Written Answers Nos. 315-329
315. Deputy Michael Lowry asked the Minister for Health if he will intervene with the Health Service Executive to prevent a case of discrimination against a seriously ill person (details supplied) in County Laois; and if he will make a statement on the matter. [44798/14]
View answerDecisions on which medicines are reimbursed by the taxpayer, are not political or ministerial decisions. These are made on objective, scientific and economic grounds by the Health Service Executive (HSE) and often on the advice of the National Centre for Pharmacoeconomics.
The HSE has been engaging with the manufacturer, Alexion Pharma, for some time in relation to the drug Eculizumab. I understand that in 2010 following prolonged discussions and in the absence of sufficient information to make a long term permanent decision around this agent, the HSE entered into an access with evidence development agreement with Alexion Pharma and St James’s Hospital, Dublin whereby the HSE provided a fund (almost €10m, inclusive of VAT) for three years (2010-2012) sufficient to treat 10 patients (the expected number of patients to be identified for treatment over that time period). At the end of this period, Alexion was expected to have developed additional evidence to allow the HSE to make a long term decision in relation to the funding of this incredibly costly agent. The HSE honoured the terms of that agreement.
The agreement lapsed and a formal re-assessment process was triggered as was agreed with Alexion / St James’s in 2010. Pending consideration of the outcome of the assessment, the HSE continued the funding commitments entered into with Alexion on behalf of the original 10 patients. The HSE has released funding of €1.9m in the first 8 months of 2014 to fund treatment for these 10 existing patients.
Many countries have struggled to accept the pricing point put forward by Alexion. The medicine in question requires €355,000 per annum plus 23% VAT (multi-year commitment) to be found for each additional patient treated.
The HSE continues to try to engage with the pharmaceutical company to arrive at a pricing point that would assist it in its efforts to fund this medicine for as many patients as possible. The HSE met the company again this month and is waiting on the company's response following that engagement. It is worth noting that the current Irish list price of €4,557.50 per vial substantially exceeds the list price in the UK (£3,150 sterling).
I would like to assure the Deputy that the Department, and the HSE, fully understand the concerns of patients regarding the availability of this drug. While I appreciate that some may take the view that the taxpayer should re-imburse every licensed medicine for whatever price the drug company demands, I hope the Deputy will appreciate that the better interests of the health service require that we re-imburse only the most effective medicines and only at a fair price.
316. Deputy Stephen S. Donnelly asked the Minister for Health further to Parliamentary Question No. 153 of 13 November 2014, if he will undertake a full risk assessment to ensure that there are no negative healthcare results for the people of counties Wicklow and east Carlow as a result of the redesign of the primary percutaneous coronary intervention programme; and if he will make a statement on the matter. [44834/14]
View answer321. Deputy Stephen S. Donnelly asked the Minister for Health further to Parliamentary Question No. 153 of 13 November 2014, if he will undertake a full review of the way the Health Service Executive made and announced a premature decision, which resulted in a temporary suspension of ambulance transfers to St. Vincents University Hospital for patients suspected of having ST elevation Myocardial Infarction, and caused widespread concern; if he will confirm that no such premature announcements are made in future; and if he will make a statement on the matter. [44880/14]
View answer322. Deputy Stephen S. Donnelly asked the Minister for Health further to Parliamentary Question No. 153 of 13 November 2014, if he will ensure that some form of stakeholder outreach is included in the redesign of the Primary Percutaneous Coronary Intervention programme, which is currently underway before any decisions are made and announced, including dialogue with frontline workers, paramedics and first responders; and if he will make a statement on the matter. [44881/14]
View answerI propose to take Questions Nos. 316, 321 and 322 together.
St. Vincent’s University Hospital (SVUH), St. James’s Hospital and Mater Misericordiae University Hospital operate as designated 24/7 Primary Percutaneous Coronary Intervention (PPCI) centres for the Greater Dublin Area.
In relation to the withdrawal of SVUH as a 24/7 PPCI centre, the HSE has advised my Department that a premature decision was taken in this regard without the normal notifications to relevant stakeholders. This resulted in a temporary suspension over the weekend of 7 November of ambulance transfers to SVUH for patients suspected of having ST elevation Myocardial Infarction (STEMI).
SVUH resumed as a 24/7 PPCI centre at 8am on Tuesday 11 November 2014.
It should be noted that at all times, patients presenting directly to SVUH with suspected STEMI had PPCI in SVUH 24/7 available, if deemed clinically necessary. The Mater and St. James's Hospital continued to provide 24/7 PPCI and accept ambulance transfer for patients with STEMI who would ordinarily have been transferred to SVUH for the period of the temporary suspension.
