Written Answers Nos. 202-209
202. Deputy Caoimhghín Ó Caoláin asked the Minister for Health when a decision will be made on the possible funding of Kalydeco for cystic fibrosis patients; the date on which this drug will be made available; and if he will make a statement on the matter. [3546/13]
View answer208. Deputy Joanna Tuffy asked the Minister for Health when he intends to approve and supply the drug, Kalydeco, for cystic fibrosis patients; and if he will make a statement on the matter. [3636/13]
View answer211. Deputy Michael Lowry asked the Minister for Health if he will fund Kalydeco for the treatment of cystic fibrosis patients; if this drug will be approved and sanctioned for the Irish market; when this drug will be made available to patients here; and if he will make a statement on the matter. [3682/13]
View answerI propose to take Questions Nos. 202, 208 and 211 together.
The HSE has received an application for the inclusion of Kalydeco (generic name: Ivacaftor) in the GMS and community drugs schemes which is being considered in line with the procedures agreed with the Irish Pharmaceutical Healthcare Association (IPHA). These include clearly documented processes and timelines for the assessment of new medicines in as timely a fashion as possible.
In accordance with these procedures, the National Centre for Pharmacoeconomics (NCPE) conducts a Health Technology Assessment (HTA) which provides detailed information on the potential budget impact of the medicine. It also assesses whether the medicine is cost effective at the price quoted by the company in question.
The NCPE published its report on the cost-effectiveness of Kalydeco on the 21st of January. The report concluded that "In view of the very high drug acquisition cost, the significant budget impact, the absence of long term clinical data and the fact that the company has failed to demonstrate the cost-effectiveness of ivacaftor we cannot recommend reimbursement of ivacaftor at the submitted price of €234,804 per patient per annum. A mechanism such as a performance based risk sharing scheme and/or a significant reduction in price could facilitate access to ivacaftor treatment for cystic fibrosis patients with the G551D CFTR mutation".
The NCPE report is an important input to assist decision making and will help inform the next stage of the process which involves further discussions with the manufacturer of the drug, in accordance with the aforementioned procedures agreed with the pharmaceutical industry. The HSE assessment process is intended to arrive at a decision on the funding of Kalydeco that is clinically appropriate, fair, consistent and sustainable. The HSE understands that patients, the Cystic Fibrosis Association of Ireland and clinicians are very anxious that a decision be made as soon as possible.
No further comment is possible at this time as the decision making process is ongoing.
203. Deputy Nicky McFadden asked the Minister for Health the way funding to improve mental health services will be targeted in 2013; and if he will make a statement on the matter. [3552/13]
View answerImplementation of A Vision for Change the 2006 Report of the Expert Group on Mental Health Policy is a priority for this Government. In 2012, a special allocation of €35m was provided for mental health to be used primarily to further strengthen Community Mental Health Teams in both adult and children's mental health services, to advance activities in the area of suicide prevention, to initiate the provision of psychological and counselling services in primary care, specifically for people with mental health problems and to facilitate the re-location of mental health service users from institutional care to more independent living arrangements in their communities, in line with A Vision for Change.
414 posts were approved to implement the €35m package of special measures. To date 175 have been filled, 171 posts have been accepted subject to process clearances (references, garda vetting etc) and the remainder are at various stages of selection. The majority of these posts will be filled by end March 2013. Full year costs for all these posts will be met from HSE 2013 base allocation.
The announcement in Budget 2013 of a further €35m for the continued development of our mental health services is additional to the €35m provided in Budget 2012. The HSE National Service Plan, which was recently approved by the Minister for Health, commits to the further development of suicide prevention initiatives, forensics and community mental health teams for adults, children, older persons and mental health intellectual disability and to the recruitment of over 470 additional staff to implement these measures. I have received assurances from the HSE that the recruitment process for the 2013 new posts, and any outstanding 2012 posts, will commence immediately.
204. Deputy Terence Flanagan asked the Minister for Health the position regarding general practitioners' practices charging for the signing of forms (details supplied); and if he will make a statement on the matter. [3608/13]
View answerUnder the General Medical Services (GMS) contract, a general practitioner (GP) is expected to provide his/her patients who hold medical cards or GP visit cards with all proper and necessary treatment of a kind generally undertaken by a GP.
The contract between the HSE and GPs under the GMS Scheme stipulates that fees are not paid to GPs by the HSE in respect of certain medical certificates which may be required, for example, "under the Social Welfare Acts or for the purposes of insurance or assurance policies or for the issue of driving licences".
