Terence Flanagan
Question:554. Deputy Terence Flanagan asked the Minister for Health his views on whether there are enough nurses in the Rotunda Hospital post-natal units; and if he will make a statement on the matter. [53769/13]
View answerNursing Staff Provision
Questions (554)
Written answers
As this is a service matter, I have asked the HSE to respond directly to the Deputy.
Medical Card Eligibility
Questions (555)
Bernard Durkan
Question:555. Deputy Bernard J. Durkan asked the Minister for Health if a medical card will be reinstated in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [53771/13]
View answerWritten answers
The 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.
Hospital Waiting Lists
Questions (556)
Peadar Tóibín
Question:556. Deputy Peadar Tóibín asked the Minister for Health the number of persons currently on the waiting list for the National Rehabilitation Centre; the average wait time; and when a person (details supplied) will be admitted. [53775/13]
View answerWritten answers
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.
Medical Card Eligibility
Questions (557)
Gerry Adams
Question:557. Deputy Gerry Adams asked the Minister for Health if women who are survivors of symphysiotomy can apply for and be allocated a medical card without being subjected to a means assessment; if a woman with a spouse or partner who has survived a symphysiotomy applies for a medical card, if the application applies to her alone; and if he will make a statement on the matter. [53776/13]
View answerWritten answers
Survivors of Symphysiotomy are eligible for a medical card, regardless of their level of income/means. The medical card, when issued, covers the Symphysiotomy survivor only.
Medical Card Eligibility
Questions (558)
Seán Ó Fearghaíl
Question:558. Deputy Seán Ó Fearghaíl asked the Minister for Health the reason medical cards have been withdrawn from two children with disabilities (details supplied) in County Kildare; if the medical cards will be restored as a matter of urgency; and if he will make a statement on the matter. [53798/13]
View answerWritten answers
The 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.
Hospital Appointment Delays
Questions (559)
Finian McGrath
Question:559. Deputy Finian McGrath asked the Minister for Health the reason a person (details supplied) is having to wait so long for an appointment with an urologist in Temple Street Hospital; and if he will make a statement on the matter. [53814/13]
View answerWritten answers
For 2013, a maximum waiting time target of 12 months has been set 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 across all specialties. In regard to urology services at Children's University Hospital Temple Street specifically, I am advised that the HSE is working with the hospital to recruit a consultant urologist
In regard to the specific patient query raised, I have asked the HSE to respond directly to the Deputy.
Medical Card Eligibility
Questions (560)
Dan Neville
Question:560. Deputy Dan Neville asked the Minister for Health if a medical card covers treatment at a centre (details supplied) in County Clare. [53870/13]
View answerWritten answers
I am advised that the services at this centre are not provided under the Health Act 1970, as amended, and consequently, no entitlement to these services under the Act arises.
Hospital Waiting Lists
Questions (561)
Finian McGrath
Question:561. Deputy Finian McGrath asked the Minister for Health the position regarding an operation in respect of a person (details supplied) in Dublin 5. [53886/13]
View answerWritten answers
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 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.
Medical Card Eligibility
Questions (562)
Timmy Dooley
Question:562. Deputy Timmy Dooley asked the Minister for Health the reason a medical card has been withdrawn in respect of a person (details supplied) in County Cork; and if he will make a statement on the matter. [53892/13]
View answerWritten answers
The 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.
Medical Aids and Appliances Provision
Questions (563)
Dan Neville
Question:563. Deputy Dan Neville asked the Minister for Health the position regarding a wheelchair in respect of a person (details supplied) in County Limerick; and if he will make a statement on the matter. [53896/13]
View answerWritten answers
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.
Health Services Staff Recruitment
Questions (564)
Kevin Humphreys
Question:564. Deputy Kevin Humphreys asked the Minister for Health the amount of money the Health Service Executive spent recruiting doctors and nurses from abroad respectively in 2010, 2011, 2012 and to date in 2013; the projected expenditure for 2014 for same; and if he will make a statement on the matter. [53909/13]
View answerWritten answers
As this is a service matter, I have referred the Deputy's question to the HSE for direct reply.
Health Services Staff Recruitment
Questions (565, 566)
Kevin Humphreys
Question:565. Deputy Kevin Humphreys asked the Minister for Health the number of non-Irish doctors and non-Irish nurses, respectively, working in the Irish health services and Health Service Executive; the number of those that have been directly recruited from abroad by the HSE, respectively; and if he will make a statement on the matter. [53910/13]
View answerKevin Humphreys
Question:566. Deputy Kevin Humphreys asked the Minister for Health the number and percentage of doctors working for the Health Service Executive that are from countries identified by the World Health Organization as having a critical shortage of health workers; and if he will make a statement on the matter. [53911/13]
View answerWritten answers
I propose to take Questions Nos. 565 and 566 together.
