Written Answers Nos. 601-624
601. Deputy Réada Cronin asked the Minister for Health the plans in place in terms of beds and staffing to meet a possible Covid-19 surge at Naas General Hospital post Christmas 2020; and if he will make a statement on the matter. [44497/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
602. Deputy Réada Cronin asked the Minister for Health the number of adults and teenagers being treated for alcohol-related injury and illness in each of the past three years; the number in north County Kildare in particular; and if he will make a statement on the matter. [44498/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
603. Deputy Réada Cronin asked the Minister for Health the number of adults and children awaiting both psychological assessment and therapy nationally; the number in north County Kildare in each of the past three years; the number waiting more than three months and six months in each group; and if he will make a statement on the matter. [44499/20]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
605. Deputy Paul Kehoe asked the Minister for Health the status of the development of a primary health centre (details supplied); and if he will make a statement on the matter. [44514/20]
View answerAs the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.
606. Deputy Seán Canney asked the Minister for Health his plans to ensure any woman who initiated a legal abortion in this country and is forced to travel if the abortion fails will receive the care they need; and if he will make a statement on the matter. [44521/20]
View answerSection 12 of the Health (Regulation of Termination of Pregnancy) Act 2018 states that a termination of pregnancy may be carried out by a medical practitioner where, having examined the woman, he or she is of the reasonable opinion formed in good faith that the pregnancy has not exceeded 12 weeks of pregnancy.
The medical practitioner must certify this opinion and three days must elapse between certification and the procedure being carried out.
It should be noted that sections 9, 10 and 11 of the Health (Regulation of Termination of Pregnancy) Act 2018 set out other grounds on which termination of pregnancy is permitted in this country.
It would not be appropriate for me, as Minister for Health, to intervene in medical practice to suggest how medical practitioners treat their patients, or to dictate the practice of obstetrics. Medical practitioners are bound through professional regulatory mechanisms to operate in accordance with best medical practice.
Clinical guidelines for the provision of termination of pregnancy services, within the legal framework set out in the Health (Regulation of Termination of Pregnancy) Act 2018, have been developed by the relevant professional medical bodies.
608. Deputy Gary Gannon asked the Minister for Health if a workplace which chooses to close due to concerns due to the risk of Covid-19 due to a 10% positivity rate should be forced to remain open; his views on whether is safe and in the best interest of the health and safety of those in that workplace; if there are workplaces other than schools which would be forced to open under these circumstances; and if he will make a statement on the matter. [44550/20]
View answerAs with other public health infectious diseases, all COVID-19 infections are reported to the HSE’s Health Protection Surveillance Centre (HPSC). You may wish to note that my Department does not receive direct notification from companies of outbreaks of Covid-19 in the workplace. The Departments of Public Health within the HSE respond to notified cases or outbreaks of Covid-19. A risk assessment of the situation is carried out and appropriate investigations are undertaken and control measures put in place. If Public Health determines there is an outbreak, an Outbreak Control Team is convened who would then advise on control measures.
The Work Safely Protocol is a revision of the Return to Work Safely Protocol published in May 2020. The revised Protocol incorporates the current advice on the Public Health measures needed to reduce the spread of COVID-19 in the community and workplaces as issued by the National Public Health Emergency Team (NPHET), my Department and the Government.
The Protocol is a general document applicable to all sectors. It sets out the minimum measures required in every place of work to prevent the spread of COVID-19 and to facilitate the reopening of workplaces following temporary closures and the ongoing safe operation of those workplace. Further information on the Protocol is available at:- https://www.gov.ie/en/publication/bb7fd-work-safely-protocol/
609. Deputy Seán Canney asked the Minister for Health his plans to provide MRI services for children who are waiting in excess of two years for an MRI; and if he will make a statement on the matter. [44553/20]
View answerI sincerely regret that children can experience a long waiting time for MRI services, and I am conscious of the burden that this places on them and their families.
