Medicinal Products Availability

Questions (551, 552)

Gerry Adams

Question:

551. Deputy Gerry Adams asked the Minister for Health if he will consider introducing a scheme to train volunteers in the use of epi-pens as first responders; and if he will make a statement on the matter. [11992/14]

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Gerry Adams

Question:

552. Deputy Gerry Adams asked the Minister for Health if he will introduce legislation to allow epi-pens to be stored in schools, workplaces and public spaces, similar to the defibrillator scheme; and if he will make a statement on the matter. [11993/14]

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Written answers (Question to Health)

I propose to take Questions Nos. 551 and 552 together.

Adrenaline pens, as injectable medicines, may only be supplied on foot of a 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. My Department is currently examining the possibility of amending the Regulations to facilitate the wider availability of adrenaline pens without prescription in emergency situations, by persons trained in the administration of these pens.

Food Allergies

Questions (553)

Gerry Adams

Question:

553. Deputy Gerry Adams asked the Minister for Health if he will establish a State-wide education programme to alert teachers, health care professionals, citizens and parents about the dangers of anaphylaxis. [11994/14]

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Written answers (Question to Health)

Anaphylaxis may arise from a wide variety of causes, including insect stings, food allergies and reaction to certain medications. It affects individuals in many different ways. General practitioners are in the best position to offer advice to sufferers and, where necessary, to refer them to hospital consultants, to advise on the use of adrenaline pens or other appropriate precautionary measures with regard to the precautions that should be taken in individual cases. Generally speaking, persons at known risk of anaphylaxis would be well advised to carry an adrenaline pen and, in the case of children, carers and teachers should be made aware of the child’s condition and have access to, and be shown how to use an adrenaline pen in an emergency. My Department has no plans to introduce a state wide anaphylaxis programme as I am satisfied that GPs are best placed to provide advice to individual patients.

Health Services Funding

Questions (554)

Brendan Griffin

Question:

554. Deputy Brendan Griffin asked the Minister for Health if adequate funding will be provided to allow a service to meet demand in County Kerry (details supplied); and if he will make a statement on the matter. [11998/14]

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Written answers (Question to Health)

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 Drugs

Questions (555)

Mary Lou McDonald

Question:

555. Deputy Mary Lou McDonald asked the Minister for Health the measures his Department will take to include a prescribed drug used for patients with Multiple Sclerosis in the medical card scheme (details supplied) [12016/14]

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Written answers (Question to Health)

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drug schemes in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013. The 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 NCPE report is an important input to assist the HSE in its decision making process and informs further discussions between the HSE and the manufacturer of the drug. 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.

Hospital Waiting Lists

Question No. 557 answered with Question No. 522.

Questions (556)

Terence Flanagan

Question:

556. Deputy Terence Flanagan asked the Minister for Health the actions he is taking to reduce waiting lists in our hospitals; and if he will make a statement on the matter. [12017/14]

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Written answers (Question to Health)

Figures at the end of December 2013 indicate that the total number of patients awaiting Outpatient appointments has reduced by 25% from 399,951 to 300,752. Of these, 295,815 are waiting less than 12 months, a level of 98.4% compliance with the Government target.

- Numbers waiting 12-24 months have reduced by 94%, from 67,529 down to 3,990

- Numbers waiting 24-36 months have reduced by 97%, from 23,726 down to 706

- Numbers waiting 36-48 months have reduced by 97%, from 7,802 down to 197

- Numbers waiting 48+ months have reduced by 99%, from 7,795 down to 44.

A key part of the management of scheduled care, and in particular outpatient waiting lists, is addressing the loss of 16% of the total potential outpatient capacity due to patients not attending scheduled outpatient appointments (often referred to as the ‘Do Not Attend’ or ‘DNA’ rate). Through the introduction of validation of current waiting lists, revised control processes in respect of patients who fail to attend booked appointments, using texts and/or letters to prompt patients about forthcoming appointments, facilitating patient choice in the arrangement of appointments and the use of electronic referral systems, it is intended to reduce the ‘DNA’ rate to 10% in 2014.

As regards Inpatient / Day Case care, the total number of adults waiting more than eight months for an inpatient or day-case procedure at 31 December 2013 was 68. This, compared with a figure of 2752 at the end of 2012, is a comparative reduction of 97.7%. If compared with the figure of 7,645 identified in August 2011, the comparative reduction exceeds 99%. Of a total of 1,731 children awaiting inpatient / day case surgery, over 91% are waiting less than 20 weeks, with approximately 170 children in breach of the target as at 31 December 2013. Those who have exceeded the target are predominantly awaiting spinal surgery in Crumlin or ENT evaluation in Temple St. It is anticipated that the appointment of a new Consultant and supporting team in Crumlin will increase the capacity for spinal surgery by 50 – 75 cases annually, which will facilitate the achievement of the 20 week target; in terms of ENT, the current shortfall is to be addressed through a combination of outsourcing across a number of appropriate sites and securing additional consultant capacity.

