Written Answers Nos. 156-180
156. Deputy Bernard J. Durkan asked the Minister for Justice and Equality when a current and valid stamp 4 will be returned to a person (details supplied) in County Carlow who was in full-time employment here on foot of a work permit for eight years but had to return to their homeland for family reasons; and if she will make a statement on the matter. [30627/14]
View answerI am advised by the Irish Naturalisation and Immigration Service (INIS) of my Department that applicant was granted Long-Term Residency permission on 9 September 2010. I understand that the applicant's permission remains valid and has not to date been withdrawn. I am further advised that information made available to INIS indicates that since the granting of his Long-Term Residency in September 2010, the applicant was not resident in the State for a period in excess of three years. As the person concerned has been outside the State for a number of years, they should be advised to write to the Residence Division, Unit 3, INIS, 13-14 Burgh Quay with regard to their permission in the State.
Queries in relation to the status of individual immigration cases may be made directly to the INIS by e-mail using the Oireachtas Mail facility which has been specifically established for this purpose. This service enables up-to-date information on such cases to be obtained without the need to seek information by way of the Parliamentary Questions process. The Deputy may consider using the e-mail service except in cases where the response from the INIS is, in the Deputy's view, inadequate or too long awaited.
157. Deputy Bernard J. Durkan asked the Minister for Justice and Equality the progress to date in determination of eligibility for naturalisation in the case of a person (details supplied) in Dublin 24; and if she will make a statement on the matter. [30634/14]
View answerOfficials in the Citizenship Division of the Irish Naturalisation and Immigration Service (INIS) inform me that there is no record of an application for a certificate of naturalisation from the person referred to in the Deputy's question, who currently has permission to remain in the State until 15 August 2014.
Section 15 of the Irish Nationality and Citizenship Act 1956, as amended, provides that the Minister may, in her absolute discretion, grant an application for a certificate of naturalisation provided certain statutory conditions are fulfilled. The conditions are that the applicant must:
- be of full age
- be of good character
- have had a period of one year's continuous residency in the State immediately before the date of application and, during the eight years immediately preceding that period, have had a total residence in the State amounting to four years
- intend in good faith to continue to reside in the State after naturalisation
- have, before a judge of the District Court in open court, in a citizenship ceremony or in such manner as the Minister, for special reasons, allows—
(i) made a declaration, in the prescribed manner, of fidelity to the nation and loyalty to the State, and
(ii) undertaken to faithfully observe the laws of the State and to respect its democratic values.
A foreign national who is married to, or is the civil partner of, an Irish citizen for at least three years may apply for naturalisation under section 15A of the Irish Naturalisation and Citizenship Act 1956, as amended, where they have been continuously resident in the island of Ireland for the year immediately prior to the date of their application and for two out of the four years prior to that year. The marriage or civil partnership must be subsisting and recognised under Irish law. Section 15A provides that the Minister may waive certain conditions for naturalisation if satisfied that the applicant would suffer serious consequences in respect of his or her bodily integrity or liberty if not granted Irish citizenship.
Section 16 of the Irish Nationality and Citizenship Act 1956, as amended, provides that the Minister may, in her absolute discretion, waive some or all of the statutory conditions in certain circumstances i.e. where an applicant is of Irish descent or of Irish associations; where an applicant is a person who is a refugee within the meaning of the United Nations Convention relating to the Status of Refugees; or where an applicant is a Stateless person within the meaning of the United Nations Convention relating to the Status of Stateless persons. It is open to any individual to lodge an application for citizenship if and when they are in a position to meet the statutory requirements as prescribed in the Irish Nationality and Citizenship Act 1956 as amended.
Queries in relation to the status of individual immigration cases may be made directly to INIS by e-mail using the Oireachtas Mail facility which has been specifically established for this purpose. This service enables up to date information on such cases to be obtained without the need to seek information by way of the Parliamentary Questions process. The Deputy may consider using the e-mail service except in cases where the response from INIS is, in the Deputy's view, inadequate or too long awaited.
158. Deputy Bernard J. Durkan asked the Minister for Justice and Equality the current position in regard to determination of entitlement to residency and-or naturalisation in the case of persons (details supplied) in Dublin 15; and if she will make a statement on the matter. [30635/14]
View answerI am advised by the Irish Naturalisation and Immigration Service (INIS) of my Department that two of the persons referred to by the Deputy are documented on INIS records while the third person referred to is not. The first two persons referred to were granted permission to remain in the State in August, 2007 for an initial three year period, valid to 14th August, 2010. Their respective permissions to remain were renewed for a further three year period in August, 2010, valid to 14th August, 2013 in both cases. These renewal decision letters were both dated 4th August, 2010.
