Michael Healy-Rae
Question:641. Deputy Michael Healy-Rae asked the Minister for Health his views on correspondence (details supplied) regarding the cost of drugs; and if he will make a statement on the matter. [2738/14]
View answerMedicinal Products Prices
Questions (641)
Written answers
The State has introduced a series of reforms in recent years to reduce pharmaceutical prices and expenditure. There has been a general price freeze in operation in Ireland for medicines supplied under the community drug schemes since the mid 1990's. These have resulted in reductions in the price of thousands of medicines. Price reductions of the order of 30% per item reimbursed have been achieved between 2009 and 2013; the average cost per items reimbursed is now running at 2001/2002 levels.
Price increases have only been allowed under the national pricing agreements in exceptional circumstances. Approximately 60 products have been granted price increases since 2006. Included in this are essential medicines such as epilepsy medicines and corticosteroids. Price increases are only allowed in extremis to maintain supplies of required medicines in the Irish market and require the provision of detailed supporting evidence including international pricing.
In relation to hydrocortisone, it is appreciated that for an individual patient, the increase in its price is substantial. However, if an increase had not been agreed, the manufacturer was insistent that it would remove the product from the Irish market. If that had occurred, patients would have had to pay for an even more expensive unlicensed product. There is still only a single supplier of hydrocortisone in the Irish market, which suggests that the HSE made the right decision in allowing the price increase in order to maintain supply.
There 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 GP consultations.
The Government is committed to reducing both the State’s drugs bill and the cost to individuals of their medicines. The Programme for Government therefore gave a commitment to the introduction of reference pricing and the increased use of generics.
A number of steps have been taken on foot of this commitment, including: a major new deal on the cost of drugs in the State was concluded with the Irish Pharmaceutical Healthcare Association (IPHA) in October 2012. It will deliver a number of important benefits, including, significant reductions for patients in the cost of drugs, a lowering of the drugs bill to the State, timely access for patients to new cutting-edge drugs for certain conditions, and reducing the cost base of the health system into the future. The IPHA agreement provides that prices are referenced to the currency adjusted average price to wholesaler in the nine EU member states.
The gross savings arising from this deal will be in excess of €400 million over 3 years. €210 million from the gross savings will be available to fund new drugs.
A new agreement was also reached with the Association of Pharmaceutical Manufacturers in Ireland (APMI), which represents the generic drugs industry. Since 1 November 2012, the HSE only reimburses generic products which are priced at 50% or less of the initial price of an originator medicine. This represents a significant structural change in generic drug pricing and should lead to an increase in the generic prescribing rate. It is estimated that the combined gross savings from the IPHA and APMI deals will be in excess of €148 million in 2014.
The Health (Pricing and Supply of Medical Goods) Act 2013 provides that from June 2013 the price of all new medicinal products reimbursed under the community drug schemes will be set in accordance with the criteria set out in the Act. The Act also provides that the HSE must review all items currently reimbursable under the GMS and other community drug schemes (including prices) within three years to determine if they should remain on the reimbursement list and, if so, what price should apply. In addition, the Act 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.
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 maximum 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 and the second reference price for esomeprazole 20mg products was implemented on 1 January 2014 resulting in price reductions of 70% and 56% respectively compared to May 2013 price.
The HSE expect to implement reference prices for esomeprazole 40mg and rosuvastatin products with effect from 1 February 2014. In addition, the consultation process is also underway in relation to three more groups of medicines which have been designated as interchangeable by the IMB – Omeprazole, Lansoprazole, and Pravastatin. It is expected that reference prices will be implemented for these groups of medicines with effect from 1 March 2014. The HSE will continue the process of setting reference prices for the remaining groups of interchangeable medicinal products published by the IMB in accordance with the processes and timelines set down in the legislation. It is expected that 80% by value of the off-patent market for prescribed medicines will be subject to reference pricing by end 2014. Reference prices will ensure that generic prices in Ireland will fall towards European norms.
Health Services
Questions (642)
Bernard Durkan
Question:642. Deputy Bernard J. Durkan asked the Minister for Health if and when an appointment for genetic testing can be arranged in respect of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [2739/14]
View answerWritten answers
As the query raised by the Deputy is a service matter, I have asked the HSE to respond directly to him.
