Written Answers Nos. 469-485
470. Deputy James Bannon asked the Minister for Health if his Department has published any drug revisions for the public and medical professionals to clear up the contention that generic drugs are harming patients; and if he will make a statement on the matter. [48177/13]
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. Under the Act, the Irish Medicines Board (IMB) is responsible for the assessment for interchangeability of medicines. The IMB will review 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). The IMB will publish subsequent lists for other groups of medicines on an ongoing basis.
Under the legislation, generic substitution is not permitted until the products have been assessed for interchangeability in accordance with the criteria set out in the legislation and the IMB has decided to add the products to the List of Interchangeable Medicines. 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. Further information on the process for determining interchangeability is available on the IMB's website at www.imb.ie/EN/Human-Medicines/Generic-and-Interchangeable-Medicines.aspx.
It is 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.
Further information on the safety of generic medicines is available from the IMB website at www.imb.ie/images/uploaded/documents/GenericMedicines.pdf
An information and education campaign, aimed at both health professionals and the public, is continuing. Patient information leaflets are being delivered to all community pharmacies and GP surgeries and further information is available at the following link: www.hse.ie/generics.
471. Deputy Joe Higgins asked the Minister for Health if he will respond to representations made to his Department by a former patient of the hospital in Tallaght. [48182/13]
View answerThe representations referred to by the Deputy have been responded to by my Department. The representations referred to the conduct of the Medical Council in dealing with a particular individual's complaint. Under the Medical Practitioners Act, 2007, the Medical Council is the statutory body charged with the regulation of the medical profession in this State. I, as Minister for Health, have no role in relation to such matters and I am specifically precluded under the Act from giving policy direction to the Medical Council in relation to the performance of its functions in this area.
With regard to specific complaints in relation to experiences of individuals in our hospitals, there is a formal complaints policy, entitled “Your Service Your Say”, details of which are on the HSE website, at http://www.hse.ie/eng/services/yourhealthservice/feedback/complaints/. In accordance with this procedure, a complaint must be made in the first instance to the hospital in which the incident causing the complaint occurred. If an individual is not satisfied with the response from the hospital, a review can be sought from the HSE Director of Advocacy at Oak House, Millennium Park, Naas, Co Kildare, tel 1890 424 555, or from the Office of the Ombudsman, 18 Lower Leeson Street, Dublin 2, tel 1890 223 030, email ombudsman@ombudsman.gov.ie
I have asked the HSE to examine the specific queries raised in relation to Tallaght Hospital and to reply to you directly.
473. Deputy Dominic Hannigan asked the Minister for Health the current policy for the issuing of medical cards to children with Down's syndrome; and if he will make a statement on the matter. [48195/13]
View answerUnder Section 45 of the Health Act 1970, as amended, persons who are unable, without due hardship, to arrange a general practitioner service for themselves or their family qualify for a medical card. There is no automatic entitlement to a medical card for persons with a specific illness or disability. Under this legislation, the determination of eligibility for a medical card is the responsibility of the Health Service Executive. Section 45 requires the HSE to have regard to a person's, and their spouse or partner's overall financial situation in view of their reasonable expenditure. The HSE gives effect to this legislation and Government policy through its Medical Card National Assessment Guidelines. Where a person's income is in excess of the income thresholds set out in the National Assessment Guidelines, the HSE uses its discretion to grant a medical card to a person who is unable, due to undue hardship, to arrange a GP service. In doing so, the HSE is obliged to have regard to the financial situation and expenditure of the individual and his or her dependents.
The HSE has an effective system in place for the provision of emergency medical cards for patients who are terminally ill in palliative care, or who are seriously ill and in urgent need of medical care that they cannot afford. They are issued within twenty-four hours of receipt of the required patient details and the letter of confirmation of the condition from a doctor or a medical consultant. With the exception of terminally ill patients in palliative care, the HSE issues all emergency cards on the basis that the patient is eligible for a medical card on the basis of means or undue hardship, and that the applicant will follow up with a full application within a number of weeks of receiving the emergency card. As a result, emergency medical cards are issued to a named individual, with a limited eligibility period of six months. For persons with a terminal illness in palliative care, no means test applies. Once the terminal illness is verified, patients are given an emergency medical card for six months. Given the nature and urgency of the issue, the HSE has appropriate escalation routes to ensure that the person gets the card as quickly as possible.
The Government is committed to introducing, on a phased basis, a universal GP service without fees within its term of office, as set out in the Programme for Government and the Future Health strategy framework. As announced in the Budget, it has been decided to commence the roll-out of a universal GP service by providing all children aged 5 and under with access to a GP service without fees. This will mean that almost half of the population will have access to GP services without fees. The Government is providing new, additional funding of €37 million to meet the cost of this measure. The implementation of this measure will require primary legislation. The necessary administrative arrangements will be made during the course of 2014, when the specifics of the legislation are known.
The introduction of a universal GP service constitutes a fundamental element in the Government's health reform programme. The current Government is the first in the history of the State to have committed itself to implementing a universal GP service for the entire population. A well functioning health system should provide equal access to healthcare for its patients on the basis of health needs, rather than ability to pay. The principles of universality and equity of access mean that all residents in Ireland should be entitled to access a GP services that is free at the point of use.
