Written Answers Nos. 647-66
647. Deputy Charlie McConalogue asked the Minister for Health when a decision will be made on a medical card application in respect of a person (details supplied) in County Donegal; and if he will make a statement on the matter. [3730/13]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
648. Deputy Finian McGrath asked the Minister for Health if he wil re-visit his anti-smoking policies and actions in view of the fact that 29% of the population smoke. [3739/13]
View answerSmoking is the greatest single cause of preventable illness and premature death in Ireland, killing over 5,200 people a year. Ireland’s public health policy objective in relation to tobacco remains to promote and subsequently move towards a tobacco free society. I am committed to moving us closer towards that objective.
The Tobacco Policy Review Group will be reporting to me shortly. The report of this group will build on our existing policies and legislation. This group is examining a number of areas which need to be developed or enhanced in order to reduce smoking prevalence in Ireland. The report will also examine how to develop our cessation services in order to support those people who want to stop smoking. Of major concern to me is the number of young people who are still taking up the addiction. Research has shown that 78% of Irish smokers started smoking before they reached the age of 18, evidence that smoking initiation is largely a childhood and teenage phenomenon. The "denormalisation” of smoking within our society is key tool in stopping our children and young people from doing so. To achieve this we must make smoking less attractive to children and increase its social unacceptability.
I understand that in order for such initiatives to be successful they must be supported by the public. It is also important, however, that everyone in society recognises their role in effecting change in our lifestyle behaviours such as smoking for the benefit of everyone.
649. Deputy Colm Keaveney asked the Minister for Health in view of the urgency of the issue, with many victims of symphysiotomy now elderly and frail, and in view of the importance of the issue in creating a redress scheme, if he will provide some measure of justice to the persons concerned; when he will publish the final version of the Walsh Report on symphysiotomy; and if he will make a statement on the matter. [3747/13]
View answerMy first priority is to ensure that the women who have had a symphysiotomy have their health needs comprehensively and professionally met. In this regard, the HSE provides a range of services to women who continue to suffer the effects of having had this procedure. These services include the provision of medical cards, the availability of independent clinical advice and the organisation of individual pathways of care and the arrangement of appropriate follow-up.
As the Deputy is aware, my Department has commissioned an independent research report in relation to the practice of symphysiotomy in Ireland. The research included a consultation process involving patient groups, health professionals and in particular the women who have experienced symphysiotomy. The researcher is currently finalising the report based on the consultation and it is also planned to have a peer review process. It is hoped that the report will be published early in 2013. The research report will inform the Department’s overall consideration of this matter, including the consideration of any actions that may be required and possible legal implications. It would be premature for me to make any other comments at this stage on what actions might be taken, prior to giving full consideration to the recommendations of the report.
650. Deputy Billy Timmins asked the Minister for Health the position regarding Kalydeco (details supplied); and if he will make a statement on the matter. [3748/13]
View answer696. Deputy Ciara Conway asked the Minister for Health if he will provide an update on the Health Service Executive's decision to purchase Kalydeco for use in the treatment of Cystic Fibrosis; and if he will make a statement on the matter. [4223/13]
View answer703. Deputy Tom Fleming asked the Minister for Health when he will expedite the current negotiations between the Health Service Executive and the manufactures of the drug kalydeco for treatment of cystic fibrosis patients; and if he will make a statement on the matter. [4245/13]
View answer713. Deputy Tom Fleming asked the Minister for Health if he will make the Kalydeco available free of charge to Cystic Fibrosis patients here; and if he will make a statement on the matter. [4338/13]
View answerI propose to take Questions Nos. 650, 696, 703 and 713 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 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. e 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.
651. Deputy Robert Troy asked the Minister for Health if he will ensure that the final report from the review team in the Cavan/Monaghan Health Service Executive area concerning a person (details supplied) and Wheatfield prison is published without further delay. [3757/13]
View answerI have had enquiries made of the HSE regarding this matter. The HSE has advised that its Local Health Manager in Cavan/Monaghan commissioned a review into the case. The review is at an advanced stage but certain issues of consent are still to be addressed. In the circumstances, the HSE has been asked to respond further to the Deputy in this matter.
652. Deputy Simon Harris asked the Minister for Health if his attention has been drawn to the fact that there is no speech and language support available in an area (details supplied) in County Wicklow due to maternity leave and sick leave; and if he will make a statement on the matter. [3760/13]
View answer653. Deputy Simon Harris asked the Minister for Health the current waiting time for initial referral to speech and language therapy in an area (details supplied) in County Wicklow for each of the years 2007 to 2012 inclusive; the number of children availing of this service; the number of adults availing of this service; the measures already taken and being taken currently to address this; and if he will make a statement on the matter. [3761/13]
View answerI propose to take Questions Nos. 652 and 653 together.
