Medical Aids and Appliances Provision

Questions (665)

Andrew Doyle

Question:

665. Deputy Andrew Doyle asked the Minister for Health if a scheme or mechanism is in place by either his Department or the Health Service Executive so that used foldable walkers, walking sticks and crutches from previous patients are made available for new patients, with sterilisation to ensure that their reuse is to the proper standard; if his attention has been drawn to the fact that such a scheme or mechanism would allow for significant saving for the Exchequer; and if he will make a statement on the matter. [31735/13]

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Written answers (Question to Health)

In relation to the particular query raised by the Deputy, as this is a service issue, I have asked the Health Service Executive to respond directly to the Deputy in this matter.

Hospital Services

Questions (666)

Patrick O'Donovan

Question:

666. Deputy Patrick O'Donovan asked the Minister for Health if he will provide details on the way a person who believes that the care that they received in a public hospital was below standard and led to a deterioration in their quality of life and a longer than normal stay as an inpatient in hospital may attain compensation and redress for their situation. [31752/13]

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Written answers (Question to Health)

Part 9 of the Health Act 2004 provides for the making of complaints. The Health Service Executive (HSE) has published a "National Healthcare Charter, You and Your Health Service" which outlines what service users can expect and what their responsibilities are whenever and wherever they use health services and the mediation and facilitation provided for the handling of complaints. This document is available at www.hse.ie.

Hospital Services

Questions (667)

Clare Daly

Question:

667. Deputy Clare Daly asked the Minister for Health the reason Mallow Hospital will not take children under six years of age given that the South Doc facility only has one night doctor and in the event of a day doctor being late on the shift, potentially has no staff available to deal with medical emergencies; and the steps he intends to take to ensure that children in medical emergencies have access to timely treatment. [31787/13]

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Written answers (Question to Health)

In relation to the particular query raised by the Deputy, as this is a service issue, I have asked the Health Service Executive to respond directly to the Deputy in this matter.

Nursing Homes Support Scheme Applications

Questions (668)

Brendan Griffin

Question:

668. Deputy Brendan Griffin asked the Minister for Health if a decision has been made on an application for the nursing home support scheme in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [31827/13]

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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.

Respite Care Services

Questions (669)

Ciaran Lynch

Question:

669. Deputy Ciarán Lynch asked the Minister for Health the reason a person (details supplied) in County Cork was refused respite care; if he will confirm that male patients are at a disadvantage compared to female patients seeking respite care; and if he will make a statement on the matter. [31830/13]

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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.

Hospital Procedures

Questions (670, 671, 672, 673)

Pearse Doherty

Question:

670. Deputy Pearse Doherty asked the Minister for Health if he will list the number of hip replacement operations carried out on public patients at a hospital (details supplied) in County Donegal for the past three years; the number of operations that have been carried out to date in 2013; the number planned; and if he will make a statement on the matter. [31832/13]

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Pearse Doherty

Question:

671. Deputy Pearse Doherty asked the Minister for Health if he will list the number of hip replacement operations carried out on private patients at a hospital (details supplied) in County Donegal for the past three years, the number of operations that have been carried out to date in 2013; the number planned; and if he will make a statement on the matter. [31833/13]

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Pearse Doherty

Question:

672. Deputy Pearse Doherty asked the Minister for Health if he will provide details in tabular form on the number of operations carried out by a hospital (details supplied) in County Donegal per department on public patients for 2011, 2012 and to date in 2013. [31834/13]

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Pearse Doherty

Question:

673. Deputy Pearse Doherty asked the Minister for Health if he will provide details in tabular form on the number of operations carried out by a hospital (details supplied) in County Donegal per department on private patients for 2011, 2012 and to date in 2013. [31835/13]

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Written answers (Question to Health)

I propose to take Questions Nos. 670 to 673, inclusive, together.

In relation to the particular queries raised by the Deputy, as these are service issues, I have asked the Health Service Executive to respond directly to the Deputy in these matters.

Home Help Service Provision

Questions (674)

Finian McGrath

Question:

674. Deputy Finian McGrath asked the Minister for Health the position regarding home help in respect of a person (details supplied) in Dublin 9. [31840/13]

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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.

