Written Answers Nos 223-237
223. Deputy Billy Kelleher asked the Minister for Health to provide an update on the publication of the Misuse of Drugs (Amendment) Bill 2016, to amend section 2(2) and other sections of the 1977 Misuse of Drugs Act; when he expects the Bill to be enacted; and if he will make a statement on the matter. [17674/16]
View answerThe Misuse of Drugs (Amendment) Bill 2016 was published on Tuesday 21 June. It brings under the scope of the Misuse of Drugs Act 1977 a number of substances, including certain prescription medicines which are being sold on the streets by drug dealers, and makes a number of technical amendments to the Act.
Yesterday, the Supreme Court up held the constitutionality of Section 2(2) of the Misuse of Drugs Act, 1977. Consequently no amendment to that section is now required.
224. Deputy Billy Kelleher asked the Minister for Health his views on the delay in drafting regulations to enable the introduction of Suboxone (an alternative to methadone), bearing in mind that they were expected at the end of Q1 2016, and there is need for a notification period of three months under the European technical standards directive once the regulations have been published; his further views that these delays are unacceptable, as there is an urgent need for the availability of Suboxone to cater for persons with opioid dependency; and if he will make a statement on the matter. [17675/16]
View answerSuboxone is a medicinal product comprising of the drugs buprenorphine and naloxone. It is authorised as a substitution treatment for opioid drug dependence, within a framework of medical, social and psychological treatment. It is currently being provided to a cohort of patients involved in the piloting and feasibility study for Suboxone.
At the request of the Department of Health, the HSE set up an implementation group to introduce, supervise, monitor and review the wider availability and cost of buprenorphine/naloxone products for opioid substitution therapy. In January 2016 the Director General of the HSE submitted the report of this Opioid Substitution Implementation Group to my predecessor, the Minister of State with special responsibility for drugs strategy. No decision on the report was taken at that time. The report recommends the phased, increased access to buprenorphine/naloxone for a cohort of patients in specific circumstances, subject to required legislation being enacted and resourcing. It was noted in the report that additional funding would be required and that these additional resources for 2016 had not been allocated.
The mechanisms proposed in this report will require legislative changes to be made. If the provision of Suboxone is to be given the same statutory basis as methadone, in order to ensure its safe, appropriate and cost-effective use, an amendment to the Misuse of Drugs (Supervision of Prescription and Supply of Methadone) Regulations 1998 will be necessary.
The Misuse of Drugs (Amendment) Act 2015 was enacted as emergency legislation in March 2015 following a Court of Appeal decision on a constitutional challenge to section 2(2) of the Misuse of Drugs Act 1977. The 2015 Act reconfirmed the existing Ministerial regulations and orders made under the 1977 Act, including the Misuse of Drugs Regulations 1988 and the 1998 Methadone Regulations. As a result, these Regulations may only now be amended by primary legislation.
As you know, on Tuesday the Misuse of Drugs (Amendment) Bill 2016 was published. The primary purpose of this Bill is to protect public health by bringing certain substances which are open to misuse and known to be traded on the illicit market under the scope of the Misuse of Drugs legislation, as well as aiding the law enforcement functions of An Garda Síochána and the Customs Service. The Bill provides for a small number of other amendments of a technical nature including the ‘unlocking’ of the previously confirmed Regulations and Ministerial Orders.
It is hoped that this Bill can be enacted before the summer recess. Controlling the substances in the Bill is part one of a two-step process. Regulations are also required to allow legitimate users (patients with a prescription, health professionals) to possess the newly controlled substances. Work is underway on drafting these regulations as a matter of priority. Any regulations made in relation to buprenorphine/naloxone will be drafted subsequent to this legislative agenda and will then be subject to the 3-month EU notification under the Technical Standards and Regulations Directive 2015/1535/EU.
225. Deputy Billy Kelleher asked the Minister for Health his views on the fact that according to recent research published by Health Research Board, there has been an increase in the number of persons dying from methadone overdoses, with the number of deaths due to methadone overdoses, the largest cause of deaths by poisoning in Ireland, ahead of even heroin overdoses; if, based on this data on methadone overdoses, he will fast-track the availability of Suboxone, to provide an alternative to methadone, as a way to reduce such overdose risks, given the much lower risk of overdose from Suboxone; and if he will make a statement on the matter. [17676/16]
View answerAccording to a Health Research Board report on drug-related deaths for 2013, the latest year for which data is available, the total number of drug-related poisoning deaths increased from 361 in 2012 to 387 in 2013. Methadone was implicated in 93 poisoning deaths in 2013, compared with 86 in 2012. However, the majority of poisoning deaths where methadone was implicated, involved other drugs. There is clear evidence to indicate that having access to drug treatment is one of the major factors in reducing drug-related deaths.
Suboxone is a medicinal product comprising the drugs buprenorphine and naloxone. It is authorised as a substitution treatment for opioid drug dependence, within a framework of medical, social and psychological treatment. It is currently being provided to a cohort of patients involved in the piloting and feasibility study for Suboxone.
