Written Answers Nos. 671-693
671. Deputy Seán Ó Fearghaíl asked the Minister for Health if he will direct the Health Service Executive to restore therapies to a child (details supplied) in County Kildare; and if he will make a statement on the matter. [6943/13]
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.
672. Deputy Tom Fleming asked the Minister for Health the position regarding cataract surgery in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [6945/13]
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.
673. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the efforts he has made and will make to ensure prompt processing of Garda vetting applications, with particular reference to those of potential staff members of healthcare facilities; if he will detail the contact he has had with the Department for Justice and Equality in this regard; and if he will make a statement on the matter. [6948/13]
View answerGarda vetting of relevant health service staff has my full support. While Garda vetting is a matter for employers in the first instance, I am not aware of excessive delays in relation to the vetting of potential staff members.
It is the case that the vetting of potential staff can extend the duration of the appointment process, particularly at times when a significant volume of clearances may be required. I am of the view, however, that it is essential that the vetting process is not compromised. Officials in my Department had contact with officials of the Department of Justice and Equality last year in relation to the National Vetting Bureau (Children and Vulnerable Persons) Act 2012. This, however, was not connected to the issue raised by the Deputy.
674. Deputy Dan Neville asked the Minister for Health the number of the 39 child and adolescent mental health services accepting referrals of all young people up to and including 17 years of age as recommended in A Vision for Change. [6950/13]
View answerThe Child and Adolescent Mental Health Service (CAMHS) was traditionally provided to children aged 0 - 15 years, and care and treatment of 16 and 17 year olds was the responsibility of adult services. However, A Vision for Change recommended that CAMHS should be provided for all up to the age of 18 years. The implementation of A Vision for Change is a work in progress, and transitional arrangements apply as CAMHS is expanded to facilitate the provision of services to 16 and 17 year olds.
Last year, the HSE finalised "Access Protocols for 16 and 17 year olds to Mental Health Services" which came into effect from 1st January this year. In an effort to ensure that children are treated in an age appropriate manner, the new protocol provides that from 1st January 2013, CAMHS will accept referrals of all new cases of children up to their 17th birthday, and from 1st January 2014, the service will accept referrals of all new cases of children up to their 18th birthday.
The fourth Annual Report on CAMHS, published by the HSE in December 2012, provides a detailed picture of the current stage of development of HSE Child and Adolescent Mental Health Services. Progress in a number of key areas includes a 10% increase in the number of new cases seen by CAMHS for the period October 2011 – September 2012, and a continued reduction in the number of children and adolescents admitted to adult units.
As the issue raised by the Deputy relates to a service matter, it has been referred to the HSE for direct reply in respect of the detailed information sought.
675. Deputy Terence Flanagan asked the Minister for Health the position regarding a vaccine damage compensation scheme in respect of a person (details supplied); and if he will make a statement on the matter. [7001/13]
View answerThe issues contained in the Report of the Vaccine Damage Steering Group are complex. They need to be considered in the wider context of how best to address the long term health and social needs of people who may have experienced adverse outcomes from all healthcare interventions.
676. Deputy Richard Boyd Barrett asked the Minister for Health if he will provide all details of cuts and changes to ambulance services across the country since his appointment, including the rationale for the areas chosen for implementing changes or cuts; the planned savings to his Department of these changes; the actual savings to his Department; and the resulting changes in the response time to ECHO and DELTA calls that resulted from these changes. [7002/13]
View answerThe HSE National Ambulance Service (NAS) is not a static service. It deploys its resources in a dynamic manner and works on a regional and national, not a local, basis. The dynamic deployment of ambulance resources ensures that the nearest appropriate resource is mobilised to the location of any incident. In this context, any removal of overtime inefficiencies will be addressed through more efficient deployment and utilisation of resources.
The Deputy may be aware that, following a referral to the Labour Court under the Public Service Agreement, the NAS is progressing a number of efficiencies arising from the Court's decision. These operational efficiencies include the removal of on-call arrangements in rosters, where ambulance staff are not actually on duty in ambulance stations or vehicle but must be summoned for a 999 call. This means that it could take over 20 minutes for an emergency ambulance to leave its station after the crew has been tasked. All parties accept that, in accordance with a Labour Court recommendation, providing ambulance services under on-call arrangements should cease. As the Deputy's query relates to operational matters for the Health Service Executive, this question has been forwarded to the HSE to reply directly to the Deputy.
677. Deputy Richard Boyd Barrett asked the Minister for Health in view of the fact that there is no ambulance service in north Kildare between 7 a.m. and 7 p.m. on a Thursday since September 2012, if ECHO and DELTA calls on Thursdays in this area are being responded to in the Health Information and Quality Authority recommended timeframe of 19 minutes. [7003/13]
View answer678. Deputy Richard Boyd Barrett asked the Minister for Health the rationale for cutting the north Kildare ambulance service on Thursdays between 7 a.m. and 7 p.m.; and if there is any other ambulance area in the country with a population of 100,000 that has a 12 hour period on a weekly basis in which there is no ambulance service. [7004/13]
View answerI propose to take Questions Nos. 677 and 678 together.
