Written Answers Nos. 623 - 647
623. Deputy Michael McCarthy asked the Minister for Health if he will ensure that an urgent surgical procedure is carried out in respect of a person (details supplied) in County Cork; and if he will make a statement on the matter. [25328/14]
View answerThe National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, 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 the particular query raised by the Deputy, I have asked the HSE to respond directly to him on this matter.
624. Deputy Sean Fleming asked the Minister for Health when the Health Service Executive expect to reach a decision on the approval of eculizumab in the community drugs scheme; and if he will make a statement on the matter. [25330/14]
View answerThe Health Service Executive (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 Eculizumab (Brand: Soliris) in the community drug schemes. The application was considered in line with the procedures and timescales agreed in 2012 by my Department and the HSE with the Irish Pharmaceutical Healthcare Association (IPHA). In accordance with these procedures, the National Centre for Pharmacoeconomics (NCPE) conducted a pharmacoeconomic evaluation of Eculizumab and concluded that, at a total cost per patient per year of €437,247 and a cumulative gross budget impact over 5 years estimated at €33 million, the therapy did not represent value for money for the treatment of patients in the Irish healthcare setting. In addition, the manufacturer did not include an economic model as part of their submission and failed to demonstrate the cost-effectiveness of this therapy. Consequently, the NCPE was unable to recommend reimbursement of the product under the community drug schemes. 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 high cost new medicines that is clinically appropriate, fair, consistent and sustainable. The HSE is now carefully considering all the issues which arise in relation to the proposed benefits and costs of this medicine and expects to reach a decision in the near future.
625. Deputy Dominic Hannigan asked the Minister for Health his Department's interaction with the campaign group, SOUND; and if he will make a statement on the matter. [25334/14]
View answer626. Deputy Dominic Hannigan asked the Minister for Health the Health Service Executive's interaction with the campaign group, SOUND; and if he will make a statement on the matter. [25335/14]
View answerI propose to take Questions Nos. 625 and 626 together.
Both myself and officials from my Department, the Health Service Executive and the Department of Education and Skills have met with representatives of SOUND (sufferers of unique narcolepsy disorder), on a number of occasions, to address their concerns and outline services available.
My priority as Minister for Health is to ensure that children/adolescents affected by narcolepsy with symptom onset post pandemic vaccination are provided with services and supports to meet their health needs.
The HSE and the Department of Education and Skills provide a range of services and supports to individuals diagnosed with narcolepsy following pandemic vaccination regardless of age, on an ex gratia basis. These services and supports which are co-ordinated by the HSE National Advocacy Unit are intended to provide that individuals receive tailored assistance to address their specific requirements, where appropriate. It is acknowledged that treatment and individual medical needs may need to be reassessed over time to take account of changes in their condition or circumstances.
The health supports include clinical care pathways to ensure access to rapid diagnosis and treatment, multidisciplinary assessments led by clinical experts, counselling services for both the individuals and their families, discretionary medical cards for those who have been diagnosed have been provided to allow unlimited access to GP care and any prescribed medication, reimbursement of vouched expenses incurred in the process of diagnosis and treatment, including travel expenses for attending medical appointments; physiotherapy, occupational therapy assessments, dental assessments and dietary services all on a needs basis. Regional coordinators have been appointed to assist individuals to provide advice, information and access to local services.
The HSE Advocacy Unit is in regular contact with individuals affected by narcolepsy and meets representatives of SOUND on an ongoing basis to respond to issues as they arise. I have also met with representatives of SOUND on two occasions to discuss their needs. Furthermore the Chief Medical Officer and officials from my Department, the HSE and the Department of Education and Skills have met with SOUND a number of times, the last occasion in November 2013 to address issues of concern.
627. Deputy Billy Kelleher asked the Minister for Health if he is willing to change his position and allow famprya to be covered under the long-term illness scheme; and if he will make a statement on the matter. [25339/14]
View answer735. Deputy Jack Wall asked the Minister for Health in respect of the product fampyra which has been licensed for sale in Ireland since January 2014 and is presumably considered to be a safe and efficacious treatment for symptoms of multiple sclerosis, the reason this product is not yet available under the long-term illness scheme or drugs refund scheme; if he will ensure that patients with multiple sclerosis who can benefit from this product are not required to meet the full costs from their own resources; and if he will make a statement on the matter. [26015/14]
View answer744. Deputy Seán Kyne asked the Minister for Health if consideration will be given to including the medication, fampyra, for multiple sclerosis on the long-term illness scheme; and if he will make a statement on the matter. [26118/14]
View answerI propose to take Questions Nos. 627, 735 and 744 together.
The Health Service Executive (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 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. Due to the very difficult and challenging economic environment in which the Government targeted additional savings in health expenditure of €619 million in 2014, which must be achieved while protecting front line services to the most vulnerable to the greatest extent possible, the HSE decided it was not in a position to add the drug to the List of Reimbursable Items supplied under the GMS and other community drug schemes.
