Written Answers Nos. 687-711
687. Deputy Joan Collins asked the Minister for Health if he will provide the statement-letter issued in 2012 when the campaign for independent living campaigned overnight to stop cuts in their personal assistant hours. [9381/14]
View answerI refer the Deputy to the Department of Health website for a copy of the Press Statement which issued in September 2012 "Statement on HSE Financial Measures", the link for which I set out below: http://www.dohc.ie/press/releases/2012/20120904.html.
688. Deputy Caoimhghín Ó Caoláin asked the Minister for Health further to Parliamentary Questions Nos. 190 and 191 of 22 January 2014 when a response will issue from the Health Service Executive. [9385/14]
View answerIn relation to the detailed information requested by the Deputy, as this is a service matter, I have asked the Health Service Executive to respond directly to him, regarding his further question.
689. Deputy Thomas P. Broughan asked the Minister for Health the action he is taking to ensure that services for young persons with autism will be in place after they turn 18 years of age in the north Dublin area. [9392/14]
View answerThe vision for the Health Service Executive's Disability Services Programme is to contribute to the realisation of a society where people with disabilities are supported, as far as possible, to participate to their full potential in economic and social life, and have access to a range of quality personal social supports and services including respite care to enhance their quality of life.
The Health Service Executive National Service Plan 2014 and the recently published 2014 Operational Plan for the Social Care Division outline the quantum of specialist services, the key reform initiatives and the additional investment in 2014 which it has assured me will give effect to this vision in 2014. The Government is providing funding of €1.4 billion to the Disability Services Programme in 2014, including an additional €14m to address the priority needs identified by the Minister for Health and advised to the Health Service Executive (HSE). The additional funding includes €7m for the provision of new places for school-leavers and rehabilitative (life-skills) training graduates.
The HSE, through its Occupational Guidance Service, is working with schools, service providers, young people and their families to identify training needs and explore suitable options for school-leavers graduating in 2014. Many young people with disabilities will progress to further education or vocational training funded by the Department of Education and Skills. For those young people who will require ongoing HSE-funded supports, the HSE has established a National Oversight Group to coordinate a timely response to processing applications for day services and rehabilitative training places. As a result, new arrangements have been put in place for a centralised regional application process.
The HSE have informed me that they are liaising with disability agencies and the National Council for Special Education to supply the necessary information to parents and students on the new application process. The deadline for applications was the 1st of February, however some flexibility will be given since the application process is in its first year. The next stage in the process will be to identify and agree the supports required for each individual, identify the service providers who have the capacity to respond to those support needs, and agree the allocation of additional resources to support individual placements. A communications process with all stakeholders will be put in place by the end of March, and young people and their parents will be advised of the placement which will be available to them by the end of June 2014.
In relation to the specific queries raised by the Deputy, as these are service issues they have been referred to the HSE for direct reply.
690. Deputy Billy Kelleher asked the Minister for Health further to Parliamentary Question No. 177 of 5 February 2014, if he will provide the details of the 2014 budgets for hospitals (details supplied) and the 2013 outturn for same. [9397/14]
View answerAs this is a service matter, I have asked the HSE to respond directly to the Deputy.
691. Deputy Seán Kenny asked the Minister for Health his views on the current addiction services provided by the Health Service Executive; and if he will make a statement on the matter. [9420/14]
View answerThe National Drugs Strategy sets out drugs policy in Ireland for the period up to 2016. Drugs policy encompasses five pillars - supply reduction, prevention, treatment, rehabilitation and research and clear actions are in place for implementation. I am satisfied that good progress is being made across the actions of the Strategy, with the involvement of the statutory, voluntary and community sectors, and that emerging issues and threats around problem drug use are being addressed in a timely and effective manner.
In the implementation of the National Drugs Strategy particular focus is being placed on Programme for Government commitments in areas such as treatment and rehabilitation. Periodic reviews of progress across the pillars of the Strategy are carried out through the Oversight Forum on Drugs (OFD) which I chair and these are posted on my Department's website. Considerable success has been achieved with an increased number of people in the opiate substitution programme, a reduction in waiting times for access to services particularly outside the Dublin area, increased availability of places in rehabilitation programmes as well as the continued expansion of the pharmacy needle exchange programme. This work is being complemented by greater focus on integrated care plans for individuals and more co-ordinated inter-agency working with the national roll out of the National Drugs Rehabilitation Framework planned following the successful piloting of the initiative.
