthetics and orthotics; and if he will make a statement on the matter. [34668/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Health Service Executive (HSE) provides a wide range of medical and surgical aids and appliances, including prostheses and orthoses, free of charge to eligible persons following assessment by a relevant health professional.

These are provided through community services known as Community Funded Schemes and play a key role in assisting and supporting people to maintain everyday functioning, and to remain living in their homes and local community. 

Each application within a Community Health Organisation (CHO) is assessed for eligible persons by the local Resource Allocation Group. A determination is made regarding approval based on priority and funding availability within local budgets. Prosthetic services are currently provided by private providers and the cost is charged to the HSE.

At times, due to the demand for resources exceeding the available capacity, waiting lists may apply for some categories of items provided through the medical and surgical aids and appliances budget in a particular CHO. Waiting times also vary depending on the priority rating which is made by healthcare professionals based on clinical risk. Priority is given to clients with the greatest level of clinical need.

The effects of Brexit, global supply chains issues, and the rise in energy costs have unfortunately further impacted the sourcing of appropriate aids and appliances for some applicants. However, CHOs do undertake a range of initiatives to ensure optimum use of resources, for example, through the efficient recycling of stock items such as wheelchairs and walking aids. Therefore, CHOs endeavour to provide medical and surgical aids and appliances in accordance with clinical priorities and subject to budgetary and supply constraints.

A HSE National Service Improvement Programme has the aim of improving the equity of access, value for money, and functional processes of the Community Funded Schemes through the establishment of national guidelines for the provision of medical and surgical aids and appliances.

While this work was delayed due to the Covid-19 pandemic, the Programme has recommenced. A review of the current prosthetics service is underway – under the Orthotics, Prosthetics and Specialist Footwear Work Stream – and is due to be completed by early 2023.