The HSE has advised that a redesign of the PPCI programme - especially in relation to out of hours - is currently underway. The Acute Coronary Syndrome Programme in collaboration with the Acute Hospitals Division and National Ambulance Service of the HSE will enter discussions with all Dublin hospitals currently delivering PPCI, and with other stakeholders, with a view to devising the most effective and sustainable model of care for PPCI in the region.
The following information was provided under Standing Order 40A
I refer to Deputy Donnelly’s request for further information in response to Questions Nos. 316 and 321.
As indicated in my response to these PQs a redesign of the Primary Percutaneous Coronary Intervention (PPCI) programme - especially for out of hours - is currently underway.
The HSE Acute Hospitals Division (AHD) has requested that the Acute Coronary Syndrome Programme provide an update on their 2012 recommendations to provide clarification on the following questions:
(a) The number of centres required to deliver 24/7 Primary PCI in the Greater Dublin area
(b) The feasibility of maintaining 9-5 services on any site
(c) How resources will be consolidated on 24/7 sites, especially in reference to out-of-hours work.
I expect that the ACS Programme, in consultation with the AHD and the National Ambulance Service will take account of the healthcare requirements of the catchment population, including Wicklow and Carlow, in making their recommendations. Once these recommendations are received early in 2015, the AHD will be responsible for leading on their communication and implementation.
In relation to the announcement and temporary suspension of ambulance transfers to St Vincent’s University Hospital in November, it has been acknowledged by the HSE that a premature decision was taken in this regard without the normal notifications to relevant stakeholders. I have no plans to review the way in which that decision was made, however I can assure the Deputy that it won't happen again and there will be appropriate communication with all stakeholders in advance of decisions on future arrangements for delivery of 24/7 Primary PCI in the Dublin area.
I trust that this information addresses the requests for information to the Deputy’s satisfaction.
317. Deputy Brendan Griffin asked the Minister for Health if medication for the treatment of chronic obstructive pulmonary disease will be made available under the long-term illness scheme; and if he will make a statement on the matter. [44860/14]
View answerThe Long-Term Illness dependent Scheme was established under Section 59(3) of the Health Act, 1970 (as amended). Regulations were made in 1971, 1973 and 1975 specifying the conditions covered by the LTI Scheme, which are as follows: Acute Leukaemia; Mental handicap; Cerebral Palsy; Mental Illness (in a person under 16); Cystic Fibrosis; Multiple Sclerosis; Diabetes Insipidus; Muscular Dystrophies; Diabetes Mellitus; Parkinsonism; Epilepsy; Phenylketonuria; Haemophilia; Spina Bifida; Hydrocephalus; and conditions arising from the use of Thalidomide. There are no plans to extend the list of conditions covered by the LTI Scheme.
Under the Drug Payment Scheme, 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.
Under the provisions of the Health Acts, medical cards are provided to persons who are, in the opinion of the Health Service Executive (HSE), unable without undue hardship to arrange GP services for themselves and their dependants. In the assessment process, the HSE can take into account medical costs incurred by an individual or a family.
318. Deputy Michelle Mulherin asked the Minister for Health the reason for the considerable delay in implementing a replacement scheme for the discontinued mobility allowance and motorised transport grant schemes; and if he will make a statement on the matter. [44867/14]
View answer367. Deputy Michael Healy-Rae asked the Minister for Health the position regarding the travel payment scheme which was a development of a travel scheme to assist persons (details supplied) who have to travel a long way to a hospital; and if he will make a statement on the matter. [45232/14]
View answerI propose to take Questions Nos. 318 and 367 together.
The Department is seeking a solution which would best meet the aim of supporting people with severe disabilities who require additional income to contribute towards the costs of their mobility needs, while remaining within the available budget and satisfying all legal and equality concerns.
Conscious of the reports of the Ombudsman regarding the legal status of the Motorised Transport Grant and Mobility Allowance Scheme, in the context of the Equal Status Acts, the Government decided to close both schemes on 26th February, 2013. In November 2013, the Government decided that the preparatory work required for a new travel subsidy scheme and associated statutory provisions should be progressed by the Minister for Health.
Work is ongoing on the policy proposals to be brought to Government for the drafting of primary legislation for a new scheme. The challenge is to provide these benefits to a wider cohort of people, while continuing to cater for the 4,700 people already in receipt of a monthly payment, within a limited budget.
Once policy proposals have been finalised and approved by Government, the timeframe for the introduction of a new scheme will become clearer.
319. Deputy Billy Kelleher asked the Minister for Health if he will enquire and investigate the high level of cancers diagnosed over the years in areas (details supplied) in County Cork; and if he will make a statement on the matter. [44869/14]
View answerThe National Cancer Registry is the statutory body with responsibility for the collection and analysis of information relating to the incidence of cancer in Ireland. All Registry cancer registrations are geographically coded by Electoral Division (ED). The location specified by the Deputy lies within the Mallow South Urban ED.