In relation to alcohol the Government recently approved an extensive package of measures to be incorporated in a Public Health (Alcohol)Bill which are based on the recommendations contained in the Steering Group Report on a National Substance Misuse Strategy 2012. The HSE has responsibility for implementing a number of recommendations and this is reflected in the HSE Service Plan for 2014.
692. Deputy Robert Troy asked the Minister for Health when a person (details supplied) will be called by the orthopaedic section in the Midland Regional Hospital, Tullamore, County Offaly. [9479/14]
View answerA 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.
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.
693. Deputy Clare Daly asked the Minister for Health the reason the drug Fampyra is not being made available under the drug payment scheme in view of the fact that it proved very beneficial for sufferers of multiple sclerosis who had been using it for the past year and a half on trial. [9485/14]
View answerThe HSE received an application for the inclusion of Fampridine (Fampyra®) in the GMS and community drugs schemes. The application was considered in line with the procedures and timescales agreed by the Department of Health and the HSE with the Irish Pharmaceutical Healthcare Association (IPHA) for the assessment of new medicines. In accordance with these procedures, the National Centre for Pharmacoeconomics (NCPE) conducted a pharmacoeconomic evaluation of Fampridine and concluded that, as the manufacturer was unable to demonstrate the cost effectiveness of fampridine in the Irish healthcare setting, it was unable to recommend the reimbursement of the product. The report is available on the NCPE's website (www.ncpe.ie).
The HSE assessment process is intended to arrive at a decision on the funding of new medicines that is clinically appropriate, fair, consistent and sustainable. In these circumstances, the HSE has not approved the reimbursement of Fampridine under the GMS or other community drug schemes.
694. Deputy Colm Keaveney asked the Minister for Health when a person (details supplied) in County Galway is likely to receive their medical card; and if he will make a statement on the matter. [9488/14]
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.
695. Deputy Brendan Griffin asked the Minister for Health if he will renew his efforts to establish the contributions paid by a person (details supplied) in County Kildare from 1970 to 1990 in respect of their care at a facility; and if he will make a statement on the matter. [8663/14]
View answerI understand that these queries arose in the context of litigation proceedings. The level of contributions in this case was established and following the provision of relevant details to the legal representatives of the person concerned, the matter has now been satisfactorily resolved.
696. Deputy Brendan Griffin asked the Minister for Health if he will provide an update on the MRSA problem in hospitals here; the most recent statistics for hospitals over the past five years; the number of deaths that have been linked to MRSA in each of the past five years and where these occurred; and if he will make a statement on the matter. [8754/14]
View answerThe prevention of Healthcare Associated Infections (HCAIs) and colonisation/infection of our patients with antimicrobial-resistant organisms (AMR) such as MRSA is one of my priorities in protecting patient safety. HCAIs represent a major cause of preventable harm and increased healthcare costs.
The prevalence of MRSA has dropped considerably in recent years. There has been a decrease of 59% in reported cases of MRSA from 2006 to 2012. Provisional data for the first three quarters of 2013 indicates that the reduced rates are holding (see table below).
The Health Protection Surveillance Centre (HPSC) collates information from hospitals on healthcare associated infections and antimicrobial resistant organisms such as MRSA. Information is also published on an ongoing basis for overall S. aureus blood stream infections (BSI) and MRSA infection within that grouping – published quarterly to hospital level since 2007. Detailed information on MRSA rates per hospital is available on the HPSC website (www.hpsc.ie).
