Departmental Expenditure

Questions (589)

Robert Troy

Question:

589. Deputy Robert Troy asked the Minister for Health the number of credit cards issued to staff and Ministers in his Department and the total costs of each card since March 2011; and if he will make a statement on the matter. [12479/13]

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Written answers (Question to Health)

There are two corporate credit cards for official business purposes currently in use in my Department. A Bank of Ireland Visa credit card is issued to my Private Secretary and a second card is issued to a nominated officer in my Department's Finance Unit. This card is used to cover a range of costs such as publications, seminar and conference fees, annual membership fees, transport costs and software purchases where payment by credit card is required. The total amount of the transactions on each card since March 2011 are €16,321 and €13,054 respectively.

Public Sector Staff Data

Questions (590)

Billy Kelleher

Question:

590. Deputy Billy Kelleher asked the Minister for Health the measures he has taken to address the deficit of 137 staff as identified in the current public health nursing services published by the Health Service Executive in May 2012; and if he will make a statement on the matter. [12487/13]

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Written answers (Question to Health)

The Government has decided that the numbers employed across the public service must be reduced in order to meet its fiscal and budgetary targets. The health sector must make its contribution to that reduction. However, the HSE can make staff appointments once it remains within its overall employment ceiling and has the financial resources to do so. I have asked the Executive to reply directly to the deputy in relation to current Public Health Nursing staffing.

Public Sector Staff Training

Questions (591, 592, 593)

Billy Kelleher

Question:

591. Deputy Billy Kelleher asked the Minister for Health if training for DPHN will take place in 2013; the number of places that will be available; if he will he provide detail of same; and if he will make a statement on the matter. [12488/13]

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Billy Kelleher

Question:

592. Deputy Billy Kelleher asked the Minister for Health the reason training numbers for DPHN were reduced from 120 to 40 places in 2012; and if he will make a statement on the matter. [12489/13]

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Billy Kelleher

Question:

593. Deputy Billy Kelleher asked the Minister for Health the ratio of DPHN to population his Department recommends; and if he will make a statement on the matter. [12490/13]

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Written answers (Question to Health)

I propose to take Questions Nos. 591 to 593, inclusive, together.

The Public Health Nursing service within the HSE generally consists of a Director of Public Health Nursing, Assistant Directors of Public Health Nursing, Public Health Nurses and Registered General Nurses/Midwives. A small percentage of specialist posts are filled by Clinical Nurse Specialists and Advanced Nurse Practitioners. The Public Health Nurse is responsible for the delivery of the public health nursing service for specific geographic areas. The scope and range of public health nursing services are aligned to the health service demand that emerges from the population demographics and epidemiology. This demand varies depending on the complexity of health service requirements in geographic areas such as deprivation, cohort of frail older adults, extent of child health interventions, prevalence of chronic diseases etc. A specific ratio of PHNs per population has not been set nationally. I have asked the Health Service Executive to reply directly to the Deputy in relation to the specific questions about the number of training places in 2012 and 2013.

Animal Welfare Issues

Questions (594, 595)

Clare Daly

Question:

594. Deputy Clare Daly asked the Minister for Health the number of times his Department authorised concussion and-or percussive blow to the head as a permitted method of euthanasia for new-born puppies, kitten, fox cubs and or ferret kits, between 2002 and 1 January 2013; if it occurred without explicit authorisation, and the number of young animals that were killed by this method. [12491/13]

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Clare Daly

Question:

595. Deputy Clare Daly asked the Minister for Health his position in relation to concussion and or percussive blow to the head as a humane method of killing new-born puppies, kitten, fox cubs and or ferret kits; his policy and or that of the Irish Medicines Board on the use of this killing method under SI 543 European Union (Protection of Animals used for Scinetific Purposes) Regulations 2012. [12492/13]

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Written answers (Question to Health)

I propose to take Questions Nos. 594 and 595 together.

The Deputy's first question relates to the European Communities (Amendment of Cruelty to Animals Act 1876) Regulations 2002 which were revoked by the European Union (Protection of Animals Used for Scientific Purposes) Regulations 2012. These revised Regulations, which transposed Directive 2010/63/EU on the Protection of Animals Used for Scientific Purposes, came into operation on 1 January 2013 and considerably strengthened the protection of animals still needed for research and safety testing. They also play a significant role in terms of minimising the number of animals used and require that alternatives to animal testing be utilised whenever possible.

