Medicinal Products Supply

Questions (35)

Seán Crowe

Question:

35. Deputy Seán Crowe asked the Minister for Health if his attention has been drawn to the recent positive developments in the area of vaccines for lung cancer, prostate cancer and meningitis in Cuba; his views on whether the widespread availability of these vaccines for cancer and meningitis sufferers would be welcome; and if there is anything that he can do to promote their availability in here and in Europe. [44822/12]

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Written answers (Question to Health)

Internationally, research continues to result in the development of new medicines in a number of countries to fight a broad range of diseases, including those listed by the Deputy. There is a clear process whereby a pharmaceutical company may apply for a marketing authorisation to place a medicinal product on the market in Ireland.

Any pharmaceutical company that wishes to place a medicinal product on the market may seek a marketing authorisation from the Irish Medicines Board, or seek authorisation centrally from the European Medicines Agency. Strict controls are in place to ensure that whenever a new vaccine becomes available this vaccine is safe and effective.

I am kept informed by my Chief Medical Officer of new developments in this area.

Medicinal Products Expenditure

Questions (36)

John Browne

Question:

36. Deputy John Browne asked the Minister for Health the details of the deal made with the Irish Pharmaceutical Healthcare Association on 15 October 2012; and if he will make a statement on the matter. [48923/12]

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Written answers (Question to Health)

I announced on the 15th October, 2012 that intensive negotiations involving the Irish Pharmaceutical Healthcare Association (IPHA), the HSE and the Department of Health had reached a successful conclusion with a major new deal on the cost of drugs in the State. The main provisions of the new Agreement are as follows:

- With effect from 1st November 2012, the ex factory price of all patent protected medicines reimbursed in Ireland prior to September 2006 will be realigned - downwards only - to the average of the basket of 9 countries (Austria, Belgium, Denmark, Finland, France, Germany, Netherlands, Spain, and UK).

- With effect from 1st November 2012, the ex factory price of all patent expired medicines which do not have a generic equivalent on the Irish market will be realigned - downwards only - to the average of the basket of 9 countries.

- With effect from 1st November 2012, the ex factory price of all patent expired medicines which have a generic equivalent on the Irish market will be reduced to 60% of the original price. With effect from 1st November 2013, the price will be reduced to 50% of the original price.

In the case of medicines which go off patent after 1st November 2012, the ex factory price will drop to 70% of the original price as soon as a generic equivalent comes on the Irish market. After 12 months, the price will be reduced to 50% of the original price.

- With effect from 1st January 2013, the ex factory price of medicines introduced to Ireland after September 1st 2006, will be realigned - downwards only - to the average of the basket of 9 countries.

The deal will deliver a number of important benefits, including significant reductions for patients in the cost of drugs; a lowering of the drugs bill to the State; timely access for patients to new cutting-edge drugs for certain conditions; and reducing the cost base of the health system into the future,

This deal, combined with an interim agreement reached with IPHA in the Summer, means that €16 million in drug savings will be made this year. It is estimated that the deal will generate savings of up to €116m in 2013, €136m in 2014 and €150m on 2015. A breakdown of savings by scheme is not currently available. The cost of new drugs over the next three years is estimated to be €210 million.

This landmark deal with IPHA comes as legislation aimed at reducing the cost of generic drugs makes its way through the Oireachtas. The Health (Pricing and Supply of Medical Goods) Bill 2012, which will introduce a system of reference pricing and generic substitution, is a priority for this Government. It is expected that this Bill will be enacted before the end of the year and will deliver further savings in the costs of medicines for the health service and private patient.

Carer's Allowance Applications

Question No. 38 answered with Question No. 17.

Questions (37)

Timmy Dooley

Question:

37. Deputy Timmy Dooley asked the Minister for Health if his Department or the Health Service Executive is concerned about delays in processing applications for carer's payments; the implications of such delays for health services; and if he will make a statement on the matter. [48926/12]

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Written answers (Question to Health)

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

Question No. 38 answered with Question No. 17.

