Emer Higgins
Question:564. Deputy Emer Higgins asked the Minister for Health the reason the HSE no longer helps people find a GP who accepts medical card patients; and if he will make a statement on the matter. [44040/23]
View answerGeneral Practitioner Services
Questions (564, 576, 577, 578, 579)
Mary Lou McDonald
Question:576. Deputy Mary Lou McDonald asked the Minister for Health to outline the rationale behind the decision to restrict or cap the number of assigned patients each GP has to take on; the current cap for each GP; and if he will make a statement on the matter. [44079/23]
View answerMary Lou McDonald
Question:577. Deputy Mary Lou McDonald asked the Minister for Health to outline the reason for removing the obligation on GPs to take patients assigned by the HSE; the consultation, if any, that was undertaken with community-based organisations who provide support and care to vulnerable persons seeking access to healthcare; and if he will make a statement on the matter. [44080/23]
View answerMary Lou McDonald
Question:578. Deputy Mary Lou McDonald asked the Minister for Health to confirm what is meant by "limited ability to assign a GP providing GP visit card/medical card services", further to correspondence received at my office (details supplied). [44092/23]
View answerMary Lou McDonald
Question:579. Deputy Mary Lou McDonald asked the Minister for Health to confirm the arrangements that are currently in place to assign a GP to persons holding a GMS or GP only card who have tried unsuccessfully to access three GPs in their area and cannot find a GP to accept them. [44093/23]
View answerWritten answers
I propose to take Questions Nos. 564 and 576 to 579, inclusive, together.
Patient choice of doctor is a bedrock principle of the GMS Scheme for medical card and GP visit card holders. For the vast majority of individuals concerned their choice of doctor is accommodated and they are registered with their GMS GP of choice. In 2022 (last full year data available) out of a total of about 348,000 individuals who were approved for either a GP Visit Card or Medical Card, 3,927 individuals were unable to secure placement with their doctor of choice, or 1.1% of the total. In addition, 3,701 existing GMS patients were reassigned following a change in their place of residence.
For the small number of individuals unable to locate a GP themselves, the long standing process whereby the HSE may assign an eligible person to a GP’s GMS panel remains in place, in accordance with the GMS contract. Where a patient who holds a medical card or GP visit card experiences difficulty in finding a GP to accept them as a patient, the person concerned having unsuccessfully applied to at least three GPs in the area (or fewer if there are fewer GPs in the area) can apply to the HSE National Medical Card Unit which has the power to assign that person to a GP's GMS patient list.
The GP Agreement 2023, which provides for the expansion of GP care without charges to all children under 8 years and to those who earn up to the median household income, does contain arrangements in relation to the assignment of card holders/applicants to GP GMS panels. However, these arrangements do not prevent the assignment of patients and rather are in place to help the equitable distribution of assigned patients across the panels of participating GPs. Details of the arrangements, which includes the number of permitted assignments per individual GP by GMS panel size, are set out in the Agreement which is available on the website of my Department.
In addition, as per the Agreement, a joint HSE and Irish Medical Organisation working group is being established to review the operation of the patient assignment protocol with a view to ensuring that it is framed and operating in a fair, patient- and GP-centred manner.
Health Services Staff
Questions (565)
Fergus O'Dowd
Question:565. Deputy Fergus O'Dowd asked the Minister for Health for an update on the process to bring parity of pay and conditions of workers in Section 38 and Section 39 organisations; and if he will make a statement on the matter. [44043/23]
View answerWritten answers
Officials from the Department of Children, Equality, Disability, Integration and Youth with support from the Department of Health, the HSE and Tusla attended a number of engagements with trade unions under the auspices of the WRC over recent months.
That process culminated in an offer being made to unions. The offer was in line with those accepted by community and voluntary staff in other sectors. The offer to workers in this sector amounted to a 5% increase in funding for pay effective from November 2023, with 3% backdated to April 2023. A commitment to re-engage with trade union representatives following any further public sector pay agreement was also offered.
This combined offer was not accepted by trade union representatives, and it is disappointing that their members were not afforded the opportunity to vote on whether they wished to accept the 5% increase in pay funding.
The Unions have balloted for industrial action and have advised they intend to strike from the 17th of October (2023).
Any industrial action will impact negatively on service users and the Departments urge all parties to work on resolving any disputes through the appropriate forums, in the interests of users of these services. Government remains committed to working with the unions to resolve these matters.
While Government has engaged in this process, it is worth noting that Section 39 and Section 56 organisations are privately owned and operated, and the terms and conditions of employment for staff in those organisations are ultimately between the employer and their employee. The Government is not the employer for any of these staff. As this is an ongoing Industrial relations matter it would be inappropriate to comment any further.
