Jim O'Callaghan (Dublin Bay South, Fianna Fail)
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711. To ask the Minister for Health the details of the supports that his Department has provided for Ukraine and for Ukrainian people since February 2022, whether in Ukraine or within the State; the number of people supported, where relevant; the estimated cost and value of the support where available; and if he will make a statement on the matter. [8869/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Department of Health and HSE are coordinating the provision of healthcare services for more than 75,000 Ukrainian refugees under the Government's coordinated humanitarian response to the war in Ukraine. As beneficiaries of temporary protection, Ukrainian refugees are entitled to access healthcare services, on the same basis as for Irish residents.

There is a simplified and streamlined process for Ukrainian refugees to automatically qualify for a medical card. Having a GP is not a requirement for applying for the card, as one can be assigned afterwards. The HSE has issued more than 56k medical cards to Ukrainian refugees to date.

In addition, the HSE has developed an integrated refugee health service delivery model to provide healthcare services for refugees. A range of bespoke services and supports have been developed specifically for Ukrainians, including :

National Transit Centre

- The National Transit Centre in Citywest continues to operate as the main entry point for Ukrainian refugees (>90% of all arrivals) accessing the health system.

- The HSE has put in place a health assessment model for Ukrainian refugees in Citywest which identifies individual health needs that can be tracked as refugees are assigned to accommodation centres across the country.

- The Citywest health model continues to evolve in line with the emerging needs of the population

Community healthcare

- The HSE has established Area Crisis Management Teams in all community healthcare areas, which complement existing community services. The Crisis Management Teams are coordinating local service responses supported by National Public Health guidance and health needs assessment tools. The teams work closely with with the community response forums to co-ordinate interagency services at the local level.

- Community healthcare services include multidisciplinary teams that are providing in-reach services to assess urgent health needs and are referring refugees to the appropriate services. The teams conduct risk assessments in relation to Covid and other health issues including infectious diseases.

GP Services

- The HSE, in consultation with the IMO, has prepared a range of bespoke options for those accommodated in hotels and other settings. The exact model for each site varies depending on numbers and geographical distribution, all have access to GP Out-of-Hours services.

- The HSE has issued an updated GP Framework which includes guidance on maternity and infant care and the Primary Childhood Immunisation Programme. It also provides greater clarity on options available for those in emergency accommodation across the country.

- Work is ongoing with Primary Care Reimbursement Service (PCRS) to maximise the allocation of Ukrainian refugees to the General Medical Services (GMS) panels where feasible.

- The HSE is working to overcome known GP availability capacity challenges across the country but most particularly in areas with single GP Practices, existing dense populations, and in rural areas where many Practices are already at maximum capacity.

Acute Services

- Acute referral pathways and operational processes for urgent referrals are in place to respond to priority Ukrainian groups.

- The National Cancer Programme is viewing, on a case-by-case basis, those coming into the country with a treatment plan which does not align with that provided in Ireland.

- HSE Acute Services is progressing an approach to ensuring continuity of care/safe discharge from Emergency Dept for Ukrainian refugees without an assigned GP.

Public health

- Ukrainian refugees have access to COVID-19 vaccinations through GPs, pharmacists or HSE vaccination centres. HSE is developing a screening and vaccination ‘catch up’ service for Ukrainian refugees to mitigate risks of infectious disease outbreaks.

- A Catch Up Immunisation Programme for Migrant Children and Young Adults will have commenced in all CHOs before the end of February.

- Targeted public health communications are delivered to refugee populations advising them of how to keep themselves and their families safe from respiratory illnesses across the winter period and how to access Covid and Flu vaccinations. The ‘Keep well in winter’ message resources are available on the HSE Health Protection and Surveillance Centre website.

Ireland is also supporting EU solidarity with Ukraine

- Ireland has completed 28 medical evacuations of patients from Ukraine and neighbouring countries, under the EU-wide coordinated system for medical evacuations of patients from Ukraine requiring urgent medical treatment.

- The health service has donated medical humanitarian supplies with a total value of over €9.4 million, including life-saving medicines, medical equipment, consumables, and ambulances.

The HSE has spent an estimated €24m on healthcare services for refugees in 2022. The Department of Health has allocated an additional €50 million to the HSE to provide healthcare services in 2023. Additional resources may be required depending on the level of demand.

The healthcare service is playing a critical role in the Government's humanitarian response to the war in Ukraine. The planning, management and allocation of health resources has been challenging due to the arrival of 75,000 Ukrainian and 15,000 other refugees since 2022. I am confident that the health system will continue to respond to the health needs of the refugee population in 2023 and subsequent years.