These renewal decision letters advised the persons concerned of the requirement that they apply for further renewal of their permission to remain one month before their existing permission expired. Given that there is no record of any such renewal applications having been lodged to date, it is recommended that the persons concerned would proceed to do so without further delay. As stated above, the third person referred to by the Deputy is not currently documented on INIS records.
In the event that any of the persons referred to by the Deputy are seeking to obtain a Certificate of Registration from the Garda National Immigration Bureau, they will be required to produce a valid passport to attest to their identity and nationality. In the event that they cannot produce a valid passport, they will be required to provide a satisfactory explanation of the circumstances which prevent their doing so. Any such explanation will need to be backed up by documentary evidence.
Queries in relation to the status of individual immigration cases may be made directly to the INIS of my Department by e-mail using the Oireachtas Mail facility which has been specifically established for this purpose. This service enables up to date information on such cases to be obtained without the need to seek information by way of the Parliamentary Questions process. The Deputy may consider using the e-mail service except in cases where the response from the INIS is, in the Deputy's view, inadequate or too long awaited.
159. Deputy Catherine Murphy asked the Minister for Justice and Equality if she will list and itemise the title and reference of every statutory instrument signed by her from 1 May 2014 to date in tabular form; and if she will make a statement on the matter. [30655/14]
View answerAs the Deputy will be aware Statutory Instruments are laid before both Houses of the Oireachtas. This process is done electronically which facilitates the Oireachtas Library and Research Service when inputting details of these documents on their catalogue which is now available on-line. Consequently readers can now search the on-catalogue, which is updated regularly, for Statutory Instruments and other documents. This search facility can be accessed via the following link, http://opac.oireachtas.ie/liberty/libraryHome.do.
The Deputy will also be aware that details of documents laid before the Houses are included on Order Papers. In addition, I understand that the Oireachtas Library and Research Service sends a weekly e-mail (usually on a Tuesday) to all Members of the Oireachtas listing the documents that have been laid before the Houses the week before. These e-mails also provide links to the full text of all the documents. Accordingly, the information that the Deputy is seeking is available to her electronically from the facilities provided and maintained by the Oireachtas Library and Research Service.
160. Deputy Joan Collins asked the Minister for Health the number of over 70s medical card holders who have received letters regarding a review of their cards; the number of single over 70s medical card holders who have lost their card; the number of couples in receipt of the over 70s medical card who have lost their cards; and if he will provide a tabular breakdown of the number who have lost the card because they are over the limit by from €1 to €5 , €51 to €100, and €101 to €150, respectively. [30411/14]
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.
161. Deputy Brian Stanley asked the Minister for Health his views on the fact that time sheets for ambulance crews in Mullingar, Edenderry, Birr, parts of Laois and Tullamore are being collected by taxi from Longford, when ambulances travel to the same locations on a daily basis. [30427/14]
View answerAs this is a service matter, I have asked the HSE to respond directly to the Deputy.
162. Deputy Brian Stanley asked the Minister for Health if his attention has been drawn to the fact that fire service ambulances in Mullingar are often taken off the road for several hours while transporting and waiting for patients whom they carry 400 m between St. Mary's day care centre and Mullingar hospital; and his views on whether this is an efficient deployment of resources. [30428/14]
View answerAs this is a service matter, I have asked the HSE to respond directly to the Deputy.
163. 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. [30412/14]
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.
164. 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. [30413/14]
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.
165. Deputy Sandra McLellan asked the Minister for Health the reason a GP referral is not enough for a patient with severe difficulty walking to receive crutches; and if he will make a statement on the matter. [30435/14]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
166. Deputy Michael McGrath asked the Minister for Health if a person (details supplied) who receives regular warfarin injections at their GP's surgery at a cost of €20 each time may receive these for free under the medical card scheme. [30443/14]
View answerAs this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.
167. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide in tabular form the annual net and gross saving to the Exchequer, following the implementation of the Haddington Road agreement, if hospital consultant pay was capped at €150,000 per annum. [30451/14]
View answerAs this question relates to an operational matter, I have referred it to the HSE for direct reply.
168. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide the annual saving to the Exchequer if the full economic cost of the use of beds in public and voluntary hospitals for the purposes of private medical practice were paid for by private insurance operators. [30452/14]
View answer183. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the additional revenue which would be raised if all private patients in public hospitals were charged in full for services provided rather than being charged a maintenance or per diem charge; and if he will make a statement on the matter. [30467/14]
View answerI propose to take Questions Nos. 168 and 183 together.
As I previously replied to Deputy McDonald in October 2013, the HSE has estimated that the additional revenue if the full economic cost of private in-patient services, calculated on the basis of historic casemix data, were paid by the private patients, it could amount to €107 million.
169. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the number of Health Service Executive public sector workers in receipt of salaries within the bands (details supplied). [30453/14]
View answerAs this relates to an operational matter, I have referred the question to the HSE for direct reply.
170. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide in tabular form the total Health Service Executive budget for each of the years 2011, 2012, 2013 and to date in 2014; and if he will provide the same broken down by directorate, primary care, acute services, social care, health and well-being, mental health and corporate. [30454/14]
View answerThe information requested is being compiled by my Department and will be forwarded to the Deputy as soon as possible.
171. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the annual average cost of employing a basic grade Health Service Executive staff nurse. [30455/14]
View answer172. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the annual average cost of employing a basic grade Health Service Executive social worker. [30456/14]
View answer173. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the annual average cost of employing a basic grade Health Service Executive midwife. [30457/14]
View answer177. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the annual average cost of employing a Health Service Executive hospital consultant. [30461/14]
View answerI propose to take Questions Nos. 171 to 173, inclusive, and 177 together.
As these questions relate to operational matters, I have referred them to the HSE for direct reply.
174. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide in tabular form the total State spend on medicines in 2011, 2012, 2013 and to date in 2014; and if he will provide a breakdown of same by scheme between generic and patented medicines. [30458/14]
View answerThe information requested by the Deputy is not routinely available in the Department, therefore I have asked the Health Service Executive to reply directly to the Deputy.
175. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the measures introduced to promote the increased use of generic medicines; the practical implication of same; the amount saved to date; the estimated savings which would be realised by extending this scheme to the next ten most common medicines; and if he will make a statement on the matter. [30459/14]
View answer180. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will quantify the full-year savings that would be realised from the immediate introduction of generic substitution for the 60 most commonly used off-patent medications, excluding AEDs; and if he will provide detail of same based on reference pricing at 70% below branded equivalent, by cost and by volume. [30464/14]
View answerI propose to take Questions Nos. 175 and 180 together.
Under the EU/IMF Programme of Financial Support, Ireland committed to increasing the share of generic drug usage in the medium-term. My Department set a target of achieving 70% generic penetration of the off-patent market by volume by 2016. In Quarter 1 2014 generic products accounted for almost 63% of the total off-patent market by volume.
A number of enabling measures are being implemented to achieve this target, in particular, the introduction of generic substitution and reference pricing under the Health (Pricing and Supply of Medical Goods) Act 2013. In addition, it is intended to amend the relevant regulations to provide for the mandatory inclusion of the International Non-Proprietary Name (INN) on all prescriptions. Under the legislation, the Health Products Regulatory Authority (HPRA) has statutory responsibility for establishing and maintaining a list of interchangeable medical products. In doing so, the HPRA is required to have regard to a comprehensive set of qualifying conditions, all of which must be complied with before a decision is taken to make a medicinal product interchangeable. A key objective of the Act is to enable patients to opt for lower cost interchangeable generic medicines. Previously, when a specific brand of medicine was prescribed for a patient, a pharmacist could only supply that particular brand, even when less expensive generic versions of the same medicine were available. The Act now permits pharmacists to substitute medicines prescribed, provided that they have been designated as safely interchangeable by the HPRA.
Generic substitution coupled with reference pricing provides patients with an incentive to opt for the cheapest available product, but does not impose any unavoidable additional costs on patients. In general terms, when a pharmacist is presented with a prescription for an interchangeable medicine, which is not the subject of a clinical exemption, the pharmacist is obliged to offer the patient the opportunity to agree to substituting the prescribed product with an interchangeable medicine which is in stock in the pharmacy and is of lower cost to the patient or the HSE, as the case may be. The patient may either accept the interchangeable medicine offered by the pharmacist or opt to receive the branded interchangeable medicine where prescribed. Alternatively, the patient may opt to go to a different pharmacy to receive a less expensive interchangeable medicine.
Generic substitution is being introduced incrementally with the HPRA prioritising those medicines which will achieve the greatest savings for patients and the State. The Authority is in the process of reviewing an initial 40 active substances in accordance with the processes and timescales set out in the legislation. To date the HPRA has completed the assessment of 25 active substances and has updated the List of Interchangeable Medicinal Products accordingly. It is expected that assessment for interchangeability of the first 40 priority active substances (representing 80% of the off-patent market by value) will be completed by end 2014. This process will continue until all medicinal products on the List of Reimbursable Items have been assessed. Full details and information concerning the designation of products as interchangeable is available on the HPRA website through the following link: www.hpra.ie.
