Written Answers Nos. 1115-1135
1115. Deputy Billy Kelleher asked the Minister for Health the discussions he has had with the relevant members of the Northern Ireland Executive regarding a joint approach to the introduction of minimum prices for alcohol; and if he will make a statement on the matter. [46220/13]
View answerWork on developing a framework for the necessary Department of Health legislation on, among other things, Minimum Unit Pricing has been continuing. A health impact assessment has been commissioned in conjunction with Northern Ireland as part of the process of developing a legislative basis for minimum unit pricing; the genesis of this close cooperation was discussions at Ministerial and official level between both jurisdictions and these discussions are continuing. The health impact assessment will study the impact of different minimum prices on a range of areas such as health, crime and likely economic impact.
1116. Deputy Finian McGrath asked the Minister for Health the position regarding a medical card in respect of a person (details supplied). [46227/13]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information has issued to Oireachtas members.
1117. Deputy James Bannon asked the Minister for Health the position regarding an urgent hospital appointment in respect of a person (details supplied) in County Longford; and if he will make a statement on the matter. [46228/13]
View answerThe 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 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 respond directly to the Deputy in this matter.
1118. Deputy James Bannon asked the Minister for Health the position regarding an urgent hospital appointment in respect of a person (details supplied) in County Westmeath; and if he will make a statement on the matter. [46231/13]
View answerFor 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 are working 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.
1119. Deputy Seán Kyne asked the Minister for Health if he will confirm the waiting time for children and young adults in need of dental treatment including surgery and orthodontic work. [46255/13]
View answer1120. Deputy Seán Kyne asked the Minister for Health if he will outline the dental check-up programme operating in Irish schools, including the frequency of check-ups and the procedure followed in the event of follow-up treatment being required. [46256/13]
View answer1189. Deputy Éamon Ó Cuív asked the Minister for Health the waiting time for dental treatment for children and teenagers under the free dental scheme for children; the children and services covered by this scheme; and if he will make a statement on the matter. [46754/13]
View answer1190. Deputy Éamon Ó Cuív asked the Minister for Health if all primary school children still receive free dental check-ups as part of a national programme; the frequency of these check-ups; and if he will make a statement on the matter. [46755/13]
View answerI propose to take Questions Nos. 1119, 1120, 1189 and 1190 together.
The Public Dental Service of the HSE provides dental services for children up to 16 years of age and persons with special needs through its dental clinics. All HSE dental clinics prioritise emergency care for children up to 16 years of age, treatment for special needs patients and screening of children aged from 11 to 13 years, including referral for orthodontic services where necessary. After screening, follow-up treatment is provided where necessary. Other services, including screening of children 6 to 8 years, are provided but may be deferred in clinics where there is pressure on resources. The HSE Public Dental Service has recently been re-structured. It is intended that the new arrangements will facilitate standardisation of services available nationally.
The HSE provides orthodontic treatment to those who have been assessed and referred for treatment before their 16th birthday. An individual's access to orthodontic treatment is determined against a set of clinical guidelines called the Modified Index of Treatment Need. Patients with the greatest level of need, i.e. Grade 5 or Grade 4 are provided with treatment. At the time of assessment those with urgent clinical need are prioritised. It should be noted that the nature of orthodontic care means that immediate treatment is not always desirable. It is estimated that up to 5% of those on the waiting list for treatment need to wait for further growth to take place before treatment commences. The most recent information on waiting times relates to the third quarter of 2013:
|
Waiting time from assessment to commencement of treatment (Grade 4) |
1 - 6 months |
7 - 12 months |
13 - 24 months |
2 - 3 years |
Over 4 years |
TOTAL |
|
HSE Dublin Mid-Leinster |
243 |
390 |
685 |
375 |
174 |
1,867 |
|
HSE West |
711 |
259 |
1,183 |
343 |
23 |
2,519 |
|
HSE South |
91 |
133 |
152 |
933 |
237 |
1,546 |
|
HSE Dublin North East |
76 |
163 |
408 |
766 |
436 |
1,849 |
|
TOTAL |
1,121 |
945 |
2,428 |
2,417 |
870 |
7,781 |
|
Waiting time from assessment to commencement of treatment (Grade 5) |
1 - 6 months |
7 - 12 months |
13 - 24 months |
2 - 3 years |
Over 4 years |
TOTAL |
|
HSE Dublin Mid-Leinster |
452 |
310 |
465 |
271 |
98 |
1,596 |
|
HSE West |
544 |
315 |
879 |
232 |
26 |
1,996 |
|
HSE South |
536 |
333 |
392 |
307 |
1,568 |
|
|
HSE Dublin North East |
129 |
217 |
486 |
452 |
37 |
1,321 |
|
TOTAL |
1,661 |
1,175 |
2,222 |
1,262 |
161 |
6,481 |
The HSE has commissioned an independent review of orthodontic services. The outcome of this review, which is near completion, will give guidance as to what changes will be desirable to provide the best possible model of care delivery, given the current resources available and future demand for services.