Hospital Facilities
Questions (566)
Holly Cairns
Question:566. Deputy Holly Cairns asked the Minister for Health if his attention has been drawn to staff dissatisfaction at the removal of 480 staff car parking spaces from the CUH and CUMH campus to accommodate new capital projects; whether staff and their representative unions will be consulted regarding the removal of car parking spaces; and if he will make a statement on the matter. [44054/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Qualifications Recognition
Questions (567)
Holly Cairns
Question:567. Deputy Holly Cairns asked the Minister for Health the average time it takes for physiotherapists who received their qualification in Ireland to be accredited by CORU; the average time it takes for physiotherapists who received their qualification outside Ireland to be accredited by CORU; and if he will make a statement on the matter. [44055/23]
View answerWritten answers
Departmental officials have been in touch with CORU on the matters raised by the Deputy. CORU has confirmed that the average time it takes Irish qualified physiotherapists to be registered with CORU is eight weeks from commencing the application process. The timeframe for registration of those with overseas physiotherapy qualifications is similar once the ‘recognition’ process is complete.
Physiotherapy qualifications awarded outside the State are assessed through a process of ‘recognition’ which involves comparison of the qualification with the standard of proficiency required of accredited Irish physiotherapy qualifications. Applicants with overseas qualifications must complete the recognition process before registration can be obtained. CORU have confirmed that the average timeframe for internationally accredited physiotherapists to have their qualification recognised is 75.30 days based on data from Q1 – Q3 of 2023.
CORU have implemented, and are implementing, a number of initiatives to help improve the timeframes for both recognition and registration including:
• Full transfer to an online application system.
• Assignment of additional temporary staff resources
• Recruitment of additional expert assessors
• Work has been ongoing to identify possible new approaches for recognition of international qualifications. In addition, new systems operable within the law as it stands are being researched and tested to speed up the process.
• CORU invite applicants whose recognition applications are considered complete to apply for registration at that time so that the recognition and registration tasks can be processed in parallel.
• The frequency of Registration Board meetings has also been increased to allow for quicker decision-making.
Hospital Transfers
Questions (568)
Alan Dillon
Question:568. Deputy Alan Dillon asked the Minister for Health if transfers can be made for families who are on the waiting list for surgery in Temple Street Hospital for a person (details supplied); and if he will make a statement on the matter. [44057/23]
View answerWritten answers
As this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Question No. 569 answered with Question No. 522.
Health Services
Questions (570)
James Lawless
Question:570. Deputy James Lawless asked the Minister for Health to examine an issue with the chiropody card system whereby a new system introduced recently has caused a delay in clinics receiving payment on time (details supplied); if he can assess this system; and if he will make a statement on the matter. [44064/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Health Services
Questions (571)
John Lahart
Question:571. Deputy John Lahart asked the Minister for Health how Ireland ranks according to the latest IQVIA Patients WAIT Indicator Survey; the rate of availability of new medicines in Ireland compared with the EU average; the average waiting time for access to new medicines in Ireland in comparison with the EU average; and the average waiting time for patients in Ireland. [44065/23]
View answerWritten answers
The Health (Pricing and Supply of Medical Goods) Act 2013 provides a rigorous process for the assessment of new medicines for reimbursement. This allows taxpayers to be confident both that the right medicines are chosen, and that those medicines are approved at a price that can sustainably be afforded in a budget-limited health service. Economic assessment is valuable to stretch the funds granted to the HSE as far as possible, allowing them to provide a range of services as well as innovative medicines for all citizens.
The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency (EMA) or the Health Products Regulatory Authority. In line with the 2013 Act, and the national framework agreed with industry, a company must first submit an application to the HSE to have a new medicine added to the reimbursement list.
The timing of company applications for reimbursement in different countries can vary for a number of reasons, not least the available market share in each country. Once a company responsible for the commercialisation of a new medicine receives market authorisation, it can apply for reimbursement in the country (or countries) of its choice. Ireland, by virtue of its size and market share, may not always be prioritised by a company in the first stages of marketing a new product. Describing timelines for reimbursement from EMA approval to HSE reimbursement approval does not consider this important factor and misrepresents the process, as statutorily the HSE would not be able to approve or assess a drug until an application for reimbursement was received.
When an application is made to have a product added to the reimbursement list in Ireland, the HSE is required, under the 2013 Act, to decide within 180 days of receiving the application, to either add the medicine to the reimbursement list or refuse to reimburse the medicine. In assessing the application, the HSE is required to consider a range of criteria including the magnitude of the clinical effect, cost effectiveness, budget impact, opportunity cost and unmet need.
The principal factors in determining the speed of reimbursement are the price at which a manufacturer applies for the reimbursement of a product and the outcome of the HSE’s rigorous assessment process as to its clinical and cost-effectiveness.
In terms of the time taken from application to a decision on reimbursement, the HSE advise that the biggest impediments to achieving the 180-day timeline is often the failure of companies to provide sufficient evidence to support the efficacy of some medicines, and the need for the HSE to get involved in protracted negotiations in seeking to achieve better prices for the State.
The State is committed to providing timely access to new and innovative medicines to all patients. Budget 2021 allocated €50 million for the reimbursement of new drugs, enabling the HSE to approve 52 new medicines. 18 of these medicines had orphan designation.
Budget 2022 allocated a further €30 million for the reimbursement of new medicines allowing the HSE to approve 60 new drugs, 16 of which had orphan designation.
Further dedicated funding of €18 million was allocated in Budget 2023, enabling reimbursement approval for 17 new drugs.
The pricing and reimbursement of medicines is a national competence. Different pharmaceutical reimbursement systems are currently in place across the EU. As Member States operate different systems, a direct comparison of the reimbursement of products is not possible.