Written Answers Nos. 1224-1249
1224. Deputy John Brassil asked the Minister for Health if he will provide appropriate funds to Cork University Hospital to open the operating theatres and end rolling closures; and if he will make a statement on the matter. [25305/16]
View answer1225. Deputy John Brassil asked the Minister for Health if he will provide funding to Cork University Hospital to allow for additional colorectal surgeons as there are a very limited number of such surgeons at present in the Cork and Kerry region and as a result there is a significant waiting list for related procedures in the region; and if he will make a statement on the matter. [25306/16]
View answerI propose to take Questions Nos. 1224 and 1225 together.
With regard to the specific queries raised by the Deputy, as these are service matters, I have asked the HSE to respond to you directly.
1226. Deputy Louise O'Reilly asked the Minister for Health the supports and grants available for clubs supporting persons with special needs; the funding available to a group (details supplied); and if he will make a statement on the matter. [25310/16]
View answerThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
1227. Deputy Pearse Doherty asked the Minister for Health when the parents of a child (details supplied) will receive an appointment from Letterkenny University Hospital; and if he will make a statement on the matter. [25325/16]
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.
1228. Deputy Michael Healy-Rae asked the Minister for Health the status of an application by a person (details supplied) for a primary medical certificate; and if he will make a statement on the matter. [25331/16]
View answerThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
1229. Deputy Ruth Coppinger asked the Minister for Health the amount and percentage of funding of HSE-funded health services including hospitals, public and voluntary derived from charitable contributions [25359/16]
View answerAs this is a service matter, it has been referred to the HSE for direct reply.
1230. Deputy Ruth Coppinger asked the Minister for Health the amount and percentage of funding of HSE-funded health services including hospitals, public and voluntary, derived from for-profit income generating schemes [25360/16]
View answerAs this is a service matter, it has been referred to the HSE for direct reply.
1231. Deputy Ruth Coppinger asked the Minister for Health the total amounts spent and budgeted for homeless services by the HSE and any other agencies under his remit in 2015 and 2016 [25361/16]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
1232. Deputy Ruth Coppinger asked the Minister for Health the information available on the estimated annual cost of offering a full-range of reproductive services to women via the HSE free at the point of use, including contraception, abortion services and fertility treatments [25362/16]
View answerAs this is a service issue, this question has been referred to the Health Service Executive for direct reply to the Deputy.
1233. Deputy Ruth Coppinger asked the Minister for Health the annual cost of restoring HSE medical, nursing, care and home help staff to 2008 levels. [25363/16]
View answerI have asked the HSE to respond to the Deputy directly on this matter.
1234. Deputy Ruth Coppinger asked the Minister for Health the financial benefits that would accrue to the drinks industry from the introduction of minimum pricing for alcohol; and if he will make a statement on the matter. [25364/16]
View answerThe Public Health (Alcohol) Bill will make it illegal to sell or advertise for sale alcohol at a price below a set minimum price. Minimum Unit Pricing (MUP) sets a minimum price per gram of alcohol. The minimum price of an alcohol product would be based on the number of grams of alcohol in the product. MUP is a targeted measure, aimed at those who drink in a harmful and hazardous manner, and designed to prevent the sale of alcohol at very cheap prices. MUP is able to target cheaper alcohol relative to its strength because the minimum price is determined by and is directly proportional to the amount of pure alcohol in the drink. The MUP is set in the Public Health (Alcohol) Bill at 10c per gram of alcohol, which equates to a minimum price of €1 per standard drink.
The University of Sheffield study reported that the alcohol products most affected by this policy are those that are currently being sold very cheaply, often below cost prices, in the off-trade, i.e. supermarkets and off-licences. The study indicated that a minimum price of 10 cent per gram will lead to an overall increase of 11.1% in the price of alcohol, with an increase of 29% in the off-trade and 0.2% in the on-trade. This in turn, would lead to an overall decrease in consumption of 8.8%, with a decrease of 19.6% in the off-trade and an increase of 0.3% in the on-trade respectively. Revenue to retailers is estimated to increase with the majority of this accruing in the off-trade.
MUP will lead to substantial health, social and economic gains. The study by the University of Sheffield has estimated that €1.7 billion savings will be accrued cumulatively over a 20-year-period. This figure includes reduced direct healthcare costs, savings from reduced crime and policing, savings from reduced workplace absence and a financial valuation of the health benefits measured in terms of quality-adjusted life years. In addition, while a number of years will be needed to see savings in relation to some illnesses, such as heart disease and cancer, MUP will also have some immediate effects on health costs, crime costs and loss of productivity due to absenteeism.