National Dementia Strategy Implementation

Questions (675)

Damien English

Question:

675. Deputy Damien English asked the Minister for Health if he will provide an update on the progress of the National Dementia Strategy, which will seek to increase awareness, ensure early diagnosis and intervention, and enhance community based services for persons living with Alzheimer's disease and other dementias; when he expects the report to be finalised and published; and if he will make a statement on the matter. [31848/13]

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Written answers (Question to Health)

It is estimated that there are currently 41,000 people with dementia in Ireland and Alzheimer's Disease accounts for the majority of cases.

Given that the number of people with dementia is expected to rise to between 141,000 and 147,000 by 2041, the Programme for Government contains a commitment to develop a National Alzheimer's and other Dementias' Strategy by 2013 to;

- increase awareness

- ensure early diagnosis and intervention and

- ensure development of enhanced community based services.

A significant amount of preparatory work has already been completed. A research review funded by the Atlantic Philanthropies to lay the foundations for the Strategy, titled Creating Excellence in Dementia Care, A Research Review for Ireland’s National Dementia Strategy was published in January 2012. A public consultation process to inform the development of the Strategy was conducted in 2012 and a report of same published on the Department's website in February 2013.

A Working Group, representative of key stakeholders from the Department, the HSE, the medical profession and the community and voluntary sector has been established, meetings of which are on-going.

While the development of the Strategy will have to have due regard to the constraints imposed by the budgetary situation, it is intended that it will be a transformative Strategy. It will have a very practical focus, will be action oriented and will focus on what can be done to make a difference to the lives of people with dementia. It is intended that a draft of the Strategy will be completed by the end of 2013.

Hospital Appointments Administration

Questions (676)

Pat Deering

Question:

676. Deputy Pat Deering asked the Minister for Health when a person (details supplied) in County Kilkenny will receive a hospital appointment and if he will expedite a response. [31942/13]

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Written answers (Question to Health)

Improving access to outpatient services is a key priority for the Government. Collaborating with individual hospitals, the SDU, together with the National Treatment Purchase Fund (NTPF) and the HSE, has developed the outpatient waiting list minimum dataset. This allows data to be submitted to the NTPF from hospitals on a weekly basis and, for the first time, outpatient data is available on www.ntpf.ie. For 2013, a maximum waiting time target has been set of 12 months for a first time consultant-led outpatient appointment and this is reflected in the HSE service plan. The SDU and the NTPF will work closely with hospitals towards achievement of the maximum waiting time.

Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she would be in the best position to take the matter up with the consultant and hospital involved. In relation to the specific hospital appointment query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.

Long-Term Illness Scheme Issues

Questions (677)

Caoimhghín Ó Caoláin

Question:

677. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the reason a person (details supplied) in County Meath is charged for medications despite being in receipt of a long-term illness card; if it is the case that these medications are covered by the long-term illness scheme; if he will acknowledge that this person is therefore disadvantaged by also having a medical card; if he will immediately review this anomaly; and if he will make a statement on the matter. [31943/13]

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Written answers (Question to Health)

Persons suffering from prescribed conditions, who are not already medical card holders, can get free drugs, medicines and medical and surgical appliances for the treatment of that condition under the Long Term Illness (LTI) Scheme.

Medical card holders are required to pay prescription charges. Prescription charges are not payable in respect of items supplied under the LTI Scheme.

In the case of persons who have both the medical card and LTI, the HSE policy is that they should use their medical card to access medicines. The main reason for this is that the supply of medicines under the LTI costs the HSE considerably more than under the GMS Scheme. A retail mark-up of 20% is payable to pharmacists for items supplied under the LTI Scheme but there is no retail mark-up for items supplied under the GMS Scheme.

The decision by the previous Government not to extend prescription charges to the Long Term Illness Scheme has given rise to the anomaly identified by the Deputy. This matter is under review.

Speech and Language Therapy

Questions (678)

Emmet Stagg

Question:

678. Deputy Emmet Stagg asked the Minister for Health when speech and language therapy will be provided to a child with autism (details supplied) in County Kildare. [31951/13]

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Written answers (Question to Health)

The Government is fully committed to protecting frontline services, including services for children with disabilities and autism, to the greatest extent possible, notwithstanding the financial constraints within which the health sector must operate. The HSE aims to ensure that therapy resources, such as Speech and Language Therapy services, are used to best effect. There has been significant investment in the area of speech and language therapists in recent years and a range of new approaches have been developed and used in many Speech and Language Therapy services across the country. These include providing structures and training to parents or carers so that they can work with the individual child to improve their speech and language. Therapy is also delivered in group settings, where appropriate.