It is open to the supplier, at any time, to submit a new application to the HSE incorporating new evidence which demonstrates the cost effectiveness of Fampridine. The HSE will then reconsider the application to add this product to the List of Reimbursable Items, in line with the agreed procedures and timescales for the assessment of new medicines.
In this context, I understand the manufacturer has indicated to the HSE that it intends to submit a revised application for Fampridine. The HSE will then reconsider the application in line with the agreed procedures and timescales for the assessment of new medicines.
628. Deputy Jerry Buttimer asked the Minister for Health if he will include spinal cord injuries as one of the conditions that will qualify for a medical card under the new regime that will take account of medical conditions; and if he will make a statement on the matter. [25349/14]
View answer630. Deputy Jerry Buttimer asked the Minister for Health if he will include 22Q syndrome and other congenital conditions as qualifying for a medical card under the new regime that will take account of medical conditions; and if he will make a statement on the matter. [25352/14]
View answerI propose to take Questions Nos. 628 and 630 together.
The Government has decided to develop a new policy framework for eligibility for the award of medical cards to take account of ongoing medical conditions. The HSE has established an Expert Panel to examine the range of conditions that should be considered as part of this process and has been asked to make an early report to Government.
In this context, the HSE has suspended reviews of medical cards where discretion had been exercised to take account of medical circumstances, pending the outcome of this process. This includes people who are currently in the appeals process. The HSE has extended eligibility of the individuals concerned, who are in the process of being advised in the normal way.
The Government is examining how best to address the situation of persons with serious medical conditions who had been issued with a medical card on a discretionary basis, but who have already completed the review process (and appeal process, as relevant) and who are not eligible to retain that card. The Government is examining the most effective and timely way of progressing such change.
629. Deputy Jerry Buttimer asked the Minister for Health the regulations and standards that apply in relation to home care and home support services; if private operators are subject to contracts for the provision of such services; and if he will make a statement on the matter. [25350/14]
View answerGovernment for National Recovery, 2011-2016 commits to developing and implementing national standards for home support services, which will be subject to HIQA inspection. Primary legislation and resources will be required for the introduction of a statutory regulation system for home care services, and this will be progressed in the context of overall legislative and resource priorities.
I would like to emphasise, however that statutory regulation or licensing is only one way of improving quality and safety and the HSE is already progressing a range of measures to improve Home Care provision overall, to standardise services nationally and to promote quality, and safety. These include a Procurement Framework for Home Care Services with quality and screening requirements which came into effect in 2012 and applies to services procured by the HSE from external providers. The HSE is currently undertaking a review of home care services with a view to improving services generally.
631. Deputy Clare Daly asked the Minister for Health the reason the Health Service Executive pays in excess of €2 billion for drugs used by medical card holders; and the checks in place to ensure that these persons are being appropriately charged by their pharmacy. [25353/14]
View answer636. Deputy Clare Daly asked the Minister for Health the reason massive price variations exist in prices of generic drugs between different pharmacies; and the action his Department is taking to ensure that those availing of the drug reimbursement scheme are not paying over the odds. [25368/14]
View answerI propose to take Questions Nos. 631 and 636 together.
The cost to the HSE of drugs and medicines supplied under the GMS, Drug Payment and Long Term Illness schemes amounted to 1.61 billion in 2013 and is projected to be €1.56 billion in 2014.
The State has introduced a series of reforms in recent years to reduce pharmaceutical prices and expenditure. 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 per items reimbursed is now running at 2001/2002 level.
A major new deal on the cost of drugs in the State was concluded with the Irish Pharmaceutical Healthcare Association (IPHA) in October 2012. 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 in October 2012 with the Association of Pharmaceutical Manufacturers in Ireland (APMI), which represents the generic drugs industry. Under this Agreement, the maximum price the HSE paid for generic products was 50% of the initial price of an originator medicine. Recent negotiations with the APMI have resulted in additional price reductions being agreed. From 1 May 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% to approximately 20%.
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 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. It is expected that referencing pricing will save approximately €50 million in 2014.
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 (http://www.pcrs.ie/), 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.
In addition, measures have been taken to increase price transparency among retail pharmacies. In March of this year the Pharmaceutical Society of Ireland issued guidelines to pharmacists on procedures and minimum standards of information to be provided to customers, including a requirement to provide an itemised receipt of purchase of medicines.
