Written Answers Nos. 551-574
551. Deputy Colm Burke asked the Minister for Health if clinics for those who have suffered from Covid-19 have been established in hospitals in order to manage patients with complications as a result of a Covid-19 diagnosis or who require follow-up care; and if he will make a statement on the matter. [44292/20]
View answerI have asked the HSE to examine the matters raised by the Deputy and to provide him with a response as soon as possible.
552. Deputy Colm Burke asked the Minister for Health if a national strategy will be put in place pertaining to the operations of clinics for those who have suffered from Covid-19; if consideration has been given to the ring-fencing of funding either at local hospital group level or national level for persons who have contracted Covid-19 and as a result have suffered prolonged ill health; and if he will make a statement on the matter. [44293/20]
View answerI have asked the HSE to examine the matters raised by the Deputy and to provide him with a response as soon as possible.
553. Deputy Colm Burke asked the Minister for Health if consideration will be given to classifying Covid-19 as a long-term medical condition in view of the long-term ill health and complications experienced by some who contracted the disease; and if he will make a statement on the matter. [44294/20]
View answerI have asked the HSE to examine the matters raised by the Deputy and to respond directly to him as soon as possible.
554. Deputy Colm Burke asked the Minister for Health if consideration will be given to implementing co-ordinated services on a national level for persons who have contracted Covid-19 and are since recovering but require follow-up care or referrals to specialists where necessary; and if he will make a statement on the matter. [44295/20]
View answerI have asked the HSE to examine the matters raised by the Deputy and to provide him with a direct response as soon as possible.
555. Deputy Colm Burke asked the Minister for Health if a co-ordinated national strategy on follow-up care for those who have contracted and been affected on a long-term basis due to Covid-19 has been discussed between his Department and hospitals with post-Covid clinic facilities; and if he will make a statement on the matter. [44296/20]
View answerI have asked the HSE to examine the matters raised by the Deputy and to provide a response to him directly as soon as possible.
557. Deputy Aengus Ó Snodaigh asked the Minister for Health the reason the drug Plenadren has not been licensed for use in Ireland despite being licensed by the European Medicines Agency nearly ten years ago; and his views on the matter. [44299/20]
View answer558. Deputy Aengus Ó Snodaigh asked the Minister for Health if consideration will be given to requesting the National Centre for Pharmacoeconomics to re-evaluate its decision in 2013 not to recommend a full pharmacoeconomic evaluation and its decision in 2017 that reimbursement is not recommended at the submitted price, given that the price in two years may have substantially dropped since then, the number of patients in Ireland is low and Plenadren has a variety of prices in other EU states. [44300/20]
View answer560. Deputy Aengus Ó Snodaigh asked the Minister for Health if there have been negotiations with the manufacture of the drug Plenadren to obtain a discount supply to threat the few patients in Ireland who would be able to avail of this life-changing drug if it was discounted, subsidised by the HSE or available on their medical cards; and if he will make a statement on the matter. [44302/20]
View answer561. Deputy Aengus Ó Snodaigh asked the Minister for Health if he has had communications with health authorities in other EU states with a view to bulk purchasing the drug Plenadren from a pharmaceutical company (details supplied) to achieve a price reduction for national health services; and if he will make a statement on the matter. [44303/20]
View answer562. Deputy Aengus Ó Snodaigh asked the Minister for Health if his attention has been drawn to the fact that the drug Plenadren is coming off licence in 2021; the steps that can be taken to encourage other pharmaceutical companies to commence production of the drug at a more affordable price for patients or their health services; and if he will make a statement on the matter. [44304/20]
View answerI propose to take Questions Nos. 557, 558 and 560 to 562, inclusive, together.
The application, assessment and decision-making process for new medicines and new uses of existing medicines is underpinned by the Health (Pricing and Supply of Medical Goods) Act 2013.
In accordance with that Act, pharmaceutical companies are required to submit a formal pricing and reimbursement application to the HSE if they wish their medicine to be added to the list of reimbursable items.
On receipt of an application, the HSE are required to comply with the various provisions and criteria contained in the Act before reaching decisions on the pricing and reimbursement of medicines under the community drugs schemes.