The policy context for the provision of autism services to children and young people is set out in the HSE National Review of Autism Services: Past, Present and Way Forward Report (2012) and the Progressing Disabilities Services for Children and Young People (0-18s) Programme. The objective of the Progressing Disabilities Programme is to achieve a national, unified approach to delivering disability health services so that there is a clear pathway to the services for all children, regardless of where they live, what school they go to or the nature of their disability. This Programme aims to remedy the variations in service provision that currently persist around the country.

As the particular issue raised by the Deputy relates to an individual case, this is a service matter for the HSE. Accordingly, I have arranged for the question to be referred to the HSE for direct reply to the Deputy.

Cancer Screening Programmes

Questions (679)

Denis Naughten

Question:

679. Deputy Denis Naughten asked the Minister for Health his plans to roll out a screening programme to detect the presence of genetic mutations BRCA1 and BRCA2 genes which bring a higher risk of breast cancer; and if he will make a statement on the matter. [31959/13]

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Written answers (Question to Health)

The communication of information on cancer risk and carrier probability is not straightforward. There is a degree of uncertainty with respect to the probability of inheriting a predisposing genetic mutation, of gene penetrance and hence of developing cancer. People who are concerned about a family history of breast cancer may require information to help them deal with the complex medical and social choices linked with different levels of breast cancer risk management options, and support to cope with the associated uncertainty and anxiety. It is therefore not appropriate to develop a general population based screening programme for the presence of genetic mutations.

Breast cancer is the most common invasive cancer diagnosed in women in Ireland. A comprehensive symptomatic breast service is available for women in the eight designated cancer centres. Most cases of breast cancer arise in women with no apparent close family history. The majority of people with a family history of breast cancer will not be at substantially increased risk.

However, five to ten per cent of all breast cancers are explained by the presence of BRCA1 or BRCA2 mutations. The lifetime risk of breast cancer in these women may be as high as 80%. However, not all familial clusters can be explained by known breast cancer susceptibility genes such as BRCA1 or BRCA2.

The National Cancer Control Programme (NCCP) established a National Hereditary Cancer Programme in 2011 with the National Centre for Medical Genetics in Crumlin Hospital. Additional genetic testing clinics have been established in St James's and the Mater Hospitals in Dublin - with a similar service due to be opened in Cork University Hospital in the coming months. In 2012 the new clinics in the Mater and St James's Hospitals assessed and tested almost 200 women (with breast or ovarian cancer) for the BRCA gene mutation. This represents more than a 100% increase in the numbers of women tested nationally compared with 2011.

There are two groups of women involved – those who have been diagnosed with cancer and those who have a family member who has been found to carry a gene mutation. Testing is undertaken on the basis of agreed medical criteria and is always preceded by genetic counselling. The NCCP and National Centre for Medical Genetics are continuing to work to ensure that the service is expanded to meet national needs.

Accurate predictive breast cancer genetic testing on a healthy woman with a family history of breast cancer is not clinically useful, unless a specific gene alteration has been identified in an affected family member. Well women without a personal history of breast cancer who are concerned about their family history should in the first instance discuss their concerns with their family doctor. The GP will want to know details of the family history and any information available in relation to genetic testing of relatives. The GP may then refer the patient to a specialist secondary care service such as a Symptomatic Breast Disease Unit, if there are features highly suggestive of familial disease, for more detailed assessment.

Preventative Medicine

Questions (680)

Denis Naughten

Question:

680. Deputy Denis Naughten asked the Minister for Health his plans to offer tamoxifen or raloxifene to all women aged over 35 years old with a family history of breast and related cancers; and if he will make a statement on the matter. [31960/13]

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Written answers (Question to Health)

Breast cancer is the most common invasive cancer diagnosed in women in Ireland. A comprehensive symptomatic breast service is available for women in the eight designated cancer centres. Most cases of breast cancer arise in women with no apparent close family history. The majority of people with a family history of breast cancer will not be at substantially increased risk.

Women at increased risk of breast cancer due to their family history have a specific range of strategies currently available to reduce their risk. For those for whom risk-reducing surgery is unsuitable or unacceptable, chemoprevention using drugs such as tamoxifen and raloxifene may represent a more acceptable means of risk reduction.