Waiting list initiatives introduced in 2011 have meant that dental services dependent on acute service capacity have been assessed in accordance with waiting times and not just on numbers waiting. Intravenous (IV) sedation clinics have been put in place in 4 hospitals using HSE dental staff who have undertaken Diplomas in IV Sedation and Relative Analgesia. This will be extended further in 2014. It is intended that more adults with special needs will be treated using IV sedation rather than general anaesthetic, thus relieving pressure on hospital services and waiting lists.
1121. Deputy Seán Kyne asked the Minister for Health if, in the unlikely event of a person losing his or her medical card, while undergoing treatment in a public hospital, the Minister will confirm to whom the cost of treatment post medical-card cessation falls. [46257/13]
View answerAll medical card applicants are informed, by letter, of the outcome of their application and persons' eligibility is not removed without having been informed of such a decision. Those who are unsuccessful are given an explanation of the decision, including a detailed financial breakdown. The unsuccessful applicants are informed of their right to seek a review of the decision by the PCRS or to appeal the decision to the HSE Appeals Office. Where a person, who previously held a valid medical card or GP visit card submits an appeal to a decision not to renew a medical card within 21 days of that decision, the card previously held is reactivated once the HSE (PCRS) is informed of the appeal by the Appeals Office.
In the unlikely event that a person's eligibility expired without his/her knowledge and that person was taken suddenly ill and required hospitalisation, PCRS would try to accommodate the immediate needs of the individual. If this were to amount to a change in circumstances, the individual could have his/her application reviewed by PCRS, once he/she informs the HSE of the circumstances.
1122. Deputy Seán Kyne asked the Minister for Health the progress made to date on the introduction of generic medication; and if there will be an obligation on persons on the long-term illness scheme or with medical cards to accept generic medicines. [46280/13]
View answerThe Health (Pricing and Supply of Medical Goods) Act 2013, which came into operation on the 24th of June, introduces a system of generic substitution and reference pricing. This legislation will promote price competition among suppliers and ensure that lower prices are paid for these medicines resulting in further savings for both taxpayers and patients.
Under the Act, the Irish Medicines Board (IMB) is responsible for the assessment for interchangeability of medicines. Generic substitution will be introduced incrementally with the IMB prioritising those medicines which will achieve the greatest savings for patients and the State. The Board is in the process of reviewing an initial 20 active substances, which equates to approximately 1,500 individual medicines. They include statins, proton pump inhibitors, angiotensin-converting-enzyme (ACE) inhibitors and angiotensin II receptor blockers.
The first List of Interchangeable Medicines, containing groups of atorvastatin products, was published by the IMB on the 7th August. The second and third lists containing groups of esomeprazole and rosuvastatin products were published on the 20th and 24th September, respectively. The fourth and fifth lists containing groups of omeprazole and pravastatin products have also been published (on the 11th and 22nd October, respectively).
Once the IMB has assessed the initial 20 priority products, then a further list of priority products will be identified and assessed by the IMB and the process will continue until all medicinal products on the reimbursable list have been assessed.
Once a List of Interchangeable Medicines is published by the IMB a two stage price reduction process gets underway. First, under the terms of the 2012 APMI Agreement, the price of all relevant products fall by 20%, e.g. atorvastatin prices were reduced from 1st September and esomeprazole and rosuvastatin prices were reduced from 1st October. Secondly, the legislation also provides that the HSE may set a reference price for each group of interchangeable products published on the List of Interchangeable Products with a view to introducing further significant price cuts.
