Written Answers Nos. 1015 - 1035
1015. Deputy Aengus Ó Snodaigh asked the Minister for Health further to Parliamentary Question No. 232 of 10 October 2012, the reason for the delay in the approval of ankle and foot orthotics in respect of a person (details supplied) in County Dublin; if he will ensure that this application is processed promptly; and when the child is likely to get approval in order that their splints may be ordered [47543/12]
View answerAs the Deputy's question relates to service matters I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
1016. Deputy Finian McGrath asked the Minister for Health if he will not cut the funding in respect of an organisation (details supplied) [47544/12]
View answerPending completion of the national estimates, budgetary and service planning process for 2013 it is not possible to predict the service levels to be provided next year.
1017. Deputy Peter Mathews asked the Minister for Health if he will ensure that the recommendation of the Joint Department of Health/Health Service Executive Working Group proposed Model for reference Pricing and Generic Substitution report is followed so that all anti epileptic drugs be excluded from generic substitution; and if he will make a statement on the matter. [47598/12]
View answerUnder the Health (Pricing and Supply of Medical Goods) Bill, the Irish Medicines Board has statutory responsibility for establishing and publishing a list of interchangeable medicinal products in respect of which it is satisfied that all the medicinal products which fall into a group of interchangeable medicinal products are, for prescription purposes, interchangeable with each other. It is important to point out that generic medicines must meet exactly the same standards of quality and safety and have the same effect as the originator medicine. All of the generic medicines on the Irish market are required to be properly licensed and meet the requirements of the Irish Medicines Board. To further enhance the patient safety aspect of generic substitution, Section 13 of the Bill gives a prescriber the option of indicating on a prescription that a branded interchangeable medicinal product should, for clinical reasons, not be substituted.
The Health (Pricing and Supply of Medical Goods) Bill 2012 was published on the 13th of July 2012. The Bill completed its passage through the Seanad on Wednesday, the 19th of September, and is currently continuing its passage through the Dáil. An Implementation Group on Generic Substitution and Reference Pricing has been established and it held its inaugural meeting on the 9th of August 2012. The Group is to meet with stakeholders, including the Irish Epilepsy Association, in the near future.
1018. Deputy Seán Ó Fearghaíl asked the Minister for Health if he will arrange for urgent surgical intervention in respect of a person (details supplied); and if he will make a statement on the matter. [47599/12]
View answerAs this is a service matter, it has been referred to the Health Service Executive for direct reply.
1019. Deputy Terence Flanagan asked the Minister for Health if he will respond to a query regarding the recycling of crutches; and if he will make a statement on the matter. [47601/12]
View answerAs this is a service matter, it has been referred to the Health Service Executive for direct reply.
1020. Deputy Seán Ó Fearghaíl asked the Minister for Health if he will approve a medical card in respect of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [47607/12]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.
1021. Deputy Thomas P. Broughan asked the Minister for Health the amount owed in total by health insurers in hospitals here since 2009; and his views on the global figure and the amount that each hospital is owed on an individual basis; the steps he is taking to recoup these fees; and if he will make a statement on the matter. [47624/12]
View answerThe amount of money outstanding in private insurance income at the 31st July 2012 is €216m, of which €125m is due to statutory hospitals and €91m to voluntary hospitals.
It is acknowledged that the public hospital system has unacceptably long delays in relation to income collection and a number of measures are being progressed in order to address this. The HSE is continuing a drive to reduce the time taken to submit claims to private health insurance companies. A key element in this drive includes the implementation of an electronic claims management system in its hospitals which has commenced with six hospitals already live. This system will address the deficiencies of the paper based process and will also ensure that standardised work practices are implemented across hospitals. In the meantime, the Department has agreed, in principle, a system of improved cash-flow and accelerated payment with private health insurers. This will provide a once-off cash flow benefit in 2012 in the order of €125m.
1022. Deputy Olivia Mitchell asked the Minister for Health if he will provide a list of hospitals operated or funded by the Health Service Executive who have service level agreements in place with third party commercial entities to undertake the collection of cord blood; and if he will make a statement on the matter. [47625/12]
View answerThe Deputy's question relates to service delivery matters and accordingly I have asked the HSE to respond directly to her.
1023. Deputy Mary Lou McDonald asked the Minister for Health the number of home help hours withdrawn from the system for elderly persons since the beginning of this year. [47628/12]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
1024. Deputy Billy Kelleher asked the Minister for Health the amount he expects to spend on medicines in 2012; if the Health Service Executive has sufficient budgetary resources to meet this cost; and if he will make a statement on the matter. [47680/12]
View answer1025. Deputy Billy Kelleher asked the Minister for Health in view of the recent agreement with the Irish Pharmaceutical Healthcare Association, if he expects the State’s total medicines bill for 2013, to be lower than that for 2012; the extent to which it will be lower if this is the case; and if he will make a statement on the matter. [47681/12]
View answer1026. Deputy Billy Kelleher asked the Minister for Health the amount he expects to be spent on newly authorised medicines in 2012; if he will name these medicines; and if he will make a statement on the matter. [47682/12]
View answer1027. Deputy Billy Kelleher asked the Minister for Health the amount that the State’s spending on newly authorised medicines is estimated to be for each of the next three years of the Irish Pharmaceutical Healthcare Association Agreement; the person charged with compiling this estimate; and if he will make a statement on the matter. [47683/12]
View answerI propose to take Questions Nos. 1024 to 1027, inclusive, together.