Notably, there has been a decrease in reported S. aureus BSI from 1,412 cases in 2006 to 1,060 cases in 2012 (24.9% decrease). The decrease in MRSA cases as a percentage of overall bloodstream infections saw a greater decrease in this time however - a reduction from 41.9% in 2006 to 22.8% in 2012 (last full year statistics to date). To the end of Quarter 3 2013, (provisional) 180 (21.3%) of overall BSI cases were due to resistant S. aureus (MRSA) and in actual cases of MRSA reported, a 59% drop was observed:
|
Year |
No. of MRSA cases |
Decrease |
|
2006 |
592 |
- |
|
2007 |
536 |
- |
|
2008 |
439 |
- |
|
2009 |
355 |
- |
|
2010 |
305 |
- |
|
2011 |
263 |
- |
|
2012 |
242 |
59% decrease on 2006 figures |
|
2013 |
180* |
* Data provisional to the end of Q3 2013 |
While not all HCAIs are due to AMR a significant proportion are. HCAIs are not an inevitable consequence of healthcare - recent evidence suggests that up to 70% of HCAIs can be prevented depending on the type of infection and the baseline rate. The approach to prevention and control of HCAIs is similar irrespective of whether or not it is caused by an antibiotic resistant bacteria. Therefore, the Health Service Executive (HSE) has a dual focus:
- implementing measures to prevent and control HCAIs including those caused by AMR such as MRSA
- implementing specific measures for AMR including MRSA:
- These are outlined in national guidelines which have been recently updated
- Monitoring infections caused by AMR as outlined later in this response.
The HSE has implemented a number of national initiatives in this field for many years, including:
- SARI 2001-2010 (The Strategy for the Control of Antimicrobial Resistance in Ireland) which specifically outlined the national strategy for prevention of AMR and was launched by the Minister of Health in 2001.
- HSE ‘ Say No to Infection’ which focused on both HCAIs and AMR, launched in 2007
- The RCPI & HSE National Clinical Programme for the prevention and control of HCAIs and AMR which commenced in late 2010.
Public reporting of HCAIs and AMR in Irish acute hospitals:
- HCAIs Prevalence Study 2006 and 2012
- S. aureus bloodstream infection (reported quarterly since 2007) – this includes public reporting of MRSA rates per hospital
- Alcohol hand rub consumption (reported bi-annually since 2007)
- Antibiotic consumption (reported bi-annually since 2007)
- Hand hygiene compliance (reported bi-annually since 2011)
The overall aim of the National Clinical Programme for the prevention and control of HCAIs and AMR is that every healthcare worker and all parts of the healthcare system recognise that the prevention and control of HCAIs and AMR is a key element of clinical and non-clinical governance. Our healthcare systems have processes in place to ensure safe healthcare is reliably delivered irrespective of the healthcare setting. The programme focuses on getting three basic practices right every time we care for our patients, these are hand hygiene, using antimicrobials appropriately (antimicrobial stewardship) & preventing medical device-related infections i.e., IV lines/drips, urinary catheters. If the above three measures are applied consistently and reliably every time healthcare workers care for their patients/residents/client then a significant proportion of HCAIs, including that caused by AMR will be prevented.
While I welcome the reducing trend in reported rates of MRSA in Ireland, MRSA rates are comparably high with other countries. We must systematically build our actions and processes to continue to reduce the prevalence of MRSA in Ireland.
In relation to the Deputy's question about the number of deaths that have been linked to MRSA, routine data is not available on deaths from hospital acquired infections (HCAIs). In certain cases such infections may be a contributing factor to a particular death but not the primary cause, hence the difficulty in giving definitive statistics on the issue.
In December last I launched and endorsed the second National Clinical Guideline, Prevention and Control Methicillin-Resistant Staphylococcus aureus (MRSA). This National Clinical Guideline provides practical guidance on prevention and control measures for MRSA to improve patient care, minimise patient morbidity and mortality and to help contain healthcare costs. The guideline has been developed for all healthcare staff involved in the care of patients, residents or clients who may be at risk of or may have MRSA in acute hospitals, obstetrics and neonates, nursing homes/long stay residential units and the community.
I might add that I have ensured that Patient Safety has been made a priority within the HSE's Annual Service Plan through specific measures focused on quality and patient safety including HCAIs, Medication safety and implementation of Early Warning Score systems. My officials meet the HSE each month on the Service Plan and patient safety is a standing item on that agenda.