Children’s Health Ireland (CHI) has advised my Department that during the initial phases of COVID-19, all face to face hospital outpatient reviews and most of the planned diagnostic tests, including MRI, were deferred in response to the pandemic. CHI at Crumlin have recommenced the majority of outpatient and diagnostic services, albeit at reduced numbers, due to public health guidelines on social distancing
In relation to the provision of MRI services, the demand for specialist imaging has increased over recent years due to increased activity and acuity in CHI, as well as an increasing trend to utilise imaging in diagnosis and treatment. CHI have advised that, uniquely to Paediatrics, younger children and children up to 18 years old with complex needs may be unable to remain still in an MRI for the lengthy periods required to complete the scan, resulting in the requirement for a General Anaesthetic (GA) to be delivered by a Paediatric Anaesthesiologist. This limits the ability for these scans to be performed outside of CHI hospitals.
CHI have confirmed to my Department that each request for an MRI scan is carefully examined by Consultant Radiologists who must prioritise, based on clinical urgency, each case in terms of access to the scanner.
Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.
The HSE continues to optimise productivity through alternative work practices such the use of alternative settings including private hospitals, community facilities and alternative outpatient settings.
610. Deputy Patricia Ryan asked the Minister for Health if funding has been secured to complete works at Monasterevin day care centre; and if he will make a statement on the matter. [44568/20]
View answerAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
611. Deputy Patricia Ryan asked the Minister for Health if he will take steps to expedite funding for gene-silencing treatment for amyloidosis such as patisiran and equivalent drugs; and if he will make a statement on the matter. [44569/20]
View answerThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
In line with the 2013 Health Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the reimbursement list.
Reimbursement is for licensed indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.
HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).
The NCPE conducts health technology assessments (HTAs) for the HSE and makes recommendations on reimbursement to assist HSE decisions. The NCPE uses a decision framework to systematically assess whether a drug is cost-effective as a health intervention.
The additional funding of €50m provided for new medicines in Budget 2021 will allow the HSE to provide access to new and innovative medicines which have been recommended by the HSE Drugs Group, on the basis of efficacy and value for money in line with the 2013 Health Act.
The HSE has advised that it received an application in December 2018 for the reimbursement of Patisiran (Onpattro®) for the treatment of hereditary transthyretin-mediated amyloidosis (hATTR amyloidosis) in adult patients with stage 1 or stage 2 polyneuropathy.
In January 2019, a full health technology assessment (HTA) with respect to this indication was commissioned by the HSE. This assessment was completed in February 2020, with the NCPE recommending that Patisiran not be considered for reimbursement unless cost-effectiveness could be improved relative to existing treatments.
The HTA report with respect to Patisiran was reviewed by the HSE Drugs Group, along with the outputs of commercial discussions with the applicant which took place in May 2020, and the patient group submission received during the HTA process. The HSE Drugs Group requested patient and clinician input via the Rare Diseases Technology Review Committee (RDTRC) to assist the group in making its recommendation to the HSE Executive Management Team (EMT) regarding reimbursement of Patisiran.
The RDTRC convened on 24 September and reviewed the clinical data previously submitted as part of the established pricing and reimbursement process. The Committee also heard from Consultants involved in the specialist management of patients with hATTR amyloidosis.
The RDTRC continued its review of Patisiran at its subsequent meeting on 5 November which included patient input on the impact of hATTR amyloidosis.
Following these meetings, the Committee finalised a statement summarising the clinician and patient engagement on Patisiran which was forwarded to the HSE Drugs Group for consideration.
The HSE has advised that Patisiran currently sits as the 3rd item for consideration on the draft January Drugs Group Agenda. The Statement from the Rare Diseases Technology Review Committee will be considered by the Drugs Group along with the Health Technology Assessment and the outcomes from commercial negotiations.
I am further advised by the HSE that it received an application in August 2019 for the reimbursement of Inotersen (Tegsedi®) for the treatment of stage 1 or stage 2 polyneuropathy in adult patients with hereditary transthyretin amyloidosis (hATTR).
On 26 August 2019, the HSE commissioned a rapid review with respect to this indication. Following receipt of a rapid review dossier, the NCPE advised the HSE on 7 October 2019 that a full HTA was required for this medicine to assess the clinical effectiveness and cost effectiveness of Inotersen compared with the current standard of care.
The HSE commissioned a full HTA on 9 October 2019 as per agreed processes. As of 16 December 2020, the applicant has not submitted a HTA dossier to the NCPE for assessment. A completed HTA is required to progress this application, as per the formal processes governing the pricing and reimbursement of medicines.
