Written Answers Nos. 141-152
142. Deputy Joanna Tuffy asked the Minister for Health the reason there is such a discrepancy in the price of drugs here compared to other European countries (details supplied); his plans to give cancer patients access to free medication during the course of their treatment; and if he will make a statement on the matter. [38700/14]
View answerThe prices of drugs vary between countries for a number of reasons, including different prices set by manufacturers, different wholesale and pharmacy mark-ups, different dispensing fees and different rates of VAT.
The Government has introduced a series of reforms in recent years to reduce the prices of drugs and medicines which are paid for by the HSE. This has 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 cost per items reimbursed is now running at 2001/2002 levels.
A major new deal on the cost of originator drugs in the State was concluded with the Irish Pharmaceutical Healthcare Association (IPHA) in October 2012. This agreement provides that prices are referenced to the currency adjusted average price to wholesaler in nine EU member states (Austria, Belgium, Denmark, Finland, France, Germany, Netherlands, Spain, and UK) and these are the maximum prices paid by the HSE for originator drugs supplied through the community drug schemes. 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 with the Association of Pharmaceutical Manufacturers in Ireland (APMI), which represents the generic drugs industry, in 2012. Under this Agreement the maximum price the HSE pays for generic products was 50% of the initial price of an originator medicine, this was further reduced to 40% from 1 May 2014. This has resulted in the price differential between off-patent drugs and most generic equivalents increasing from 5% to approximately 20%.
The Health (Pricing and Supply of Medical Goods) Act 2013 introduces 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. 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 estimated that reference pricing will yield €50 million in savings in 2014.
The reference price for Anastrozole is €28 per pack of 28 tablets with effect from 1 May 2014. In setting the reference price the HSE took account of prices across the EU, where there is significant variation in price, and sought to balance value for money versus sustainability of supply in a small market. The reference price represents a 39% reduction and is subject to review on an annual basis.
In the case of drugs and medicines which are reimbursed 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. It would nonetheless be disappointing 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.
There are no plans to extend access to free medication to cancer patients specifically under the community drugs schemes. Support for the cost of medication is provided under the Drug Payment Scheme, whereby no individual or family pays more than €144 per calendar month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals incurring ongoing expenditure on medicines.
In addition, people who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card. In the assessment process, the Health Service Executive can take into account medical costs incurred by an individual or a family.
143. Deputy Seán Crowe asked the Minister for Health if he will provide a breakdown on the average waiting time for an appointment for the adult vascular outpatient department in the Adelaide and Meath Hospital in Tallaght, Dublin 24. [38709/14]
View answerAs this is a service matter, I have asked the HSE to respond directly to the Deputy.
144. Deputy Seán Crowe asked the Minister for Health in view of the Prospectus report in 2009, that suggests 579 intensive care unit beds were needed by 2020, if he will confirm that there were 289 ICU beds in 2009; if he will confirm that there are now 233 ICU beds; and his plans to improve this situation that is undermining the health and well-being of critically ill patients. [38710/14]
View answerThe HSE commissioned Prospectus management consultancy in 2008 to undertake an independent review of the existing adult critical care provision and an assessment of the future requirements to the year 2020 thus enabling planning for a future model of critical care based on evidence. This review placed significant emphasis on international best practice and the application of these practices to existing service provision in Ireland.
The major deliverable of the review was a detailed report based on three key components: capacity and data, work practices, admission polices & related clinical issues. The report recommended that the number of critical care beds should increase from 289 to 579 over the period 2010 to 2020. It also recommended a model for the delivery of adult critical care that is underpinned by a network approach, whereby ‘hub’, ‘spoke’, and ‘local’ hospitals work together to provide the patient with safe and high quality critical care, in a timely manner. At the time of the 2008 report adult critical care services were provided in 37 hospitals (52 units) across the country, including in a number of the smaller hospitals where beds were described as critical care beds but in practice treated low volumes of critical care patients. The report has informed the work of the HSE critical care clinical programme which was subsequently established.
On behalf of HSE operations, the critical care programme completes an annual census to collate each hospital provider's critical care bed capacity and medical and nursing staffing establishment. Based on the 2014 national census of critical care beds, there are 233 adult critical care beds in public hospitals. The HSE has advised that while there has been a net reduction in the number of critical care beds nationally, the HSE and the Critical Care Programme are working to ensure more appropriate referral of patients requiring higher levels of critical care to major hub hospitals identified by the HSE as meeting a number of criteria in relation to activity volume and strategic importance for the future. The HSE is focused on delivering improvements in the way that critical care is organised and delivered within the hospital group structure to ensure patients receive the same high quality of care no matter where they are treated. There is now a more co-ordinated approach to the planning and delivery of critical care, within and across hospital groups, with a focus on small hospitals managing routine urgent or planned care locally and more complex critical care managed in the larger hub hospitals where the relevant clinical critical care expertise can be provided.
