Timmy Dooley
Question:62. Deputy Timmy Dooley asked the Minister for Health how he proposes to address ongoing concerns regarding the ambulance service; and if he will make a statement on the matter. [27588/15]
View answerAmbulance Service Provision
Questions (62)
Written answers
The National Ambulance Service (NAS) has undergone significant reform and modernisation in recent years and this continues in 2015. Key to the reform is the development of a single national control system and the rationalisation of control centres to one national centre. This project is introducing better technology and improving response times. Developments such as national digital radio, computer aided dispatch, mobile data and electronic patient care reporting will allow the NAS to deploy resources more effectively and efficiently, on a national rather than a small geographic basis.
I was pleased to recently open the new state of the art facility for the National Emergency Operations Centre (NEOC) in the Rivers Building in Tallaght. This building is at the core of the NAS command, control and dispatch service, where 112/999 calls are received and emergency paramedic teams are dispatched. The facility enables the NAS to see all available paramedic teams and vehicles in real time, ensuring that the closest available resource is dispatched to an emergency as soon as a call is received.
Wexford, the only remaining regional centre, will transfer to the NEOC later this year. Discussions are underway with Dublin Fire Brigade, with a view to integrating ambulance call taking and dispatch for the Dublin area and making the best use of HSE and Dublin Fire Brigade ambulance resources on a real-time basis.
A €5.4m budget increase in 2015 is helping to address service gaps, particularly in the west, by reforming rostering and staffing additional stations. Tuam and Mulranny stations have now commenced operations and discussions are nearing conclusion concerning staffing of a newly refurbished facility at Loughglynn. This facility is expected to open shortly. The number of community first response teams is expanding, with 123 teams now operating. The Emergency Aeromedical Support Service continues to provide rapid access to appropriate treatment for very high acuity patients.
I am confident that all of these measures will further improve our ambulance service in 2015.
Vaccination Programme
Questions (63)
Maureen O'Sullivan
Question:63. Deputy Maureen O'Sullivan asked the Minister for Health if he is satisfied that the human papilloma virus Gardasil vaccine is totally safe; and his views that in light of concerns raised by parents and concerned parties over the possible health effects of the vaccine that there should be an information guide and consent form sent to parents so they can make an informed decision if they wish their children to be vaccinated [27694/15]
View answerWritten answers
Immunisation is regarded as one of the safest and most cost-effective of health care interventions. International studies and scientific assessments suggest that the best way to prevent most disease due to human papilloma virus (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 the National Immunisation Advisory Committee (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® is a medicinal product which has been authorised for use across the European Union since 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. This is done by both monitoring of individual adverse reaction reports received by competent authorities across Europe (including the HPRA) and Periodic Safety Update Reports (PSURs) submitted by the Marketing Authorisation Holder (i.e. license holder) for the vaccine on a regular basis. The most recent EU review of cumulative global safety update data completed in December 2014 concluded that the benefit/risk profile for Gardasil® remains positive and concluded that no updates to the product information (Summary of Product Characteristics (SmPC) and Package Leaflet (PL)) were considered necessary.
Up to the 8 June 2015, the Health Products Regulatory Authority (HPRA) has received 873 reports of suspected adverse reactions/events notified in association with Gardasil®. National monitoring experience has been consistent with the expected pattern of adverse effects known to occur with the vaccine, as outlined in the approved product information (Summary of Product Characteristics (SmPC) and Package Leaflet (PL)) for Gardasil® . The majority of the reports received to date involved events/reactions related to injection site reactions, malaise, headache, myalgia, fatigue, gastrointestinal symptoms and skin reactions. Vaccination related events such as dizziness and syncope (fainting) was also reported and would not be unexpected in this patient population.
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 will continue to be so.
The HSE delivers the HPV vaccination programme and provides written information to pupils receiving HPV immunisation and to their parents. The information booklet addresses key questions about HPV, cervical cancer and HPV vaccine, its efficacy, safety and possible side effects. This information can also be found at www.hpv.ie.
Vaccination Programme
Questions (64)
Robert Troy
Question:64. Deputy Robert Troy asked the Minister for Health if he will meet with a support group that has been established for the parents of children who have suffered serious health complications following the administering of the human papilloma virus vaccination; and if he will make a statement on the matter. [27722/15]
View answerWritten answers
Immunisation is regarded as one of the safest and most cost-effective of health care interventions. International studies and scientific assessments suggest that the best way to prevent most disease due to human papilloma virus (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 the National Immunisation Advisory Committee (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® is a medicinal product which has been authorised for use across the European Union since 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. This is done by both monitoring of individual adverse reaction reports received by competent authorities across Europe (including the HPRA) and Periodic Safety Update Reports (PSURs) submitted by the Marketing Authorisation Holder (i.e. license holder) for the vaccine on a regular basis. The most recent EU review of cumulative global safety update data completed in December 2014 concluded that the benefit/risk profile for Gardasil® remains positive and concluded that no updates to the product information (Summary of Product Characteristics (SmPC) and Package Leaflet (PL)) were considered necessary.
