Limerick East): I move: “That the Bill be now read a Second Time.”
The purpose of this Bill is to make provision for primary health care services free of charge for persons who have contracted hepatitis C from a blood product or blood transfusion.
When the possible link between the anti-D product and hepatitis C was brought to the attention of my Department in February 1994, the immediate concerns were the protection of all future recipients of anti-D immunoglobulin and the identification of any risk for mothers who received the anti-D product in the past. The first objective was met by the immediate introduction of a new virally inactivated anti-D product to all maternity hospital units and the second objective was met by the launch by the Blood Transfusion Service Board of the national screening programme for anti-D recipients.
The 58,905 women who received anti-D between 1970 and February 1994 have been screened under the national blood screening programme and 980 have screened positive for hepatitis C antibodies, of whom 466 have tested positive for the virus. A targeted lookback programme to identify persons who had contracted hepatitis C from a blood transfusion was also undertaken. To date 263 living recipients have been traced under this programme. Testing for hepatitis C antibodies has been carried out on 208 persons and testing for hepatitis C virus has been carried out on 176 persons, of whom 72 have evidence of continuing hepatitis C infection.
The optional screening programme commenced in early September 1995 to trace a small number of persons who may have contracted hepatitis C from a blood transfusion who would not be traced under the targeted lookback programme. Some 7,901 persons have come forward for testing to date, of whom 20 have been confirmed positive for hepatitis C antibodies and 15 are positive for hepatitis C virus. The Government is committed to providing a high quality health service for all persons who have contracted hepatitis C from a blood transfusion or a blood product. Substantial progress has already been made during the past year in meeting the many complex and varied health care needs of those persons who have contracted hepatitis C. This has been made possible by a process of consultation between my Department and Positive Action — a support group for anti-D women and their families — and Transfusion Positive — a support group for blood transfusion recipients and their families, the Irish Kidney Association and the Irish Haemophilia Society.
Many of the concerns, particularly about future health care arrangements expressed by these groups have been addressed. The special health care programme involves an extensive range of services in the following areas: (i) secondary health care services; (ii) primary health care services; (iii) special research programme; (iv) statutory Monitoring Body.
Secondary health care treatment for those persons who have contracted hepatitis C from a blood product or blood transfusion has been provided since early 1994 at special consultant staffed clinics at six designated hospitals: St. James's Hospital, Dublin; Beaumont Hospital, Dublin; Mater Hospital, Dublin; St. Vincent's Hospital Dublin; Cork University Hospital and University College Hospital, Galway.
Specific funding will be provided in the Book of Estimates each year to ensure the consolidation and maintenance into the future of a high quality hospital in-patient and out-patient service including prescribed medication for persons who have contracted hepatitis C from a blood transfusion or blood product. The secondary care element of the health care services programme includes provision for: (i) access to in-patient and out-patient treatment; (ii) non-payment of hospital charges; (iii) appropriate staffing levels and arrangements for staff training; (iv) equipment for hepatitis C units; (v) anti-viral therapies and therapy initiation programmes; (vi) liver transplantation; (vii) treatment outside Ireland where necessary; (viii) liaison between the hospital service providers; and (ix) prompt referral to clinicians for conditions associated with hepatitis C.
The treatment services will also be available to children and partners who are hepatitis C positive. These secondary care services are being provided for under the Health Act, 1970.
The Government recognises the need for specific research in relation to hepatitis C particularly in view of the fact that hepatitis C was described for the first time in 1989 and that a reliable screening test had only become available in 1991. I have, therefore, arranged with the Health Research Board, for the establishment of a special programme of reseach on hepatitis C including research projects into hepatitis C as it relates to persons infected through the use of anti-D product. I have provided special funding of £100,000 to the Health Research Board to enable this special research programme to commence this year.
To ensure that the health service as it relates to persons who have contracted hepatitis C from a blood product or blood transfusion is responsive to the changing needs of such patients, I am establishing a statutory consultative council which will advise me on matters relating to hepatitis C. I have circulated a draft establishment order to interested groups for their views. The functions of the consultative council will include: the monitoring of health and counselling services for persons with hepatitis C; the making of recommendations on the organisation and delivery of services for persons with hepatitis C; publication of information on hepatitis C; and liaison with the health research board in relation to the special programme of hepatitis C research projects.