The National Ambulance Service is not a static service. The NAS deploys its emergency resources in a dynamic manner and works on an area and national, rather than a local, basis. The dynamic deployment of ambulance resources ensures that the nearest appropriate resource within a region is mobilised to the an incident.
For dynamic deployment of emergency resources within a region to be effective, those resources must be available to be used as efficiently as possible. Following a referral to the Labour Court under the Public Service Agreement, the NAS is currently progressing a number of efficiencies arising from the Court's ruling, including more efficient rostering and the removal of overtime built in to rosters. New rosters are now in place, including in the greater Dublin area, and are operating successfully. The Health Information and Quality Authority (HIQA) has developed key performance indicators (KPIs) for pre-hospital emergency care, which classify 999 emergency calls by clinical status. Clinical Status 1 (Echo) calls involve life-threatening emergencies of cardiac or respiratory origin, while Clinical Status 1 (Delta) calls involve life-threatening emergencies other than cardiac or respiratory. The target times for responding to Echo and Delta calls are 7 minutes 59 seconds by a first responder (a person trained in minimum basic life support and use of a defibrillator) and 18 minutes 59 seconds for a patient-carrying vehicle. With effect from January 2012, HIQA set the standard at 75% within the target time for first responders and a target has been set at 80% within the target time for patient-carrying vehicles.
The NAS has been taking a number of steps to improve emergency responses. These include development of a Performance Improvement Action Plan, an Intermediate Care Service, the national control centre reconfiguration project and a trial emergency aeromedical service.
In light of the above, and following a review of the validity of time-based KPIs, it is considered, in line with international views, that clinical outcomes would be more appropriate as performance indicators. Accordingly, work has begun on their development.I also welcome the fact that use of clinical indicators will enable a focus on Clinical Status 1 (Echo and Delta) calls.
In relation to the specific queries raised by the Deputy, as these are service matters, they have been referred to the Health Service Executive for direct reply.
679. Deputy Terence Flanagan asked the Minister for Health if he will provide a breakdown of the investigations that are taking place into the death of a person (details supplied); the timeline for the publication of these reports; and if he will make a statement on the matter. [7006/13]
View answerThe investigations currently underway in relation to the case referenced by the Deputy are those of the Health Service Executive (HSE), Health Information and Quality Authority (HIQA) and the Coroner's Office.
The HSE's investigation team continues to work to complete its investigation in the shortest timeframe possible to achieve the objectives of the investigation. It is the intention of the HSE to publish the final report of the investigation.
The Health Information and Quality Authority (HIQA) is currently conducting an investigation into the safety, quality and standards of services provided by the HSE to patients, including pregnant women, at risk of clinical deterioration, including those provided in University College Hospital Galway (UCHG) and as reflected in, among other things, the care and treatment provided to Savita Halappanavar. As with all previous investigations conducted by the Authority, as the independent regulator of health and social care services, the Authority will carry out the investigation in line with published terms of reference.
The Authority will prepare a report of the findings of the investigation and make local and national recommendations as to the safety, quality and standards of services provided by the HSE, to the extent that the Authority considers appropriate. The report will then be submitted to the Board of the Authority for approval before publishing it a time the Authority deems appropriate.
The Coroner's Office held a preliminary inquest hearing on 18th January last and is scheduled to commence its full inquest during April. The inquest is held under the Coroner's Acts and my Department has no involvement in this independent process thus I am not in a position to advise or comment on the structure or duration of that process.
680. Deputy Sean Fleming asked the Minister for Health when a fair deal payment will be approved in respect of a person (details supplied) in County Laois; and if he will make a statement on the matter. [7007/13]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
681. Deputy Seán Kenny asked the Minister for Health when he will be in a position to appoint a coordinator for the Dublin north east drugs task force. [7011/13]
View answerThe Deputy will be aware that Drugs Task Force coordinators are, in the main, employed by the HSE and the position is therefore subject to the recruitment moratorium. I understand that the HSE recently sought expressions of interest from staff for the position but no applications were received. Other potential avenues are now being explored by the HSE with a view to filling the vacancy as soon as possible.
682. Deputy Gerald Nash asked the Minister for Health his views on Ireland's obligation to implement the European working time directive on legal working hours for the medical profession; if he will provide a commitment to fulfil the State's obligations in this regard; and if he will make a statement on the matter. [7031/13]
View answer693. Deputy Sean Fleming asked the Minister for Health his plans to introduce the European working time directive on legal working hours for the medical profession with particular reference to non-consultant hospital doctors; and if he will make a statement on the matter. [7137/13]
View answerI propose to take Questions Nos. 682 and 693 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 Health Service Executive 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 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 HSE National Service Plan 2013 states 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. The Executive is currently finalising its National Operational Plan to support the implementation of the National Service Plan. This will specify in greater detail the actions to be taken in relation to EWTD compliance.
683. Deputy Gerald Nash asked the Minister for Health his plans for wide dissemination to all relevant parties of information about the facility by which people with a terminal diagnosis may be given a medical card immediately the terminal diagnosis is verified by a registered medical practitioner regardless of patient means in view of recent press reports which suggest that some patients and their medical and social care teams may not be aware of this facility; and if he will make a statement on the matter. [7040/13]
View answerI have asked the Health Service Executive for a report on the issue raised by the Deputy. I will revert to the Deputy on the matter as soon as possible.
