Written Answers Nos. 439-457
439. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if the introduction of medicine use review by pharmacists has been examined as a way to improve compliance, and reduce wastage of medication; and if he will make a statement on the matter. [24772/15]
View answerIn 2010, a Health Service Executive/Irish Pharmacy Union working group developed a Medicines Use Review (MUR) project involving Primary Care teams, GPs and Pharmacists. An evaluation of the project found that it had achieved most of its objectives and established that structures and relationships within the primary care system in Ireland can facilitate such a process.
Pharmacy services are well placed within the community to provide essential health advice and to support effective care at the lowest level of complexity and in a cost-effective manner. Proposals such as MUR services undertaken by pharmacists offer new and innovative ways to provide the services we require. Such proposals must however generate real savings on existing public expenditure as the health service continues to operate within tight budget constraints.
The Department is currently examining this issue having regard to the evidence base for such a service and any contractual or funding implications.
440. Deputy Terence Flanagan asked the Minister for Health if he will meet with an organisation (details supplied); and if he will make a statement on the matter. [24790/15]
View answerAll meeting requests are considered. My private office has no outstanding request from this organisation. The organisation in question has requested a meeting in the past and I have responded. My position on this matter remains unchanged at this time.
441. Deputy Terence Flanagan asked the Minister for Health if he will consider setting up a perinatal hospice service for babies who may not live for long after birth; and if he will make a statement on the matter. [24791/15]
View answerProviding appropriate care sensitively for children who may not live for long after birth is particularly important given that parents and families only have a short precious amount of time with their baby.
The Palliative Care For Children with Life-Limiting Conditions in Ireland - A National Policy, was published by my Department in March 2010. The policy places significant emphasis on caring for children in their own homes rather than recommending the development of a children's hospice. With regard to perinatal services, the evidence available to us suggests that the best location of care is within the maternity or paediatric setting.
The HSE is working to ensure that quality palliative care is available to all those who need it. In that regard, the HSE’s Acute Hospitals Division, in partnership with the Clinical Palliative Care Programme, the Primary Care Division and the Irish Hospice Foundation, has recently commenced a programme of work to support general, maternity and paediatric hospitals to develop comprehensive plans for palliative, end-of-life and bereavement care. Each maternity unit will identify how it can best support the palliative care needs of parents and their babies. It is considered that this approach is preferable to establishing a very limited number of separate services.
A programme of care for children with life-limiting conditions has been established including the appointment of a Paediatric Consultant with a Special Interest in Palliative Care, based in Crumlin. As well as supporting other paediatricians, the Consultant also provides clinical support and advice to maternity hospitals and neonatologists. Eight Children’s Outreach Nurses have also been appointed, and a further two nurses will be appointed this year.
442. Deputy Sean Fleming asked the Minister for Health if he is satisfied that all service users in residential non-congregated community houses are receiving consistent care in respect of organisations which the Health Service Executive funds by section 38 agreements, in view of the fact that in some of the houses there can be on duty on different nights, qualified staff nurses, qualified social care workers, non-qualified social care worker qualified by the grandfather rule, or care assistants without any of the above qualifications or training, and that these carry out the same work as other staff on other occasions; his views that this level of care is appropriate; and if he will make a statement on the matter. [24800/15]
View answerI have asked the HSE to respond to the Deputy directly on this 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.
443. Deputy Michael Healy-Rae asked the Minister for Health his views on a matter (details supplied) regarding St. John of God, North East Services in County Louth; and if he will make a statement on the matter. [24805/15]
View answerI welcome the publication of the HIQA inspection report published on 12 June into St. Mary's residential disability services, St. John of God North East Community Services, Drumcar, County Louth. Our ongoing priority is the safeguarding of vulnerable people in the care of the health service. I welcome the fact that a plan has been drawn up by the management in St. John of God to implement all the issues highlighted by HIQA on inspection, to ensure the safeguarding of residents, with targeted deadlines to address them.
These plans include new management structures to ensure effective governance and safeguarding of residents. However much work remains to be carried out on an ongoing basis to ensure this and all facilities comply with Disability Residential Standards. I understand that St Mary's Drumcar and the HSE have agreed to establish a Joint Task Group to support St Mary's, in addressing its immediate challenges, and planning for medium and long-term developments of the service.