European Court of Human Rights Judgments

Questions (39)

Mick Wallace

Question:

39. Deputy Mick Wallace asked the Minister for Health if he has received the report from the expert group in relation to the A, B and C v Ireland judgment in the European Court of Human Rights; his views on the fact that it is now 11 months since this group was established with a view to reporting back to Government within six months; the reasons for this delay; and if he will make a statement on the matter. [48824/12]

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Written answers (Question to Health)

I wish to inform the Deputy that I have not yet received the report of the Expert Group on the judgment in A, B and C v Ireland. The matters the Group is examining are of a complex and sensitive nature; and they requested an extension to the time limit they were given to complete their work. The Expert Group expects their report will be completed and submitted to me shortly for my consideration and I will subsequently submit it to Government.

Departmental Reports

Questions (40)

Peadar Tóibín

Question:

40. Deputy Peadar Tóibín asked the Minister for Health the date on which he will publish the Small Hospitals Report Securing the Future of Smaller Hospitals: A Framework for Development; if he will confirm that this report recommends the closure of the ICU and full ED services at Our Lady's Hospital, Navan, County Meath, as well as at eight other sites; if he will provide an update in the proposed development of a new regional hospital in the Health Service Executive North East area; if he will commit to maintaining ICU and full ED services at Our Lady's Navan until such a facility is in place; and if he will make a statement on the matter. [48979/12]

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Written answers (Question to Health)

The future organisation of our acute hospitals is a major policy issue for the Government. It is essential that all hospitals provide care in the right way, at the right location, and in a manner that ensures a safe, high quality service for all.

The Government is committed to securing and further developing the role of our smaller hospitals which will see them provide more, not fewer services. The challenge is to make sure that they provide services, which can safely be delivered in these settings, in order to maximise the benefit to patients. All hospitals, irrespective of size, as well as associated GP and community services, must work together in an integrated way. There have already been very significant developments recently in health care delivery, particularly in the context of shifts to day surgery and ambulatory care, and the centralisation of low volume high complexity care into larger centres. In this context, it is necessary that we redefine the role of the smaller hospitals so that they continue to play a central part of the Irish Health care system.

The Framework for Smaller Hospitals defines the role of the smaller hospitals. It outlines the need for smaller hospitals and larger hospitals to operate together. The Framework outlines the wide range of services that can be provided within the smaller hospital. It defines the need for the smaller hospital to be supported within a group of hospitals in terms of education and training, continuous professional development, the sustainable recruitment of high quality clinical staff and the safe management of patients who present with varying levels of complexity. It also sets out to address the categories of services that should transfer from the larger to the smaller hospitals and vice versa within a Hospital Group so that services are delivered in the most appropriate hospital.

Work is in progress on developing a detailed plan for service enhancements in each of the nine smaller hospitals that are covered by the Smaller Hospitals Framework. These plans are based on detailed local analysis of the services in place and what can be provided in the future.

I am determined to ensure that as many services as possible can be provided safely and appropriately in smaller, local hospitals. On this basis, the organisation of hospital services nationally, regionally and locally will be informed by the ongoing development of the HSE Clinical Programmes. With this in mind the Framework will set out what services can and should be delivered safely by these hospitals in the interest of better outcomes for patients.

The Smaller Hospitals Framework is currently being examined in the context of the overall reorganisation of the health services. The HSE is in the final stages of a consultation process to help inform the details of the service changes. This consultation process has sought feedback from all stakeholders, including local communities and health professionals in each hospital who deliver the service, and their feedback will be captured as input to the change process. Until this process has been fully completed I do not think that it is appropriate to comment on individual hospitals at this time.

It is my intention to publish the Framework when this process has been completed.