1235. Deputy Louise O'Reilly asked the Minister for Health further to the recommendations contained in the British Government’s report on antimicrobial resistance (details supplied) his plans to enact the key recommendations contained in the report here; and if he will make a statement on the matter. [25378/16]
View answer1236. Deputy Louise O'Reilly asked the Minister for Health if he will recommend, as part of the ongoing discussion on a national action plan on antimicrobial resistance, the setting of targets for the reduction of usage and or prescribing of antibiotics in health care settings, particularly in primary care; and if he will make a statement on the matter. [25379/16]
View answer1237. Deputy Louise O'Reilly asked the Minister for Health if he will recommend, as part of the ongoing discussion on a national action plan on antimicrobial resistance, the introduction of diagnostic testing at primary care level to alleviate the over prescription of antibiotics and other microbes to treat viruses and infections; if consideration will be given to rolling out a pilot scheme on this similar to those being run in Britain; and if he will make a statement on the matter. [25380/16]
View answer1238. Deputy Louise O'Reilly asked the Minister for Health the status of the Irish national action plan on antimicrobial resistance that is aligned with the global action plan; if submissions have been called for; when the action plan will be finished; if the action plan will be published in advance of the World Health Assembly in 2017; if Members of the Oireachtas or the relevant Oireachtas committees will receive a briefing on this, particularly given its importance in terms of future healthcare planning; and if he will make a statement on the matter. [25381/16]
View answer1239. Deputy Louise O'Reilly asked the Minister for Health if the National Interdepartmental AMR consultative committee has met, or sought submissions from, external groups, organisations or medical companies on its work or the national action plan; if not, if he will recommend that external submissions be sought; and if he will make a statement on the matter. [25382/16]
View answer1240. Deputy Louise O'Reilly asked the Minister for Health if, and the way, the national interdepartmental AMR consultative committee is measuring the number of persons or incidents where antimicrobial resistance has occurred within the health care services here; if work is being undertaken to examine the costs and knock-on effects on other parts of the health service because of AMR and the over prescription of antibiotics; and if he will make a statement on the matter. [25383/16]
View answerI propose to take Questions Nos. 1235 to 1240, inclusive, together.
The rise in antimicrobial resistance is universally recognised at global, European and national levels, including Ireland, as one of the greatest potential threats to human and animal health with possible serious consequences for public health, animal welfare and the agriculture and food sectors.
There is international consensus through the 'One Health' Initiative to which the WHO (World Health Organisation), FAO (Food and Agriculture Organisation) and the OIE (World Health Organisation for Animal Health) are signatories, that tackling the global public health threat of AMR requires action across human and animal health sectors, agriculture and the wider environment. The 'One Health' concept is a worldwide strategy for expanding interdisciplinary collaborations and communications in all aspects of health care for humans, animals and the environment.
The Lord O'Neill Report referenced by the Deputy is welcomed by Ireland and is a valuable addition to the serious debate on the worldwide threat of antimicrobial resistance. The author's concerns about both the human and economic costs of increasing resistance to often life saving treatment in the form of antibiotics is a matter which is being addressed at international, EU and national levels. The Report's recommendations on reducing demand for antimicrobials, improving global surveillance of drug resistance and antimicrobial consumption in humans and animals are in line with the WHO Global Action Plan on Antimicrobial Resistance which Ireland supports.
In relation to the setting of targets for the reduction of usage and or prescribing of antibiotics, particularly in primary care, the Director General of the HSE has set up a Taskforce to address the issue of healthcare associated infections (HCAIs) and antimicrobial resistance (AMR). The group is tasked with addressing the above issue and is drafting an Action Plan to address aspects relating to antimicrobial resistance. Currently, there is limited surveillance data on antimicrobial prescribing in the community, thus work on setting targets is still being progressed.
For the first time the Department's National Healthcare Quality Reporting System (NHQRS) Second Annual Report 2016 reported data on antibiotic consumption in the community. The community antibiotic consumption dataset contains regional monthly wholesaler to retail pharmacy sales data from over 95% of the wholesalers and manufacturers in Ireland.
Prescription level data from the Primary Care Reimbursement Service (PCRS) has shown a decrease in the number of antibiotic prescriptions in recent years, and there is some indication that the quality of antibiotic prescribing in the community is improving in line with national guidelines. The HSE is currently working towards developing and implementing a system to provide prescription-level surveillance and audit data for antimicrobial prescribing in Primary Care, which would include individual prescriber feedback to support improved prescribing practices.
In the meantime other actions by the Executive to address this issue include:
- Updating the antimicrobial prescribing guidelines for use in primary care settings.
- A list of “preferred antibiotics” has been developed for Primary Care settings and there are a series of implementation programmes underway to promote the use of a restricted number of antibiotics in community settings (including educational sessions for GPs, promotion via the HSE Medicines Management Programme, and an improvement project based in GP Out-Of-Hours centres).
- The national primary care prescribing guidelines (www.antibioticprescribing.ie) include recommendations around diagnostic testing for some specific conditions.