In respect of GI Endoscopy, over 99% of patients waiting for routine endoscopy procedures are waiting less than 13 weeks. As at 31 December 2013, 73 patients were waiting over 3 months, thereby exceeding the 13 week target: plans have been drawn up to ensure that no patient is waiting more than 13 weeks in 2014. This will be achieved by opening additional endoscopy units, focusing on more robust levels of control of the GI Endoscopy programme and the use of periodic outsourcing where necessary, to increase capacity within the system. All of these measures will enable the HSE to regain and maintain compliance with the 13 week target.

The HSE Service plan includes a specific €30 million fund to address hospital service pressures and every effort will be used to deploy this fund as effectively as possible to achieve and surpass service plan activity targets. In order to ensure that patients who require emergency, acute or elective care can access that care, the HSE is also seeking to maximise the discharge options available to patients who no longer require such care by opening additional sub-acute beds, where such capacity is available and providing additional home care supports so that as many older people as possible can be supported at home. These measures will help to expedite the discharge of patients whilst ensuring they continue to receive the care appropriate to their needs, thus reducing delayed discharges further, easing ED trolley waits and reducing the risk of cancellation of elective procedures.

Question No. 557 answered with Question No. 522.

Medical Card Applications

Questions (558)

Bernard Durkan

Question:

558. Deputy Bernard J. Durkan asked the Minister for Health the progress made to date in the determination of an application for medical card in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [12033/14]

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Written answers (Question to Health)

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 Drugs

Questions (559)

Brian Walsh

Question:

559. Deputy Brian Walsh asked the Minister for Health if he will consider the inclusion of a drug (details supplied) under the GMS scheme; and if he will make a statement on the matter. [12051/14]

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Written answers (Question to Health)

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drug schemes in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013. Therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

HSE Funding

Questions (560)

Terence Flanagan

Question:

560. Deputy Terence Flanagan asked the Minister for Health if he will provide a list of organisations currently in receipt of Health Service Executive funding; if such organisations are subject to a service level agreement containing a clause prohibiting the use of funding to change law or Government policies, or prohibiting the use of funding to persuade persons to adopt a view on law or public policy; and if he will make a statement on the matter. [12054/14]

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Written answers (Question to Health)

This question has been referred to the HSE for direct reply to the Deputy.

Medicinal Products Prices

Questions (561)

John Halligan

Question:

561. Deputy John Halligan asked the Minister for Health his understanding of the pricing structure of generic drugs as in certain chemists in County Waterford these so-called generic medications seem to be as costly as their named brand counterparts; his views on whether the pricing structure of medication should be on a par throughout the country; and if he will make a statement on the matter. [12061/14]

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Written answers (Question to Health)

Under an agreement reached in October 2012 with the Association of Pharmaceutical Manufacturers in Ireland (APMI), which represents the generic drugs industry, the maximum price the HSE pays for generic products is 50% of the initial price of an originator medicine. Recent negotiations with the APMI have resulted in additional price reductions being agreed. From 1 April 2014, the maximum price the HSE will pay for generic products will be 40% of the initial price of an originator medicine. This will result in the price differential between off-patent drugs and most generic equivalents increasing from 5% currently to approximately 20%.

The Health (Pricing and Supply of Medical Goods) Act 2013 introduced a system of generic substitution and reference pricing. 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 resulting in a 70% reduction in the price paid by the HSE for these products since May 2013. Reference prices for esomeprazole 20mg products and esomeprazole 40mg products were implemented on 1 January 2014 and 1 February 2014, respectively, resulting in price reductions of 56% respectively compared to May 2013 price. Reference prices were also set for rosuvastatin products with effect from 1 February 2014 resulting in a 40% reduction in the prices paid for these products.

With effect from 1 March 2014, the HSE implemented reference prices for a further four groups of interchangeable medicines - Lansoprazole, Omeprazole, Pravastatin - resulting in substantial reductions in the prices the HSE pays for these products. The reference prices are published on the HSE website at http://www.hse.ie/eng/health/hl/Generics/ref/.

In addition, the consultation process is also underway in relation to four more groups of medicines which have been designated as interchangeable by the IMB – Lercanidipine, Pantaprazole, Ramipril and Quetiapine. It is expected that reference prices will be implemented for these groups of medicines with effect from 1 April 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 Quarter 1 2015. Reference prices will ensure that generic prices in Ireland will fall towards European norms.

In the case of drugs and medicines which are paid for by the HSE, prices are set in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013 or the terms of the framework agreements between the Department of Health and the HSE and the representative bodies for pharmaceutical manufacturers in Ireland. However, neither the Minister for Health nor the HSE has any power to set the prices of drugs and medicines purchased by private patients. However, I would be disappointed if all pharmacists were not passing on the benefits of lower prices to patients. The HSE advises the public that if they are being charged prices which exceed the reimbursement price listed on the HSE website, plus a dispensing fee of between €3.50 and €5, then they should discuss the differential with their pharmacist to ensure they get the best possible price for the medicine concerned.

Finally, my Department has asked the Pharmaceutical Society of Ireland (the pharmacy regulator) to consider how to provide greater price transparency in retail pharmacies. This examination is ongoing.