The decision-making body for the reimbursement of medicines under the Health Act 2013 is the HSE EMT. The EMT will, on receipt of the outcome of the respective Drugs Group deliberations, make the decision on whether a given medicine will be reimbursed.
The applications for Patisiran and Inotersen remain under consideration in line with the 2013 Health Act.
612. Deputy Ruairí Ó Murchú asked the Minister for Health the number of children waiting for scoliosis treatment and surgery; the wait time for same; his plans to ensure no child is waiting while their health deteriorates; and if he will make a statement on the matter. [44579/20]
View answerI sincerely regret that children can experience a long waiting time for treatment for scoliosis, and I am conscious of the burden that this places on them and their families.
In response to the Covid-19 pandemic Children’s Health Ireland had to take measures to defer most scheduled care activity between March and May of this year. This decision was in line with the advice issued by the National Public Health Emergency Team in accordance with the advice of the World Health Organisation.
It is of note that key social distancing measures and Infection Prevention and Control requirements, such as two-metre distancing, have a material impact on the available physical space to deliver all hospital services, including scoliosis procedures, and this has significantly impacted both available capacity and operational activity levels.
Despite these challenges, by 4th December, Children’s Health Ireland had carried out 304 scoliosis procedures, 150 of which were spinal fusions, 25 fewer than the same period last year. 154 other spinal procedures were carried out, 27 fewer than last year.
Children’s Health Ireland has advised my Department that as of 4th December, there were 120 patients on the spinal fusion waiting list, an increase of 21 patients compared to the start of the year.
There were 74 patients on the waiting list for other spinal procedures, which is a decrease of 10 patients since the start of 2020.
There were 68 patients on the Active Spinal waiting list over 4 months, of which 47 patients are waiting for spinal fusion surgery and 21 patients are waiting other spinal procedures.
Children’s Health Ireland is exploring initiatives to increase access to scoliosis services, such as transferring additional patients who meet the clinical criteria to the National Orthopaedic Hospital Cappagh for treatment and holding additional Orthopaedic Outpatient Clinics at Cappagh. Children’s Health Ireland is also working with the National Treatment Purchase Fund to source additional capacity in Private Hospitals.
613. Deputy Rose Conway-Walsh asked the Minister for Health the number of dentists who have withdrawn from the dental treatment services scheme; the number of dentists remaining in the scheme by county; and if he will make a statement on the matter. [44587/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
614. Deputy Rose Conway-Walsh asked the Minister for Health the number of persons waiting on lists as both inpatients and outpatients for Mayo University Hospital; the average wait time; the number waiting more than one, two, three and four years, respectively; and if he will make a statement on the matter. [44591/20]
View answer615. Deputy Rose Conway-Walsh asked the Minister for Health the wait time for outpatient appointments at Mayo University Hospital and University Hospital Galway, respectively; and if he will make a statement on the matter. [44592/20]
View answer616. Deputy Rose Conway-Walsh asked the Minister for Health the number of children on the waiting list to see a paediatrician in County Mayo; and if he will make a statement on the matter. [44593/20]
View answer617. Deputy Rose Conway-Walsh asked the Minister for Health the number of children awaiting an outpatient appointment at Mayo University Hospital and University Hospital Galway; the comparison to the same period in 2019; and if he will make a statement on the matter. [44594/20]
View answerI propose to take Questions Nos. 614 to 617, inclusive, together.
It is recognised that waiting times for scheduled appointments and procedures have been impacted as a direct result of the COVID-19 pandemic.
In response to the Covid-19 pandemic the HSE had to take measures to defer most scheduled care activity in March, April, and May of this year. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by the National Public Health Emergency Team (NPHET) in accordance with the advice of the World Health Organisation.
Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.
The HSE continues to optimise productivity through alternative work practices such the use of alternative settings including private hospitals, community facilities and alternative outpatient settings.
In addition the National Treatment Purchase Fund (NTPF) is currently reviewing strategies to maximise activity and benefit for patients, to include, increased use of private hospitals, funding weekend and evening work in public hospitals, funding “see and treat” services where minor procedures are provided at the same time as outpatient consultations, funding hybrid services where public and private hospitals contribute to the treatment of patients, virtual clinics and clinical validation.