Ambulance Service Response Times

Questions (41)

Denis Naughten

Question:

41. Deputy Denis Naughten asked the Minister for Health the progress that has been made in the Health Service Executive west region since the introduction of standardised ambulance response times; the steps being taken to improve ambulance response times in the region; and if he will make a statement on the matter. [48750/12]

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Written answers (Question to Health)

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

Health Services Staff Issues

Questions (42)

Dara Calleary

Question:

42. Deputy Dara Calleary asked the Minister for Health his plans to make health service employees work longer hours; and if he will make a statement on the matter. [48937/12]

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Written answers (Question to Health)

There are no plans at present to require health service employees to work longer hours. Health service management met recently with the principal health unions and outlined the nature of the financial and staffing challenges facing the sector in 2013 and beyond. In that context, management tabled a range of flexibility and reform proposals, within the scope of the Public Service Agreement, to ensure that savings and efficiencies are maximised.

Subsequently, and in response to a request by the Implementation Body to each sector, a revised Action Plan for implementation of the Agreement in the health sector has been submitted for consideration to the Body.

Mobility Allowance Eligibility

Questions (43, 83)

Richard Boyd Barrett

Question:

43. Deputy Richard Boyd Barrett asked the Minister for Health his plans to review the mobility allowance for persons over 66 years of age; and if he will make a statement on the matter. [48892/12]

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Caoimhghín Ó Caoláin

Question:

83. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the way he intends to address the refusal by his Department of mobility allowance to persons over 66 years of age; if he will immediately remove the age restrictions; if he will provide for retrospective payment to all those entitled; and if he will make a statement on the matter. [48958/12]

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Written answers (Question to Health)

I propose to take Questions Nos. 43 and 83 together.

This matter requires further consideration by Government in order to meet the requirements of the Equal Status Acts and to ensure no hardship for those currently in receipt of the Mobility Allowance. The Department of Health is seeking further legal advice as to the options available to the Government.

The Ombudsman is asking the Department to remove the upper age limit as a condition of the Mobility Allowance scheme with immediate effect; authorise the Health Service Executive (HSE) to reconsider the application for complaints in the report without taking account of the upper age limit; and instruct the HSE to reconsider applications since 1 April 2011, which were refused solely on the basis of the upper age limit, without regard to the upper age limit.

The Department is not in a position to amend the circular relating to the Mobility Allowance as recommended in the report. The recommendations, if implemented, would ignore the very serious financial constraints on the Department, the HSE and the State generally. Implementation of the recommendations would create liabilities that the State could not afford.

Palliative Care Services

Questions (44)

John Browne

Question:

44. Deputy John Browne asked the Minister for Health the action he will take on foot of the recent NESC report Quality and Standards in Human Services in Ireland: End of Life Care in Hospitals; and if he will make a statement on the matter. [48936/12]

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Written answers (Question to Health)

Government policy on Palliative Care is contained in the Report of the National Advisory Committee on Palliative Care (2001) and the Health Service Executive Five Year / Medium Term Framework for Palliative Care Services (2009-13).

In common with a series of NESC reports, the one raised by the Deputy in relation to End of Life Care in Hospitals, calls for various actions. These reflect to varying degrees initiatives currently being pursued by the Department and the HSE and include, for example, implementation of existing commitments on quality, increased professionalisation of care, and improving performance indicators or other measures at national and local levels to ensure optimum delivery of palliative care.

The Government remains committed to the delivery of the best possible palliative and End-of-Life care services nationally including addressing geographical deficits and progressing agreed paediatric care policy.

The recent report by NESC is a valuable contribution to on-going consideration of developing these policies and services in the future, and it is in that context being examined in detail by the Department.