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.
654. Deputy Robert Troy asked the Minister for Health if he will adjust the proposal to cut graduate nurses wages by 20% in view of the fact that nurses are already one of the lower paid medical professions and graduate nurses will be carrying out the same duty as those on a higher scale; the reason the Health Service Executive has now advised all local managers, by circular of the 14 December 2012, to immediately discontinue all existing contracts already in place for 2012 graduates; and if he will make a statement on the matter. [3773/13]
View answer662. Deputy Seán Ó Fearghaíl asked the Minister for Health if he will address the concerns raised in correspondence (details supplied) regarding the graduate initiative; and if he will make a statement on the matter. [3832/13]
View answer695. Deputy Stephen S. Donnelly asked the Minister for Health the bench marking analysis undertaken in relation to the Health Service Executive’s current graduate nurse/midwife recruitment scheme to arrive at the new starting salary of €22,000 per annum; and if he will make a statement on the matter. [4217/13]
View answer723. Deputy Michael Healy-Rae asked the Minister for Health his views on whether the proposal to take on one thousand nurses at a reduced pay rate has been a failure and has been exposed as being completely unfair, unworkable, and that the places offered will not be taken up; and if he will make a statement on the matter. [4377/13]
View answerI propose to take Questions Nos. 654, 662, 695 and 723 together.
Under the Initiative, 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 salary level was set having regard to the norms for such programmes and the need to achieve significant savings on nurse agency and overtime expenditure. The Minister for Public Expenditure and Reform has also agreed that participants in this initiative will not be counted for the purposes of the Health Sector 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.
A proportion of graduate nurses and midwives were employed on temporary, time-limited contracts in autumn 2012 to cover the period between the end of their Fourth-Year 36-week clinical placement and the commencement in January 2013 of the clinical placements of the next cohort of Fourth-Year students. Such contracts are not intended to be of long duration. In line with existing practice and the need strictly to control staffing costs and headcount, hospital management have been advised by the HSE that these contracts should not be continued beyond January 2013.
655. Deputy Billy Kelleher asked the Minister for Health if he will publish the report from the Health Insurance Authority which recommended the health insurance levy rates to apply in 2013; and if he will make a statement on the matter. [3777/13]
View answer656. Deputy Billy Kelleher asked the Minister for Health if his decision on setting the health insurance levy rates for 2013 was based on a Health Insurance Authority report which assumed that 16% of policy holders would hold non-advanced policies; and if he will make a statement on the matter. [3778/13]
View answerI propose to take Questions Nos. 655 and 656 together.
Each year the Health Insurance Authority, (HIA) prepares the Report of The Health Insurance Authority to the Minister for Health, in accordance with Section 7E (1)(b) of the Health Insurance Acts, 1994 – 2012, with the most recent report produced in November 2012. These Reports set out the HIA’s evaluation and analysis of information returns supplied by insurers, together with its recommendations for Risk Equalisation credits and associated Stamp Duty to apply for the following year.
In setting the rates for Risk Equalisation Credits, following consultation with the Minister for Finance, I must have regard to the principal objective of the Health Insurance Act (as amended), which is to ensure that access to health insurance cover is available to consumers with no differentiation between them, in particular as regards the cost of health services, based on health risk status, age or sex. I must also have regard to the aims of: avoiding overcompensation of registered undertakings or former undertakings, maintaining the sustainability of the market, having fair and open competition in the health insurance market and avoiding the Risk Equalisation Fund having a surplus or deficit from year to year.
The HIA Reports are very detailed and include substantial market sensitive data. The 2011 Report was published in redacted form on the Department’s website. My Department, in conjunction with the HIA, is currently finalising a redacted version of the 2012 Report for publication shortly. In relation to the 16% of the insured population who currently have a lower level of cover, I am confident that when the new rates applicable under the Risk Equalisation Scheme come into effect on 31 March, there will continue to be a significant number of such policies available to consumers.
657. Deputy Charlie McConalogue asked the Minister for Health when a decision will be made on an application in respect of a person (details supplied) in County Donegal; and if he will make a statement on the matter. [3787/13]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
658. Deputy Billy Kelleher asked the Minister for Health if he will investigate complaints about the quality of the South Doc service being provided to Youghal, County Cork, following claims of refusal to travel to Youghal or instances of failure to show up; and if he will make a statement on the matter. [3796/13]
View answer90% of the population have access to GP out-of-hours services in 14 centres nationally, in all HSE regions, in at least part of every county. Over 2,000 GPs provide services in the co-ops. Attendance at a treatment centre would usually follow initial telephone triage and the HSE reports that this is a good proxy measure for hospital avoidance via Emergency Department attendance. In relation to the specific issue raised by the Deputy, as this is a service matter I have asked the HSE to respond to the Deputy directly on the matter.