The HSE estimates that expenditure in 2012 on drugs and non-drug items (dressings, etc.) under the GMS and community drug schemes, including mark ups and dispensing fees will be approximately €1.7 billion. In addition, about €300m will be spent on drugs and medicines used in public hospitals. The HSE estimates that the cost of new drugs in 2012 will be approximately €15 million. Examples include the cancer drug, ipilimumab, and the hepatitis C drugs, boceprevir and teleprevir. The cost of new drugs between 2013 and 2015 is estimated to be approximately €70 million per annum. It is estimated that the recent agreement with the Irish Pharmaceutical Healthcare Association (IPHA) will generate gross savings of up to €116m in 2013. However, the net savings will be affected by the cost of new drugs and by any significant increase in the volume of drugs consumed under the community drugs schemes.
1028. Deputy Billy Kelleher asked the Minister for Health the mechanism by which reference pricing for medicines will be delivered; the person who set the reference price; the model that will be used; the date on which it will take effect; and if he will make a statement on the matter. [47684/12]
View answerThe Health (Pricing and Supply of Medical Goods) Bill 2012 provides for the introduction of a system of generic substitution and reference pricing. Generic substitution allows pharmacists to substitute a cheaper generic equivalent, at the patient’s request, when a more expensive product has been prescribed. Reference pricing involves setting a common reimbursement amount for selected groups of medicines, which will be done by the HSE. Only the reference price is reimbursed by the State. Eligible patients can avoid out-of-pocket payments by opting for a generic medicine at or below the reference price.
Reference pricing coupled with generic substitution provides patients with an incentive to opt for the cheapest available product, but does not impose any unavoidable additional costs on patients. As more medicines come off patent, the introduction of generic substitution and reference pricing will ensure that both taxpayers and patients will benefit from increased competition in the pharmaceutical market.
Savings will be achieved by limiting reimbursement to the reference price, allowing patients to opt for less expensive versions of the prescribed medicine, and promoting price competition between the manufacturers of interchangeable medicines.
1029. Deputy Tom Fleming asked the Minister for Health the steps he proposes to take to address concerns (details supplied) in respect of Kerry General Hospital where as a result of cuts up to 500 surgical operations were cancelled over the summer period and a further 300 cancellations are planned between now and the end of the year; if he will reassure the County Kerry public that this hospital will not be downgraded; and if he will make a statement on the matter. [47669/12]
View answerOver the last two to three years, despite a reduction in budget, the HSE have made considerable gains in relation to service provision at Kerry General Hospital. The hospital will retain the level of services required to provide services in its 24 hour Emergency Department (ED), into the future. The newly opened ED and the two recently appointed ED consultants are testament to this achievement along with the upskilling and development of nursing posts to the role of advanced nurse practitioner. The new ED provides the environment to deliver a range of services in an appropriate environment for both those attending as well as the staff who provide the service.
Allied to that, there has been an expansion in consultant physician numbers in the hospital in conjunction with the impending opening of the new Acute Medical Assessment Unit and the associated relocation of cardiology services to new facilities within the hospital. Tralee Community Nursing Unit was recently opened and this enabled the transfer of long stay care services from the acute hospital to more appropriate facilities, a move greatly welcomed by the community. There has also been an expansion in consultant surgeon numbers. These are just some of the positive developments that have taken place and are not the mark of a hospital with a doubt as to its future.
Surgical services in Kerry General Hospital are currently delivering well in excess of the funded level of provision. Hospital management, in conjunction with the consultant surgeons, put measures in place to control the position or it would otherwise have placed the hospital in further financial difficulty. Prudent management is required to ensure appropriate measures are in place to provide service to the funded level and not beyond. In this regard it is also important to be clear that at no stage has there been a reduction imposed or considered in relation to emergency surgery in the hospital.
All clinical targets such as in-patient and day procedure activity have to be adhered to and where there are areas of activity over the service plan targets control measures are put in place to bring activity into line with the hospital service plan. For example in Kerry General Hospital sixty theatre lists were removed over the summer period to control activity levels in line with resource and this will be extended as necessary. This has culminated in a necessary planned reduction of theatre usage over the coming months.
It is acknowledged that there are significant challenges in delivering services in the current economic environment. As with all public hospitals, there is an increasing demand for services at Kerry General Hospital. Despite the high level of flexibility shown by the staff to maintain and improve the level and quality of service, the task is a constant and significant challenge. The management team at Kerry General Hospital are aware of these issues and are constantly working to resolve them.
The delivery of safe services has remained the priority across the Kerry Area in 2012 and the cooperation and flexibility of staff across the services, in line with the requirements of the Public Service Agreement, has yielded significant success.