- There have been a series of public information campaigns targeting community antibiotic use between 2008 and 2014. Post marketing surveillance has shown an improvement in public knowledge around antibiotics.
- A very successful public information website (www.undertheweather.ie) was developed by HSE, ICGP, and IPU, and launched in 2014, promoting self-care for self-limiting illnesses and avoiding unnecessary antibiotic use.
- Ireland has taken part in European Antibiotic Awareness Day since 2008; the initiative has been linked to the launch of professional and public information campaigns.
A recent review of antibiotic prescribing via the Primary Care Reimbursement System (PCRS) has shown a reduction in the rate of antibiotic prescribing, particularly among children and young adults (who have been the principal target groups of public information campaigns in this area, and of the “undertheweather.ie” website). In addition, this review has shown that the pattern of antibiotic prescribing has improved, in line with national primary care antibiotic prescribing guidelines. Diagnostic testing at primary care level is recognised as a useful component in helping to improving prescribing practices and reducing over-prescribing of antimicrobials. There are a number of research studies currently underway looking at novel diagnostic tools in the international setting.
The European Union at both Council and European Parliament levels supports a Community Strategy against AMR having regard to the 'One Health' concept. The Commission's 2012 AMR 5-year action plan has recently been revised through Council Conclusions on the next steps under a ‘One Health’ approach to combat AMR, adopted at the Council's Employment, Social Policy, Health and Consumer Affairs Council (EPSCO) meeting on 17 June last. Ireland has continued to support the EU drive to combat AMR and actively engaged in discussions on the new Council Conclusions. The Council calls on Member States to have in place before mid-2017 'a national action plan against Antimicrobial resistance based on the 'One Health' approach and in line with the objectives of the WHO Global Action Plan'.
In recognition of the serious and increasing threat of antimicrobial resistance and the requirement for a ‘whole of Government’ approach to health issues, the Department of Health’s Chief Medical Officer (CMO) and the Department of Agriculture, Food and the Marine’s Chief Veterinary Officer (CVO) established a high level National Interdepartmental AMR Consultative Committee in 2014 to address this issue. The Committee meets Ireland’s requirements to have an Intersectoral co-ordination mechanism for addressing AMR at European level, including the development of a national action plan against AMR as required of Member States in the WHO's Global Action Plan against AMR (2015).
The Committee has a clear role and mandate across the human and animal health sectors. Committee membership consists of representatives of both Departments and of a range of relevant health and veterinary specialist agencies, including other relevant bodies with a remit across the two sectors; membership is representative of major stakeholders. The Committee meets bi-annually and its last meeting was in April 2016. The Committee's work plan for 2016 includes development of a national action plan against AMR, which includes ongoing engagement with all relevant stakeholders, both Committee member and others. This work is continuing and the Committee is scheduled to meet again in late 2016 to assess progress on this major agenda item. It is intended that the National Action Plan will be finalised by mid-2017 in line with European Council requirements. Should the relevant Oireachtas Committee issue an invitation my Department would be happy to brief the Committee on the National Action Plan on AMR when finalised.
HCAI surveillance is complex. Information on excess costs of HCAIs such as prolonged hospital stay, further treatments required, attributable mortality and other complications can be complex to assess, particularly to confirm that complications are directly linked to HCAI episodes and not to other factors. National HCAI surveillance systems at European level are, however, in place and EU Member States collect routinely-generated antimicrobial susceptibility testing data in invasive infections and report to the European Centre for Disease Control (ECDC) through its European Antimicrobial Resistance Surveillance Network (EARS-Net).
The ECDC assesses this data along with estimated costs of increased hospital stays and treatments. European estimates indicate that approximately 4.1 million patients are estimated to acquire a HCAI in the EU each year with 37,000 attributable deaths annually and HCAIs also contributing to an additional 110,000 deaths. The burden of HCAI is also reflected in significant financial losses. According to the ECDC these infections account for approximately €7 billion per year. The ECDC 2011-2012 Point Prevalence Survey of HCAIs and AMR use in European hospitals estimates that Ireland had 494 patients with a HCAI. This equated to a mean of 9,554 beds occupied per day. (A Point Prevalence Survey gives a snapshot picture of the number of patients with a HCAI in hospital at a particular point in time).
The National Clinical Guideline 'Prevention and Control Methicillin-Resistant Staphylococcus aureus (MRSA)', endorsed by the National Clinical Effectiveness Committee (NCEC) in 2013 estimated the cost of HCAI in Ireland for 2011, extrapolated from national (HSE) and international sources, at €118, 257,312 with 29,388 patients acquiring a HCAI.