I have been assured that St. John of God North East Services including all staff and management and the HSE remain fully committed to working collaboratively towards continued residential service provision in the Louth region.
As the Deputy's question relates to service matters, it has been referred to the Health Service Executive (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.
444. Deputy Seán Ó Fearghaíl asked the Minister for Health if he will address the concerns raised by the parents of a child (details supplied) in County Kildare; and if he will make a statement on the matter. [24810/15]
View answerAs this is a service issue this question has been referred to the HSE for direct reply. If you have not received a reply within 15 working days, please contact my Private Office and they will follow up the matter with them.
445. Deputy Peter Mathews asked the Minister for Health the elements of the national clinical programme for asthma, excluding the free general practitioner care for those under six years of age, that has been implemented since this Government came to office; the revised timetable for full implementation of the programme; and if he will make a statement on the matter. [24817/15]
View answerThe HSE through its Clinical Strategy and Programmes Division has established the National Clinical Programme for Asthma (NCPA). The purpose of the National Clinical Programmes is to describe models of care and formulate guidelines, where necessary, which aim to improve quality access and value of clinical care. The NCPA also supports ongoing education for health professionals, patients and family/carers.
The Adult Emergency Asthma Guideline was published in January 2012 and is available on the HSE website at: http://www.hse.ie/eng/about/Who/clinical/natclinprog/asthmaprogramme/adultemergencyathma.pdf.
A draft revised guideline is currently undergoing evaluation by the National Clinical Effectiveness Committee and is awaiting approval.
The Paediatric Emergency Asthma Guideline has been developed and is also available at: http://www.hse.ie/eng/about/Who/clinical/natclinprog/asthmaprogramme/paediatric.pdf.
The NCPA also worked with the Irish College of General Practitioners (ICGP) in the development of "Asthma Control in General Practice" which is a guideline for managing a patient with Asthma in primary care. This document is available on the ICGP website at:http://www.icgp.ie/go/search?r=home&q=asthma+control+in+general+practice&x=0&y=0.
This is due to be updated later in 2015.
A self-learning asthma E-Learning 6 modular theoretical programme based on the national evidenced based guidelines and developed by NCPA in conjunction with the Asthma Society of Ireland (ASI) is freely available on http://www.hseland.ie and www.asthmasociety.ie for any healthcare professional who wishes to update their knowledge. This will enable healthcare professionals to underpin their skill sets with theory. There is also a similar programme available for GPs on the ICGP website. In addition, a practical workshop is also being delivered by the respiratory Clinical Nurse Specialists for staff in primary and secondary care. This education programme will continue throughout 2015.
Up-to-date information is available for patients, their families and carers. These easily accessible patient asthma education supports have been implemented in conjunction with the NCPA's key stakeholder, the Asthma Society of Ireland, to assist guided self-management for this chronic condition. These are also jointly available on the HSE and ASI websites.
The NCPA has developed a National Model of Care for Asthma which details how physicians, nurses, and other health care professionals will work with engaged patients to make the clinical decisions most appropriate to their circumstances and to collaborate with specialist colleagues in providing a safe, seamless patient experience within the health system in Ireland. This is has been approved by the HSE leadership team and will be launched later this year. The National Clinical Programme for Asthma is committed to working with the HSE’s operational divisions in implementing this Model of Care. The under 6 contract for GPs that is currently being implemented for asthma in primary care is based on asthma management detailed in the Model of Care.
The Asthma Integrated Care Demonstrator Project in Primary Care has been a key focus of the NCPA throughout 2015. The Demonstrator Project aims to deliver Asthma management in the primary care setting. Care will be delivered by a community based Clinical Nurse Specialist (Respiratory - Integrated Care). The project is funded through the HSE's Primary Care Division and is supported by the National Clinical Programme for Asthma, in conjunction with the HSE's Health & Wellbeing Division. This project aims to provide patient assessment with spirometry and a self-management programme and will be established and supported at Primary Care level. The self-management programme will include disease specific education, including appropriate use of medication, avoidance of risk factor exposure and detection of deterioration.
As outlined above, the components of the programme are being implemented on an ongoing basis. The various guidelines are being revised from time to time in line with international best practice. When the Model of Care is launched later this year, it will be up to the relevant operational divisions within the HSE to implement the programme.