Health Services

Questions (562)

Michael Healy-Rae

Question:

562. Deputy Michael Healy-Rae asked the Minister for Health the action that can be taken in respect of a person (details supplied); and if he will make a statement on the matter. [12064/14]

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Written answers (Question to Health)

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.

Hospital Equipment

Questions (563, 564)

Brian Walsh

Question:

563. Deputy Brian Walsh asked the Minister for Health the reason that the extracorporeal shockwave lithotripor service commenced by University Hospital Galway on 29 August 2012, two years after the machine was purchased, was discontinued two days later and not recommenced until 2014 [12065/14]

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Brian Walsh

Question:

564. Deputy Brian Walsh asked the Minister for Health the locations at which the extracorporeal shockwave lithotripor machine purchased by University Hospital Galway in 2010 was stored between the time of its purchase and its commencement for use at the hospital in 2014, and if it was made available for use by practitioners in the private sector during this period. [12066/14]

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Written answers (Question to Health)

I propose to take Questions Nos. 563 and 564 together.

As these are service matters, I have asked the Health Service Executive to respond directly to the Deputy.

Mental Health Services Provision

Questions (565)

Richard Boyd Barrett

Question:

565. Deputy Richard Boyd Barrett asked the Minister for Health if there are any plans to refurbish St. Brendan's Psychiatric Hospital, Grangegorman, Dublin 7. [12069/14]

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Written answers (Question to Health)

Management of the health estates is a service matter. Therefore your question has been referred to the Health Service Executive for direct reply.

Health Services Provision

Question No. 567 answered with Question No. 522.

Questions (566)

Tom Fleming

Question:

566. Deputy Tom Fleming asked the Minister for Health if he will provide Internet facilities in the Health Service Executive-owned health centre in Glenbeigh, County Kerry, where at present there is no Internet facility; if he will take into consideration, so as to comply with HSE guidelines and allow for the prescribing of medicines and so on, that it will be necessary for the health centre in Glenbeigh to have Internet facilities by the beginning of April 2014; and if he will make a statement on the matter. [12071/14]

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Written answers (Question to Health)

As this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.

Question No. 567 answered with Question No. 522.

Hospital Charges

Questions (568)

Mattie McGrath

Question:

568. Deputy Mattie McGrath asked the Minister for Health the amount the Health Service Executive has raised through the practice of charging families or next of kin of loved ones who have died in road traffic accidents €100 since 2011; and if he will make a statement on the matter. [12084/14]

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Written answers (Question to Health)

I have asked the Health Service Executive for a report on the issue raised by the Deputy. I will revert to the Deputy on the matter as soon as possible.

Professional Qualifications

Questions (569)

Terence Flanagan

Question:

569. Deputy Terence Flanagan asked the Minister for Health the laws by which psychotherapists are governed here; and if he will make a statement on the matter. [12086/14]

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Written answers (Question to Health)

While the profession of psychotherapist is not currently regulated on a statutory basis in Ireland, psychotherapists are subject to legislation similar to other practitioners including consumer legislation, and to competition, contract and criminal law.

The Health and Social Care Professionals Act 2005 provides for the statutory regulation of the 12 health and social care professions of clinical biochemist, dietitian, medical scientist, occupational therapist, orthoptist, physiotherapist, podiatrist, psychologist, radiographer, social care worker, social worker and speech and language therapist. Under the Act. the system of statutory registration comprises a registration board for each of the twelve designated professions, a Health and Social Care Professionals Council with overall responsibility for the regulatory system, and a committee structure to deal with disciplinary matters. To date, five registration boards are operational and it is expected that the registration boards and their registers for the remaining seven designated professions should be established by the end of 2015.

The Health and Social Care Professionals Act 2005 also provides that the Minister for Health may, by regulation, designate a health and social care profession not already designated if he or she considers that it is in the public interest to do so and if specified criteria have been met. Whilst the immediate priority is to proceed with the establishment of the registration boards for the twelve professions currently designated under the Act, I am committed to bringing counsellors and psychotherapists within the ambit of the Act as soon as possible.

A number of counsellor and psychotherapist national groups have come together as the Psychological Therapies Forum to advise as a single voice for the professions in so far as is possible. However, a number of issues remain to be clarified. These include decisions on whether one or two professions are to be regulated, on the title or titles of the profession or professions, and on the minimum qualifications to be required of counsellors and psychotherapists. In relation to the latter, Quality and Qualifications Ireland (QQI), the successor to HETAC, has established a Standards Development Group for Counselling and Psychotherapy which aims to establish standards of knowledge, skills and competence to be acquired by candidates for educational qualifications that will be required for careers in counselling and/or psychotherapy. This is an essential prerequisite to regulation of the profession. In addition, the standards of proficiency to be required of existing practitioners for registration will need to be established and the necessary qualifications prescribed. QQI produced a draft Report to which my Department furnished a response in November 2013.

My Department will closely study the final QQI report as soon as it is available and will then engage with relevant stake holders in order to work through the outstanding issues with a view to achieving regulation of counsellors and psychotherapists as soon as possible in the best interests of the protection of the public.