Reference pricing involves the setting of a common reimbursement price, or reference price, for a group of interchangeable medicines. It means that one reference price is set for each group or list of interchangeable medicines, and this is the price that the HSE will reimburse to pharmacies for all medicines in the group, regardless of the individual medicine’s prices. The first reference price (for atorvastatin products) was introduced on the 1st of November.
Reference prices are being introduced on a phased basis. The HSE is currently in the process of setting reference prices for esomeprazole products which, it is anticipated, will apply from 1st December 2013.
Under the legislation, a pharmacist shall offer the patient the opportunity to agree to the pharmacist substituting the prescribed product for a substitute product (from within a group of interchangeable products) which is in stock and is the lowest cost to the patient or the State. If the product offered is at or below the reference price then the legislation does not impose any unavoidable costs on the patient. However, if the patient wishes to have the more expensive product, then he/she will be liable for the difference between the reference price and the price of the product.
The IMB will only add a medicine to the List of Interchangeable Medicines if it meets all the qualifying criteria and can be safely substituted for each of the medicines which fall within a group of interchangeable medicines.
Occasionally circumstances may arise where due to an individual patient issue or characteristic that it may not be advisable to switch between different brands of a medicine even if the medicine is included in a group of interchangeable medicines. When this arises a prescriber will be able to indicate on a prescription that substitution should not take place. A pharmacist will then dispense the medicine indicated on the prescription.
1123. Deputy Dan Neville asked the Minister for Health if he will consider adding new ostomy products to the list of products approved for sale here as these products have widespread use in the UK and the European Union. [46295/13]
View answer1161. Deputy Dan Neville asked the Minister for Health his plans to add new ostomy products approved for sale here (details supplied). [46508/13]
View answerI propose to take Questions Nos. 1123 and 1161 together.
The HSE is not in a position to increase the current levels of expenditure on ostomy and urinary products unless cost effectiveness with clear patient benefit can be demonstrated. The HSE will require evidence to be presented as part of any product application process for addition to the List of Reimbursable Items in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
1124. Deputy Jack Wall asked the Minister for Health when a person (details supplied) in County Kildare will receive a hospital appointment; and if he will make a statement on the matter. [46299/13]
View answerFor 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 are working 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.
1125. Deputy Billy Kelleher asked the Minister for Health the number of requests the Health Service Executive has made under section 8 of the Health (Alteration of Criteria for Eligibility) Act 2013 to the Department of Social Protection to provide personal data where it is required for assessing or reviewing the eligibility of persons for services provided under the Health Acts 1970 to 2013; and if he will make a statement on the matter. [46300/13]
View answer1126. Deputy Billy Kelleher asked the Minister for Health the number of requests the Health Service Executive has made under section 8 of the Health (Alteration of Criteria for Eligibility) Act 2013 to the Revenue Commissioners to provide personal data where it is required for assessing or reviewing the eligibility of persons for services provided under the Health Acts 1970 to 2013; and if he will make a statement on the matter. [46301/13]
View answer1127. Deputy Billy Kelleher asked the Minister for Health the number of requests the Health Service Executive has received under section 8 of the Health (Alteration of Criteria for Eligibility) Act 2013 from the Department of Social Protection to provide personal data where the data is required to calculate the means of a person in order to assess or review entitlements to benefits and services provided under the Social Welfare Acts; and if he will make a statement on the matter. [46302/13]
View answer1128. Deputy Billy Kelleher asked the Minister for Health the number of requests the Health Service Executive has received under section 8 of the Health (Alteration of Criteria for Eligibility) Act 2013 from the Revenue Commissioners to provide personal data when the Commissioners require the personal data for the purpose of assessing or collecting any tax, duty or other charge payable to the Revenue Commissioners; and if he will make a statement on the matter. [46303/13]
View answerI propose to take Questions Nos. 1125 to 1128, inclusive, together.
The information sought by the Deputy is not readily available. However, I have asked the Health Service Executive to supply this information to me and I will forward it to the Deputy as soon as possible.
