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Tuesday, 22 Sep 2015

Written Answers Nos. 978-994

Substance Misuse

Questions (978)

Éamon Ó Cuív

Question:

978. Deputy Éamon Ó Cuív asked the Minister for Health if he will provide an estimate of financial resources spent each year on the care of persons suffering the effects of alcoholism; the trend of expenditure in the past few years; the approximate number of persons per year; if the cost is purely on hospital-community costs; if the amount provided to their agencies each year can be estimated; his views on the cost to industry of alcoholism; if any statistics are available; and if he will make a statement on the matter. [31376/15]

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Written answers

The provision of services to prevent and treat addiction to alcohol is the responsibility of the Health Service Executive and as such, I have referred this element of the question to the Health Service Executive for attention and direct reply. 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.

The Report of the Steering Group on a National Substance Misuse Strategy, 2012 noted that the majority of Irish people drink in a harmful manner. The report further noted that the harms caused by the misuse of alcohol were estimated to cost the Exchequer €3.7 billion in 2007 representing 1.9% of Gross National Product that year. The figure is taken from the report, "Costs to Society of Problem Alcohol Use in Ireland", 2011. The estimate is based on the methods used in similar reports from other developed countries including the United Kingdom and used data from surveys and surveillance systems. The costs are broken down as follows:

-

€ million

% of Total Cost

Cost to the healthcare system of alcohol-related illnesses

1,200

32

Cost of alcohol-related crime

1,189

32

Cost of alcohol-related road accidents

526

14

Cost of output lost due to alcohol-related absence from work

330

9

Cost of alcohol-related accidents at work

197

5

Cost of alcohol-related suicides

167

5

Cost of alcohol-related premature mortality

110

3

Total

3,719

100

I hope the above clarifies the cost of financial resources spent.

Orthodontic Services Provision

Questions (979)

Éamon Ó Cuív

Question:

979. Deputy Éamon Ó Cuív asked the Minister for Health if he will provide details of the waiting list for orthodontic treatment in the Dublin area; the way those on the list are treated; if treated by his Department, Health Service Executive staff or if contracted out to private orthodontists; his views on the matter; if he will explain the new scheme whereby cases are referred to orthodontists in Northern Ireland; the way in which these are paid; if it is a combination of tax relief from the Irish Exchequer plus a direct fee of some €1,740 if private orthodontists in Dublin and so on have been offered this work on similar terms; if not, the reason; if the arrangement has been made by him or has his approval; if he will clarify and extend the offer of work to orthodontists working in the Irish State since the Irish taxpayer is at least paying the fee in part; and if he will make a statement on the matter. [31380/15]

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Written answers

The HSE provides orthodontic treatment to those who have been assessed and referred for treatment before their 16th birthday. It should be noted that the nature of orthodontic care means that immediate treatment is not always desirable. It is estimated that in up to 5% of cases it is necessary to wait for further growth to take place before treatment commences. Patients are assessed by the HSE Orthodontic Service under the modified Index of Treatment Need. Patients with the greatest level of need i.e. Grade 5 or Grade 4 are provided with treatment by the HSE.

Information on waiting times is collated by the HSE by region and for the intervals as shown. The information on waiting times for treatment for Quarter 2 of 2015 for the two HSE regions which include Dublin is as follows:

Waiting time from assessment to commencement of treatment

1 - 6 months

7 - 12 months

13 - 24 months

25-48

months

Over 48 months

TOTAL

HSE Dublin Mid-Leinster

897

985

1,675

1,243

199

4,999

HSE Dublin North East

271

518

1,032

1,585

748

4,154

While there is no scheme in place whereby the HSE makes arrangements for patients to receive orthodontic treatment in Northern Ireland, under EU Directive 201/24/EU, now commonly referred to as the Cross Border Directive (CBD), it is open to persons entitled to public patient healthcare in Ireland to choose to avail of that healthcare in another EU or EEA country or Switzerland. Such patients are reimbursed to a maximum of the level of cost that would have been assumed if this healthcare had been provided in this jurisdiction. The care must be provided outside the State and may be availed of in the public or private sector. The CBD does not provide for the patient to access the care in his or her State of residence.

