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Thursday, 9 Jul 2015

Written Answers Nos. 202-211

Medicinal Products Supply

Questions (202)

Tony McLoughlin

Question:

202. Deputy Tony McLoughlin asked the Minister for Health in view of recent reports, the developments that have taken place since May 2015 between the manufactures of the drug, Fampyra, for patients who suffer with multiple sclerosis and the Health Service Executive over the possibility of having this drug covered in the national drug scheme; when this medication will be made available; and if he will make a statement on the matter. [28054/15]

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Written answers

The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drug schemes in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013. Prior to reimbursing any medicine, the HSE considers a range of statutory criteria 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.

In May 2013 the HSE decided that it could not approve the reimbursement of Fampridine (Fampyra) under the GMS or other schemes as the manufacturer had failed to demonstrate or provide any formal justification for the prices proposed. The HSE decision was in line with many other European countries who have also, to date, not provided for the drug under their public health systems.

The HSE re-engaged with the company in July 2014 (and again in October 2014) seeking improved commercial offerings. The outputs of those commercial engagements were re-considered by the HSE Drugs Committee at its November 2014 meeting.

The Committee decided to seek additional detailed information from clinical experts as to how a responder only reimbursement scheme (i.e patients confirmed as positive responders to the medication) would operate for this product. The feasibility of this option is currently under consideration.

Health Services Staff Recruitment

Questions (203)

Robert Troy

Question:

203. Deputy Robert Troy asked the Minister for Health when a consultant orthodontist will be appointed to the Health Service Executive midlands area; if this position is being advertised outside of Ireland, and if so, in what countries; and how frequently. [28056/15]

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Written answers

I 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.

Medical Card Applications

Questions (204)

Willie Penrose

Question:

204. Deputy Willie Penrose asked the Minister for Health the reason correspondence in an application for a medical card to the Health Service Executive on behalf of a person (details supplied) in County Westmeath was never replied to; and if he will make a statement on the matter. [28058/15]

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Written answers

The 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.

Medical Card Applications

Questions (205)

Bernard Durkan

Question:

205. Deputy Bernard J. Durkan asked the Minister for Health the progress to date in determining an application for a medical card for a person (details supplied) in County Laois; and if he will make a statement on the matter. [28061/15]

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Written answers

The 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.

Medical Card Eligibility

Questions (206)

Brendan Griffin

Question:

206. Deputy Brendan Griffin asked the Minister for Health if he will introduce an automatic entitlement to full medical cards for children in receipt of a domiciliary care allowance; and if he will make a statement on the matter. [28064/15]

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Written answers

Under the provisions of the Health Acts, medical cards are provided to persons who are, in the opinion of the 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. Where deemed appropriate in particular circumstances, the HSE may exercise discretion and grant a medical card even though an applicant's means exceed the prescribed threshold. Where a person does not qualify for a medical card, they may be provided with a GP Visit Card, appropriate therapy or other community supports or drugs.

The Domiciliary Care Allowance (DCA) payment is made by the Minister for Social Protection to carers in respect of a child at home under 16 years of age with a severe disability, where it has been determined that the child requires ongoing care and attention, substantially over and above the care and attention usually required by a child of the same age. Eligibility for the DCA is not based primarily on the medical or psychological condition, but on the resulting lack of function of body or mind necessitating the degree of extra care and attention required. As such it is not possible to say if a particular child or any particular medical condition or disability will qualify for a payment under the DCA scheme.

Out of an approximate population of 1 million people under the age of 16 years, almost 450,000 held a medical card or a GP visit card. Approximately 29,000 children qualified for the DCA payment in 2014. It is estimated that about two-thirds of children qualifying for a DCA payment also hold a medical card. In addition, from 1 July 2015, all children under the age of 6 years are entitled to access a GP service free of charge, as part of the first phase of introducing a universal GP service in Ireland.

At the time of the publication of the report of the Expert Panel on Medical Need for Medical Card Eligibility the HSE announced a range of actions to enhance the operation of the medical card scheme and make it more sensitive to people’s needs. The medical card system is now operating in a more sensible and sensitive manner. The HSE is exercising greater discretion, as is evident in the increase in the number of discretionary medical cards in circulation which have grown by 67% from 52,000 in mid-2014 to 87,000 by mid-2015.