The HSE has no role in encouraging companies to make applications for reimbursement under the 2013 Act and nor does the legislation support joint negotiating or bulk purchasing with other EU member countries.
Modified-release Hydrocortisone (Plenadren) is licensed for the treatment of adrenal insufficiency in Ireland and throughout the EU since 2011.
I understand that the HSE received a pricing and reimbursement application for modified-release Hydrocortisone (Plenadren) in 2016 for the treatment of adrenal insufficiency in adults. In April 2019, following the assessment and deliberative process, the HSE made the decision to refuse the application, pursuant to Section 18 of the Health (Pricing and Supply of Medical Goods) Act 2013.
I am informed that the HSE does not currently have an open pricing and reimbursement application for modified-release Hydrocortisone. However, the HSE remains open to receiving and considering a new pricing and reimbursement application from the pharmaceutical company.
559. Deputy Aengus Ó Snodaigh asked the Minister for Health if his attention has been drawn to the rare and often forgotten medical condition craniopharyngioma; the number of children with the condition; the number of adult sufferers here; and his views on the matter. [44301/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
563. Deputy Colm Burke asked the Minister for Health if consideration will be given to awarding a consultant contract to existing specialists in public health medicine as per the recommendations of the Crowe Horwath report, the Scally report and the report of the Covid-19 nursing homes expert panel; and if he will make a statement on the matter. [44305/20]
View answerI am fully committed to delivering on the recommendations that were made for public health in the Crowe Horwath report. That report recognised the very important role that public health medicine plays in the health of our population and in how our health service is managed and delivered.
This Government and I have been very clear in our support for the creation of Consultant posts in Public Health Medicine. My Department, in conjunction with the HSE, have completed a substantial amount of work on a detailed framework for the future public health model that includes consultant level roles. A related business case seeking consultant status has been submitted to the Department of Public Expenditure and Reform for consideration and officials in both Departments are currently engaging in order to progress this as soon as possible.
This government is committed to investment in our public health workforce. Prior to the Covid-19 pandemic, there were 254 people working full-time across Ireland’s public health workforce. At the end of September, I announced ambitious plans to double this workforce by hiring more public health doctors, nurses, scientists and support staff. Recruitment for these positions commenced immediately and is progressing well.
The HSE’s Pandemic Workforce Plan also includes the recruitment of 400 temporary staff to Public Health Departments across the country in order to strengthen our response to the current pandemic.
The permanent resourcing committed in the workforce plan is an investment in the future service delivery model for Public Health, as envisaged in the 2018 Crowe Horwath Report.
564. Deputy Colm Burke asked the Minister for Health if consideration will be given to implementing targeted measures to recruit and retain hospital consultants across all specialties to increase the number of consultant posts in line with the recommended ratios of the national clinical programmes and the postgraduate training bodies and to address the shortage of hospital consultants in Ireland in comparison to its European counterparts; and if he will make a statement on the matter. [44306/20]
View answer'Demand for Medical Consultants and Specialists to 2028 and the Training Pipeline to Meet Demand', the Report published by National Doctors Training and Planning Unit, HSE, this year incorporated the views of key stakeholders, including the National Clinical Programmes and the Postgraduate Training Bodies. It identified significant shortfalls in the ratio of consultants to population across specialties and the numbers required to meet these, taking account of current stakeholder perspectives and the earlier Hanly Report 's recommendations.
The Report recognises that Sláintecare gives an opportunity to work towards a more integrated, planned and sustainable workforce and the demand estimates in the Report will allow for better planning to meet future needs.
It has been recognised for many years that it is necessary to increase the ratio of consultants to population across specialties to move to a consultant delivered service. Sláintecare identified the need to increase consultant capacity and for workforce planning and the Government is committed to annual increases in consultant numbers in the years ahead, building on increases to-date and addressing the shortfalls identified in the Report.
In the 12 months to the end of October 2020 consultant numbers increased by 225 whole time equivalents to 3,456 and over the past 5 years numbers have increased by 735 (wte's). The Government is also committed to the introduction of the Sláintecare Consultant Contract early next year and to making this as attractive as possible to support future recruitment and retention.