The 2002 Regulations transposed Directive 86/609/EEC into Irish law. Under these Regulations, it was a requirement that where an animal was killed, it was done by a humane method. In this context "humane method" is defined as "the killing of the animal with the minimum of physical and mental suffering, depending on the species". From 2007 onwards account was taken of Commission Recommendation (2007/526/EU) on guidelines for the accommodation and care of animals used for experimental and other scientific purposes. This Recommendation set out requirements in relation to humane killing in respect of all species and, where appropriate, more specific requirements were outlined in relation to certain species.

Individual statistical information in relation to the specific humane methods of killing for individual projects was not a requirement under Directive 86/609/EEC and was not, therefore, included in the consequential transposing Regulations. My Department is not aware of any method of killing done as part of a scientific experiment which was conducted without explicit authorisation. If the Deputy is in possession of information that might indicate that this is the case, I would urge you to provide such information to the IMB, which is the Competent Authority in this area.

The new legislation, now in force, sets out a comprehensive range of measures that must be complied with in relation to methods of killing. It requires that where an animal (used or intended to be used in a procedure, or bred specifically so that their organs or tissues may be used for scientific purposes) is killed, the person responsible for the killing shall ensure that the method of killing with the minimum pain, suffering and distress is used, and the animal is killed by a competent person in the establishment of the breeder, supplier or user, as appropriate. Additionally it requires that in the case of the killing of an animal covered by Annex IV to the Directive, the breeder, supplier or user, or other person responsible, shall ensure that the appropriate method of killing as set out in that Annex is used.

The IMB believes that it would be unlikely that newborn puppies or kittens would have been euthanised by way of the methods outlined in the Deputy's question. Any such euthanasia would more likely have been carried out by injection of a lethal dose of barbiturate (i.e. anaesthetic overdose). The IMB policy in relation to the euthanasia of animals used for scientific purposes in establishments that have been authorised in accordance with EU Directive 2010/63/EU is that only those methods that are set out in the Directive should be used. In accordance with Regulation 8(1) of SI No 543 of 2012, which came into effect on 1 January 2013, the method for euthanasia of animals that is used shall be the method where the minimum pain, suffering and distress is experienced.

Motorised Transport Grant

Questions (596)

Gerry Adams

Question:

596. Deputy Gerry Adams asked the Minister for Health if he will provide an update on the processing of the motorised transport grant in respect of a person (details supplied) in County Meath, in view of the fact that this application is currently under an appeal; and the impact the recent Government decision will have on the processing of this appeal. [12498/13]

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Written answers (Question to Health)

The position regarding appeals processes for applications for Motorised Transport Grant which were underway prior to 26th February 2013, is that they will continue to be processed. If the appeal is upheld, payment will be made. I have referred the specific case mentioned by the Deputy to the Health Service Executive, for direct reply to the Deputy.

Medicinal Products Licensing

Questions (597)

Paul Connaughton

Question:

597. Deputy Paul J. Connaughton asked the Minister for Health if his Department will allow the drug sativex to be distributed to multiple sclerosis sufferers here; and if he will make a statement on the matter. [12499/13]

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Written answers (Question to 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. Under the Misuse of Drugs Act, 1977, the manufacture, production, preparation, sale, supply, distribution and possession of cannabis or cannabis-based medicinal products are unlawful except for the purposes of research.

My Department is currently examining how authorised cannabis-based medicinal products for patients suffering from Multiple Sclerosis may be legally prescribed by medical practitioners and used by patients for the treatment of MS in Ireland. In that respect, Department officials have been engaging with experts to identify how best to legally describe authorised cannabis-based medicinal products while maintaining existing controls on cannabis and cannabis substances. While the legislative amendments required can be made by means of statutory instrument, the legal issues are complex. The matter is being progressed as quickly as possible in my Department and it is hoped to bring forward legislative proposals in mid-2013.

Hospital Services

Questions (598)

Nicky McFadden

Question:

598. Deputy Nicky McFadden asked the Minister for Health if he will ensure that any proposals for hospital groupings in the Midlands will not adversely impact services currently provided at Midlands Regional Hospitals including Mullingar and that patient care and provision of adequate services will not be compromised; and if he will make a statement on the matter. [12504/13]

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Written answers (Question to Health)

In preparing the Report on the Establishment of Hospital Groups as a Transition to dependent Hospital Trusts, consideration was given to a wide breadth of international and national academic literature and reviews on relevant issues such as hospital reform, quality health care provision, financial management of health care, academic health linkages and organisational reform. As part of this work, cognisance was taken of the findings of the comparative review carried out by the Health Research Board (HRB) of independent hospital trusts in a number of countries and the factors identified as contributing most to successful trusts. These considerations, and the comprehensive consultation process undertaken with stakeholders, have informed the development of recommendations on the formation of specific groups and arrangements for the management and governance of all groups. These recommendations have been considered and endorsed by a Strategic Board composed of representatives with national and international expertise in health service delivery, governance and linkages with academic institutions.