659. Deputy Clare Daly asked the Minister for Health if he will reverse the cutbacks in relation to St. Michael's House with particular reference to access to swimming pool facilities at weekends [3803/13]
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.
660. Deputy Clare Daly asked the Minister for Health the steps he intends to take to implement a statuary agreement to assist the survivors of thalidomide. [3811/13]
View answerThe Government's main aim is to address the health and personal social care needs of thalidomide survivors living in Ireland. I have also stated that I am willing to enter into a discussion about a health care package; an ex-gratia payment having regard to current financial circumstances; and a statement to the Dáil recognising the challenges faced by survivors. It is not proposed to address these issues on a statutory basis.
661. Deputy Barry Cowen asked the Minister for Health if a bilateral cochlear implant operation will be carried out on a person (details supplied) in County Offaly; if he will outline his policy on such operations; and if he will make a statement on the matter. [3812/13]
View answer689. Deputy Barry Cowen asked the Minister for Health if a bilateral cochlear implant will be carried out on persons (details supplied); the reason Ireland does not carry out bilateral cochlear implants in line with the rest of the developed world; and if funding will be made available for the implants. [4181/13]
View answer705. Deputy Michael Lowry asked the Minister for Health if he will ensure that funding is provided for the provision of bilateral cochlear impacts for children in the State; the reason this treatment has not been provided to date; if his attention has been drawn to the long term negative effects for children arising from an inability to access this treatment; and if he will make a statement on the matter. [4249/13]
View answer732. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the reason bilateral cochlear implants are not funded in this State; if he will acknowledge the significant benefits of this procedure in comparison to unilateral implants; if he will address this issue; and if he will make a statement on the matter. [4439/13]
View answerI propose to take Questions Nos. 661, 689, 705 and 732 together.
I am advised that Beaumont Hospital carried out over ninety cochlear implants in 2012 and that over seven hundred patients are currently under the care of the hospital programme which provides rehabilitation and programming on a recurring basis. In relation to the specific queries raised by the Deputy's, including the individual cases, as these are service issues they have been referred to the HSE for direct reply.
663. Deputy Aengus Ó Snodaigh asked the Minister for Health when the new members for the National Children's Hospital Development Board will be appointed. [3841/13]
View answerThe decision to locate the new children's hospital on the St James's campus was announced on 6 November last. In identifying the new site, the Government 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 decision on location was made in the best interests of children, with clinical considerations being of paramount importance. 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.
Following the announcement of the Government's decision, detailed consideration has been given to the project management structures and governance arrangements required to enable delivery of the project as quickly as possible and to the highest quality and I intend to bring proposals to Government very shortly on this issue. The terms of office of the majority of Board members having expired on 5 December, I have appointed senior representatives from my Department and the HSE as an interim measure aimed at ensuring effective governance and decision-making for the project at this important initial stage to ensure the project continues without delay during this transitional phase.
664. Deputy Aengus Ó Snodaigh asked the Minister for Health the progress made in relation to the National Paediatric Hospital being located at St James's Hospital, Dublin; when a planning application will be lodged; and if he will make a statement on the matter. [3842/13]
View answerOn 6 November last, the Government decided that the new children’s hospital would be co-located with St James’s Hospital on its campus. This followed the refusal of planning permission in February 2012 for the hospital on the Mater campus, and subsequently the establishment of an independent Review Group to consider next steps (the “Dolphin Group”). Following the Government decision on the location, the first priority has been to consider governance issues for this complex and hugely important project, given the need to ensure that this project proceeds securely to completion. I intend to bring a Memorandum to Government on these issues shortly. Pending this, preliminary work is underway in relation to the project in its new location, while a review of urgent care centre(s) configuration is underway and a time-limited review of Dublin maternity services configuration is to commence as soon as possible. While a significant proportion of the work that was done for the project on the Mater site, including the internal configuration and adjacencies, will be transferable, a new design for the new site will be required before a planning application can be made.