Health Services
Questions (643)
Joe Carey
Question:643. Deputy Joe Carey asked the Minister for Health if he will re-examine the file of a person (details supplied) in County Clare; the reason surgery is no longer deemed necessary in this case; and if he will arrange for a second opinion. [2740/14]
View answerWritten answers
As this is a service matter, it has been referred to the HSE for direct reply.
Medical Card Applications
Questions (644)
Tom Fleming
Question:644. 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. [2741/14]
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 Card Eligibility
Questions (645)
Bernard Durkan
Question:645. Deputy Bernard J. Durkan asked the Minister for Health the eligibility for a medical card in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [2759/14]
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.
Parliamentary Questions Data
Questions (646)
Dara Calleary
Question:646. Deputy Dara Calleary asked the Minister for Health the total number of parliamentary questions submitted to him in 2012 and in 2013 regarding the provision of ambulance services in the country or any aspect of ambulance service; the standard response time for such questions; any significant deviations on the response time; his opinion of the responsiveness of the National Ambulance Service to parliamentary questions. [2780/14]
View answerWritten answers
Information on the number of Parliamentary Questions referred by the Department of Health to the HSE for direct reply to Deputies, where the subject matter concerns the National Ambulance Service, is the following tables.
2012
|
Total Received |
0-5 Days |
6-10 Days |
11-15 Days |
On Time (%) |
16-20 Days |
20+ Days |
|
97 |
63 |
10 |
20 |
93 (96%) |
2 |
2 |
2013
|
Total Received |
0-5 Days |
6-10 Days |
11-15 Days |
On Time (%) |
16-20 Days |
20+ Days |
|
118 |
62 |
19 |
19 |
100 (85%) |
9 |
9 |
The HSE National Service Plan commits to responding to 75% of Parliamentary Questions within 15 working days. These are classified as "on time" in the information set out. Parliamentary Questions vary in complexity and some may require more in depth examination and investigation than others before issuing a full and comprehensive response.
Abortion Services
Questions (647)
Terence Flanagan
Question:647. Deputy Terence Flanagan asked the Minister for Health the position regarding medical personnel in hospitals if they refuse to assist with abortions; and if he will make a statement on the matter. [2786/14]
View answerWritten answers
The Deputy may wish to note that, in accordance with the European Convention on Human Rights and the Medical Council’s Guide to Professional Conduct and Ethics for Medical Practitioners,the Act clarifies that medical practitioners, nurses and midwives with a conscientious objection will not be obliged to carry out or assist in carrying out lawful terminations of pregnancy, unless the risk to the life of the pregnant woman is immediate, i.e. in an emergency situation.
Abortion Services
Questions (648)
Terence Flanagan
Question:648. Deputy Terence Flanagan asked the Minister for Health the amount of money that will be spent to upgrade theatres so that they are suitable for abortions to be carried out; and if he will make a statement on the matter. [2787/14]
View answerWritten answers
No specific theatre upgrades are required to facilitate procedures to save women's lives under the Protection of Life During Pregnancy Act 2013.
Health Promotion
Questions (649)
Jerry Buttimer
Question:649. Deputy Jerry Buttimer asked the Minister for Health the position regarding the establishment of Healthy Ireland Council; if he will consider appointing a representative of the fitness industry to the council; and if he will make a statement on the matter. [2811/14]
View answerWritten answers
Healthy Ireland proposes a whole-of-government and whole-of-society response to improving the health and well-being of Irish people over the coming generation. The establishment of the Healthy Ireland Council is the most significant action within Healthy Ireland to leverage engagement with whole-of-society. The Council will provide the platform to connect and mobilise communities, families and individuals into a national movement with one aim: supporting everyone to enjoy the best possible health and well-being.
The Public Appointments Service will shortly be seeking expressions of interest for members of the Healthy Ireland Council. The purpose of this process is to provide a pool of suitable candidates from which appointments to the Healthy Ireland Council can be made. Any person interested in being considered for appointment to the Council subject their meeting the criteria set down for the position, will be required to submit the relevant details through the PAS system.