684. Deputy Bernard J. Durkan asked the Minister for Health the progress made to date in the determination of a medical card in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [7051/13]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
685. Deputy Bernard J. Durkan asked the Minister for Health the progress made to date in respect of an appeal for a medical card in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [7058/13]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
687. Deputy Tom Fleming asked the Minister for Health if he will grant an exemption from generic substitution for anti-epileptic drugs in the upcoming Health Pricing and Supply of Medical Goods Bill (details supplied); if he will take into consideration that an exclusion for AEDs is supported by the entire epilepsy community and the health care professionals who treat and care for people with epilepsy; and if he will make a statement on the matter. [7085/13]
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 deciding whether to add a group of medicinal products to the List of Interchangeable Medicinal Products, the Board must be satisfied that each medicinal product which falls within the group:
(a) has the same qualitative and quantitative composition in each of its active substances as each of the other medicinal products which fall within the group;
(b) is in the same pharmaceutical form as, or in a pharmaceutical form that is appropriate for substitution for, each of the other products in the group; and
(c) has the same route of administration as each of the other medicinal products which fall within the group.
In addition, the Bill provides that the Board is not permitted to add a group of medicinal products to the List of Interchangeable Medicinal Products where:
there is a difference in bioavailability between the medicinal products and the interchangeable medicinal products which currently fall within the group of interchangeable medicinal products which may lead to a clinically significant difference in efficacy between them, and
any of the medicinal products cannot be safely substituted for any one or more of the other medicinal products in the group.
I would like to emphasise that in making a decision to add a medicinal product to a group of interchangeable medicinal products or a group of medicinal products to the List of Interchangeable Medicinal Products the Board is obliged to have regard to the criteria as set out in the Bill and that these criteria fully reflect the recommendations set out in the Joint Department of Health/HSE report 'Proposed Model of Reference Pricing and Generic Substitution' (the Moran Report, 2010) regarding criteria for interchangeability.
To further enhance the patient safety aspect of generic substitution, Section 13 of the Bill allows a prescriber to indicate on a prescription that a branded interchangeable medicinal product should, for clinical reasons, not be substituted.
I am satisfied that these provisions address the concerns raised by the Deputy. I met with the Irish Epilepsy Association in January and explained this position.
It is also 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.
688. Deputy Michael McGrath asked the Minister for Health when a suitable wheelchair will be provided for a person (details supplied) in County Cork. [7100/13]
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.
689. Deputy Robert Troy asked the Minister for Health if he will grant approval for Ampligen, a drug which helps people with Myalgic Encephalomyelitis; and if he will make a statement on the matter. [7111/13]
View answer692. Deputy Robert Troy asked the Minister for Health if he has made any representations to the US Food and Drug Administration with regard to approving the drug Ampligen for all M.E. patients here. [7134/13]
View answerI propose to take Questions Nos. 689 and 692 together.
Before a medicine can be placed on the Irish market the manufacturer has to seek an authorisation from the Irish Medicines Board (IMB) or in the case of certain medicinal products, the European Medicines agency (EMA). In the case of Ampligen, because of the biotechnology nature of the active substance involved, any application for Ampligen to be made available to European patients has to be made to the EMA. I have no information on whether or not such an application has been received by the EMA.
The current position therefore is that Ampligen has not been authorised to be placed on the market in Europe. The Food and Drug Administration (FDA) is the regulatory authority for medicines in the US. The FDA has refused an application to make this product available in the US citing safety and efficacy concerns.
The FDA operates outside of this jurisdiction and it would not be appropriate for me to make representations to the FDA on the manner in which it regulates medicinal products for American patients.
690. Deputy Tom Fleming asked the Minister for Health if he will ensure an area (details supplied) in County Kerry is adequately served with an ambulance service; and if he will make a statement on the matter. [7129/13]
View answerThe National Ambulance Service (NAS) is not a static service. The Service deploys its resources in a dynamic manner and works on an area and national, rather than a local, basis. The dynamic deployment of ambulance resources ensures that the nearest appropriate resource is mobilised to the location of any incident.
The NAS has been taking a number of steps to improve response times. These include development of a Performance Improvement Action Plan, an Intermediate Care Service, the control centre reconfiguration project and a trial emergency aeromedical service. Following a referral to the Labour Court under the Public Service Agreement, the HSE National ambulance Service is currently progressing a number of efficiencies arising from LCR 20313, including the issue of removal of overtime built in to rosters. New rosters are now in place and are operating successfully. In relation to the specific query raised by the Deputy, as this is a service matter it has been referred to the Health Service Executive for direct reply.
691. Deputy Sandra McLellan asked the Minister for Health if he will approve funding for a car harness for a child who suffers from angel man syndrome, ADHD and epilepsy (details supplied) in County Cork; and if he will make a statement on the matter. [7132/13]
View answerThe particular issue raised by the Deputy is a service matter for the Health Service Executive. Accordingly I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