665. Deputy Peter Mathews asked the Minister for Health his plans to improve the working conditions under which non consultant hospital doctors are currently working; and if he will make a statement on the matter. [3851/13]
View answer669. Deputy Billy Kelleher asked the Minister for Health if he and the Health Service Executive will act to limit the hours worked by non-consultant hospital doctors to 24 in a consecutive sitting and 60 in a week; and if he will make a statement on the matter. [3893/13]
View answer670. Deputy Billy Kelleher asked the Minister for Health if he has any plans to change the shift hours of non-consultant hospital doctors; and if he will make a statement on the matter. [3894/13]
View answer671. Deputy Dominic Hannigan asked the Minister for Health if his attention has been drawn to an article (details supplied); his views of the contents of the article; and if he will make a statement on the matter. [3895/13]
View answer672. Deputy Michael Lowry asked the Minister for Health the steps he will take to tackle the treatment of non consultant hospital doctors; if he will put an end to the illegal long working hours being forced on such doctors; if his attention has been drawn to the detrimental impact of these long working hours have on these persons; and if he will make a statement on the matter. [3902/13]
View answer674. Deputy Róisín Shortall asked the Minister for Health if he will outline the current legislation in respect of the maximum length of a shift and meal break provisions for junior hospital doctors; if his attention has been drawn to the wide spread concern among such staff about their working conditions; and if he will outline the steps he will take to ensure all hospitals are in compliance with current legislation in this regard. [3938/13]
View answer678. Deputy Nicky McFadden asked the Minister for Health if the concerns of non-consultant hospital doctors in relation to working hours will be addressed; if the European Working Time Directive will be implemented; and if he will make a statement on the matter. [3985/13]
View answer685. Deputy Maureen O'Sullivan asked the Minister for Health if his attention has been drawn to the ongoing situation regarding non consultant hospital doctors and junior doctors who are working shifts of 36 hours or more and where some doctors are working more than 70 hours a week in total and are suffering from mental and physical health problems as a result which is also jeopardising the quality of care of hospital patients; the action he will take in response to the Health Service Executive's non-compliance with the EU Working Time Directive transposed into the Statutory Instrument No. 494 of 2004 which states the maximum number of hours of work per week should not exceed 48 hours from 1 August 2009 onwards and 11 hours of rest is mandatory every 24 hours; and if he will make a statement on the matter. [4113/13]
View answer692. Deputy Billy Timmins asked the Minister for Health the position regarding the working hours of non-consultant hospital doctors (details supplied). [4195/13]
View answer694. Deputy Róisín Shortall asked the Minister for Health the current law in respect of the maximum length of a shift and meal break provisions for non consultant hospital doctors; if his attention has been drawn to the wide spread concern among such staff regarding the working conditions; and the steps he will take to ensure that all hospitals are in compliance with the law. [4199/13]
View answer697. Deputy Ciara Conway asked the Minister for Health if he will provide an update on the EU working time directive in respect of junior doctors; if he will confirm that this will be applied in full; the measures being put in place to monitor the application of same; and if he will make a statement on the matter. [4224/13]
View answerI propose to take Questions Nos. 665, 669 to 672, inclusive, 674, 678, 685, 692, 694 and 697 together.
The Government is committed to achieving compliance with the European Working Time Directive in respect of non-consultant hospital doctors (NCHDs) by 2014. I have emphasised to the HSE the high priority the Government and I attach to this issue. In January 2012, a detailed plan for the achievement of compliance by NCHDs with the Working Time Directive was submitted to the EU Commission. The plan affirmed Ireland's commitment to achieving compliance with the Directive over a three-year time period. It committed to implementing the measures necessary, including: the implementation of new work patterns for medical staff, transfer of work undertaken by NCHDs to other grades, and the organisation of hospital services to support compliance.
The Health Service Executive’s Service Plan for 2013 specifically recognises the need to address the issue as a priority, stating that there will be a particular focus in the acute hospital service on the achievement of compliance with the European Working Time Directive amongst the non-consultant hospital doctor workforce, in line with the Implementation Plan submitted to the Commission in 2012. The HSE is currently finalising its National Operational Plan to support the implementation of the National Service Plan 2013. This will specify in greater detail the actions to be taken during the year in relation to EWTD compliance. A key priority for the HSE in 2013 will be a further reduction of average weekly hours worked and also a reduction in the duration of shifts undertaken.
S.I. No. 494 of 2004 European Communities (Organisation of Working Time) (Activities of Doctors in Training) Regulations 2004, which transposed the EU Working Time Directive for doctors in training, provides for: A maximum 48 hour average working week; A 30 minute rest break every 6 hours during period on-site on-call; 11 hours rest every 24 hours or equivalent compensatory rest before return to work; and 35 hours continuous rest per week or twice a fortnight or 59 hours continuous rest per fortnight. The 2010 Contract of Employment for NCHDs, which these staff sign on appointment, reflects the above provisions. The contract also provides that NCHDs shall not be required to work more than 24 consecutive hours on-site. A related agreement between the HSE and the Irish Medical Organisation provides that the contract is subject to the requirements of the Directive.
666. Deputy Billy Kelleher asked the Minister for Health the number of operations, medical and surgical procedures, in public hospitals that were cancelled in 2012 and to date in 2013; and if he will make a statement on the matter. [3855/13]
View answerIn relation to the particular query raised by the Deputy, as this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy in this matter.