Tamoxifen and raloxifene reduce the risk of breast cancer for women without a personal history but who have an increased risk of the disease. As they are not currently licensed for chemoprevention in well women with a family history of breast cancer in Ireland, they can only be prescribed by a doctor following professional guidance, taking full responsibility for the decision and documenting informed consent from the patient. It is not appropriate to offer them to all women aged over 35 years with a family history of breast and related cancers. Drug licensing in Ireland is the responsibility of the Irish Medicines Board.

All drugs have side effects and risks which are particularly important when they are being used to prevent other diseases. Discussion and information should include the side effects of drugs, the extent of risk reduction, and the risks and benefits of alternative approaches, such as risk-reducing surgery and surveillance. Discussion in relation to risk of cancer of the lining of the womb, or blood clotting and in relation to bone health are of particular importance for tamoxifen and raloxifene.

The communication of information on cancer risk and carrier probability is complex. There is a degree of uncertainty with respect to the probability of inheriting a predisposing genetic mutation, of gene penetrance and hence of developing cancer. People who are concerned about a family history of breast cancer may require information to help them deal with the complex medical and social choices linked with different levels of breast cancer risk management options, and support to cope with the associated uncertainty and anxiety.

The National Cancer Control Programme will be examining the most recent guidance, published this month, on Familial Breast Cancer from the National Institute for Health and Care Excellence in the UK in relation to the management of chemoprevention and other aspects of the care of patients with a family history of breast cancer.

Hospital Waiting Lists

Questions (681)

Gerry Adams

Question:

681. Deputy Gerry Adams asked the Minister for Health if a person (details supplied) in County Waterford is on the waiting list for a gastric bypass; the steps being taken to progress their health situation; the length of time they will be expected to wait for this procedure; and if he will make a statement on the matter. [31969/13]

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Written answers (Question to Health)

The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2013, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has recently been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.

In relation to this particular query raised by the Deputy, I have asked the Health Service Executive to investigate the situation and respond directly to the Deputy in this matter.

Health Services Issues

Questions (682)

Bernard Durkan

Question:

682. Deputy Bernard J. Durkan asked the Minister for Health if he has studied recent submissions from the Vasculitis Ireland Awareness foundation with particular reference to the need for early diagnosis for those suffering from the medical complaint and the need to ensure awareness of the condition in view of the fact it is a rare disease; and if he will make a statement on the matter. [31971/13]

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Written answers (Question to Health)

I am aware of the literature circulated by the Vasculitis Ireland Awareness foundation.

There is no set treatment regime for vasculitis. Treatment depends on the type of vasculitis that a person has, the organs affected and the severity or otherwise of the condition. Treatment may involve taking over the counter medication and/or prescription medication or, in certain cases, surgery. A patient's General Practitioner or Consultant is in the best position to advise on the particular treatment options in each individual case.

Nursing Home Services

Questions (683, 684, 685)

Catherine Murphy

Question:

683. Deputy Catherine Murphy asked the Minister for Health the number of patients currently on the placement list for long-term nursing home care in the State; if he will indicate the average cost of maintaining a patient in an acute hospital who would otherwise be accommodated in a nursing home; and if he will make a statement on the matter. [31980/13]

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Catherine Murphy

Question:

684. Deputy Catherine Murphy asked the Minister for Health if he will provide details of the number of beds in private nursing homes which the Health Service Executive has reserved for use under the fair deal scheme; where they are located; and if he will make a statement on the matter. [31981/13]

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Catherine Murphy

Question:

685. Deputy Catherine Murphy asked the Minister for Health if he will detail the number of public nursing home beds available under the fair deal scheme by location; and if he will make a statement on the matter. [31982/13]

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Written answers (Question to Health)

I propose to take Questions Nos. 683 to 685, inclusive, together.

The latest information available to the Department indicates that there were 873 people on the national placement list for the Nursing Homes Support Scheme at end-April and that the average time spent awaiting funding was 49 days. However, not all of these people would have been in acute hospitals. Between January and April 2013, about 43% of all applications for the Scheme were from people in acute hospitals.

The HSE does not reserve beds in private nursing homes for use under the Scheme. Individuals who have been approved for funding under the Scheme can choose the nursing home in which they wish to reside, subject to the nursing home:

- being an 'approved nursing home' for the purposes of the Scheme,

- having an available bed, and,

- being able to meet the individual's particular needs.

A list of all 'approved nursing homes' is available on the HSE's website.

The average cost of maintaining a person in an acute hospital and the number of public nursing home beds available under the Nursing Homes Support Scheme are services matters and, as such, have been referred to the Health Service Executive for direct reply.