Consultation fees charged by general practitioners to private patients and to GMS patients outside the terms of the GMS contract are a matter of private contract between the clinicians and the patients. While I have no role in relation to such fees, I would expect clinicians to have regard to the overall economic situation in setting their fees. I should add that General Practitioners who hold GMS contracts with the HSE must not seek or accept money from medical card or GP visit card holders in respect of routine treatment.
205. Deputy Mattie McGrath asked the Minister for Health if he will reverse the proposals to reduce the salary for graduate nurses under the graduate programme to protect the future of the nursing profession here and to avoid an exodus of graduate nurses from the country in a bid to find employment in a health service that will value their profession; his views on whether the nursing profession have already taken their fair share in cuts; and if he will make a statement on the matter. [3611/13]
View answer212. Deputy Billy Timmins asked the Minister for Health the position regarding the proposed new graduate nurse and midwife recruitment initiative (details supplied); and if he will make a statement on the matter. [3684/13]
View answer216. Deputy Billy Timmins asked the Minister for Health his views on correspondence (details supplied) regarding the nursing and midwifery graduate initiative which shows that these graduates will be the lowest paid health care workers in the developed world; and if he will make a statement on the matter. [3696/13]
View answerI propose to take Questions Nos. 205, 212 and 216 together.
Given the unprecedented economic challenges faced by the country, including the ongoing requirement to achieve reductions in public sector employment, the Graduate Employment Initiative will support the retention of recently-qualified graduate nurses and midwives within the Irish health system and a reduction in unsustainable expenditure on agency nurse staffing.
Under the Initiative, up to 1,000 graduate nurses and midwives will be recruited on two-year contracts and will be paid 80% of the first point of the Staff Nurse Scale. They will also qualify for premium payments and allowances on a pro rata basis, bringing expected average pay to approximately €25,000 per year, excluding overtime. The initiative will enable them to gain valuable work experience and development opportunities post-graduation. The employment of graduates in a specific graduate scheme is a widespread practice in other sectors of the economy. The rate of pay under this scheme is within the norms for such programmes.
Given the requirement to achieve reductions in staff numbers in the health sector and to maximise savings, it is not possible at present, other than in very limited circumstances, to offer employment positions. The Minister for Public Expenditure and Reform has agreed that participants in the initiative will not be part of the Health Sector's Employment Ceiling. The initiative therefore provides a valuable opportunity for a substantial number of recently-qualified nurses and midwives to work in Ireland at a time when job opportunities in the public service are, regrettably, very limited.
206. Deputy Kevin Humphreys asked the Minister for Health if he or his officials met any representatives of the tobacco industry in the last six months; and if he will make a statement on the matter. [3622/13]
View answerIreland thus has obligations under Article 5.3 of the WHO FCTC which deals with protecting public health policies from commercial and other vested interests of the tobacco industry. These obligations relate to Government, government officials and persons employed by state funded agencies among others. Last May I wrote to all my Government colleagues reminding them of our duties and obligations under the WHO Framework in relation to interaction with the tobacco industry. I have asked them to ensure that members of their Departments and organisations under their remit are very much aware of their obligations under the framework in the context of any interactions with representatives of the tobacco industry.
207. Deputy Martin Ferris asked the Minister for Health when a person (details supplied) in County Waterford will be called for an operation at Waterford Regional Hospital. [3629/13]
View answerShould the patient's general practitioner consider that the patient's condition warrants an earlier appointment, he/she would be in the best position to take the matter up with the consultant and hospital involved.
In relation to the specific query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.
209. Deputy Finian McGrath asked the Minister for Health the position regarding speech and language therapy in respect of a person (details supplied). [3644/13]
View answerAs the Deputy will be aware, the Department of Education and Skills has primary responsibility for addressing the educational needs of children with disabilities. However the health sector has a role in terms of providing health-related supports to these children, where required.
The Health Service Executive is currently reconfiguring therapy resources for children with disabilities aged 0 to 18 year, including those with autism. Its National Programme on Progressing Disability Services for Children and Young People (0-18 years) , established since 2010, seeks to bring consistency in service delivery and a clear pathway to services for all children with disabilities according to need, regardless of where they live, which pre-school or school they attend or the nature of their disability. In practical terms this means that health professionals and parents will know exactly where a child should be referred and how to refer them. Services may be provided at primary care level or by early intervention and school age disability teams, with access to specialist services, according to the child's needs.
The particular issue of speech and language supports that has been raised by the Deputy is a service matter for the Health Service Executive. Accordingly I have arranged for the Deputy's questions to be referred to the Health Service Executive for direct reply to the Deputy.
