asked the Minister for Health if he is satisfied that all incidents of notifiable diseases are being reported; if he will consider reviewing the procedures to ensure a more effective method of reporting; and if he will make a statement on the matter.
Ceisteanna — Questions. Oral Answers. - Notifiable Diseases.
15.
The number of cases of infectious diseases notified to my Department under the Infectious Diseases Regulations, 1981, does not represent the true incidence of these diseases. Despite the fact that the diseases are under-notified, the current level of reporting does enable my Department and the health boards to monitor trends in the incidence of the diseases, based on which appropriate interventions may be initiated.
Ideally, however, information regarding infectious diseases should be as comprehensive as possible and, with the objective of improving notification and reporting, my Department recently reviewed the appropriate procedures. Following this review, a comprehensive circular was issued to the health boards on 7 March last laying down revised guidelines designed to facilitate the collection and dissemination of detailed information regarding infectious diseases.
Is it not a fact that it is compulsory to report infectious diseases or am I mistaken in this? Are the medical profession not compelled — and have been for a long number of years — to report certain diseases which are classified as notifiable diseases? Is the Minister saying that they are not adhering to these regulations?
It is true that, under the 1981 regulations, medical practitioners, including family doctors and hospital doctors, are obliged to notify the local DCC, and MOH on a regular weekly basis of cases, or suspected cases, of notifiable diseases seen by them. Then the MOH, in turn, compiles a return in respect of his community care area and submits this return to the Department of Health every week. We then compile a national return of the diseases on the basis of the returns furnished from the various community care areas. We circulate national weekly returns back to the health boards, to all the community care teams and to the other appropriate personnel. Medical practitioners are also paid to do it. There have been some very old fees obtaining, for example, 12½p for each disease, except venereal disease and tuberculosis, for which for some reason a fee of 25p was payable. I up-dated the whole lot. Arising from a review carried out I am now paying a notification fee of £1.50 for each case or suspected case. I have up-dated the other regulations. As and from this year I think there will be a very considerable improvement. I am gravely concerned about some diseases, for example, the under-notification in relation to venereal disease, indeed its massive under-notification in this country. The framework has to be tightened up very considerably. The fees are now at a realistic level but, as the Deputy knows, the medical profession generally do not sign documents or submit returns unless they are paid to do so.
I congratulate the Minister on having up-dated the procedures. Has the Minister got the power — if he wishes to use it — to prosecute in cases where he knows that notifiable diseases have not been notified. Does he intend to use that power if he has it?
Yes, there is a statutory requirement devolved on medical practitioners to do so. I have sent a special circular to each health board. A model letter is being sent to each medical practitioner in each health board area. I have sent a detailed letter and also the particular questionnaire to be returned on a weekly basis under the 1981 regulations. I have also listed the particular diseases which are obliged to be notified or returned.
On the basis of the increase in fees to £1.50 for the notification of either infectious diseases or suspected infectious diseases, is the Minister satisfied there is no danger that some members of the medical profession might not have greater suspicions now that the fee payable has been increased? Has the Minister any comment to make on that?
No, the matter will be normalised, particularly in relation to venereal disease. I am particularly concerned that contact-tracing and so on should be brought fully up to date. I am satisfied that the regulations are now being effectively implemented.