Tuesday, 6 Nov 2012

Written Answers Nos. 1036-1056

Drugs Payment Scheme Administration

Questions (1036)

Finian McGrath

Question:

1036. Deputy Finian McGrath asked the Minister for Health if he will support the new drug for Cystic Fibrosis patients (details supplied) [47802/12]

Written answers

Minister of State at the Department of Health

The HSE recently received an application for Kalydeco's inclusion under the Community Drugs Scheme. In accordance with normal procedures, the National Centre for Pharmacoeconomics must conduct a Health Technology Assessment (HTA) on this product which will consider if the drug is cost effective at the price offered to the HSE. No reimbursement decision will be made until the HTA has been completed.

Health Services Expenditure

Questions (1037)

Mattie McGrath

Question:

1037. Deputy Mattie McGrath asked the Minister for Health under the bilateral agreement with the UK, the amount charged by the Health Service Executive for the treatment of patients who would be covered by the UK health system; the way this charge is calculated; what this charge is used for; and if he will make a statement on the matter. [47781/12]

Written answers

Minister for Health

Ireland operates a bilateral health care reimbursement agreement with the United Kingdom, in respect of health services provided under EU Regulations, covering such persons as temporary visitors between the two countries, pensioners of one country and their dependants residing in the other country, and the dependant families of persons employed in the other country. Under the terms of the agreement net liability between the two countries is calculated on a lump sum basis rather than an individual basis. The amount payable is the net difference between the costs to the Irish health services of providing care to those with only UK entitlements and the cost to the UK health services of providing services to those with only Irish entitlements. The payment made in any one year is based on an estimate of the number of persons falling within categories eligible for reimbursement and for whom each country is liable and an estimate of the average cost of providing health care treatment. The amount payable is agreed following compilation of the necessary data and discussions between the two administrations. Payments are made in advance and are subject to final settlement once all necessary statistical and financial information is complete. Total payments in any one year can relate to both final settlements in respect of previous years' liabilities and advance payments in respect of the current year.

By far the largest part of the net payment received from the UK authorities on an annual basis relates to the provision of health care to UK pensioners and their dependants residing in Ireland. The estimated number of pensioners for whom each country is liable was based on a survey by both administrations undertaken every three years, the most recent of which was completed in 2008. Recently both administrations agreed in principle to work towards a form of pensioner registration which will form the basis for calculating pensioner reimbursement costs in the future and agreed interim arrangements, based on previous survey results trends, for determining pensioner liability pending the implementation of same.

The amounts are received by the Health Service Executive as Appropriations-in-Aid and are offset against the gross funding requirements of the Executive at national level thus reducing the net liability to the Exchequer. A net amount of €270 million was received under the bilateral agreement in 2011.

Medicinal Products Licensing

Questions (1038)

Brian Walsh

Question:

1038. Deputy Brian Walsh asked the Minister for Health if he will provide an update on work by his Department to examine the way cannabis based medicinal products such as Sativex may be legally prescribed by medical practitioners for use by patients for the treatment of Multiple Sclerosis here; and if he will make a statement on the matter. [47811/12]

Written answers

Minister of State at the Department of Health

My Department has been informed by the Irish Medicines Board (IMB) that it is in receipt of a market authorisation request from a manufacturer under the EU Mutual Recognition Procedure for a medicinal product containing Cannabis extract. This product is indicated for the relief of symptoms of spasticity for people with multiple sclerosis. Clinical trials in Ireland relating to this product will not be required.

Department officials are currently examining how best to legally describe authorised cannabis-based medicinal products so that they may be prescribed to patients in Ireland while maintaining existing controls on cannabis and cannabis substances similar to those that apply to other controlled drugs that can be misused. It is hoped to bring forward legislative proposals in early 2013.

Medical Card Appeals

Questions (1039)

Jack Wall

Question:

1039. Deputy Jack Wall asked the Minister for Health the position regarding an appeal against the decision to refuse an application for a full medical card in respect of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [47814/12]

Written answers

Minister for Health

As this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.

Medical Card Drugs

Questions (1040, 1166)

Dara Calleary

Question:

1040. Deputy Dara Calleary asked the Minister for Health the name of each drug and product which has been withdrawn from the medical card scheme in 2012 and the basis for the withdrawal of each item [47815/12]

Aengus Ó Snodaigh

Question:

1166. Deputy Aengus Ó Snodaigh asked the Minister for Health if he will provide a list of medications that have been taken off the medical card over the past 12 months [48531/12]

Written answers

Minister of State at the Department of Health

I propose to take Questions Nos. 1040 and 1166 together.