At present a national procurement process is underway to provide treatment for certain categories of misalignment by a panel of independent practitioners under contract to the HSE over the next three years. This initiative will especially focus on those waiting for 4 years or longer. It is expected that this initiative will commence later this year and will have a positive impact on waiting times.

Counselling Services Provision

Questions (980)

Michael Healy-Rae

Question:

980. Deputy Michael Healy-Rae asked the Minister for Health if he will address a matter (details supplied) regarding counsellors employed by the Health Service Executive; and if he will make a statement on the matter. [31383/15]

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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.

Prescriptions Charges

Questions (981)

Michael McGrath

Question:

981. Deputy Michael McGrath asked the Minister for Health the position regarding the application of prescription charges for persons who have Ehlers-Danlos syndrome; if he will consider providing them with an exemption from the charge; and if he will make a statement on the matter. [31385/15]

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Written answers

Prescription charges are part of a set of measures introduced by Government in recent years to reduce pharmaceutical drugs expenditure. Medical card holders are required to pay a prescription charge of €2.50 per item for medicines and other prescription items supplied to them by community pharmacists, subject to a cap of €25 per month for each person or family.

At present, the only exemptions from prescription charges apply to children in the care of the Health Service Executive, patients participating in the Methadone Treatment Scheme, and asylum seekers living in direct provision. There are no plans to introduce exemptions for specific medical conditions.

Hospitals Expenditure

Questions (982, 983)

Pearse Doherty

Question:

982. Deputy Pearse Doherty asked the Minister for Health if he will provide in tabular form the amount of money which has been paid each year since 2008, to private companies for contracted laundry services for a hospital (details supplied) in County Donegal; the projected savings, for each of these years of having these services carried out by the private sector; and if he will make a statement on the matter. [31389/15]

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Pearse Doherty

Question:

983. Deputy Pearse Doherty asked the Minister for Health if he will provide in tabular form a breakdown, of the total staff numbers, including details of their positions, employed at a hospital (details supplied) in County Donegal each year since 2008; the number of agency staff who have been employed at the hospital during this period as well as the number who are employed directly by the Health Service Executive with regards to these figures; and if he will make a statement on the matter. [31390/15]

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Written answers

I propose to take Questions Nos. 982 and 983 together.

As these are service matters they have 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.

Tobacco Control Measures

Questions (984, 985, 986, 987, 988)

Micheál Martin

Question:

984. Deputy Micheál Martin asked the Minister for Health his position on e-cigarettes; and if he will make a statement on the matter. [31396/15]

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Micheál Martin

Question:

985. Deputy Micheál Martin asked the Minister for Health if he or his Department have plans to introduce legislation to ban the use of e-cigarettes in the workplace; and if he will make a statement on the matter. [31397/15]

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Micheál Martin

Question:

986. Deputy Micheál Martin asked the Minister for Health if he and his Department are assessing the impact of the use of e-cigarettes by users and also if the impact of e-cigarettes in workplaces is being considered; and if he will make a statement on the matter. [31398/15]

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Micheál Martin

Question:

987. Deputy Micheál Martin asked the Minister for Health if environmental health officers are concerned regarding the impact of the use of e-cigarettes in workplaces; if he has discussed the matter with them; and if he will make a statement on the matter. [31399/15]

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Micheál Martin

Question:

988. Deputy Micheál Martin asked the Minister for Health if he and his Department have any concerns regarding the use of e-cigarettes in workplaces and its impact on younger persons in particular; and if he will make a statement on the matter. [31400/15]

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Written answers

I propose to take Questions Nos. 984 to 988, inclusive, together.

E-cigarettes and other non-medicinal nicotine delivery systems are not regulated under tobacco control legislation because they do not contain tobacco. They must however, comply with the European Communities (General Product Safety) Regulations which specify the duties of producers and distributors placing products on the market.

While e-cigarettes do not contain tobacco, they do contain nicotine, a highly addictive substance which is the driver for cigarette smoking. Hence, there are legitimate concerns about the public health benefits of allowing such products to exist without regulation. Because they are a relatively recent product, there is limited scientific information available to balance the potential harms and benefits that might arise from more widespread public use.