1129. Deputy Billy Kelleher asked the Minister for Health the timeframe in which the air conditioning and ventilation systems in our surgical theatres are cleaned and decontaminated; if the Department is satisfied with the systems in place; if there are plans to change or upgrade the systems; and if he will make a statement on the matter. [46304/13]
View answer1131. Deputy Billy Kelleher asked the Minister for Health the rate of detection of airborne infectious diseases in our surgical theatres; the frequency with which inspections are carried out; and the method and the way these results compare to international standards. [46307/13]
View answerI propose to take Questions Nos. 1129 and 1131 together.
As this is a service matter it has been referred to the Health Service Executive for direct reply.
1130. Deputy Sean Fleming asked the Minister for Health when hip replacement surgery will be scheduled in respect of a person (details supplied) in County Laois; and if he will make a statement on the matter. [46306/13]
View answerThe 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 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 respond directly to the Deputy in this matter.
1132. Deputy Brendan Griffin asked the Minister for Health if he will provide the continuous positive airflow pressure machine and the replacement parts used for the treatment of sleep apnoea to medical card holders; and if he will make a statement on the matter. [46308/13]
View answerArrangements have been in place for the rental of Continuous Positive Airflow Pressure Machines for some time both for Medical Card Holders and Drug Payment Scheme card holders where the person suffers from sleep apnoea. Funding for the purchase of such appliances by medical card holders may be considered within the overall priority setting for funding at local level from the Aids and Appliances budget.
1133. Deputy Brendan Griffin asked the Minister for Health if urgent orthodontic treatment will be provided in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [46324/13]
View answerThe HSE provides orthodontic treatment to patients based on their level of clinical need. An individual's access to orthodontic treatment is determined against a set of clinical guidelines and priority is given to patients with greatest needs. The HSE has been asked to examine the specific query raised by the Deputy and to reply to him as soon as possible.
1134. Deputy Billy Kelleher asked the Minister for Health the reason for the delay in the processing of the nursing home grant scheme in respect of a person (details supplied) in Dublin 14; if he will expedite the application; and if he will make a statement on the matter. [46326/13]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
1135. Deputy Tom Fleming asked the Minister for Health the number of discretionary medical cards awarded in 2010, 2011, 2012 and to date in 2013; the number that were refused during the same period; the number of discretionary cards that have been withdrawn during this period; the number that have been withdrawn to date in 2013; the reason for the policy change in respect of discretionary medical cards; the reason discretionary cards are being removed from persons who suffer from cancer, leukaemia, cystic fibrosis and other serious and life-threatening illnesses; and if he will make a statement on the matter. [46336/13]
View answer1211. Deputy Tom Fleming asked the Minister for Health the number of discretionary medical cards awarded in County Kerry in 2010, 2011, 2012 and to date in 2013; the number that were refused during the same period; the number of discretionary cards that have been withdrawn during this period; the number that have been withdrawn to date in 2013; the reason for the policy change in respect of discretionary medical cards; the reason discretionary cards are being removed from persons who are suffering from cancer, leukaemia, cystic fibrosis and other serious and life-threatening illnesses; and if he will make a statement on the matter. [46820/13]
View answerI propose to take Questions Nos. 1135 and 1211 together.
Under the provisions of the Health Act 1970, eligibility for health services in Ireland is based primarily on residency and means and medical cards are not awarded to any particular group of patients on the basis of a specific medical condition. However, the HSE has discretion to grant a medical card in certain circumstances. Medical card applicants who are unsuccessful following the means assessment, but who indicate that they suffer from a medical condition, are then referred to the Medical Officer for consideration on a medical discretionary basis.
The processing of medical cards at a national level, rather than at a local level as before mid-2011, ensures that all people are assessed in a similar and fair manner when applying for a medical card. The consideration of discretion is now standardised and operates in an equitable manner. The medical card scheme is now underpinned with a stronger foundation which enables better governance, more transparency and efficient modern processes. Under these processes, nobody who is entitled to a medical card will lose it or be refused one.
I would like to point out that there has been no change in the policy of awarding discretionary medical cards.
The information sought by the Deputy concerning medical card figures granted on a discretionary basis is not readily available. However, I have asked the Health Service Executive to supply this information to me and I will forward it to the Deputy as soon as possible.