In response to a previous query, the Registry analysed the incidence rates of cancer in this location in 2010, using data covering the 1994-2007 period, and the results showed that there was no statistically significant difference between cancer incidence in Mallow South Urban and national incidence rates.
I have asked the Registry to update these results incorporating the additional four years (2008-2011) for which data is complete and to forward them to the Deputy.
320. Deputy Michael Healy-Rae asked the Minister for Health the position regarding a medical card in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [44878/14]
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. If the Deputy has not received a reply from the HSE within 15 working days, please contact my Private Office who will follow up the matter with them.
Questions Nos. 321 and 322 answered with Question No. 316.
323. Deputy Billy Kelleher asked the Minister for Health when or if National Immunisation Advisory Committee will make a recommendation with regard to the Meningitis B vaccine in the primary childhood immunisation programme here [44901/14]
View answerThe immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The NIAC is a committee of the Royal College of Physicians of Ireland comprising of experts in a number of specialties including infectious diseases, paediatrics and public health. To date, NIAC has not made any recommendation in relation to the use of Meningitis B vaccine in the primary childhood immunisation programme in Ireland. However, NIAC has issued guidance in relation to the use of the Meningitis B vaccine in the control of clusters or outbreaks of Meningococcal B disease.
Should NIAC recommend the inclusion of MenB vaccine into the primary childhood immunisation programme, my Department, in association with the HSE National Immunisation Office will examine the issue.
Meningococcal disease is caused by the Meningococcal bacteria. It is a notifiable disease under the Infectious Diseases (Amendment) Regulations 2011 (S.I. No. 452 of 2011).
The Weekly Infectious Disease Report for week 45, published by the Health Protection Surveillance Centre on 12 November 2014, indicates that there have been 37 cases of Meningococcal disease notified up to 8 November 2014. This is a decrease of 12 on the same period in 2013.
324. Deputy Michael Healy-Rae asked the Minister for Health if moneys are available to assist a person (details supplied) in County Kerry with their cost of travelling to the Mater Hospital in Dublin for treatment [44910/14]
View answerAs this is a service matter, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.
325. Deputy Olivia Mitchell asked the Minister for Health his plans to bring the 65 beds in the older wards of Leopardstown Park hospital up to Health Information and Quality Authority standard; and if he will make a statement on the matter. [44916/14]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply. If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up the matter with them.
326. Deputy Thomas P. Broughan asked the Minister for Health the frequency with which the list of medications covered by the Health Service Executive Primary Care Reimbursement Service is reviewed; and the reasons medications required to prepare patients to undergo the procedure of a colonoscopy are not covered by the HSE Primary Care Reimbursement Service [44924/14]
View answerThe Reimbursement List is updated on a monthly basis with products which have applied for addition to the Reimbursement List where they satisfy the Health (Pricing and Supply of Medical Goods) Act 2013.
Separately, the Health (Pricing and Supply of Medical Goods) Act 2013 provides that the HSE must review all items currently reimbursable under the GMS and community drug schemes within three to five years to determine if they should remain on the reimbursement list and, if so, what price should apply.
Colonoscopies are not carried out in the community setting therefore it is expected that hospital authorities would make comprehensive arrangements to provide all of a patient's requirements in connection with a diagnostic and/or surgical service that the hospital provides.
327. Deputy Billy Timmins asked the Minister for Health the position regarding medical card applications in respect of persons (details supplied) [44939/14]
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. If the Deputy has not received a reply from the HSE within 15 working days, please contact my Private Office who will follow up the matter with them.
328. Deputy Billy Kelleher asked the Minister for Health if the Nursing and Midwifery Board of Ireland published annual reports for 2012 and 2013; and if same are available on-line [44940/14]
View answerI wish to advise the Deputy that as the Nursing and Midwifery Board is a statutory agency, I have referred your question to it for direct reply.
If you have not received a reply from the NMBI within 15 working days please contact my Private Office and they will follow up the matter with them.
329. Deputy Tom Fleming asked the Minister for Health if he will intervene and restore the cut of €44,437.50 to the budget of an association (details supplied) in County Kerry as this deficit will have a dramatic and detrimental effect on front line services and puts a serious doubt on the future viability of this association who are providing essential and vital services to a vulnerable sector of society; and if he will make a statement on the matter. [44945/14]
View answerThe Government is fully committed to ensuring the on-going delivery of vital services and supports to people with disabilities within available resources.
The Health Service Executive (HSE) is currently in the process of preparing its 2015 National Service Plan including its disability services programme for children and adults with disabilities.
In relation to the specific query raised by the Deputy on Kerry Parents & Friends Association, as this is a service issue, it has been referred to the HSE for direct reply. If the Deputy has not received a reply from the HSE within 15 working days, he can contact my Private Office and they will follow up the matter with the HSE.