On foot of the Keane Report, the Director General of the HSE established a Clinical Advisory Group (CAG). The CAG is to provide clinical oversight and guidance to the operation of the medical card system. This is with a view to ensuring that the relatively small percentage of cases requiring the recognition of the burden of a medical condition over and above financial hardship can be accommodated. The CAG is continuing its consideration of the medical card assessment process to provide for the measurement of the burden of disease.

Medical Card Eligibility

Questions (207)

Bernard Durkan

Question:

207. Deputy Bernard J. Durkan asked the Minister for Health if he will review eligibility for a medical card in the case of a person (details supplied) in County Kildare, given that the person is in receipt of a disability allowance and the person's spouse has a full medical card; and if he will make a statement on the matter. [28066/15]

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Written answers

The 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.

Medical Card Applications

Questions (208)

Bernard Durkan

Question:

208. Deputy Bernard J. Durkan asked the Minister for Health the progress to date in determining an application for a medical card for persons (details supplied) in County Kildare; and if he will make a statement on the matter. [28067/15]

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Written answers

The 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.

Nursing Home Accommodation Provision

Questions (209)

Catherine Murphy

Question:

209. Deputy Catherine Murphy asked the Minister for Health if he is aware that the Health Information and Quality Authority has advised that several nursing homes should reduce their patient numbers starting in September 2015; if the Health Service Executive is prepared for a knock-on demand for beds at acute hospitals as a result; the position regarding the development nationally of appropriate step-down facilities to alleviate pressure upon nursing homes; and if he will make a statement on the matter. [28068/15]

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Written answers

The Health Information and Quality Authority (HIQA) has indicated that a number of public units do not fully meet the standards one would expect to find in a modern nursing home. This is not surprising given the age and structure of many of our public nursing homes. Compliance issues are in the main related to physical infrastructure and to issues such as personal space and privacy and access to toilet facilities. It is important to stress that the care provided to residents of these facilities is of a generally high standard.

Discussions are ongoing between the Health Service Executive (HSE) and HIQA in this context. Addressing these issues will require prioritisation across facilities within the overall resources that can be made available, and the Government's priority is to ensure that appropriate placements continue to be available for those who need them.

In Budget 2015, additional funding of €25m was provided to support services that provide alternatives to, and relieve pressures on, acute hospitals. Of this €25m, €10m was used to provide an additional 300 places under the Nursing Homes Support Scheme. This reduced the waiting time for approved applicants from 17 weeks to 4 weeks. Up to €8m was used to provide access to an additional 115 short-stay beds across the Dublin area. Up to €5m was used to provide 400 additional Home Care Packages which will benefit 600 people in the course of the year, and €2m was used to expand the Community Intervention Team services in primary care across Dublin and the surrounding region.

In April 2015 the Government provided a further €74m to address issues that impact on delayed discharges. This amount built on the €25m provided earlier and was allocated as follows: €44m was allocated to the Nursing Homes Support Scheme to provide an additional 1,600 places and to further reduce waiting times for approved applicants from 11 to 4 weeks; the remaining €30m was principally applied to provide additional transitional beds, some of which were on a temporary basis to address the particular pressures then being experienced by acute hospitals.

The Department of Health and the HSE will continue to deploy the mix of available resources to provide the services and supports that meet the needs and wishes of older people as effectively as possible.

Hospital Appointments Status

Questions (210)

Billy Timmins

Question:

210. Deputy Billy Timmins asked the Minister for Health the position regarding an eye operation in respect of a person (details supplied) in County Wicklow; and if he will make a statement on the matter. [28089/15]

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Written answers

Under 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.

The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the Health Service Executive, sets out the processes that hospitals are to implement to manage waiting lists.

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.

Health Services Provision

Questions (211)

Billy Kelleher

Question:

211. Deputy Billy Kelleher asked the Minister for Health when the Health Service Executive will increase the staffing levels at St. Ita's in Newcastle West, County Limerick to allow this facility to be used to its full potential, and to fulfil its designated use as a palliative care and hospice unit; and if he will make a statement on the matter. [28092/15]

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Written answers

As 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.

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