Hospital Services

Questions (45)

Bernard Durkan

Question:

45. Deputy Bernard J. Durkan asked the Minister for Health if he will ensure that any reorganisation of general hospital services throughout the country will not result in the closure or downgrading of existing hospitals on the grounds of being obsolete or outdated particularly if this has been caused by a lack of a proper development plan with adequate funding over the past number of years; if the need to meet patient needs in a particular catchment area will continue to remain the major criterion for the future development of the general hospital services; if the determination of such policy rests with his Department, the Health Service Executive or others; and if he will make a statement on the matter. [48921/12]

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Written answers (Question to Health)

Under the Programme for Government 2011-2016, the Government committed to developing a universal, single-tier health service, which guarantees access to medical care based on need, not income. On foot of this commitment the Government will introduce a system of Universal Health Insurance (UHI).

A key stepping stone to the new system will be to develop independent not-for-profit hospital trusts in which all hospitals will function as part of integrated groups. The rationale behind the establishment of hospital groups and trusts is to support increased operational autonomy and accountability for hospital services in a way that will drive service reforms and provide the maximum possible benefit to patients.

The work on hospital groups is not about downgrading hospitals. It is about the bringing together groups of hospitals to form single cohesive entities to allow maximum flexibility in management, budgets and service delivery.

The provision of services at any hospital site will primarily be determined by the appropriate clinical programme for that service, taking account of the population which the hospital serves and services provided by other hospitals which are within reasonable a reasonable commute.

Each Hospital Group will have a single consolidated management team with responsibility for performance and outcomes. It is intended that non-executive Boards, consisting of representative experts, will oversee each Hospital Group management team and will have responsibility for decisions in relation to services in all hospitals in the Group.

Earlier this year I appointed Professor John Higgins to chair a Strategic Board on the Establishment of Hospital Groups. A Project Team was tasked with developing criteria which will assist my Department in the development of policy in relation to the composition of hospital groups, governance arrangements, current management frameworks and linkages to academic institutions. The Team carried out a comprehensive consultation process with all acute hospitals and other health service agencies as well as reviewing a significant number of written submissions.

Work is continuing on finalising a Draft Report on the recommendations for submission to the Strategic Board for consideration when they meet on 14th November. The Report will be submitted to me when the Board have signed off on it and in turn, I will then bring it to Cabinet.

The Government will then decide on the initial make up of hospital groups which be established on an administrative basis pending the legislation required to set up hospital trusts by 2014. Before those trusts are established the make-up and functioning of the Groups will be reviewed and if changes prove necessary then they will be made with Government approval when the hospital trusts are being formed.

National Children's Hospital Status

Questions (46)

Niall Collins

Question:

46. Deputy Niall Collins asked the Minister for Health the date on which the report of the Dolphin Review Group on the national children's hospital will be published; and if he will make a statement on the matter. [48955/12]

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Written answers (Question to Health)

Following the refusal of planning permission by An Bord Pleanála of planning permission for the new children's hospital on the Mater site, I established a Review Group chaired by Dr Frank Dolphin (the Dolphin Group) to advise on next steps. Their report was presented to me on 8 June last.

On Tuesday, I announced the Government’s decision to develop the new children’s hospital at the campus of St James’s Hospital in Dublin. In identifying the new site, the Government has carefully considered the report of the Dolphin Group along with detailed supplementary information on cost, time and planning which was subsequently sought from those members of the Group with the relevant technical expertise. The report was published on Tuesday on the website of my Department.

This decision has been made in the best interests of children, with clinical considerations being of paramount importance. It is essential that the new children’s hospital can deliver best clinical outcomes for our children. Co-location with an adult hospital has been deemed essential by the Dolphin report, and by all previous reports on this issue, while tri-location with a maternity hospital is optimal. Co-location, and ultimately tri-location with a maternity hospital, on the St James's campus will support the provision of excellence in clinical care that our children deserve.

I intend to move quickly now to put in place all the necessary structures and governance arrangements to enable the delivery of this project as quickly as possible and to the highest quality. This Government regards the building of the new children’s hospital as a key priority and no effort will be spared in expediting its completion.

