Written Answers Nos. 158-165
158. Deputy Thomas P. Broughan asked the Minister for Health the reason serious overcrowding continues at the accident and emergency in Beaumont Hospital in view of the fact that he had ample time to prepare a programme to end accident and emergency overcrowding at Beaumont and the other accident and emergency centres in the State. [2945/15]
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.
159. Deputy Thomas P. Broughan asked the Minister for Health if additional medical staff will be allocated to the accident and emergency department of Beaumont Hospital, Dublin 9. [2946/15]
View answerI have asked the HSE to respond to the Deputy directly on the matter. 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.
160. Deputy Brendan Griffin asked the Minister for Health if a home help care package being provided in respect of a person (details supplied) in County Kerry will be reviewed and increased; and if he will make a statement on the matter. [2966/15]
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.
161. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the details of private health insurance and the fact that maternity benefits are included in the minimum level of benefits that companies must offer; if this is applied in all policies irrespective of gender; if this cost is split evenly between genders by way of government levies; and if he will make a statement on the matter. [2980/15]
View answerThe inclusion of maternity benefit in all health insurance products is a statutory requirement, as part of a legal obligation on health insurers to provide a specific minimum level of benefit in all health insurance products sold. Minimum benefit is one of the key principles on which the Irish private health insurance regulatory system is based. Minimum Benefit Regulations, made under the Health Insurance Acts, require insurers to offer a minimum benefit to every insured person. The key purpose of the Regulations is to ensure the continued availability of the type of broad hospital cover traditionally held as a minimum by the insured population and to ensure that individuals do not significantly underinsure.
The Minimum Benefit Regulations ensure that all consumers obtain an appropriate minimum level of health insurance cover regardless of what plan they purchase and that every plan available is inclusive of a minimum suite of benefits/procedures, some of which are available to the market as a whole and some of which will be applicable specifically to either men or women. By way of example, the Regulations include provision for such medical treatments as a prostatectomy or testicular biopsy (in the case of men) and cervical biopsy or maternity services (in the case of women).
Therefore, the broad base line of procedures provided by minimum benefit should not be looked at in gender specific or age-related terms, but rather as a cohort of benefits and procedures that are important and of benefit to the community of the insured population and thus should be protected and provided as a minimum base to all.
162. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the details of reports of a cluster of cases of Guillain-Barré syndrome in an area (details supplied) in County Meath; if the Health Service Executive will investigate this cluster to ascertain whether there is an environmental or infectious cause; the action the HSE department of public health will take; and if he will make a statement on the matter. [2981/15]
View answerAs this is a service matter it has been referred to the Health Services 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.
163. Deputy Brendan Ryan asked the Minister for Health if the Health Service Executive will fund a drug in order to assist persons (details supplied) with the rare condition paroxysmal nocturnal haemoglobinuria; and if he will make a statement on the matter. [2985/15]
View answerThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drugs schemes in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013.
This requires consideration of a range of statutory criteria prior to reimbursing any medicine, including clinical need, cost-effectiveness and the resources available to the HSE.
The decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds by the HSE on the advice of the National Centre for Pharmacoeconomics. They are not political or ministerial decisions.
This drug Eculizumab is indicated for the treatment of patients with Paroxysmal Nocturnal Haemoglobinuria or PNH. It is considered to be one of the most expensive drugs in the world.
I understand that in 2010 the HSE entered into an interim Access with Evidence Development Agreement between the company Alexion Pharma and St James's Hospital to treat 10 patients with this drug. The interim agreement was put in place with the expectation that future evidence would emerge which would assist with the future decision making on this drug.
The HSE received an application for the inclusion of Eculizumab in the GMS and community drugs scheme. In accordance with agreed procedures the National Centre for Pharmacoeconomics conducted a pharmacoeconomic evaluation of Eculizumab.
The National Centre for Pharmacoeconomics published an evaluation of the medicine in October 2013 which found that the manufacturer failed to demonstrate the cost-effectiveness of this drug and reimbursement would have an estimated cumulative gross budget impact for the HSE of €33 million over 5 years. Consequently the National Centre for Pharmacoeconomics was unable to recommend reimbursement of the product under the community drugs scheme.
Notwithstanding the pharmacoeconomic evaluation of this drug, in recognition of the burden of illness experienced by those with PNH, the HSE has been engaging with the manufacturer, Alexion Pharma, for some time in seeking to arrive at a price that would assist it in its desire to fund this medicine for as many patients as possible within the resources available.
The price being offered at present would involve the medicine in question costing €420,000 per annum for each additional patient treated, with treatment continuing over a person's lifetime in most cases.