632. Deputy Jack Wall asked the Minister for Health the cost for a person (details supplied) who is a medical card holder for a 24-hour blood pressure monitor; and if he will make a statement on the matter. [25357/14]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
633. Deputy Dara Calleary asked the Minister for Health the situation in relation to the restoration of discretionary medical cards for cancer patients; if this development will result in all cancer patients receiving discretionary medical cards; and if he will make a statement on the matter. [25358/14]
View answer649. Deputy Michael Healy-Rae asked the Minister for Health the position regarding a medical card in respect of persons (details supplied) in County Kerry; and if he will make a statement on the matter. [25417/14]
View answer659. Deputy Tony McLoughlin asked the Minister for Health if an appeal will be considered under the discretionary medical card in respect of a person (details supplied) in County Sligo; and if he will make a statement on the matter. [25492/14]
View answerI propose to take Questions Nos. 633, 649 and 659 together.
The Government has decided to develop a new policy framework for eligibility for the award of medical cards to take account of ongoing medical conditions. The HSE has established an expert panel to examine the range of conditions that should be considered as part of this process and has been asked to make an early report to Government.
In this context, the HSE has suspended reviews of medical cards where discretion had been exercised to take account of medical circumstances, pending the outcome of this process. This includes people who are currently in the appeals process. The HSE has extended eligibility of the individuals concerned, who are in the process of being advised in the normal way.
The Government is examining how best to address the situation of persons with serious medical conditions who had been issued with a medical card on a discretionary basis, but who have already completed the review process (and appeal process, as relevant) and who are not eligible to retain that card. The Government is examining the most effective and timely way of progressing such change.
634. Deputy Seán Ó Fearghaíl asked the Minister for Health if he will arrange for an urgent surgical procedure to be provided for a child (details supplied) in County Kildare; and if he will make a statement on the matter. [25359/14]
View answerThe National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, 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 the particular query raised by the Deputy, I have asked the HSE to respond directly to him on this matter.
635. Deputy Finian McGrath asked the Minister for Health the position regarding services for children with disabilities in respect to an organisation (details supplied) in Dublin 5; and if he will make a statement on the matter. [25361/14]
View answer736. Deputy Finian McGrath asked the Minister for Health the position regarding services for children with disabilities in respect of the organisation, the Northside Forum for People with Disabilities, (details supplied) in Dublin 5. [26071/14]
View answerI propose to take Questions Nos. 635 and 736 together.
As 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 these questions to be referred to the HSE for direct reply to the Deputy.
637. Deputy Michael Moynihan asked the Minister for Health the position regarding a medical card application in respect of a person (details supplied) in County Cork [25372/14]
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.
638. Deputy Róisín Shortall asked the Minister for Health if he will abolish the medical card scheme once universal health insurance is fully implemented; if so, if he will confirm the manner in which services currently provided by the medical card scheme will be provided; and if the State or health insurers will determine and fund these services. [25387/14]
View answerUniversal Health Insurance (UHI) will require a new system of eligibility, based on a legally defined basket of services. The basket will comprise a UHI standard package of services and services that will continue to be funded directly by the Exchequer. The exact composition of the basket of services under UHI will be considered by an Expert Commission which will be established shortly. At a minimum it is expected that the UHI standard insurance package will cover GP services, acute hospital services and acute mental health services.
There will be a new financial support system and those individuals on the lowest income will receive a full subsidy to cover the compulsory premium for their healthcare. It is my intention that medical card holders will continue to receive the same range of benefits under UHI as they currently receive. In terms of future funding arrangements, services included in the standard UHI package will be purchased by the insurers. Insurers will be funded by the premiums paid directly by individuals to their chosen insurer and by the subsidies provided by the Government on behalf of those who qualify. Services in the overall health basket but outside of the UHI standard package will continue to be funded by a combination of Exchequer and out-of-pocket payments as at present.
639. Deputy James Bannon asked the Minister for Health if he will expedite an appointment in respect of a person (details supplied) in County Longford; and if he will make a statement on the matter. [25389/14]
View answerThe National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, 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 the particular query raised by the Deputy, I have asked the HSE to respond directly to him on this matter.
640. Deputy James Bannon asked the Minister for Health when a person (details supplied) in County Westmeath will be reissued with a discretionary medical card. [25390/14]
View answer695. Deputy James Bannon asked the Minister for Health the position regarding a discretionary medical card in respect of a person (details supplied) in County Longford; and if he will make a statement on the matter. [25834/14]
View answerI propose to take Questions Nos. 640 and 695 together.
The Government has decided to develop a new policy framework for eligibility for the award of medical cards to take account of on-going medical conditions. The HSE has established an expert panel to examine the range of conditions that should be considered as part of this process and has been asked to make an early report to Government.
In this context, the HSE has suspended reviews of medical cards where discretion had been exercised to take account of medical circumstances, pending the outcome of this process. This includes people who are currently in the appeals process. The HSE has extended eligibility of the individuals concerned, who are in the process of being advised in the normal way.
The Government is examining how best to address the situation of persons with serious medical conditions who had been issued with a medical card on a discretionary basis, but who have already completed the review process (and appeal process, as relevant) and who are not eligible to retain that card. The Government is examining the most effective and timely way of progressing such change.