Up to the 8 June 2015, the Health Products Regulatory Authority (HPRA) has received 873 reports of suspected adverse reactions/events notified in association with Gardasil®. National monitoring experience has been consistent with the expected pattern of adverse effects known to occur with the vaccine, as outlined in the approved product information (Summary of Product Characteristics (SmPC) and Package Leaflet (PL)) for Gardasil®. The majority of the reports received to date involved events/reactions related to injection site reactions, malaise, headache, myalgia, fatigue, gastrointestinal symptoms and skin reactions. Vaccination related events such as dizziness and syncope (fainting) was also reported and would not be unexpected in this patient population.
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 will continue to be so.
The HSE delivers the HPV vaccination programme and provides written information to pupils receiving HPV immunisation and to their parents. The information booklet addresses key questions about HPV, cervical cancer and HPV vaccine, its efficacy, safety and possible side effects. This information can also be found at www.hpv.ie .
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.
HSE Expenditure
Questions (65)
Billy Kelleher
Question:65. Deputy Billy Kelleher asked the Minister for Health if he will provide an update on the Health Service Executive’s financial position; the net current deficit of the executive against profile at the end of June 2015; if additional expenditures announced for free general practitioner care and to tackle overcrowding in emergency departments in hospitals are reflected in this; the latest projection for the overall deficit in 2015; and if he will make a statement on the matter. [27657/15]
View answerWritten answers
The April Health Service Performance Report, the latest published, shows year to date net expenditure of €4.116 billion against a profile of €3.980 billion, leading to a variance of €136m. The acute hospital sector is reporting a deficit of €61m, which represents 45% of the overall deficit; PCRS and Local Schemes account for €39m; and Social Care is reporting a deficit of €9m. There are smaller variances across other programmes.
In Vote terms the HSE related subheads are approximately €45m over profile at end June.
Free GP Care had not commenced at end April and is therefore not reflected in the above figures. Additional costs associated with addressing Emergency Department overcrowding are reflected in the position to date.
Given the uncertainty around certain expenditure areas it is too early to be definitive as to the overall deficit in 2015.
Medical Conditions
Questions (66)
Paul Murphy
Question:66. Deputy Paul Murphy asked the Minister for Health his views on increasing awareness of fibromyalgia among medical professionals; the measures his Department is taking to provides supports to fibromyalgia sufferers and research into the condition; and if he will make a statement on the matter. [27664/15]
View answerWritten answers
Fibromyalgia is a medical disorder which causes chronic pain in addition to other symptoms such as fatigue and reduced physical function. The medical management of fibromyalgia relates to careful management of the symptoms including pain control. Patients with fibromyalgia can avail of a variety of treatments and support in the primary care and hospital settings. These can include patient education, exercise, cognitive – behavioural therapy as well as medication.
The issue of increasing awareness of the condition among medical professionals has been brought to the attention of the National Clinical Programme for Rheumatology. The programme advised that it is estimated that in region of 30% of the referrals to rheumatology services in the hospital setting are related to fibromyalgia.
The National Clinical Programme has no specific fibromyalgia study planned however, healthcare professionals can apply to the Health Research Board for research funding into fibromyalgia.
Medical Conditions
Questions (67)
Caoimhghín Ó Caoláin
Question:67. Deputy Caoimhghín Ó Caoláin asked the Minister for Health in view of his positive reasoned response to the report prepared by the Oireachtas Joint Committee on Health and Children on the benefits of an all-island approach to deep brain stimulation, his plans regarding the appointment of a deep brain stimulation specialist nurse to co-ordinate and manage patient support before and after the procedure, and a similar appointment required north of the Border; his plans to provide for and instruct the Health Service Executive to proceed with such an appointment; and if he will make a statement on the matter. [27596/15]
View answerWritten answers
In responding to the Report on Deep Brain Stimulation (DBS) which was compiled earlier this year by the Oireachtas Joint Committee on Health and Children, I indicated my support for an all-island approach to the provision of this treatment and committed to progressing this matter in talks with my counterpart in Northern Ireland. The North/South Ministerial Council deals with a variety of cross border health initiatives and the provision of DBS on an all-island basis will be considered in that forum.
At an operational and clinical level the HSE is willing to recommend and facilitate referral of suitable patients to the Belfast centre, given the stated advantages identified in the Oireachtas Joint Committee report, as well as keeping further DBS-related service developments under review. Specific recommendations by the Committee in respect of specialist nursing posts to coordinate and manage patient support before and after treatment have been noted by the HSE for consideration. As these are service matters, 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.