474. 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. [48197/13]
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 Health Service Executive, 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 HSE to respond directly to the Deputy in this matter.
475. Deputy Billy Kelleher asked the Minister for Health if Directive No. 2011/24/EU came into force on 25 October having been adopted in March 2011; if it has been signed into law; if he will confirm whether doctors who treat polio patients will now be able to explore medical treatment for polio survivors in the other 27 EU member states with the Irish health budget absorbing the cost; and if he will make a statement on the matter. [48200/13]
View answerThe EU Directive on Patients’ Rights in Cross Border Healthcare provides rules for the reimbursement to patients’, including polio survivors, of the cost of receiving treatment abroad, where the patient would be entitled to such treatment in their home Member State (Member State of Affiliation) and supplements the rights that patients already have at EU level through the legislation on the coordination of social security schemes (regulation 883/04).
The Directive seeks to ensure a clear and transparent framework for the provision of cross-border healthcare within the EU, for those occasions where the care patients seek is provided in another Member State rather than in their home country. However, it should be emphasised that the vast majority of EU patients receive healthcare in their own country and prefer to do so.
The Department of Health is continuing to work on the necessary statutory arrangements to fully implement the Directive and draft legal provisions to put in place the statutory provisions for these arrangements are being prepared and will be implemented as soon as possible. Nevertheless, there are administrative arrangements in place in respect of the key provision of the Directive in relation to a national contact point (NCP), which has been set up within the HSE. The principle function of the NCP is to facilitate exchange of information for patients concerning their rights and entitlements relating to receiving healthcare in another Member State, in particular the terms and conditions for reimbursement of cost, the procedures for accessing and determining those entitlements. The NCP also has a responsibility to ensure that all enquirers are informed of the rights, if any, that they may have through the legislation on the coordination of social security schemes (regulation 883/04) and which may be more beneficial to them. Patients’ requiring information on Ireland's implementation of the Directive may access NCP information on the Cross Border Directive (CBD) through the HSE’s main website.
477. Deputy Brendan Griffin asked the Minister for Health if he will include medicines for the treatment of asthma under the long-term illness scheme; and if he will make a statement on the matter. [48212/13]
View answerThere are no plans to extend the list of conditions covered by the Long Term Illness Scheme. Under the Drug Payment Scheme, no individual or family pays more than €144 per calendar month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals incurring ongoing expenditure on medicines. In addition, people who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card. In the assessment process, the Health Service Executive can take into account medical costs incurred by an individual or a family. Those who are not eligible for a medical card may still be able to avail of a GP visit card, which covers the cost of general practice consultation.
478. Deputy Caoimhghín Ó Caoláin asked the Minister for Health to provide information on the investigations into the care provided for a person (details supplied) in County Roscommon which are in train and scheduled; and if he will make a statement on the matter. [48220/13]
View answerAs this is a service matter this question has been referred to the HSE for direct reply.
479. Deputy Jonathan O'Brien asked the Minister for Health the number of respite beds available in Cork city in 2013; the number available for dementia sufferers in 2013; the number of applications made for respite and a breakdown of the number of applications made in respect of dementia sufferers in 2013; and if he will make a statement on the matter. [48231/13]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
480. Deputy Charlie McConalogue asked the Minister for Health when a reply will issue to an interim letter (details supplied); and if he will make a statement on the matter. [48232/13]
View answerMy colleague Minister Reilly has asked the Health Service Executive to set up a meeting with the Deputy and the local group. In this regard the Executive will be in touch with the Deputy shortly.
481. Deputy John O'Mahony asked the Minister for Health when a person (details supplied) in County Mayo will receive an orthodontic appointment; and if he will make a statement on the matter. [48233/13]
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.
482. Deputy Sean Fleming asked the Minister for Health when a suitable home care package will be provided in respect of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [48236/13]
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.
483. Deputy Terence Flanagan asked the Minister for Health the reason the expenses of those aged 70 years and over are not taken into account when assessing for a medical card; and if he will make a statement on the matter. [48243/13]
View answerMedical Card and GP Visit Card eligibility under the scheme for persons aged 70 or older is solely based on an assessment of gross income.
For persons aged 70 or older who are assessed as ineligible under the gross income limits that apply, they may also have their eligibility assessed under the standard means tested medical card scheme. This assessment is based on net income and assessable outgoing expenses. The qualifying income thresholds under this scheme are lower than over -70s gross income thresholds. If a person is means assessed ineligible for a medical card under the general scheme and that person has other social, medical or financial circumstances relevant to an assessment of their ability to provide for their medical needs or the medical needs of any dependants they may have, these factors will be considered to decide if a medical card or GP visit card should be approved on discretionary grounds under the ‘undue hardship’ or ‘undue burden’ provision of the medical card scheme.
484. Deputy Bernard J. Durkan asked the Minister for Health if much-needed speech therapy will be provided to a person (details supplied) in County Kildare; and if he will make a statement on the matter. [48257/13]
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.
485. Deputy Ciara Conway asked the Minister for Health when the national sexual health strategy will be published; and if he will make a statement on the matter. [48270/13]
View answerThe development of a National Sexual Health Strategy is nearing completion. I intend to submit the Strategy to Government for approval as soon as possible.