In the current financial environment the Health Service Executive (HSE) is facing a challenge to deliver services in a way that will minimise any adverse impact on patients and continue to protect, as far as possible, the most vulnerable citizens. Unfortunately, it has become necessary for the HSE to suspend certain products from its list of reimbursable items. These include glucosamine, omega-3 triglyceride products, orlistat, and gluten-free products.

Glucosamine is indicated for the management of symptoms of osteoarthritis. The National Centre for Pharmoeconomics (NCPE) have assessed the cost-effectiveness of glucosamine on two occasions and concluded that it did not offer value for money to the HSE. However, glucosamine products are available over the counter without prescriptions.

Omega-3 triglyceride products (e.g. Omacor) have been identified both nationally and internationally as not being cost effective or being of lesser benefit to patients. However, these products are also available over the counter without prescriptions, as is Orlistat.

Gluten-free products have become more widely available in supermarkets in recent years and tend to be significantly cheaper than products sold through community pharmacies. A Supplementary Welfare Allowance Adult Diet Supplement may be awarded by the Department of Social Protection to eligible persons. Persons wishing to apply for this allowance can do so by completing an application form which can be downloaded at the following link: http://www.welfare.ie/EN/Forms/Documents/swa9.pdf. Separate application forms are available for children. For persons who are not awarded a Diet Supplement, moneys spent on gluten-free foods can be taken into account for tax purpose.

A full list of items available under the community drug schemes is available on the HSE's Primary Care Reimbursement Service website, www.pcrs.ie (choose 'List of Reimbursable Items'). In addition, the monthly updates (additions and deletions) to the product list are provided at the same location under 'Updates to the List of Reimbursable Items and High Tech Scheme List'.

Health Services Provision

Questions (1041)

Finian McGrath

Question:

1041. Deputy Finian McGrath asked the Minister for Health the supports available in respect of persons (details supplied) in Dublin 17 [47819/12]

Written answers

Minister of State at the Department of Health

As 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.

Home Help Service Provision

Questions (1042)

Finian McGrath

Question:

1042. Deputy Finian McGrath asked the Minister for Health the position regarding home help in respect of a person (details supplied) in Dublin 3 [47820/12]

Written answers

Minister of State at the Department of Health

As this is a service matter it has been referred to the Health Service Executive for direct reply.

General Medical Services Scheme Administration

Questions (1043)

Michael Healy-Rae

Question:

1043. Deputy Michael Healy-Rae asked the Minister for Health the position regarding replacement doctors (details supplied); and if he will make a statement on the matter. [47712/12]

Written answers

Minister of State at the Department of Health

A General Medical Services (GMS) panel can become vacant for a number of reasons, some of which can be foreseen and planned for, such as retirements or resignations, and others may arise due to unforeseen circumstances, for example sudden death or sudden incapacity of a general practitioner (GP).

In the case of foreseen/planned vacancies, the HSE will endeavour to put appropriate arrangements in place in advance of the GP retiring/resigning. Retirements can be planned for well in advance and the transition to a replacement GP contractor(s) generally runs smoothly, with minimal inconvenience arising for patients. In the case of resignations, the time frame for effecting the transition will normally be 3 months. Occasionally, due to logistical factors outside of the HSE's control, it can prove challenging to have the permanent replacement in situ prior to the existing contractor's departure but where this arises, temporary arrangements, such as the appointment of a locum or cross cover by other GPs in the locality, are put in place in the interim.

In the case of unforeseen vacancies arising due to the sudden death of a GP, the HSE is required to put an interim arrangement in place to ensure continuity of service for patients pending the engagement of a replacement GP contractor(s). This would involve locum cover or cross cover as mentioned above.In the case of sudden incapacity, the GP (where he/she is in a position to do so) would organise the interim cover arrangements and where he/she is not in a position to so do, the HSE would make the necessary arrangements pending either the GPs return to duty or the engagement of a replacement GP contractor(s).

I should point out that at no time in any of the above scenarios are GMS patients left without a named doctor. It is also worth noting that the enactment of the Health (Provision of General Practitioner Services) Act 2012 is of relevance in this context. As the number of GPs entering the GMS under the provisions of this Act increase over time it will assist in mitigating any service continuity issues that may arise when GMS panels become vacant, particularly in unforeseen circumstances.