Disability Services Provision
Questions (68)
Caoimhghín Ó Caoláin
Question:68. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the ratio of therapy providers in speech and language therapy, occupational therapy and physiotherapy to those with special needs in all regions; the numbers on waiting lists, which have led to parents being forced to access unaffordable private therapy; his plans to deal with this; and if he will make a statement on the matter. [27595/15]
View answerWritten answers
The Government is committed to providing and developing services for children with special needs and to improving access by these children to health related therapy services.
Health related therapy supports and interventions for children, including speech and language therapy, occupational therapy and physiotherapy, can be accessed through both the HSE’s primary care services and its disability services, depending on the level of need. It is estimated that up to 95% of people’s health and social service needs can be met within a primary care setting and most children with a disability or developmental delay will have their needs met by their local primary care services. The specialist disability services look after children with more complex needs.
Additional funding of €20m was allocated in 2013 to strengthen primary care services and to support the recruitment of prioritised front-line primary care posts, such as speech and language therapists. In addition, the HSE has introduced a number of initiatives specifically in relation to speech and language therapy such as therapists increasing clinic based work instead of domiciliary work and providing family centred interventions in a group as opposed to a one-to-one setting, whenever possible.
The HSE is also engaged in a major reconfiguration of its existing therapy resources for children with disabilities, including autism, aged up to eighteen years, into geographically based specialist multi-disciplinary 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, what school they go to or the nature of the individual child’s difficulties.
The Programme is a key priority for the Executive’s Social Care Division in 2015. Additional funding of €4 million was specifically allocated in 2014 to drive implementation of the Programme equating to approximately 80 therapy posts. An additional €4m has been allocated to the Programme in 2015 (equating to €6m in a full year) to fund a further 120 posts.
It is anticipated that these measures, collectively, will significantly help reduce current waiting lists and ensure that services are delivered in a more equitable manner.
Within this context, I have asked the HSE to provide the Deputy with the detailed operational information he has requested.
Vaccination Programme
Questions (69)
Dara Calleary
Question:69. Deputy Dara Calleary asked the Minister for Health if he will provide an update on the implementation of the recommendation by the national immunisation advisory committee that a meningococcal B vaccine be included in the primary childhood immunisation programme; and if he will make a statement on the matter. [27581/15]
View answerWritten answers
The 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.
The Department received a letter from the Chairman of NIAC regarding the introduction of the Meningitis B vaccine into the Primary Childhood Immunisation Schedule. In this letter the committee recommends the inclusion of Meningococcal B vaccine in the primary immunisation programme, if the vaccine can be made available at a cost-effective price.
NIAC has issued guidance in relation to the use of the Meningococcal B vaccine in the control of clusters or outbreaks of the disease. The vaccine has been used in accordance with the NIAC guidance, along with other measures, to control outbreaks of the disease.
I am awaiting further advices from NIAC concerning the administration of the vaccine and how this impacts on the current vaccines in the Primary Childhood Immunisation Schedule. I have asked the HSE to engage with the manufacturer with a view to establishing whether a cost effective and sustainable price is achievable in Ireland without prejudice to the ultimate decision on whether the vaccine should be introduced or not.
The Department of Health in conjunction with the HSE, is examining evidence based changes to the Primary Childhood and Schools Immunisation Schedule. The resource implications of the introduction of any new vaccine will be considered in the context of the Estimates Process, the review of HSE vaccination services, engagement with the manufacturers, and the HSE Service Planning Process.
Immunisation policy is based on providing a safe, sustainable and cost-effective programme of immunisation. The introduction of any new vaccine into the primary childhood immunisation schedule will be considered in the context of recommendations from NIAC, the outcome of cost-effective analysis, the conclusions of the review of HSE vaccination services currently being carried out, and resource availability.
Community Welfare Services Provision
Questions (70, 102)
Anthony Lawlor
Question:70. Deputy Anthony Lawlor asked the Tánaiste and Minister for Social Protection if she will provide an update as to when a community welfare office will be opened in Naas, County Kildare; and if she will make a statement on the matter. [28191/15]
View answerAnthony Lawlor
Question:102. Deputy Anthony Lawlor asked the Tánaiste and Minister for Social Protection when a community welfare office will be opened in Naas in County Kildare; and if she will make a statement on the matter. [28183/15]
View answerWritten answers
I propose to take Questions Nos. 70 and 102 together.
The Department delivers its services including the Community Welfare Service (CSW) in the context of a new service delivery model called Intreo. This new model offers practical, tailored employment services and supports for jobseekers. The Intreo service including an integrated reception for clients is currently being rolled out in Newbridge. The model of service delivery for CWS in Kildare is operated through a phone, postal and appointments based service. The Naas area continues to operate this CWS model which can facilitate home visits or appointments where necessary. There are no plans to change the current model at this time.
Question No. 71 withdrawn.