Health Insurance Cover
Questions (650)
Michael Healy-Rae
Question:650. Deputy Michael Healy-Rae asked the Minister for Health the reason a single man cannot get private health insurance without maternity cover; the reason an elderly lady cannot get cover without maternity cover being on that policy; and if he will make a statement on the matter. [2823/14]
View answerWritten answers
The inclusion of maternity benefit in all health insurance products is a statutory requirement, as part of a legal obligation on health insurers to provide a specific minimum level of benefit in all health insurance products sold. Minimum benefit is one of the key principles on which the Irish private health insurance regulatory system is based. Minimum Benefit Regulations, made under the Health Insurance Acts, require insurers to offer a minimum benefit to every insured person. The key purpose of the Regulations is to ensure the continued availability of the type of broad hospital cover traditionally held as a minimum by the insured population and to ensure that individuals do not significantly under-insure.
The Minimum Benefit Regulations ensure that all consumers obtain an appropriate minimum level of health insurance cover regardless of what plan they purchase and that every plan available is inclusive of a minimum suite of benefits/procedures, some of which are available to the market as a whole and some of which will be applicable specifically to either men or women. By way of example, the Regulations include provision for such medical treatments as a prostatectomy or testicular biopsy (in the case of men) and cervical biopsy or maternity services (in the case of women). Importantly, under Community Rating everybody is charged the same premium for any specific health insurance plan available on the market, irrespective of their age, gender and the current or likely future state of their health, and the plan purchased will include this minimum suite of benefits.
Therefore, the broad base line of procedures provided by minimum benefit should not be looked at in gender specific or age-related terms, but rather as a cohort of benefits and procedures that are important and of benefit to the community of the insured population and thus should be protected and provided as a minimum base to all.
Health Services Staff Data
Questions (651)
Caoimhghín Ó Caoláin
Question:651. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide a full list of section 38 bodies; the salaries of chief executive officers; the detail of any top-up payments paid in each; and if he will make a statement on the matter. [2824/14]
View answerWritten answers
The information sought by the Deputy is a matter for the HSE and, accordingly, I have asked the HSE to respond directly to him.
Health Services Staff Data
Questions (652)
Caoimhghín Ó Caoláin
Question:652. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide a full list of Section 39 bodies; the salaries of CEOs; the detail of any top-up payments paid in each; and if he will make a statement on the matter. [2825/14]
View answerWritten answers
This question has been referred to the HSE for direct reply to the Deputy.
Ambulance Service Response Times
Questions (653)
Gerry Adams
Question:653. Deputy Gerry Adams asked the Minister for Health if he will confirm that on 13 January 2013 an ambulance based in Drogheda was providing cover in Navan and as a result took 30 minutes to respond to an emergency call in respect of a woman who had collapsed on West Street in Drogheda; the reason the ambulance was providing cover in Navan; his views views on whether these response times are satisfactory; and if he will make a statement on the matter. [2839/14]
View answerWritten answers
HIQA published its Pre-hospital Emergency Care Key Performance Indicators for Emergency Response Times in 2011, classifying 112/999 emergency calls by clinical status. Clinical Status 1 ECHO calls involve life-threatening emergencies of cardiac or respiratory origin. Clinical Status 1 DELTA calls involve life-threatening emergencies of other than cardiac or respiratory origin.
Since they were introduced in 2011, the HSE has been implementing the HIQA response time standards on a phased basis, in tandem with planned service improvements. In 2013, NAS exceeded the National Service Plan response time target for ECHO calls of 70% of patient-carrying vehicles on scene within 18 minutes 59 seconds. The DELTA response time performance was however 4% below the national target of 68%. In 2014, the targets have increased to 80% for both call types.
It is acknowledged that sole reliance on response times to measure performance is restrictive and a poor reflection of ambulance service work. Therefore, in line with many other jurisdictions, we are working to develop clinical outcome indicators for pre-hospital emergency responses. The first outcome indicator, for the return of spontaneous circulation in the Emergency Department in 40% of certain out-of-hospital cardiac arrests, has been introduced in the 2014 Service Plan.
HIQA, as part of its Business Plan for 2014, and in line with its programme for the monitoring of the National Standards for Safer Better Healthcare, will review the governance and management arrangements of pre-hospital emergency care services to include the timely call-handling, response, assessment, diagnosis, care and transportation of the acutely ill patient to the appropriate healthcare facility. This review had been due to commence in the 2nd quarter of 2014; however, in light of a number of recent incidents, the Authority has agreed to my request to commence the review in quarter 1. I understand that the review will focus initially on the governance arrangements for the service and how those arrangements translate into the safety, quality and effectiveness of services for patients.