At the request of the Department of Health, the HSE set up an implementation group to determine the conditions to govern the wider availability of buprenorphine/naloxone products for opioid substitution therapy. In January 2016, the HSE submitted its report to the Department. The report recommends the phased increased access to buprenorphine/naloxone for a cohort of patients in specific circumstances, including the resources required, subject to the required legislation being enacted to provide buprenorphine/naloxone on the same statutory basis as methadone. If the provision of Suboxone is to be made on this basis, any regulations made in relation to Suboxone will need to be drafted subsequent to the legislative agenda associated with the Misuse of Drugs (Amendment) Bill 2016.
Methadone maintenance treatment is a critical stabilising treatment, which is the most appropriate substitution treatment for the majority of patients. Naloxone is an opioid antagonist which is used to reverse the effects of overdose of opioids such as heroin, morphine and methadone and has been proven to be an effective way of reducing the number of opioid overdose deaths. In May 2015, the HSE undertook a demonstration project to assess and evaluate the suitability and impact of using a pre-filled Naloxone injection which is designed for non-medical administration in Ireland. The project involved 600 opiate users receiving take-home naloxone on prescription. It also included those recently released from custody who have been identified as at high risk of opioid overdose. These drug users and those close to them have been trained on how to administer naloxone and to recognise the signs of an overdose. The HSE has advised that an evaluation of the demonstration project has been completed and a national implementation plan is currently being developed.
226. Deputy David Cullinane asked the Minister for Health the cost of reintroducing allowances for public sector workers in his Department; and if he will make a statement on the matter. [17686/16]
View answerThe outcome of the Review of Public Sector Allowances was published by the Department of Public Expenditure and Reform on 18 September 2012.
The Delegates (and Chairpersons) Allowance (payable to officials who travel outside of Ireland and the UK to represent Ireland at meetings of the EU or other international organisations, or who act as Chairpersons of EU committees) was abolished for both new beneficiaries and existing staff. This allowance was estimated to cost in the region of €1 million in 2011 across all Government Departments. The estimated annual cost of reintroducing this allowance for officers in my Department would be in the region of €30,000.
227. Deputy David Cullinane asked the Minister for Health the cost of ensuring public sector workers recruited in his Department post-2011 are paid on the pre-2011 rate; and if he will make a statement on the matter. [17696/16]
View answerThe cuts in Public Sector pay that were introduced under FEMPI legislation are being restored on a phased basis to all grades who are officers of my Department in accordance with instructions from the Department of Public Expenditure and Reform (DPER). This restoration is centrally negotiated and decided by DPER. There is no distinction in pay rates between Officers of this Department who entered the service pre or post 2011.
228. Deputy Róisín Shortall asked the Minister for Health if his attention has been drawn to the situation whereby the student debt burden on those qualifying from graduate entry medicine is so great that many are being forced to emigrate to secure remuneration that will allow them to make repayments, and that many of these newly qualified doctors cannot afford the Irish Medical Organisation registration fee; if he has considered incentives to retain these graduates here; and if he will make a statement on the matter. [17706/16]
View answerI recognise that the recruitment and retention of medical doctors who graduate and are trained in Ireland is important to the effective functioning of the Irish health service, and is in keeping with our obligations under the WHO Global Code of Practice on the International Recruitment of Health Personnel.
In July 2013, a Working Group, chaired by Prof Brian MacCraith, President, Dublin City University, was established to carry out a Strategic Review to examine and make high-level recommendations relating to training and career pathways for doctors with a view to:
- Improving graduate retention in the public health system;
- Planning for future service needs; and
- Realising maximum benefit from investment in medical education and training.
The Working Group completed its work in June 2014 and, in all, submitted three reports and made 25 recommendations. The reports address a range of barriers and issues relating to the recruitment and retention of doctors in the Irish public health system.
The Deputy can be confident that the implementation of the recommendations of the Strategic Review of Medical Training and Career Structure Working Group is a priority for my Department and the Health Service Executive . The Strategic Review recommendations are being implemented through a range of structures and processes across the health system. Each recommendation has an identified business owner and progress updates are sought by my Department on a regular basis. To support implementation of the recommendations, my Department has also established an Implementation Monitoring Group, comprising key stakeholders. To date, three progress reports on the implementation of the recommendations have been published on my Department’s website.
The Deputy may wish to note that on foot of a key recommendation the implementation of higher pay rates for new entrant Consultants, including provision for the application of incremental credits, was sanctioned in 2015.
With regard to the specific matter of the Irish Medical Organisation registration fee, this is not an issue in which I have any function.
229. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [17726/16]
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.
230. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [17728/16]
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.
231. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [17730/16]
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.
232. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [17731/16]
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.
The scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, 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.
233. Deputy Robert Troy asked the Minister for Health the status of an appointment for a person (details supplied). [17732/16]
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.
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 HSE, 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.
234. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [17733/16]
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.
235. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [17735/16]
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.
236. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [17737/16]
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.
237. Deputy Michael Healy-Rae asked the Minister for Health the status of appointments for persons (details supplied); and if he will make a statement on the matter. [17738/16]
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.