The Regional Service Plan 2012 set out an ambitious programme of reorganisation of services given the position that there would be a reduction in staffing and available funding. The evidence as outlined for the Kerry Area shows that significant progress has been made in the majority of the targets as set out in the plan. The hospital in particular is working with the requirements of the clinical programmes in acute medicine, surgery and emergency medicine, to be as efficient as possible in the face of the demand for the services, and will continue to do so to the year end.
With regard to consultant positions in the hospital, vacancies are being processed through the Public Appointments Service in order to replace staff who have retired. Replacement positions in the areas of radiology, anaesthetics, and orthopaedic surgery are currently being processed in this manner. Two replacement positions in paediatrics have recently been filled.
Finally, there should be no concern with regard to the future of Kerry General Hospital as a level three hospital, and the above outline of developments show that the hospital remains of significant importance in the network of acute services in the South area.
1030. Deputy Robert Troy asked the Minister for Health if he will issue a date for a hip operation in Tullamore Hospital, County Offaly, in respect of a person (details supplied) in County Westmeath [47670/12]
View answerAs this is a service matter, it has been referred to the Health Service Executive for direct reply.
1031. Deputy Jack Wall asked the Minister for Health the position regarding hospital transport in respect of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [47695/12]
View answerAs this is a service matter, it has been referred to the Health Service Executive for direct reply.
1032. Deputy Jim Daly asked the Minister for Health the position regarding a medical card holder paying the difference in cost between a generic drug and a branded drug and for pharmacies to accept the payment for the difference in cost; and if he will make a statement on the matter. [47732/12]
View answerThe Health (Pricing and Supply of Medical Goods) Bill 2012 provides for the introduction of a system of generic substitution and reference pricing. Generic substitution allows pharmacists to substitute a cheaper generic equivalent, at the patient’s request, when a more expensive product has been prescribed. Reference pricing involves setting a common reimbursement amount for selected groups of medicines, which will be done by the HSE. Only the reference price is reimbursed by the State. Eligible patients can avoid out-of-pocket payments by opting for a generic medicine at or below the reference price.
Reference pricing coupled with generic substitution provides patients with an incentive to opt for the cheapest available product, but does not impose any unavoidable additional costs on patients.
1033. Deputy Bernard J. Durkan asked the Minister for Health if he will review the decision to refuse a medical card in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [47756/12]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.
1034. Deputy Seamus Kirk asked the Minister for Health if he will outline the areas in which hospitals north and south will cooperate with each other; the potential services which will be operated on a cross border basis; and if he will make a statement on the matter. [47759/12]
View answerThe North-South Feasibility Study, finalised in 2009, examined the potential for joint co-operation in health across an extensive range of health and social care services. It set out 10 priority recommendations and many of these are already being taken forward. Areas of ongoing collaboration include - child protection, cancer research, health promotion, suicide prevention, radiotherapy services, paediatric congenital cardiac surgery and a range of initiatives under the Interreg IVA funding initiative. The Study was published on the websites of the Irish Department of Health and the Department of Health, Social Services and Public Safety in Northern Ireland last December.
At a departmental level co-operation between the two jurisdictions is active and ongoing. "Transforming Your Care: a Review of Health and Social Care in Northern Ireland." also recommends co-operation on a number of key issues. My officials are liaising with their counterparts in the Department of Health, Social Services and Public Safety in Northern Ireland on how to progress these issues.
A good example of North South cooperation is the development of new radiotherapy facilities at Altnagelvin Hospital, where it is expected that services will commence in 2016. The Unit will provide more locally accessible and timely services and improve patient travelling times for patients in the North Western area, particularly patients in the Donegal area.
The Minister has committed once-off capital funding up to a ceiling of €19 million for the project and the HSE will fund the provision of radiotherapy services for patients from the Republic of Ireland. These patients will continue to have their diagnosis, surgery and other treatment planning in either Letterkenny General or Galway University Hospital, or one of the eight designated cancer centres. Chemotherapy will also be provided in either Letterkenny or Sligo General Hospital. Complex cancers, e.g. pancreatic cancer, will be managed at the designated cancer centres.
With regards to paediatric congenital cardiac surgery in particular there have been two meetings between the Department of Health and the Department of Health and Social Services and Public Safety and contacts are continuing with a view to determining as soon as possible how best an all-island service might be established and how soon this could be realised if it is determined, through consultation, to be the optimum solution. Another meeting is to take place on 9th November and in the meantime a project team comprising the hospital, HSE and Department of Health in Dublin is working on the issue to establish precisely the requirement to put in place this all-island service.
I am committed to working together with my Northern colleagues on issues of common concern and benefit. This is of particular relevance in the current time when both jurisdictions are implementing change and pushing forward health reform.
1035. Deputy Jack Wall asked the Minister for Health when a person (details supplied) will receive a hospital appointment; and if he will make a statement on the matter. [47799/12]
View answerAs this is a service matter, it has been referred to the Health Service Executive for direct reply.