National Children's Hospital Location

Questions (47)

Bernard Durkan

Question:

47. Deputy Bernard J. Durkan asked the Minister for Health if in the determination of the location for the new children's hospital he will have particular regard to the unsuitability of the previously preferred location on planning grounds and that there was general agreement on its unsuitability on the grounds of traffic congestion and parking; if he will ensure that the new location will have regard to this issue and that the soon to be chosen site will represent the easiest possible access from all parts and that such access is measured in time of peak traffic times; if he will further ensure that the need to easy and rapid access for children in need of urgent treatment is strictly observed, that the concerns of the parents of sick children are borne in mind and that preparatory expenditure to date does not become a determining factor; and if he will make a statement on the matter. [48920/12]

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Written answers (Question to Health)

Following the refusal of planning permission by An Bord Pleanála of planning permission for the new children's hospital on the Mater site, I established a Review Group chaired by Dr Frank Dolphin (the Dolphin Group) to advise on next steps. Their report was presented to me on 8 June last.

On Tuesday, I announced the Government’s decision to develop the new children’s hospital at the campus of St James’s Hospital in Dublin. In identifying the new site, the Government has carefully considered the report of the Dolphin Group along with detailed supplementary information on cost, time and planning which was subsequently sought from those members of the Group with the relevant technical expertise.

This decision has been made in the best interests of children, with clinical considerations being of paramount importance. It is essential that the new children’s hospital can deliver best clinical outcomes for our children. Co-location with an adult hospital has been deemed essential by the Dolphin report, and by all previous reports on this issue, while tri-location with a maternity hospital is optimal. Co-location, and ultimately tri-location with a maternity hospital, on the St James's campus will support the provision of excellence in clinical care that our children deserve.

Despite the fact that access issues were a dominant feature of previous discussions around the Mater site, An Bord Pleanala did not cite difficulty of access to, or lack of parking at, the site as reasons for refusal. The Dolphin Report notes that St James’s has “excellent public transport services” with four bus services, a Luas stop on campus and two others adjacent. Data provided by the National Ambulance Service does not indicate any significant difference in national ambulance driving times overall to each of the location options. A higher percentage of children in Dublin live within a 10 km radius of St James than live within 10 km of any other potential site. It is recognised that most of the children who will attend this hospital will arrive by car. Dublin City Council has indicated to St James that the campus can accommodate about 2,000 spaces in total.

I intend to move quickly now to put in place all the necessary structures and governance arrangements to enable the delivery of this project as quickly as possible and to the highest quality. This Government regards the building of the new children’s hospital as a key priority and no effort will be spared in expediting its completion.

National Children's Hospital Status

Questions (48)

Mary Lou McDonald

Question:

48. Deputy Mary Lou McDonald asked the Minister for Health the position regarding the development of the national children's hospital; and if he will make a statement on the matter. [48972/12]

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Written answers (Question to Health)

Following the refusal of planning permission by An Bord Pleanála of planning permission for the new children's hospital on the Mater site, I established a Review Group chaired by Dr Frank Dolphin (the Dolphin Group) to advise on next steps. Their report was presented to me on 8 June last.

On Tuesday, I announced the Government’s decision to develop the new children’s hospital at the campus of St James’s Hospital in Dublin. In identifying the new site, the Government has carefully considered the report of the Dolphin Group along with detailed supplementary information on cost, time and planning which was subsequently sought from those members of the Group with the relevant technical expertise.

This decision has been made in the best interests of children, with clinical considerations being of paramount importance. It is essential that the new children’s hospital can deliver best clinical outcomes for our children. Co-location with an adult hospital has been deemed essential by the Dolphin report, and by all previous reports on this issue, while tri-location with a maternity hospital is optimal. Co-location, and ultimately tri-location with a maternity hospital, on the St. James's campus will support the provision of excellence in clinical care that our children deserve.

I intend to move quickly now to put in place all the necessary structures and governance arrangements to enable the delivery of this project as quickly as possible and to the highest quality. This Government regards the building of the new children’s hospital as a key priority and no effort will be spared in expediting its completion.