The formation of hospital groups is fundamentally an organisational change that of itself will not trigger immediate changes in service provision. It will provide a platform for much better strategically planned and more effective changes in service provision to ensure that patient care is improved and certainly not compromised or less adequate in relation to any area in the Country. Lessons learnt from other jurisdictions as well as the learning gained from the operation of the hospital groups will be taken on board in creating the legislative framework for hospital trusts here. The intention is, of course, that the trusts and the reformed health system within which hospital trusts will operate will be designed in a way that best suits Irish requirements and this will be done in a way that seeks to avoid difficulties encountered in other jurisdictions.

Water Fluoridation

Questions (599)

Michael Moynihan

Question:

599. Deputy Michael Moynihan asked the Minister for Health his views on whether there is a need to implement a fully independent toxicological and epidemiological study into the public health effects of adding fluoride to all public water schemes here in view of the mounting scientific evidence against the practice of water fluoridation (details supplied), and the increasing abandonment of the policy of public water fluoridation in most EU member states, as well as numerous cities in the United States; and if he will make a statement on the matter. [12505/13]

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Written answers (Question to Health)

Water fluoridation and the use of appropriate fluorides is a major plank of public health policy in Ireland in the prevention and management of tooth decay. In 2002 the Forum on Fluoridation, which was established to review this policy, concluded that the fluoridation of public piped water supplies should continue as a public health measure. The effects of fluoridation on health and related matters are kept under constant review. The Irish Expert Body on Fluorides and Health, established in 2004, monitors new and emerging issues on fluoride and its effects . It advises that the balance of scientific evidence worldwide confirms that water fluoridation, at the optimal level, does not cause any ill effects and is the safest and most cost effective method of protecting the oral health of the population. The opinion of the Expert Body is supported by the World Health Organisation; the Centre for Disease Control and Prevention, the Public Health Service and the Surgeon General of the United States; the World Dental Federation; the International Association for Dental Research; the Royal College of Physicians of England and by major international scientifically validated reviews in many countries.

The Harvard study referred to by the Deputy was a review of studies mainly from China. These studies were assessed by the Expert Body in 2011 and were found to be of no relevance to Ireland given our regulated fluoridation levels. The view is that the overall design of the studies is poor and they do not provide evidence of any effect on children's IQ from either high or low fluoride levels. The EU Scientific Committee on Health and Environmental Risks (SCHER) in its 2011 Report shared this view of the studies. Some European countries choose salt fluoridation or milk fluoridation as an alternative to water fluoridation in their public health programmes while others use fluoride mouth-rinses and/or tooth-brushing or painting of teeth with fluorides. Additionally, all European countries promote the widespread use of fluoride toothpastes. The USA, Canada, Australia, New Zealand, United Kingdom, Israel, Malaysia, Singapore, Hong Kong, Argentina, Chile, and Columbia actively fluoridate water supplies. Fluoridation coverage in the USA has increased by around 24 million people between 2002 and 2012.

Medical Card Applications

Questions (600)

Tom Fleming

Question:

600. Deputy Tom Fleming asked the Minister for Health if he will expedite a medical card application in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [12523/13]

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Written answers (Question to Health)

The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

Legislative Programme

Questions (601)

Dominic Hannigan

Question:

601. Deputy Dominic Hannigan asked the Minister for Health when he expects the Health (Pricing and Supply of Medical Goods) Bill 2012 to pass all stages; when he expects the savings proposed in it to be passed on to the Exchequer; and if he will make a statement on the matter. [12532/13]

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Written answers (Question to Health)

The Health (Pricing and Supply of Medical Goods) Bill 2012, which is currently before the House, provides for the introduction of a system of generic substitution and reference pricing. e timeframe for the passage of the Bill is a matter for the Oireachtas.

Symphysiotomy Report

Questions (602)

Gerald Nash

Question:

602. Deputy Gerald Nash asked the Minister for Health if he will provide a date for the publication of the Walsh report into the practice of symphysiotomy; and if he will make a statement on the matter. [12537/13]

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Written answers (Question to Health)

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.

My first priority is to ensure that the women who have had this procedure 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.