The Act also allows the HSE to set a reference price for groups of interchangeable medicines. 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 HSE sets reference prices for each group of interchangeable products in accordance with the criteria set out in section 24(3) of the legislation as follows:
(a) the ability of suppliers of the relevant listed items to meet patient demand for the relevant listed items;
(b) the value for money afforded by the relevant listed items;
(c) the equivalent relevant prices (if practicably available) of the relevant listed items in all other Member States where one or more than one of the relevant listed items is marketed;
(d) the relevant prices of therapeutically similar listed items;
(e) the resource available to the Executive; and
(f) the terms of any agreements in place (whether entered into before, on or after the commencement of this section) between the Executive and any representative body of the suppliers of drugs, medicines, or medical or surgical appliances where the agreement relates, whether directly or indirectly, to the price of one or more of those items.
The first reference price for atorvastatin products was implemented on 1 November 2013. The HSE has continued to implement reference prices for Lists of Interchangeable Medicinal Products published by the HPRA in accordance with the procedures and timescales set out in the 2013 Act. To date the HSE has implemented reference prices for 14 of the 25 interchangeable lists resulting in reductions of between 70% and 20% in the prices paid by the HSE for these products compared to May 2013. In addition, the HSE will implement reference prices for a further six lists of interchangeable medicines on 1 August 2014.
The HSE will continue the process of setting reference prices for the remaining groups of interchangeable medicinal products published by the HPRA in accordance with the processes and timescales 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 resulting in further significant reductions in the price of generic medicines. Reference prices will ensure that generic prices in Ireland will fall towards European norms. Full details and information concerning the implementation of reference pricing is available on the HSE website through the following link: www.hse.ie.
It is expected that referencing pricing will save approximately €50 million in 2014. However, it is not possible at this stage to provide accurate figures regarding the potential savings to be generated from extending reference pricing beyond the initial 40 priority active substances, as this depends on various factors including prevailing prices, number of competitors, availability of substitute products, and market dynamics. However, it is the HSE's policy to set reference prices that maximise the savings for the State and patients consistent with protecting continuity of supply for essential medicines in the Irish market. Consequently reference prices will not be set so low as to jeopardise the supply of the relevant medicines.
176. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the annual average cost of providing a fully resourced Health Service Executive ambulance service. [30460/14]
View answerAs this is a service matter, I have asked the HSE to respond directly to the Deputy.
178. Deputy Caoimhghín Ó Caoláin asked the Minister for Health his views on whether the full implementation of the recommendations of the PA consulting report and action plan of September 2012 addressing weaknesses in financial management and cost containment within the Health Service Executive could deliver savings of 5% of the total HSE budget; and if he will make a statement on the matter. [30462/14]
View answerFinancial Reform is a key element of Future Health - A Strategic Framework for Reform of the Health Service 2012 – 2015. Following on from the report referred to by the Deputy, the HSE commenced the Finance Reform Programme in Autumn 2012. Central to the establishment of this programme was the recognition that successful implementation of Future Health and the wider reform agenda will require fundamental changes in the way financial management is delivered across the health system in Ireland. The successful delivery of these reforms is dependent on having robust financial systems and reporting in place to meet future requirements, as current practices are not sustainable in the emerging landscape.
One of the main outputs of Phase 1 of the programme was the development of a new operating model for finance in health which was contained in the document entitled Defining Financial Management: A Finance Operating Model for Health in Ireland. This was endorsed in September 2013 by the Finance Reform Board and there was also a presentation to me as Minister for Health on key elements of the Programme and the proposed next steps. This report encompasses a roadmap for the finance function to facilitate delivery of an efficient and effective financial service to meet the emerging requirements of the changing organisational face of the Health System.
A critical enabler for the transformation of financial management is the introduction of a single Integrated Financial Management System (IFMS) which is considered to be the single most important non-clinical priority for the HSE this year. A detailed business case for a new operating model has been submitted to my Department and the Department of Public Expenditure and Reform in relation to securing the necessary approval to procure a new Integrated Financial Management System (IFMS) for the health service. A new integrated financial system will greatly enhance the health sector's ability to effectively manage and monitor its budget at all levels.
179. Deputy Caoimhghín Ó Caoláin asked the Minister for Health in view of the fact that the ESRI report, Delivery of Pharmaceuticals in Ireland - Getting a Bigger Bang for the Buck, published in January 2012, stated that prices of new pharmaceuticals, subject to patent protection, could be reduced further by setting the ex-factory price with reference to the lowest-priced comparator member state and that an examination of data from recent years suggests prices would decline by 20% to 25% if such an approach were adopted, to quantify the savings which could be made by introducing this measure with immediate effect; and if he will make a statement on the matter. [30463/14]
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. Therefore the matter has been referred to the HSE for attention and direct reply to the Deputy.