The information requested by the Deputy concerning Mayo University Hospital (MUH) and Galway University Hospital (GUH) is outlined in the attached documents. This information shows the number of patients on IPDC and OPD waiting lists waiting over 1,2,3 & 4 years at MUH and average wait time; the wait time for OPD at MUH & GUH; the number of children on MUH and GUH OPD waiting list for 2020 and 2019; the number of children on paediatric waiting lists by area of residence in Co. Mayo.
The Deputy should note that GUH are currently upgrading their waiting list systems and they have been unable to provide up to date Outpatient Waiting List details. The last update provided to NTPF was archived at the beginning of October 2020. It is anticipated that this matter will be resolved shortly.
[href="https://data.oireachtas.ie/ie/oireachtas/debates/questions/supportingDocumentation/2020-12-17_pq614a-17-12-2020_en.xlsx">Table A</a>]
[href="https://data.oireachtas.ie/ie/oireachtas/debates/questions/supportingDocumentation/2020-12-17_pq614b-17-12-2020_en.xlsx">Table B</a>]
618. Deputy Rose Conway-Walsh asked the Minister for Health the number of persons waiting to access the national counselling service by county; the average wait time; the number of persons waiting over one year by county; and if he will make a statement on the matter. [44595/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
619. Deputy Rose Conway-Walsh asked the Minister for Health the number of persons waiting for cataracts surgery by county; the average wait time; the number waiting over one, two, three and four years, respectively by county; and if he will make a statement on the matter. [44596/20]
View answerIn recent years, my Department has worked with the HSE and the National Treatment Purchase Fund (NTPF) to improve access for patients waiting for high volume procedures, including cataracts. Ophthalmology services are provided throughout all hospital groups in the country, with cataract removal one of the key procedures carried out as part of this specialty.A key development in improving access to Ophthalmology services was the opening of a stand-alone high-volume consultant-led cataract theatre by the University of Limerick Hospital Group in Nenagh Hospital in 2018, with the intention that it would facilitate patients from surrounding geographical areas to avail of their treatment there. The impact of such initiatives can be seen in the reduction in the waiting times to access cataract procedures since 2018. At the end of November 2020 there were 4,186 patients waiting compared to 6,378 in November 2018.
In considering these figures it is important to recognise that waiting times for scheduled appointments and procedures have been impacted as a direct result of the COVID-19 pandemic this year. The HSE had to take measures to defer most routine scheduled care activity in March, April, and May. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and urgent time-critical work. This decision was in line with the advice issued by the National Public Health Emergency Team (NPHET) in accordance with the advice of the World Health Organisation.
Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols. The HSE continues to optimise productivity through alternative work practices such the use of alternative settings including private hospitals, community facilities and alternative outpatient settings.
In addition the NTPF is currently reviewing strategies to maximise activity and benefit for patients, to include increased use of private hospitals, funding weekend and evening work in public hospitals, funding “see and treat” services where minor procedures are provided at the same time as outpatient consultations, funding hybrid services where public and private hospitals contribute to the treatment of patients, virtual clinics and clinical validation.
The cataract data requested by the Deputy is outlined in the attached documents. This data contains the number of patients waiting over 1, 2, & 3 years on the cataract waiting list by county and the average number of days waiting by county.
620. Deputy Rose Conway-Walsh asked the Minister for Health the number of persons waiting for physiotherapy services by county; the average wait time; and if he will make a statement on the matter. [44597/20]
View answer621. Deputy Rose Conway-Walsh asked the Minister for Health the number of children waiting for physiotherapy services by county; the average wait time; and if he will make a statement on the matter. [44598/20]
View answerI propose to take Questions Nos. 620 and 621 together.
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
622. Deputy Bernard J. Durkan asked the Minister for Health the progress to date in the determination of eligibility for a medical card in the case of a person (details supplied); and if he will make a statement on the matter. [44614/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
623. Deputy Bernard J. Durkan asked the Minister for Health the progress to date in the determination of eligibility for a medical card in the case of a person (details supplied); and if he will make a statement on the matter. [44615/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
624. Deputy Bernard J. Durkan asked the Minister for Health the progress to date in the determination of eligibility for a medical card in the case of a person (details supplied); and if he will make a statement on the matter. [44616/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