565. Deputy Colm Burke asked the Minister for Health if consideration will be given to increasing the number of basic and higher postgraduate specialist training posts in order to meet the demand with the number of posts front-loaded in year 1 accompanied by a corresponding increase in the number of consultants required to provide training; and if he will make a statement on the matter. [44307/20]
View answerIn relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
566. Deputy Colm Burke asked the Minister for Health if consideration will be given to the modernisation of postgraduate specialist training reflecting changes in the practice of medicine and the changing demographics of doctors in training by establishing a differentiated model that provides clearer career paths with greater predictability of training arrangements, greater predictability at the outset of training schemes regarding locations of rotations over the course of a scheme and the improvement of working conditions as set out in the recommendations made in the report of the Strategic Review of Medical Training and Career Structures; and if he will make a statement on the matter. [44310/20]
View answerIn relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
567. Deputy Colm Burke asked the Minister for Health if investment of targeted incentives for general practice and the development of infrastructure, including premises, medical equipment, diagnostic equipment and IT equipment, will be considered, as per the recommendations in a report (details supplied); and if he will make a statement on the matter. [44311/20]
View answerThis subject is one which the Department of Finance has responded to in the past. Specifically, question 39811/19 addressed investment in general practitioner infrastructure.
The Minister for Finance at the time advised that his Department had published guidelines for the evaluation of potential tax expenditures. The Department of Finance would remain best placed to respond to the Deputy on this subject.
568. Deputy Colm Burke asked the Minister for Health if further financial supports to allow newly established general practices to remain financially viable and open to patients will be reviewed; and if he will make a statement on the matter. [44312/20]
View answer569. Deputy Colm Burke asked the Minister for Health if further financial supports will be considered in order for established general practices to employ additional general practitioners, practice nurses and other support staff; and if he will make a statement on the matter. [44313/20]
View answerI propose to take Questions Nos. 568 and 569 together.
Under the General Medical Services (GMS) scheme, general practitioners are reimbursed for the services they provide to medical card and GP visit card holders. The scheme provides a range of supports for GPs. In addition, the 2019 GP Agreement provides for additional and enhanced supports as well as a significant increase in investment in general practice over the lifetime of the agreement.
Under the GMS scheme GPs are paid a subsidy towards the cost of employing a practice nurse and/or a practice secretary. The rate payable depends on the GP's GMS panel size and the level of experience of the nurse or secretary. A practice manager subsidy is also available. GPs working in rural areas who meet the qualifying criteria will qualify for an annual rural support allowance. In addition, locum expenses are provided to cover various GP leave expenses.
The 2019 Agreement on GP contractual reforms will see the Government increase investment in general practice by approximately 40% (€210 million) between 2019 and 2023, providing for significant increases in capitation fees for GPs who participate in the reform programme and the introduction of new fees and subsidies for additional services such as the chronic disease programme. The rural support allowance has been increased for participating GPs, an additional support has been introduced for GPs working in disadvantaged urban areas, and improvements have been made to maternity and paternity leave arrangements.
570. Deputy Colm Burke asked the Minister for Health if consideration will be given to establishing a multi-annual programme of investment in 5,000 additional public acute bed capacity, including investment in standalone public hospitals for elective care and a doubling of critical care capacity to 550 critical care beds; and if he will make a statement on the matter. [44314/20]
View answerThe Programme for Government, Our Shared Future, commits to continuing investment in our health care services in line with the recommendations of the Health Service Capacity Review and the commitments in Project Ireland 2040. The Health Service Capacity Review 2018 found that the net requirement in combination with health system reform is for an additional 2,590 hospital beds by 2031 (2,100 inpatient, 300 day case and 190 critical care). The National Development Plan provides for the addition of the full 2,590 beds by 2027.
The Department of Health is working with the HSE to increase acute capacity in hospitals throughout the country to meet this and other health demands. Government allocated €236 million revenue and €40 million capital expenditure as part of Budget 2021 to fund additional acute beds on a permanent basis. This funding will provide, by the end of 2021, an additional 1,146 acute beds. A proportion of these beds will be funded as part of the HSE’s Winter Plan 2020/21.