The EU Tobacco Products Directive (2014/40/EU), inter alia, provides for the regulation of certain aspects of e-cigarettes across EU Member States. My Department is working to transpose the Directive into national legislation by the May 2016 deadline.

The Directive will:

- set mandatory safety and quality requirements e.g. on nicotine content, ingredients and devices, as well as refill mechanisms etc., for e-cigarettes;

- make health warnings and information leaflets obligatory;

- introduce notification requirements for manufacturers and importers of e-cigarettes; and

- impose stricter rules on advertising and monitoring of market developments.

In addition to the regulations under the Directive, e-cigarettes will be further regulated in Ireland through the introduction of a retail licensing system. The legislation, approved by Government will also prohibit the sale of these products to, and by, persons under 18 years of age.

Currently the evidence base does not support prohibiting vaping in public places although individual organisations/companies are free to introduce an e-cigs free policy. My Department will continue to monitor evidence on the potential harms and any benefits of these products, so as to inform decisions around any future additional regulation in this area.

Hospital Waiting Lists

Questions (989)

Michael Healy-Rae

Question:

989. Deputy Michael Healy-Rae asked the Minister for Health the position regarding an appointment for plastic surgery for a person (details supplied) in County Kerry; and if he will make a statement on the matter. [31401/15]

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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.

Medical Card Applications Data

Questions (990)

John O'Mahony

Question:

990. Deputy John O'Mahony asked the Minister for Health if he will provide in tabular form the number of medical card applications received in January to August 2015; and if he will make a statement on the matter. [31402/15]

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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 Administration

Questions (991)

John O'Mahony

Question:

991. Deputy John O'Mahony asked the Minister for Health the reason there are no timeframes for decision when medical card applications are sent to medical officers for decision; the reason for this; and if he will make a statement on the matter. [31403/15]

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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 Administration

Questions (992)

John O'Mahony

Question:

992. Deputy John O'Mahony asked the Minister for Health the number of medical cards granted within the 15 days timeframe; and if he will make a statement on the matter. [31404/15]

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Written answers

As at week ending 14 September 2015, 95.19% of medical card applications received by the Primary Care Reimbursement Services were processed within a 15 day timeframe.

The HSE provides weekly statistics on turnaround times on its website- http://www.hse.ie/eng/services/list/1/schemes/mc).

Health Services

Questions (993)

Derek Keating

Question:

993. Deputy Derek Keating asked the Minister for Health the number of diagnoses of Lyme disease here in recent years; the number of diagnoses for Lyme disease that were missed, in view of the case of a person (details supplied) in County Dublin; his views on the matter; his further views on the quality of testing here; and if he will make a statement on the matter. [31410/15]

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Written answers

Lyme disease became a notifiable disease in Ireland in 2012, the notifiable entity being that of Neuroborreliosis. Since then, 8 cases were notified in 2012, 13 in 2013, 18 in 2014 and 7 provisionally for this year. As with any illness, it is not possible to say how many cases may have been undiagnosed.

It is not appropriate for me to comment on any individual case. What I would say is that current best advice is that the diagnosis of Lyme Borreliosis should be made after careful evaluation of the patient's clinical history, physical findings, laboratory evidence and exposure risk evaluation.

The general position regarding testing for Lyme Disease is that antibody testing is the mainstay of laboratory testing but these tests need to be performed by an appropriately accredited laboratory, ideally using validated CE marked assays. In addition, international guidelines recommend a two-stage approach for serology testing. Samples are first screened using an enzyme immunoassay (EIA). Reactive results are further investigated using a second test, the immunoblot (Western Blot). It is possible to get a preliminary positive screening test (EIA) which is not confirmed when interpreted with the result of the second immunoblot test.

The Health Protection Surveillance Centre of the HSE has established a Lyme Borreliosis sub-committee of its Scientific Advisory Committee to consider methods to raise awareness and improve surveillance of Lyme Borreliosis in Ireland. Part of the committee's work will also be to undertake a survey of Borreliosis laboratory practice in Irish clinical laboratories which should provide valuable information on the manner in which Lyme testing takes place in Ireland.

Question No. 994 answered with Question No. 745.
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