The HSE's engagement with the company has now been concluded. The Executive is considering the outcome of that engagement and I expect that the HSE will shortly make its determination. It is regrettable that to date the company has not been able to provide this drug at a more sustainable price to the HSE to reflect the clinical evidence.
I would like to assure the Deputy that I fully understand the concerns of patients regarding the availability of this drug and that every effort is being made to achieve a satisfactory outcome. While I appreciate that some may take the view that the taxpayer should reimburse every licensed medicine for whatever the price the drug company demands, the better interests of the health service require that we reimburse only the most effective medicines and only at a fair price.
164. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 407 of 18 December 2014, if his attention has been drawn to the fact that the current waiting list for the early intervention team in Dublin 15 is now 14 months; the action which he will take to address this situation; and the support which will be made available in respect of a person (details supplied) in Dublin 15 and their family in the interim. [2991/15]
View answerAll Health Service Executive areas have significant early intervention services in place for children with disabilities aged zero to eighteen years. These are provided directly by the HSE or by voluntary service providers funded by the HSE. At the same time, the HSE has recognised the need to improve the way in which both early intervention services and services for school aged children are delivered. It is currently engaged in a major reconfiguration of its existing therapy resources for children with disabilities into multi-disciplinary geographically based teams, as part of its National Programme on Progressing Disability Services for Children and Young People (0-18 years). The key objective of this Programme is to bring about equity of access to disability services and consistency of service delivery, with a clear pathway for children with disabilities and their families to services, regardless of where they live, where these children go to school or the nature of the individual child’s difficulties.
The Programme is a key priority for the HSE’s Social Care Directorate. An additional €4 million was allocated this year to assist in implementing the Programme, equating to approximately 80 additional therapy posts, and further investment in the Programme will take place in 2015. An additional €4 million was specifically allocated in 2014 to drive implementation of the Programme, equating to approximately 80 additional therapy posts. Further investment of €4 million will also be made to support the development of therapy services in 2015 (equating to €6 million in a full year). The transition to this new service model is taking place on a phased basis and includes consultation and engagement with stakeholders, including service users and their families.
Within this context, I have asked the Executive to provide the Deputy with the detailed information that she has requested. 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.
165. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if the Health Service Executive will fund the drug soliris, eculizumab, for the treatment of paroxysmal nocturnal haemoglobinuria; and if he will make a statement on the matter. [2995/15]
View answerThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drugs schemes in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013.
This requires consideration of a range of statutory criteria prior to reimbursing any medicine, including clinical need, cost-effectiveness and the resources available to the HSE.
The decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds by the HSE on the advice of the National Centre for Pharmacoeconomics. They are not political or ministerial decisions.
This drug Eculizumab is indicated for the treatment of patients with Paroxysmal Nocturnal Haemoglobinuria or PNH. It is considered to be one of the most expensive drugs in the world.
I understand that in 2010 the HSE entered into an interim Access with Evidence Development Agreement between the company Alexion Pharma and St James's Hospital to treat 10 patients with this drug. The interim agreement was put in place with the expectation that future evidence would emerge which would assist with the future decision making on this drug.
The HSE received an application for the inclusion of Eculizumab in the GMS and community drugs scheme. In accordance with agreed procedures the National Centre for Pharmacoeconomics conducted a pharmacoeconomic evaluation of Eculizumab.
The National Centre for Pharmacoeconomics published an evaluation of the medicine in October 2013 which found that the manufacturer failed to demonstrate the cost-effectiveness of this drug and reimbursement would have an estimated cumulative gross budget impact for the HSE of €33 million over 5 years. Consequently the National Centre for Pharmacoeconomics was unable to recommend reimbursement of the product under the community drugs scheme.
Notwithstanding the pharmacoeconomic evaluation of this drug, in recognition of the burden of illness experienced by those with PNH, the HSE has been engaging with the manufacturer, Alexion Pharma, for some time in seeking to arrive at a price that would assist it in its desire to fund this medicine for as many patients as possible within the resources available.
The price being offered at present would involve the medicine in question costing €420,000 per annum for each additional patient treated, with treatment continuing over a person's lifetime in most cases.
The HSE's engagement with the company has now been concluded. The Executive is considering the outcome of that engagement and I expect that the HSE will shortly make its determination. It is regrettable that to date the company has not been able to provide this drug at a more sustainable price to the HSE to reflect the clinical evidence.
I would like to assure the Deputy that I fully understand the concerns of patients regarding the availability of this drug and that every effort is being made to achieve a satisfactory outcome. While I appreciate that some may take the view that the taxpayer should reimburse every licensed medicine for whatever the price the drug company demands, the better interests of the health service require that we reimburse only the most effective medicines and only at a fair price.
