Question No. 15 answered with Question No. 11.

Question No. 16 answered with Question No. 6.

Tobacco Control Measures

Question No. 18 answered with Question No. 6.

Questions Nos. 19 and 20 answered with Question No. 13.

Question No. 21 answered with Question No. 6.

Questions (17)

Maureen O'Sullivan

Question:

17. Deputy Maureen O'Sullivan asked the Minister for Health his reasons for banning a smoking cessation aid which has been effective for long-term smokers trying to cease tobacco smoking; if there have been tests on electronic cigarettes and electronic vapour devices which determined his decision; and if he will make a statement on the matter. [21152/14]

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Written answers (Question to Health)

I would like to thank the Deputy for her question. As I have not introduced any measures on the area to date, I assume the Deputy is referring to the recent announcement by the Health Service Executive that the use of e-cigarettes will no longer be permitted in any of its facilities or campuses. The ban commenced on 1 May, as part of the HSE’s Tobacco Free Campus policy, which, in line with Tobacco Free Ireland, our national policy, aims to denormalise smoking and to protect the health of staff and patients.

The HSE has told me that the decision was taken because e-cigarettes pose a challenge to smoke-free campus enforcement and come with safety concerns for a healthcare environment. Taking into consideration the practical issues, the HSE has decided that e-cigarettes should be prohibited on campuses in the same way as tobacco products. However, the Executive has committed to reviewing this policy as new evidence becomes available.

Contrary to the Deputy’s statement regarding smoking cessation aids, the majority of e-cigarettes are not presented by their manufacturers as a smoking cessation aid, and they are therefore not licensed as such.

A World Health Organisation Study Group Report concluded that the safety and extent of nicotine uptake from e-cigarettes has not been established and that not enough scientific evidence existed to validate the claim that the products were smoking cessation aids. The Report also notes that the delivery of nicotine to the lung might be dangerous and that it was of global importance to address lung delivery in scientific studies. Further research and clinical trials were recommended.

The European Tobacco Products Directive, which will come into force later this month, provide for the regulation of e-cigarettes. The Tobacco Directive will:

- set mandatory safety and quality requirements e.g. on nicotine content, ingredients and devices, as well as refill mechanisms etc., for e-cigarettes,

- make health warnings and information leaflets obligatory,

- introduce notification requirements for manufacturers and importers of e-cigarettes

- impose stricter rules on advertising and monitoring of market developments.

In addition, it is my intention to introduce further regulation on e-cigarettes in the near future.

Question No. 18 answered with Question No. 6.
Questions Nos. 19 and 20 answered with Question No. 13.
Question No. 21 answered with Question No. 6.

Hospital Staff

Questions (22)

Richard Boyd Barrett

Question:

22. Deputy Richard Boyd Barrett asked the Minister for Health the measures his Department will put in place to address the failures to implement a European Court of Justice ruling on working time which was made more than ten years ago; and if he will make a statement on the matter. [17476/14]

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Written answers (Question to Health)

The provisions of the European Working Time Directive (EWTD) encompass a number of measures to protect workers' welfare and safety, including a maximum 48 hour working week - averaged over a reference period, daily and weekly rest periods and the granting of compensatory rest where the working day exceeds 13 hours. Under the Directive, the 48 hour average working week became a requirement for NCHDs with effect from 1 August 2009. The Directive has been fully transposed into Irish law.

I have emphasised to the HSE the importance of achieving EWTD compliance as soon as possible. The HSE has been working intensively to advance implementation of the Directive in respect of NCHDs and considerable progress has been made over the last 12 months. HSE data shows that average working hours for NCHDs in 2009 was 60 hours a week, 54 hours per week in 2012 and 51.4 hours in the second half of 2013.

Intensive negotiations conducted at the Labour Relations Commission in September and October resulted in agreement on a joint approach, involving hospital management, the IMO and NCHDs to achieve EWTD compliance. The agreement focused in particular on steps to be taken in the period up to the NCHD rotation on 13 January 2014 to eliminate shifts in excess of 24 hours. In January and February this year progress made by acute hospitals on achieving compliance with the agreed maximum 24 hour shift target was assessed. That assessment showed that the majority of hospitals had made significant progress with over 90% compliance. Fines were imposed on 10 hospitals in March where progress was deemed unsatisfactory.

NCHD recruitment and retention is required in order to facilitate the achievement of EWTD compliance. Achievement of full compliance will also require reorganisation of the delivery of certain services within Hospital Groups. The number of NCHDs in the public health system has increased by over 200 in recent years and now exceeds 4,900. However, there are international shortages of NCHDs in certain categories and specialties. There are also some hospitals to which it has been difficult to attract NCHDS, for a range of reasons including training opportunities and rural location. Where feasible consultant recruitment is being pursued as an alternative to the use of NCHDs.

I set up the MacCraith Group to undertake a Strategic Review of Medical Training and Career structure last summer. Its work will support the attainment of EWTD compliance. The Group is to make recommendations aimed at improving the retention of medical graduates in the public health system, planning for future service needs and achieving the maximum benefit from investment in medical education and training. It provided an Interim Report in December 2013 focusing on training and last month provided a further report covering career structures and pathways following training. The Group is to provide a final report, encompassing workforce planning, by the end of June 2014.