641. Deputy Jack Wall asked the Minister for Health the position regarding disability services in an area (details supplied); and if he will make a statement on the matter. [25391/14]
View answerThe Health Service Executive has recognised the need to increase the level of consistency and standardisation in the way services for children with disabilities are delivered. It is currently engaged in a reconfiguration of existing therapy resources to multidisciplinary geographic based teams for children as part of its National Programme on Progressing Disability Services for Children and Young People (0-18 years).
The aim of the Progressing Disability Services for Children and Young People Programme is to achieve a national, unified approach to delivering disability health services so that there is a clear pathway to services for all children, regardless of where they live, what school they go to or the nature of their disability.
The Programme is organised at national, regional and local level and includes representatives from the health and education sectors, non-statutory service providers and parents. An additional €4m has been specifically allocated in 2014 to drive implementation of the Programme. This equates to approximately 80 therapy posts.
As the specific issue raised by the Deputy is an operational matter for the HSE I have arranged for the Deputy's question to be referred to the Executive for direct reply to him.
642. Deputy Dominic Hannigan asked the Minister for Health if he has been notified by each hospital of its policies for the release of medical records to persons who were raised in mother and baby homes, industrial schools or adopted and whose mothers and fathers have passed away and who need access to their family's medical records for health reasons; if the Supreme Court decision of 2011 where the Rotunda Hospital won a case against a person seeking the medical records of a paternal grandfather who had passed away has had an impact on the ability of persons to get family medical records, even if they were raised in mother and baby homes, industrial schools or adopted; if his Department has had any communication with the Data Protection Commissioner in relation to this court case and its implications; if his Department has spoken with each individual hospital regarding this court case and its impact on persons' access to medical records; if his Department has not made these requests or contacted each individual hospital, if the Health Service Executive has done so; if the HSE has done so, whether it is possible to get a list of each hospital and each of their individual policies on the granting of medical records to family members raised in mother and baby homes, industrial schools or adopted and whose mothers and fathers have passed away; and if he will make a statement on the matter. [25392/14]
View answerThe principle underlying legislation governing the release of information is that it is the duty of public bodies to release information to the greatest extent possible consistent with the public interest and the right to privacy. In line with the Programme for Government, the Freedom of Information Bill, due to be enacted later this year, provides for a general right of access to records held by public bodies. It sets out that in applying exemptions, the right of access should only be set aside where the exemptions very clearly support a refusal of access. This is intended to overcome any uncertainty inadvertently caused by the Supreme Court judgment in the Rotunda case referred to by the Deputy.
When dealing with requests for records from parents or guardians or requests relating to deceased persons, my Department and the HSE must abide by the Freedom of Information and Data Protection Acts. S.I. 387 of 2009 deals with this issue and the Minister for Finance issued a Guidance Note (http://foi.gov.ie/files/2010/09/Guidance_Notes_Sept_09.pdf), to assist staff in the HSE and Tusla, the Child and Family Agency, in this regard.
The Department of Finance Freedom of Information Central Policy Unit advised public bodies that requests for personal information under the Freedom of Information Acts should be taken as a request under the Data Protection Acts and when considering refusing access, should check that such refusal is permitted under the Data Protection Acts and vice versa.
I am referring the remainder of the Deputy's question to the HSE for direct reply.
643. Deputy Patrick O'Donovan asked the Minister for Health further to Parliamentary Question Nos 744 and 745 of 18 February 2014, when replies will issue; and if he will make a statement on the matter. [25393/14]
View answerI wish to inform the Deputy that the information requested in relation to the amounts of bad debts resulting from unpaid hospital bills is being finalised and will be sent to the Deputy by the HSE shortly.
The information requested in relation to the amounts of uncollected revenue from private health insurance companies was issued to the Deputy by the HSE on the 24th March.
644. Deputy Robert Troy asked the Minister for Health if a person (details supplied) in County Westmeath will receive an appointment at the eye and ear hospital without further delay. [25398/14]
View answerShould 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.
645. Deputy Brian Walsh asked the Minister for Health if a medical card review will be expedited in respect of a person (details supplied) in County Galway; and if he will make a statement on the matter. [25403/14]
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.
646. Deputy Noel Harrington asked the Minister for Health the reason the availability of souvenaid has been removed from a medical card holder (details supplied), who has Alzheimer's disease; if there are any proposals to have it made available again; and if he will make a statement on the matter. [25410/14]
View answerThe Health Service Executive is responsible for the administration of the primary care schemes, therefore, the HSE has been asked to examine the specific issue raised by the Deputy and to reply to him as soon as possible.
647. Deputy Michael Healy-Rae asked the Minister for Health the position regarding a medical card in respect of persons (details supplied) in County Kerry; and if he will make a statement on the matter. [25412/14]
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.