Vaccination Programme

Questions (1044)

Michael Healy-Rae

Question:

1044. Deputy Michael Healy-Rae asked the Minister for Health his views on whether his Department should follow the American example in that all children must have all vaccinations before starting school; and if he will make a statement on the matter. [47715/12]

Written answers

Minister for Health

Ireland's recommended immunisation programme is based on the guidelines of the National Immunisation Advisory Committee (NIAC) of the Royal College of Physicians of Ireland. The objective of the Primary Childhood Immunisation Programme is to achieve an uptake level of 95%, the rate recommended by the World Health Organization, required to provide population immunity and to protect children, and the population generally, from the potentially serious diseases concerned. Since 2011 this 95% rate has been achieved for 6 in 1 vaccination. This protects children against Diphtheria, Tetanus, Pertussis, Polio Hepatitis B and Haemophilous Influenzae type b. It is not the Government’s intention to make vaccinations mandatory.

Health Services Expenditure

Questions (1045)

Caoimhghín Ó Caoláin

Question:

1045. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the level of funding provided by the State to the Brothers of Charity Services for each of the years 2009 to 2012 inclusive; the cuts to funding in the past 12 months; his views on whether the current level of funding is appropriate to deliver these vital services; if he will reinstate funding cuts to-date; and if he will make a statement on the matter. [47840/12]

Written answers

Minister of State at the Department of Health

As 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.

National Children's Hospital Location

Questions (1046, 1047, 1048)

Billy Kelleher

Question:

1046. Deputy Billy Kelleher asked the Minister for Health the contacts he has had with a person (details supplied) in relation to the building of a National Children's Hospital; and if he will make a statement on the matter. [47843/12]

Billy Kelleher

Question:

1047. Deputy Billy Kelleher asked the Minister for Health if he has had any communication with a person (details supplied) in relation to the Dolphin Report; and if he will make a statement on the matter. [47844/12]

Billy Kelleher

Question:

1048. Deputy Billy Kelleher asked the Minister for Health if he or any intermediary acting on his behalf has had any communication with a person (details supplied), in relation to the Dolphin Report and the building of a National Children's Hospital; and if he will make a statement on the matter. [47845/12]

Written answers

Minister for Health

I propose to take Questions Nos. 1046 to 1048, inclusive, together.

As you will be aware, I established an independent Review Group to consider the implications of the decision of An Bórd Pleanála, received on 23 February 2012, to reject the planning application for the proposed construction of a national paediatric hospital on the site of the Mater Misericordiae Hospital. The aim of the Review was to consider all the possible options for the earliest possible delivery of a new children's hospital. The group presented its report to me in June.

Since the report has been presented to me I have been carefully considering its contents and the issues involved and have sought further detailed analysis on technical issues from members of the Dolphin Group with particular expertise in these areas. I will bring the report and supplementary analysis to Government shortly, with my recommendation. Together in consultation with my colleagues in the cabinet we will then make a decision on the location of the new children's hospital.

While my Department has had informal contact with the individual referred to in regard to the new children's hospital, no independent report or formal advice has been sought from this individual nor from any other individual separate to the Dolphin Group. There is one process only. I can assure the Deputy that at the heart of any decision that is made in relation to the new children's hospital, the needs of the patient will be central to this process.

Departmental Bodies

Questions (1049)

Michael Creed

Question:

1049. Deputy Michael Creed asked the Minister for Health if he has given any consideration to the amalgamation of the Pre-Hospital Emergency Care Council with HIQA; and if he will make a statement on the matter. [47786/12]

Written answers

Minister for Health

The amalgamation of the Pre-hospital Emergency Care Council (PHECC) and HIQA is not being considered.

Health Services Provision

Questions (1050)

Gerry Adams

Question:

1050. Deputy Gerry Adams asked the Minister for Health whether it is the case that a person (details supplied) in County Louth was contacted by the Health Service Executive and told to cancel an appointment they had made in London for a CT scan as a result of a change in procedures for issuing an E112, that they were told they would have to see a consultant here before having the CT scan in London; if the person will have to go through this procedure for every appointment; the extent of the delays caused to their treatment as a result of these new procedures; his views on whether requiring a person to seek an appointment with a consultant here through the public system in advance of every appointment in London will cause inordinate delays in their treatment; if he is satisfied the correct procedures were followed in this case; and if he will make a statement on the matter. [47849/12]

Written answers

Minister for Health

As this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.

Hospital Waiting Lists

Questions (1051)

Robert Troy

Question:

1051. Deputy Robert Troy asked the Minister for Health the position regarding a hospital appointment in respect of a person (details supplied) [47852/12]

Written answers

Minister for Health

As this is a service matter, it has been referred to the Health Service Executive for direct reply.

Medical Card Application Numbers

Questions (1052)

Brendan Griffin

Question:

1052. Deputy Brendan Griffin asked the Minister for Health the number of medical cards currently in the system; the number of persons directly dependent on these cards; and if he will make a statement on the matter. [47881/12]

Written answers

Minister of State at the Department of Health

At the end of August 2012, a total of 1,836,604 medical cards and 131,318 GP Visit cards have been issued. Nearly 43% of the national population currently has free access to GP services under the GMS Scheme (40% medical card & 2.9% GP visit card). This compares to 31% as at end 2007.