446. Deputy Peter Mathews asked the Minister for Health if he will provide an annual breakdown of expenditure incurred by the Exchequer since the national clinical programme for asthma was agreed in 2011; and if he will make a statement on the matter. [24818/15]
View answerAs this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy. 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.
447. Deputy Pat Deering asked the Minister for Health when a person (details supplied) in County Carlow will have a procedure carried out at Beaumont Hospital in Dublin 9. [24822/15]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual. In relation to the particular query raised, as 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.
448. Deputy Billy Kelleher asked the Minister for Health if he is satisfied with the grant scheme put in place to remove lead water pipes; if he has concerns regarding the health of the general public who are exposed to lead pipes; and if he will make a statement on the matter. [24823/15]
View answerThe Minister for the Environment, Community and Local Government is responsible for policy and legislation in relation to drinking water quality. Since 1 January 2014 Irish Water has statutory responsibility for the provision of public water services.
The Government recently approved a National Strategy to reduce exposure to lead in drinking water which was prepared by the Department of Environment, Community and Local Government (DECLG) and my Department, in consultation with Irish Water, the HSE and the EPA. Part of the Strategy will see the establishment of a new grant scheme to assist low income households to replace lead pipes in their home. It is envisaged that the grant scheme will be administered by local authorities and that the available resources will be prioritised to areas of highest risk. The terms and conditions of the scheme will be publicised as soon as they are finalised by the DECLG, who will have responsibility for the scheme.
One of the main health risks associated with lead in water is that it can affect the development of a child’s brain leading to problems with learning and behaviour. Lead may harm the kidneys and may contribute to high blood pressure. It has also been linked to cancer.
The HSE has advised that no level of lead in drinking water is now considered to be completely safe. It is therefore best to keep everybody’s exposure to lead, from all sources (drinking, eating, inhaling), as low as possible. Everybody should therefore try to drink water with as little lead in it as possible. Further advice can be obtained on the following websites.
HSE consumer advice
http://www.hse.ie/eng/health/hl/water/drinkingwater/lead/EPA_HSE_Drinking_Water_Consumer_Advice_Note_Lead.pdf.
Joint position paper of the EPA and HSE
http://www.hse.ie/eng/health/hl/water/drinkingwater/lead/HSE_EPA_JointPositionPaperLeadinDrinkingWater.pdf.
449. Deputy Billy Kelleher asked the Minister for Health if he will provide, in tabular form, the number of home help hours provided in each local health office area, for every month in 2015 to date; and, for every month and each local health office, the way it compares against target. [24858/15]
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.
450. Deputy Bernard J. Durkan asked the Minister for Health arising from overcrowding experienced in the accident and emergency unit in Naas General Hospital in County Kildare over some time, and his subsequent decision to provide for the recruitment of extra appropriate nursing and other staff, the extent to which the requisite staff has been recruited, appointed, and taken up duty; if further staff level increases are required to ensure the smooth, effective and safe operation of the unit at the hospital, in line with best practice; and if he will make a statement on the matter. [24865/15]
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.
451. Deputy Thomas Pringle asked the Minister for Health if he will consider meeting with a support group (details supplied) which includes concerned parents whose children were affected by the human papilloma virus vaccination; and if he will make a statement on the matter. [24866/15]
View answerThe immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). 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. The committee's recommendations are informed by public health advice and international best practice.
Immunisation is regarded as one of the safest and most cost-effective of health care interventions. The importance of immunisation is acknowledged by all the major international health organisations, particularly the World Health Organization (WHO).
Gardasil vaccine has been authorised for use across the European Union since September 2006. It was first introduced into the national immunisation programme in Ireland in 2010.
International studies and scientific assessments suggest that the best way to prevent most disease due to human papillomavirus (HPV) is to vaccinate as many girls and women as possible. The HPV vaccine protects girls from developing cervical cancer when they are adults. It is available free of charge from the HSE for all girls in 1st year of secondary school. This is in accordance with the recommendation received from NIAC which indicated that the HPV vaccine should be offered on an annual basis to all girls aged 12. The advice, based on public health considerations and supported by the cost-effectiveness analysis, is that HPV vaccines confer maximum benefit both individually and on a population basis if administered prior to HPV exposure.