The further development of critical care facilities is being considered in the context of service planning process for 2015.
145. Deputy Ciara Conway asked the Minister for Health if he will provide an update on the palliative care unit in Waterford University Hospital; the timeframe for same; the progress to date; when he expects the unit will be operational; and if he will make a statement on the matter. [38713/14]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
146. Deputy Ciara Conway asked the Minister for Health if he will provide a breakdown, in tabular form, of the level of Health Service Executive funding received by each of the hospice groups nationally for each of the past five years; and if he will make a statement on the matter. [38714/14]
View answer147. Deputy Ciara Conway asked the Minister for Health if he will provide a breakdown, in tabular form, of the annual running costs for each of the hospice groups nationally for each of the past five years; and if he will make a statement on the matter. [38715/14]
View answer148. Deputy Ciara Conway asked the Minister for Health if he will provide a breakdown, in tabular form, of the level of Health Service Executive funding received by each of the hospice groups expressed as a percentage of the annual running costs for each of the hospice groups nationally for each of the past five years; and if he will make a statement on the matter. [38716/14]
View answerI propose to take Questions Nos. 146 to 148, inclusive, together.
As these are service matters they have been referred to the Health Service Executive for direct reply.
149. Deputy Seán Kenny asked the Minister for Health if he will confirm that the ambulance service provided from Kilbarrack fire station will not be withdrawn; and if he will make a statement on the matter. [38743/14]
View answerAmbulance services in the Dublin area are provided by Dublin Fire Brigade under an agreement between Dublin City Council and the HSE. Distribution of resources within the city is a matter, in the first instance, for Dublin Fire Brigade.
The Deputy may wish to note that an independent review of emergency ambulance services in Dublin is currently under way to determine the best model of ambulance provision for the city, including distribution of services. The review was commissioned by Dublin City Council and the HSE and is being carried out by the UK Association of Ambulance Chief Executives. I am advised that the review is expected to be completed in the New Year.
150. Deputy Catherine Murphy asked the Minister for Health the public dental health services available to children in post-primary education in County Kildare who are covered by a medical card; and if he will make a statement on the matter. [38754/14]
View answer151. Deputy Catherine Murphy asked the Minister for Health the public dental health services available to children in post-primary education in County Kildare if they are not covered by a medical card or health insurance; and if he will make a statement on the matter. [38756/14]
View answer169. Deputy Catherine Murphy asked the Minister for Health the public dental health services that are available to children in post-primary education in County Kildare; and if he will make a statement on the matter. [38807/14]
View answerI propose to take Questions Nos. 150, 151 and 169 together.
Dental services for children up to 16 years of age and persons of all ages with special needs are provided by the Public Dental Service of the HSE through its dental clinics. All HSE dental clinics prioritise emergency care for children up to 16 years of age, treatment for special needs patients and screening of children aged from 11 to 13 years, including referral for orthodontic services where necessary. Other services, including screening of children 6 to 8 years, are provided but may be deferred in clinics where there is pressure on resources.
The Dental Treatment Service Scheme (DTSS) provides access to dental treatment for medical card holders over the age of 16. All medical card holders are entitled to specific dental treatments e.g., an annual dental examination, two fillings in each calendar year, extractions as necessary. Additional treatments are available to persons with specific medical conditions including persons in receipt of care or services for a disability and persons on a register of disability.
152. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question No. 80 of 30 September 2014, in addition to the measures that he will be undertaking, if he will initiate an immediate awareness campaign among local autism groups, schools, general practitioners, and online, warning people of the dangers of MMS and CD, as there are citizens taking or being given this poison in the belief that it is a cure. [38758/14]
View answerI have no plans to undertake an awareness campaign.
The Health Products Regulatory Authority (HPRA) advises consumers not to take Master Minister Solution (MMS) or CD. The Food Safety Authority and the National Poisons Information Centre of Ireland have also issued a public safety warning regarding the use of MMS.
The HPRA has confirmed that it is actively following up on this issue as a matter of urgency. Consumers experiencing side effects thought to be associated with MMS are advised to consult a health care professional.