Health Services Expenditure

Questions (1053)

Caoimhghín Ó Caoláin

Question:

1053. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the level of funding provided by the State to Prosper Fingal and Knockrosse House for each of the years 2009 to 2012 inclusive; the cuts to funding in the past 12 months; his views on whether the current level of funding is appropriate to deliver these services; if he will reinstate funding cuts to-date; and if he will make a statement on the matter. [47879/12]

Written answers

Minister of State at the Department of Health

As 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.

Special Educational Needs Services Provision

Questions (1054, 1055, 1056)

Michael McGrath

Question:

1054. Deputy Michael McGrath asked the Minister for Health if he will provide a copy of the health policy that underpins the proposed changes of reducing therapy service provision to children with a moderate intellectual disability, specifically in the context of established special needs schools, in order to increase therapy service provision to children with special needs in mainstream [47886/12]

Michael McGrath

Question:

1055. Deputy Michael McGrath asked the Minister for Health if he will provide a copy of the guidelines or policy document on access to therapy provision for children in established special needs schools in the context of the proposed change to community based therapy provision [47888/12]

Michael McGrath

Question:

1056. Deputy Michael McGrath asked the Minister for Health if the targets on the date specific project plan spanning dates in 2010/2011 as outlined in the HUB Change, specifying the proposed changes regarding therapy access for children with special needs were achieved on time; and if this project plan failed to meet its targets, the reason for same [47889/12]

Written answers

Minister for Health

I propose to take Questions Nos. 1054 to 1056, inclusive, together.

The Health Service Executive has recognised the need to increase the level of consistency and standardisation in the way both early intervention services and services for school-aged children with disabilities are delivered and to this end is currently engaged in a reconfiguration of existing therapy resources to geographic based teams for children (0-18 years).

The National Programme on Progressing Disability Services for Children and Young People (0-18 years) has been established since 2010. It is supported by a National Co-ordinating Group which has representatives from the Department of Health and the Department of Education and Skills in addition to other key stakeholders. The Programme is based on the recommendations of the Report of the National Reference Group on Multidisciplinary Services for Children aged 5-18 Years produced by representatives of the professions and management involved in delivering multi-disciplinary services to children which is available on the HSE website www.hse.ie.

The Programme aims to address the following issues in relation to children’s disability services:

- Inequity of access to services due to inconsistent development of services;

- Environmental change arising from the reorientation towards mainstream education leading to increasing demand for health services to support inclusion;

- Increasing demand for services due to population growth and increased identification of children with disability;

- The need to re-align services with emerging primary care and integrated service structures.

Implementation of the Programme encompasses two elements:

- Ongoing work in co-ordinating and re-organising early intervention services for children aged 0-5 years into integrated, geographically based teams;

- Supporting the re-organisation of services for school-age children aged 5-18 years according to the same model.

The Programme is rolling out at national, regional and local level and involves representatives from the health and education sectors, statutory and non-statutory service providers and parents working together to see how current services can best be re-organised.

The HSE is working very closely with the education sector, which is fully involved in the development of the Programme, to ensure that, from the children’s and parents’ perspective, the services provided by each sector are integrated. An Education and Health Working Group, comprising representatives of both sectors, is developing a framework for closer working relationships.

Information concerning implementation of the Programme is available on the HSE’s Change Hub learning and development website www.hseland.ie. This includes an updated Project Plan covering 2011/2012 with updated targets, as identified in the HSE National Service Plan 2012. While significant progress has been made to date in rolling out the Programme, targets in some areas have not been met for a variety of reasons. Local Implementation Groups have now commenced in all but two areas. Quarterly reports on progress and achievement in meeting targets are monitored by the Programme’s National Co-ordinating Group.

Decisions regarding any local re-organisation of services are the responsibility of the Local Implementation Groups (LIGs). These include stakeholders such as representatives of the service providers involved, parents and the educational sector representatives. Detailed local area action plans are being developed by the LIGs with the following objectives:

- One clear pathway to services for all children with disabilities according to need;

- Resources used to the greatest benefit for all children and families;

- Health and education working together to support children to achieve their potential.

The long term goal of this Programme is to bring consistency in service delivery and a clear pathway to services for all children with disabilities according to need. Implementation of this Programme will have a positive impact on the provision of clinical services for all children requiring access to health related supports, regardless of where they live or which pre-school or school they attend. While the Programme supports the principle of providing access to mainstream education where appropriate, it also recognises a continuing role for special schools.