697. Deputy Brendan Griffin asked the Minister for Health his views on a matter (details provided) regarding a hip operation; and if he will make a statement on the matter. [8758/14]
View answerThe management of inpatient and daycase waiting lists for patients awaiting public health care is based on the principle that after urgent and cancer patients are treated, then clinically assessed routine patients should be seen in chronological order (i.e. longest waiter first).
Should the patient's general practitioner consider that the patient's condition warrants an earlier appointment, he/she would be in the best position to take the matter up with the consultant and hospital involved.
In relation to the specific query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.
698. 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. [9507/14]
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.
699. Deputy Ann Phelan asked the Minister for Health in respect of Waterford Regional Hospital, there are two part-time consultants in post and one ophthalmic surgeon, there are three permanent vacancies, one of which is currently being advertised and it is proposed that a second post will be filled from the panel, however, approval has been sought in respect of a third post; if approval has been given, when is it expected that the posts in question will be filled; if it is expected that as a result of filling these positions cataract operations will be increased in Waterford Regional Hospital; and if he will make a statement on the matter. [9511/14]
View answerIn relation to the detailed information requested by the Deputy, as these are service matters, I have asked the Health Service Executive to respond to her directly.
700. Deputy Michael Colreavy asked the Minister for Health if he will allay the very real fears of persons in Sligo, Leitrim, south Donegal and west Cavan by confirming that full maternity services will continue at Sligo Regional Hospital and by confirming that the hospital's neonatal intensive care unit will continue to be used to care for newborn ill infants. [9528/14]
View answerAs the Deputy may be aware, my Department is currently developing a new National Strategy for Maternity Services which will determine the optimal configuration of maternity services to ensure that women in Ireland have access to safe, high quality maternity care in a setting most appropriate to their needs. As part of the development of the Strategy, maternity services in all parts of the country will be reviewed and evaluated. It is intended to publish the Strategy this year.
A draft report into maternity services in the West/North West Hospital Group makes no recommendations in relation to the closure of any of the five maternity units, or indeed any neonatal intensive care unit, within the Hospital Group.
701. Deputy Stephen S. Donnelly asked the Minister for Health his plans to cut the waiting times for those who require wheelchairs and aids by allowing the Health Service Executive to take back and recycle those that are no longer required by a patient, often stockpiled in nursing homes and other facilities; if such an approach is feasible; and if he will make a statement on the matter. [9534/14]
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.
702. Deputy Charlie McConalogue asked the Minister for Health when a final reply will issue in respect of correspondence (details supplied); and if he will make a statement on the matter. [9538/14]
View answerA final reply in respect of the correspondence mentioned above has been drafted and will issue to the Deputy shortly.
703. Deputy Patrick O'Donovan asked the Minister for Health when he expects to introduce minimum unit pricing for alcohol; and if he will make a statement on the matter. [9541/14]
View answerThe Government has approved an extensive package of measures to deal with alcohol misuse to be incorporated in a Public Health (Alcohol) Bill. These measures are based on the recommendations contained in the Steering Group Report on a National Substance Misuse Strategy, 2012 and include provisions for the introduction of minimum unit pricing for alcohol products. Work on developing a framework for the necessary Department of Health legislation is continuing.
A health impact assessment, in conjunction with Northern Ireland, has been commissioned as part of the process of developing a legislative basis for minimum unit pricing. The assessment will study the impact of different minimum prices on a range of areas such as health, crime and likely economic impact. The study should be finalised by the end of Quarter 2 this year.
704. Deputy Gerry Adams asked the Minister for Health the steps that have been taken by his Department to ensure that all pharmacies are aware that under existing provisions in the current Medicinal Products (Prescription and Control of Supply) Regulations 2003 they are permitted to supply in emergency circumstances without a prescription. [9567/14]
View answer705. Deputy Gerry Adams asked the Minister for Health when he and his Department will decide to carry out a review of the Medicinal Products (Prescription and Control of Supply) Regulations 2003 in view of a request to pilot a study regarding the administration of adrenaline in the treatment of anaphylaxis by trained anaphylaxis first responders; and if he will make a statement on the matter. [9568/14]
View answer706. Deputy Gerry Adams asked the Minister for Health if his Department concluded its examination of the legal basis upon which adrenaline can be administered to a patient where the adrenaline has been prescribed for the patient by a medical practitioner or other prescriber; and if he will make a statement on the matter. [9569/14]
View answerI propose to take Questions Nos. 704 to 706, inclusive, together.