In Ireland, the Health Products Regulatory Authority (HPRA) is the regulatory authority for medicines in Ireland. Gardasil vaccine is a medicinal product authorised by the European Commission on 20 September 2006 following a positive opinion from the Committee for Medicinal Products for Human Use (CHMP) at the European Medicines Agency (EMA). With this authorisation, the vaccine can be marketed in all EU Member States. Since first authorisation the HPRA has continuously monitored the safety of Gardasil. This monitoring includes a review of global safety data in addition to national experience with use of the vaccine. The EMA is responsible for the scientific evaluation of medicines developed by pharmaceutical companies for use in the European Union.
While no medicine (including vaccines) is entirely without risk, the safety profile of Gardasil has been continuously monitored since it was first authorised both nationally and at EU level.
The HPRA continues to ensure that the quality, safety and efficacy of all vaccinations licensed in Ireland, including HPV, meet the required standards. The safety profile of Gardasil has been continuously monitored since it was first introduced both nationally and at EU level and like all medicines and vaccines it will continue to be so.
As Minister for Health I consider meeting any organisation in the health area that requests to do so. However, due to scheduling commitments I am not always available to meet all who request a meeting.
452. Deputy Sandra McLellan asked the Minister for Health his plans for the 30 patients at University Hospital Waterford who are on the waiting list for an orthopaedic specialist (details supplied); and if he will make a statement on the matter. [24879/15]
View answerWith regard to the specific query raised by the Deputy, as 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.
453. Deputy Colm Keaveney asked the Minister for Health if a person (details supplied) in County Galway who is in critical need of orthopaedic surgery, who has been on a waiting list for surgery since February 2014, who suffers from chronic continuous pain, and who has no possibility of returning to work prior to surgery, will be able to access treatment in another eurozone country, in terms of European Union (Application of Patients Rights in Cross-Border Healthcare) Regulations 2014; the way applicants can access their entitlements under Statutory Instrument No. 203, as amended by Statutory Instrument No. 65 of 2015; if the person, in this case, requires prior authorisation as per the conditions laid out in section12 of the Statutory Instrument No. 203 of 2014; if so, the application process, both as a general rule, and with specific application to the case in point; and if he will make a statement on the matter. [24884/15]
View answerThe Health Service Executive operates the EU Directive on Patients' Rights in Cross Border Healthcare in Ireland. Through the National Contact Point (NCP) office the HSE provides information for patients on the Cross-Border Directive on its website - http://www.hse.ie/eng/services/list/1/schemes/cbd/ - and also by phone. The principal function of the NCP is to facilitate exchange of information for patients concerning their rights and entitlements relating to receiving healthcare in another Member State, in particular the terms and conditions for reimbursement of cost and the procedures for accessing and determining those entitlements. The NCP is able to inform patients what the cost of their treatments would be in Ireland to allow them make a comparison with the costs they are being quoted for comparable treatment in another Member State.
Prior approval will be required for all hospital care involving overnight accommodation, healthcare that involves treatments presenting a particular risk for the patient or the population, or healthcare which would be provided which could raise serious concerns with regard to the quality or safety of the care. The patient must submit a fully completed application form accompanied by the appropriate referring letter. The application for prior authorisation must be assessed and a determination given prior to the patient availing of the treatment abroad. A decision can be expected between 15 and 20 working days following the receipt of a completed application and any other information/clarification requested.
The NCP also has a responsibility to ensure that all inquirers are informed of the right to healthcare, if any, that they may have through the European legislation on the co-ordination of social security schemes (EU Regulation 883/04) and which may be more beneficial to them.
The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible. 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.
455. Deputy Dan Neville asked the Minister for Health his views on a matter (details supplied) regarding temporary residents, European Union visitors and European health insurance cards; and if he will make a statement on the matter. [24901/15]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible. 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.
456. Deputy Finian McGrath asked the Minister for Health if he will address a matter (details supplied) regarding mental health patients; and if he will make a statement on the matter. [24904/15]
View answerAs this is a service issue this question has been referred to the HSE for direct reply. If you have not received a reply within 15 working days, please contact my Private Office and they will follow up the matter with them.
457. Deputy Michael Healy-Rae asked the Minister for Health the position regarding an application for a medical card in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [24907/15]
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.