Prescription Charges

Questions (603)

Finian McGrath

Question:

603. Deputy Finian McGrath asked the Minister for Health the position regarding medication or reliefs in respect of persons (details supplied) [12539/13]

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Written answers (Question to Health)

I understand this question refers to prescription charges. Medical card holders are required to pay a €1.50 charge per item for medicines and other prescription items supplied to them by community pharmacists, subject to a cap of €19.50 per month for each person or family. Prescription charges do not apply to children in the care of the HSE or to methadone supplied to patients participating in the Methadone Treatment Scheme.

Optical Services

Questions (604, 608)

Tom Fleming

Question:

604. Deputy Tom Fleming asked the Minister for Health if he will introduce a scheme to improve eyecare for 12 to 16 years olds in view of the fact that at present there is no specific scheme for the majority of this age group and many of these children receive no eyecare at all; if he will take into consideration that approximately 10% of children up to the age of 12 years require glasses or contact lenses, while more than 20% do by the age of 16 years; and if he will make a statement on the matter. [12551/13]

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Michael Healy-Rae

Question:

608. Deputy Michael Healy-Rae asked the Minister for Health his views on a submission (details supplied) regarding eye care facilities; and if he will make a statement on the matter. [12602/13]

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Written answers (Question to Health)

I propose to take Questions Nos. 604 and 608 together.

All children of primary school age are provided with an optical screening service by the HSE. Any refractive errors are treated and spectacles or other appropriate care is provided where necessary. Children between 12 and 16 years, whose parents are in receipt of a medical card or Long Term Illness card, are eligible for HSE eye-care services when they are named on their parents' cards. Other children between 12 and 16 years are eligible to be seen by a HSE eye doctor when there is a medical reason for the eye condition, rather than a refractive error. Such patients may be referred for treatment after being examined by an optometrist.

National Newborn Screening Programme

Questions (605)

Thomas P. Broughan

Question:

605. Deputy Thomas P. Broughan asked the Minister for Health the position regarding the 1.6 million newborn screening card blood samples; his views on whether the destruction of the blood sample bank may have negative implications for future preventative health research initiatives; and if he will make a statement on the matter. [12559/13]

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Written answers (Question to Health)

In late 2009, the Data Protection Commissioner received a complaint from a member of the public regarding the retention of newborn screening cards. The basis of the complaint, which was upheld by the DPC was that newborn screening cards should not be retained indefinitely without consent as this breached the Data Protection Acts 1998 and 2003. As the Commissioner said ..."it is important to make clear that the position that developed was unlawful and could not be allowed to continue".

Following meetings between the Deputy Data Protection Commissioner, officials from my Department, the HSE and the Children's University Hospital, Temple Street a number of changes to the National Newborn Screening Programme were agreed including obtaining written consent from the mother to have her new born child screened, retention of the newborn screening card for ten years and the retention of information on those cards for twenty five years. It was also agreed to destroy existing cards that are older than ten years. It must be remembered that there is no written consent from parents for the retention or use of these newborn screening cards taken between 1984 and 2002 for research or other purposes.

Following representations from a number of people and organisations, who pointed out the potential value of the cards for research, I requested the HSE to conduct a review of the decision to destroy these cards. The review examined both the legal and ethical basis for retention of newborn screening cards including the potential use of the cards for research purposes. The Review Group supported the decision to destroy the cards and following careful consideration I accepted the Group's recommendation. I must emphasise that this decision was taken to ensure that the HSE and the Children's University Hospital meet their ethical and legal obligations under the Data Protection Acts. However, the Review Group also explored how the cards could be made available to the research community in a way which is compatible with legal and ethical obligations.

In line with its recommendations, the HSE has been running an information campaign offering people the opportunity to have their screening card returned to them, prior to any cards being destroyed. This campaign is due to end on 31 March 2013, after which any remaining unclaimed cards are scheduled to be destroyed. This will ensure that anyone who wishes to donate newborn screening cards for research will be afforded the opportunity to do so. I am seeking information from the HSE as to the effectiveness of their campaign to ensure people have been adequately informed about their rights.

Medical Card Applications

Questions (606)

Michael Healy-Rae

Question:

606. Deputy Michael Healy-Rae asked the Minister for Health the position regarding a medical card in respect of a person (details supplied); and if he will make a statement on the matter. [12564/13]

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Written answers (Question to Health)

The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

Mobility Allowance Eligibility

Question No. 608 answered with Question No. 604.

Questions (607)

Billy Timmins

Question:

607. Deputy Billy Timmins asked the Minister for Health the position regarding a mobility scooter in respect of a person (details supplied) in County Wicklow; and if he will make a statement on the matter. [12592/13]

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Written answers (Question to 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.

Question No. 608 answered with Question No. 604.