I would also like to inform the Deputy that the National Ambulance Service will undertake its own capacity review to determine current and future service delivery needs. This process will examine a number of areas, including staff numbers and skill mix, as well as resource distribution.
I have asked the HSE to respond directly to the Deputy in relation to the specific information requested.
HIQA Investigations
Questions (654, 655, 656, 657)
Gerry Adams
Question:654. Deputy Gerry Adams asked the Minister for Health if his attention has been drawn to the fact that an ambulance was available in Our Lady of Lourdes Hospital in the early hours of New Year’s Day when an ambulance from Ardee was dispatched to Drogheda to respond to the stabbing of a person (details supplied); and if he will make a statement on the matter. [2840/14]
View answerGerry Adams
Question:655. Deputy Gerry Adams asked the Minister for Health if he will provide details of the Health Information and Quality Authority investigation into the ambulance response to the stabbing of a person (details supplied); and if he will make a statement on the matter. [2841/14]
View answerGerry Adams
Question:656. Deputy Gerry Adams asked the Minister for Health if he will ask Health Information and Quality Authority to carry out a thorough investigation into the resourcing, structure and management systems of the ambulance service in the north east region; and if he will make a statement on the matter. [2842/14]
View answerGerry Adams
Question:657. Deputy Gerry Adams asked the Minister for Health if he will ensure that any investigation by Health Information and Quality Authority into the ambulance service in County Louth is carried out in consultation with those frontline staff in our ambulance service who work long hours and provide a remarkable service, often with inadequate resources; and if he will make a statement on the matter. [2843/14]
View answerWritten answers
I propose to take Questions Nos. 654 to 657, inclusive, together.
At the outset I would like to express my sympathies to the family of the person concerned.
The National Ambulance Service (NAS) has reviewed the call received on 1st January 2014 requesting ambulance assistance in the Rathmullan Park area of Drogheda and has noted that there was a significantly high level of demand on the ambulance service at the time of the call. However, the NAS is satisfied that the call was appropriately prioritised and that the closest available ambulance was tasked to the call.
The Health Information and Quality Authority as part of its Business Plan for 2014, and in line with its programme for the monitoring of the National Standards for Safer Better Healthcare, will review the governance and management arrangements of pre-hospital emergency care services to include the timely call-handling, response, assessment, diagnosis, care and transportation of the acutely ill patient to the appropriate healthcare facility. This review had been due to commence in the 2nd quarter of 2014, however, in light of a number of recent incidents, the Authority has agreed to my request to commence the review in quarter 1. I understand that the review will focus initially on the governance arrangements for the service and how those arrangements translate into the safety, quality and effectiveness of services for patients.
I would also like to inform the Deputy that the NAS will undertake its own capacity review to determine current and future service delivery needs. This process will examine a number of areas, including staff numbers and skill mix, as well as resource distribution.
Departmental Funding
Questions (658)
Catherine Byrne
Question:658. Deputy Catherine Byrne asked the Minister for Health further to Parliamentary Question No. 548 of 10 December 2013, the voluntary and community organisations funded by his Department in 2013 or the latest year for which such information is available; the amount provided in each case and the purpose for which it was provided. [2862/14]
View answerWritten answers
The only source of Departmental funding for voluntary and community organisations, other than Local and Regional Drugs Task Forces, is through National Lottery Grants. Details of the National Lottery Grants provided by my Department are available on the Department's website, www.dohc.ie. If the Deputy requires more specific details, or seeks further clarification, please let me know.
Since the Deputy's previous question I have identified the attached payments made to voluntary and community groups under the Local and Regional Drugs Task Forces in 2013.
General Practitioner Services
Questions (659)
Thomas Pringle
Question:659. Deputy Thomas Pringle asked the Minister for Health if there will be an opt-in mechanism for general practices to register for free GP care for the under sixes; if he can still guarantee that all those under six will have access to free GP care; and if he will make a statement on the matter. [2863/14]
View answerWritten answers
The Government is committed to introducing, on a phased basis, a universal GP service 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 which is being drafted. The Department and the HSE are currently considering the changes that need to be made to the GMS contract to facilitate the roll-out of GP services free to all children aged 5 and under.
Under the existing medical card and GP visit card contracts, it is always open to GPs to choose to participate or not and similar arrangements will apply under the new legislation. The Government is aiming to have this measure in place around the middle of this year.