In May 2010, Ireland was one of the 193 Member States that unanimously adopted the WHO Global Code of Practice on the International Recruitment of Health Personnel at the 63rd World Health Assembly. The Global Code establishes and promotes voluntary principles and practices for the ethical international recruitment of health personnel and the strengthening of health systems. The Department of Health, in collaboration with the Health Service Executive and Irish Aid, is the designated national authority for reporting on implementation of the Global Code.
Ireland is committed to implementation of the Global Code, as evidenced most recently by the national commitments given at the 3rd Global Forum on Human Resources for Health. Ireland has also been recognised internationally for its work in this area, receiving a Health Worker Migration Policy Council Innovation Award in November 2013. This award celebrates progress made by countries working to address the challenges of health worker migration.
I have asked the HSE to revert directly to the Deputy in relation to the data sought. I am committed to Ireland achieving self-sufficiency in medical staffing and, as set out in the Haddington Road Agreement, the retention of graduates of Irish Medical Schools within the public health system and the attraction back to Ireland of such graduates, where they have left previously.
Medical Workforce Data
Questions (567)
Kevin Humphreys
Question:567. Deputy Kevin Humphreys asked the Minister for Health the number and percentage of Irish trained doctors currently working overseas; and if he will make a statement on the matter. [53912/13]
View answerWritten answers
The figures requested by the Deputy are not available. However, the Medical Council's Medical Workforce Intelligence Report, published on 25th July, 2013 provides useful information concerning doctors on the Medical Council's Register in 2012. It noted that 16,392 doctors retained registration with the Medical Council Register, while a further 1,256 doctors entered the register for the first time. On the other hand, 1,419 doctors did not retain registration, representing an exit rate of 8%. These movements resulted in a 3% fall in the number of doctors registered at the end of 2012 compared with 2011. The Council reported that "a relatively high proportion of recent graduates from Irish medical schools are leaving the register". The exit rate was highest amongst those aged 65 years and over, 19.2%; with 6.4% of those aged 25 - 29 and 6.3% of those aged 30 - 34 exiting. However, it also found that doctors who qualified abroad (the 6 world regions averaged 13%) were more likely to exit the register than those who qualified in Ireland (5.8%).
It should be borne in mind that there is a global demand for doctors and that they are a mobile workforce. A range of factors, including opportunities to gain further experience and/or specialist training, the levels of pay available, working conditions generally and other economic factors and social conditions in different countries influence trends in migration.
I want to ensure that the talented NCHD workforce we train are offered rewarding and satisfying career paths here in Ireland. In July this year, I set up a Working Group chaired by Professor Brian MacCraith, President of DCU, to carry out a strategic review of the medical training and career structure of NCHDs. The terms of reference of the review include making recommendations aimed at improving graduate retention in the public health system; planning for future service needs; realising maximum benefit from investment in medical education and training.
The Group has submitted its interim report to me and it will be published shortly. The Group is now moving to stage two of its work with a view to submitting its final report to me by June 2014.
I am determined that as part of the overall health reform programme we build a public health system that values the contribution and commitment of trainee doctors. The agreement reached between the HSE and the IMO at the LRC in October on addressing working hours and achieving EWTD compliance specifically encompassed doctor recruitment and retention. It reaffirms the commitment in the Haddington Road Agreement to reviewing the current career structure from Intern to Consultant/Specialist level with the aim of further developing career and training pathways for all grades of NCHD to consultant/specialist level. The objective is the retention of graduates within the public health system and the attraction back to Ireland of such graduates where they have left previously.
Health Services Staff
Questions (568)
Kevin Humphreys
Question:568. Deputy Kevin Humphreys asked the Minister for Health the steps he is taking to reduce the number of Irish health care professionals emigrating; and if he will make a statement on the matter. [53913/13]
View answerWritten answers
It should be borne in mind that there is a global demand for well-trained Irish medical staff, and that they are a mobile workforce. A range of factors including: opportunities to gain further experience, specialist training, levels of pay available, working conditions, and other economic and social conditions in different countries also influence trends in migration.
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. The HSE may, however, continue to recruit front-line staff in circumstances where it has been established that there is an urgent service requirement, and this can be accommodated within the budgetary and staff number limits in place.