At the start of this year, permanent adult critical care capacity in our public hospitals stood at 255 beds, according to the National Office of Clinical Audit. This included 204 Level 3 ICU beds and 51 Level 2 HDU beds. As part of the initial response to the pandemic, funding was provided for an additional 40 adult critical care beds in March 2020 as well as two paediatric beds.
In addition, funding totalling €52m was provided in budget 2021 for critical care beds. This will retain, on a permanent basis, the 42 critical care beds put in place on a temporary basis this year and add significant new capacity. Funded adult critical care beds will increase to 321 by end 2021, an increase of 66 over the baseline number of 255 funded beds in 2020.
This represents a significant step towards achieving the recommendations in the 2018 Health Service Capacity Review which found that an additional 2,590 inpatient beds were required by 2031.
Adding critical care capacity requires consideration of design and building timelines, disruption to existing services within the hospital, the on-site location of critical care facilities and the importance of maintaining relevant clinical adjacencies. Engagement has commenced between the Acute Hospitals Division, the Critical Care Programme and the Estates Division, and detailed assessments are underway in respect of each of the prioritised locations to determine the scope, scale and cost of the projects. The 2021 Capital Plan will include projects anticipated to complete in 2021 such as Phase 1 of a 112 bed development at the Mater Misericordiae Hospital, which is also expected to provide 8 critical care beds, and 12 critical care beds at Tallaght University Hospital.
Finally, in relation to elective care, the Elective Hospitals Oversight Group, chaired by Professor Frank Keane, is preparing the preliminary business case for new dedicated ambulatory elective only hospital facilities in Dublin, Galway and Cork. These will provide high volume, low complexity procedures on a day and outpatient basis, together with a range of ambulatory diagnostic services. Planning and scoping work has been completed and submission of the Preliminary Business Case is anticipated before end 2020.
571. Deputy Colm Burke asked the Minister for Health if consideration will be given to expanding access to diagnostic, radiology and laboratory services to allow timely access to investigations and results of same to general practitioners, which will support them in appropriately managing patients in the community; and if he will make a statement on the matter. [44315/20]
View answerBudget 2021 provided for the expansion of community diagnostics to improve access for general practice and community specialist teams including access to plain film x-rays, ultrasound, MRI, CT, ECHO, and spirometry. Of the €175m in new development money allocated to primary care for 2021, some €25m has been specifically identified to support structured GP access to diagnostics, which will enable the delivery of approximately 136,000 additional diagnostic tests over the course of the year. This will enable a greater level of care to be delivered in the community and reduces the need to refer patients to the emergency and outpatient departments.
In addition, a Community Diagnostics Implementation Group has been established. This group will ensure co-ordinated planning between a broad spectrum of stakeholders in respect of the medium to long-term approach to community diagnostics.
However, as this is a service matter, I have asked the Health Service Executive to respond directly to the deputy in order to provide further information.
572. Deputy Colm Burke asked the Minister for Health if consideration will be given to the further resourcing of diagnostic, radiology and laboratory departments in hospitals to allow timely access to investigations and results of same for hospital doctors; and if he will make a statement on the matter. [44316/20]
View answerThe Health Service Executive is currently in the process of finalising its National Service Plan for 2021, in consultation with officials from the Department of Health.
Following completion of this process, detailed Operational Plans for the coming year for each of the Executive's service areas will be developed. Appropriate resourcing to ensure the delivery of the Key Performance Indicators for 2021 as set out in the National Service Plan will be given detailed consideration by each hospital group including each hospital’s requirements in relation to diagnostics, radiology and laboratory services.
573. Deputy James Browne asked the Minister for Health further to Parliamentary Question No. 596 of 8 December 2020, the position regarding the creation of MDTs in CHOs 6, 7 and 9; the position regarding recruitment and appointment of optometrists, orthoptists and other support staff to deliver care in these teams; the locations of these MDTs; the anticipated delivery time frame; the locations of the MDTs nationwide; the date of the MDTs delivery; and if he will make a statement on the matter. [44321/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