Following consultation with interested groups, I am currently considering a number of amendments to the draft establishment order to take into account the views expressed by these groups. The secondary health care services, the consultative council and the research programme do not require new legislation as there is already statutory provision for these initiatives.
As I have already indicated, the purpose of the Health (Amendment) Bill, 1995, is to make provision for primary health care services free of charge for persons who have contracted hepatitis C from a blood product or blood transfusion. The primary health care services to be provided by the Bill, free of charge and without a means test, are: general practitioner services including prescribed drugs and medicines; dental, ophthalmic and aural services; independent counselling services; home help services; and home nursing services.
In relation to the general practitioner services, those persons entitled may attend the general practitioner of their choice for all medical conditions.
The dental, ophthalmic and aural services will be provided for these people within the meaning of section 67 of the Health Act, 1970. Home help services within the meaning of section 61 of the Health Act, 1970, and home nursing services within the meaning of section 60 of the Health Act, 1970, will also be provided free of charge to persons who have contracted hepatitis C from a blood transfusion or a blood product. These arrangements will also apply to the children and partners of persons who have contracted hepatitis C from a blood product or a blood transfusion if such children and partners have also been diagnosed positive for hepatitis C.
Following consultation with the interested groups I propose to introduce an amendment on Committee Stage to clarify the entitlement for these specific categories of patients to be treated by the general practitioner of their choice for all medical conditions.
The Bill provides at section 2 that a health board shall make available certain health services without charge to persons who have contracted hepatitis C directly or indirectly from the use of a human anti-D product. I propose to introduce an amendment to this section on Committee Stage to include persons who have contracted hepatitis C from a blood transfusion or other blood product. It was always my intention to include these additional categories of patients by way of regulation, as is clear from the health care package for hepatitis C patients which I published in December 1995. However, following consultation with the representative groups I now propose to include these specific categories in the substantive legislation to allay any concerns that their members may have.
I also propose to introduce an amendment on Committee Stage to allow the chief executive office of the relevant health board to determine eligibility for these services within his discretion. I am introducing this amendment following detailed discussions with Transfusion Positive to meet their genuine concerns regarding difficulties that might arise in acquiring past medical records for a number of their members.
In detailed discussion with Transfusion Positive over the last number of weeks officers of my Department offered to give all necessary assistance to their members who were meeting difficulties in locating past medical records. Transfusion Positive subsequently wrote to all their members and yesterday details of eight persons who were encountering difficulties were forwarded to my Department.
On Committee Stage, I also propose to bring forward an amendment to include a provision in relation to a commencement order. This will allow me time to finalise the necessary arrangements to ensure the provision of a high quality primary health care service.
In relation to the provision of the general practitioner services free of charge, I hope to commence negotiations with the general practitioner representative groups in the immediate future. I trust that the co-operation shown recently by these groups in working successfully with my Department in relation to launching the optional testing programme will carry forward into the provision of these services.
It will be necessary also to finalise arrangements in respect of the delivery of dental and other primary health care services outlined in the Bill. I am confident I will be in a position to make the commencement order at an early date to put the services provided for in this Bill into effect. I assure the House that whatever financial resources are necessary to meet the cost of these new services will be made available by me to the health boards.
In addition to providing for the health care needs of these persons, the Government is fully committed to fair compensation for those persons who contracted hepatitis C from a blood product or blood transfusion. I established the compensation tribunal on 15 December 1995 and three priority cases have been heard to date. I understand that the tribunal has also listed cases for hearing during the months of March and April. I have every confidence that the tribunal will operate smoothly, efficiently and fairly.
The Health (Amendment) Bill, 1995, will copperfasten the Government's commitment to meeting the future health care needs of persons who have contracted hepatitis C from a blood transfusion or a blood product. The health care services, both at primary care and secondary care levels, will meet the genuine concerns in relation to the continued provision of high quality health care into the future for those who have contracted hepatitis C.
I commend the Bill to the House.