Notwithstanding the need to reduce numbers employed in the public service, the Government is, however, wholly committed to the provision of training, work-experience and employment opportunities where possible. Hence, for example. the decision to implement a Nurse Graduate Initiative. This Initiative enables the health services to offer 1,000 graduate nurses positions for two years, at a time when job opportunities in the public service are very limited. The Initiative therefore supports the retention of recently qualified graduate nurses and midwives within the Irish health system, and enables them to gain valuable work experience and development opportunities post-graduation. To date 256 staff nurse/midwife graduates have commenced employment nationally.
I also want to ensure that NCHDs are offered a rewarding and satisfying career here in Ireland. In July this year, I set up a Working Group chaired by Professor Brian MacCraith, President of DCU. This Group will carry out a strategic review of the medical training and career structure of NCHDs. The terms of reference of the review include making recommendations aimed at improving graduate retention in the public health system; planning for future service needs; and realising maximum benefit from investment in medical education and training.
The Group submitted its interim report to me last week, and it will be published shortly. The Group is now moving to stage two of its work, with a view to submitting its final report to me by the end of June 2014.
I am determined that as part of the overall health reform programme we build a public health system that values the contribution and commitment of all health professionals. With regard to trainee doctors, I note that the agreement reached between the HSE and the IMO at the LRC in October, on addressing working hours and achieving EWTD compliance, specifically encompassed doctor recruitment and retention. It reaffirms the commitment in the Haddington Road Agreement to reviewing the current career structure from Intern to Consultant/Specialist level, with the aim of further developing career and training pathways for all grades of NCHD to Consultant/Specialist level. The objective is the retention of graduates of Irish Medical Schools within the public health system, and the attraction back to Ireland of such graduates where they have previously emigrated.
Medicinal Products Prices
Questions (569)
Kevin Humphreys
Question:569. Deputy Kevin Humphreys asked the Minister for Health the amount of savings he is targeting to achieve on patented medicines in 2014; if he will fully apply the powers conferred by the Health (Pricing and Supply of Medical Goods) Act 2013; and if he will make a statement on the matter. [53914/13]
View answerWritten answers
New agreements were reached with the Irish Pharmaceutical Healthcare Association (IPHA) and the Association of Pharmaceutical Manufacturers in Ireland (APMI) in October 2012. It is estimated that the combined gross savings from the IPHA and APMI deals will be in excess of €120 million in 2013 with an additional €28 million saved in 2014.
The 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. It is estimated that this system will yield €50 million in savings in 2014.
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 IMB is updating the List of Interchangeable Medicines on an ongoing basis and it expects to complete the assessment of the top 20 priority medicines by Quarter 2 2014. The process will then continue until all relevant 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. Secondly, the legislation provides that the HSE may set a reference price for groups of interchangeable products published on the List of Interchangeable Products with a view to introducing further significant price cuts. Taking both price reductions into account, atorvastatin prices are down 70% since the introduction of generic substitution.
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 implemented on 1 November 2013. The next reference price, for certain esomeprazole products, will be introduced on the 1st January 2014. Reference prices will ensure that generic prices in Ireland will fall towards European norms.
The legislation also includes a process for the review of existing prices outside of reference pricing. Each medicinal product, which was on the Reimbursement List when the legislation was commenced, must be reviewed by the HSE within three years to determine whether it should remain on the List and, if so, the price that should apply.
The Act also provides for the removal of items from the Reimbursement List and for conditional reimbursement of certain products. €10 million savings have been targeted in Budget 2014 from the delisting of products and the HSE is now considering products for review in compliance with the legislation.
Generic Drugs Substitution
Questions (570)
Kevin Humphreys
Question:570. Deputy Kevin Humphreys asked the Minister for Health the number of drugs at present that must be compulsorily prescribed by international non-proprietary name; the number he expects to have under this system by the end of 2014; the total number of drugs currently covered by the Health Service Executive under various schemes that could be replaced by generics but are not compulsory; and if he will make a statement on the matter. [53915/13]
View answerWritten answers
Currently, there are no drugs which must be compulsorily prescribed by the international non-proprietary name (INN), however, prescribers are encouraged to prescribe in a cost effective manner, including prescribing by INN, where appropriate.
As part of the Memorandum of Understanding between the Government and the Troika, the Prescription Regulations will be amended to provide for the mandatory inclusion of the INN on prescriptions. The inclusion of brand names will not be prohibited. The new regulations are expected to be completed by end Q1 in 2014.
The 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. It is estimated that this system will yield €50 million in savings in 2014.
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 IMB is updating the List of Interchangeable Medicines on an ongoing basis and it expects to complete the assessment of the top 20 priority medicines by end Quarter 2 2014. A further list of 20 priority products will then be identified and it is expected the IMB will have assessed this list by end 2014. The process will then continue until all relevant medicinal products on the reimbursable list have been assessed.
Under the Act, 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.