Under EU law, adrenaline pens, as injectable medicines, may only be supplied on foot of a valid prescription. However, there is provision in the Medicinal Products (Prescription and Control of Supply) Regulations which permits pharmacists, in emergency circumstances, to supply certain prescription-only medicines, including adrenaline pens, without a prescription.
The Pharmaceutical Society of Ireland (PSI), an independent statutory body established by the Pharmacy Act 2007, is charged with, and is accountable for, the effective regulation of pharmacy services in Ireland, including responsibility for supervising compliance with the Pharmacy Act and medicines legislation.
Pharmacists as part of their undergraduate and internship training programme are comprehensively educated on medicines and controlled drugs legislation including the provisions on the emergency supply of medicines.
In May 2012, the PSI issued up to date advice to pharmacists on the emergency supply provisions of the medicines legislation. This advice was circulated to all pharmacists via the PSI pharmacist monthly newsletter and is available to download from the PSI website.
My Department is currently examining the possibility of amending the Prescription and Control of Supply Regulations to facilitate the wider availability of adrenaline pens without a prescription in emergency situations.
707. Deputy Dara Calleary asked the Minister for Health the terms of reference for the proposed review of maternity services; the person carrying out the review; the level of public consultation there will be around the review; the timescale for the review to be published and for decisions to be taken; and if he will make a statement on the matter. [9593/14]
View answerAs the Deputy will be aware my Department is developing a new National Strategy for Maternity Services which I intend to publish this year. The development of this strategy is currently underway and it will determine the optimal configuration of maternity services to ensure that women in Ireland have access to safe, high quality maternity care in a setting most appropriate to their needs. A public consultation process will be undertaken at an appropriate time.
As part of the development of the Strategy, maternity services in all parts of the country, will be reviewed and evaluated. This is in line with one of the recommendations of the HIQA report into the death of Savita Halappanavar.
708. Deputy John Lyons asked the Minister for Health the total funding allocated for the roll-out of primary care centres in 2014 and 2015; and if he will make a statement on the matter. [9601/14]
View answerAs with all capital projects the roll out of the primary care infrastructure programme must be considered within the overall capital envelope available to the health service. There will always be more projects than can be funded by the Exchequer. There is limited funding available for new projects over the period 2014-2018 given the level of commitments and the costs to completion already in place.
The HSE has submitted its draft Capital Plan for the multi-annual period 2014-2018. The Plan requires the approval of the Minister for Health and the consent of the Minister for Public Expenditure and Reform. It is expected that consent will be sought shortly. Following this process the HSE will publish details of the Plan on its website.
709. Deputy Aengus Ó Snodaigh asked the Minister for Health the cover provided by the €100 hospital bill in respect of a person (details supplied) in Dublin 10; if a patient does not receive treatment or attention from a doctor whether they should still be issued with the bill; and if he will make a statement on the matter. [9603/14]
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.
710. Deputy Finian McGrath asked the Minister for Health the position regarding a long-term care plan for a family (details supplied) in Dublin 13; and if he will make a statement on the matter. [9606/14]
View answerAs the particular issue raised by the Deputy relates to an individual case, this is a service matter for the Health Service Executive. Accordingly, I have arranged for the question to be referred to the HSE for direct reply to the Deputy.
711. Deputy Seán Ó Fearghaíl asked the Minister for Health the total number of medical cards on 1 February 2014; the total number of general practitioner cards on the same date; and the total number for each type of card issued on a discretionary basis on that date. [9614/14]
View answerI am advised by the HSE that, at 1 February 2014, the overall number of persons with eligibility to a medical card was 1,840,760, of which 50,505 hold eligibility on the basis of the exercise of discretion. The number of persons with eligibility to a GP visit card, for the same date, was 125,930, of which 27,204 hold eligibility on the basis of the exercise of discretion.