Management and reduction of Healthcare Associated Infections (HCAIs) is made very challenging by the rise in antimicrobial resistance world wide. The World Health Organisation (WHO) states that the rise in antimicrobial resistance is one of the greatest potential threats to human and animal health at global, European and national levels with possible serious consequences for public health, animal welfare and the agriculture and food sectors.
A wide range of initiatives has been put in place in the Irish health system over several years to address HCAI and AMR including improved surveillance of infections and prescribing, infection prevention and control processes, antimicrobial stewardship initiatives, public and professional awareness raising and with a significant emphasis on the education and training of healthcare professionals.
The prevention and control of healthcare associated infections (HCAIs) and AMR has been a significant patient safety and public health priority for the Department of Health Ireland for numerous years. Ireland as a whole is fully committed to and engaged in addressing resolution of the problem of AMR and will continue to collaborate at international, EU and national levels to this end.
1241. Deputy Martin Kenny asked the Minister for Health if his attention has been drawn to a situation where some persons claim that a vaccine (details supplied) has had an adverse affect on their health; if he received correspondence on this issue; if he or officials from his Department met with any of the persons affected; and if he will make a statement on the matter. [25389/16]
View answerAs part of Ireland’s response to the pandemic (H1N1) 2009 the National Public Health Emergency Team, following advice from the Pandemic Influenza Expert Group recommended that vaccination against pandemic influenza would be provided to all citizens.
Following reports of narcolepsy among children and adolescents who were vaccinated with Pandemrix in Ireland, a National Narcolepsy Study Steering Committee was established to conduct a retrospective population based study in relation to the Irish data. This Committee comprised expertise in the areas of epidemiology, neurology, paediatrics and paediatric neurology.
The study found that there was a 13 fold higher risk of narcolepsy in children/adolescents vaccinated with the pandemic (H1N1) 2009 vaccine compared with unvaccinated children/adolescents.
The development of narcolepsy following pandemic vaccination is not a uniquely Irish issue. The results from the Irish data concur with those observed in Finland and Sweden.
All of the studies confirm a strong association between the pandemic vaccine and the development of narcolepsy in the 5 to 19 year age group. However, this is not evidence of causation and further studies are required in order to seek explanations of the increased risk of narcolepsy in children and adolescents in certain countries.
As of 7 September 2016, the Health Products Regulatory Authority (HPRA) has received 81 reports with clinical information confirming a diagnosis of narcolepsy in individuals who were vaccinated with Pandemrix (80) and Celvapan (1). The majority of these reports relate to children/adolescents.
Pandemrix accounted for 88% of pandemic influenza vaccine received and 22.5% of the population received at least one dose of Pandemrix vaccine (0.95 million out of a total population of 4.2 million). The 5-19 age group had a significantly higher uptake with 39.8% (339,312) of that age group receiving at least one dose of Pandemrix® (0.34 million out of 0.85 million).
My Department, the HSE and the Department of Education and Skills continue to work together to provide a wide range of services and supports for those affected by narcolepsy following the administration of pandemic influenza vaccine.
The HSE’s Advocacy Unit acts as liaison with service and support providers and other Government Departments to facilitate access to required services. It is in regular contact with individuals affected and regularly meets with representatives of the SOUND (sufferers of unique narcolepsy disorder). Regional co-ordinators have been appointed to assist individuals by providing advice, information and access to local services.
The ex-gratia health supports include clinical care pathways to ensure access to rapid diagnosis and treatment, multi-disciplinary assessments led by clinical experts, counselling services for both the individuals and their families, discretionary medical cards for those who have been diagnosed have been provided to allow unlimited access to GP care and any prescribed medication, ex-gratia reimbursement of vouched expenses incurred in the process of diagnosis and treatment, including travel expenses for attending medical appointments; physiotherapy, occupational therapy assessments, dental assessments and dietary services all on a needs basis.
As of 12 September 2016, legal proceedings against the Minister, the Health Services Executive and GlaxoSmithKline Biological SA have been initiated by 50 individuals. The plaintiffs allege personal injury in which they claim the development of narcolepsy (cataplexy) resulted from the administration of the H1N1 pandemic vaccine.
1242. Deputy Timmy Dooley asked the Minister for Health when a person (details supplied) will be assessed for a hearing aid; and if he will make a statement on the matter. [25393/16]
View answerAs this is a service matter, it has been referred to the Health Service Executive for reply to the Deputy.
1243. Deputy Michael Healy-Rae asked the Minister for Health his views on a matter (details supplied) regarding the lack of scanning services for pregnant women; and if he will make a statement on the matter. [25397/16]
View answer1389. Deputy Ruth Coppinger asked the Minister for Health if he has requested a report by the HSE and the relevant hospitals on a case that was recently reported in the media (details supplied); and if he will make a statement on the matter. [25914/16]
View answerI propose to take Questions Nos. 1243 and 1389 together.
At the outset, I offer my sincerest condolences to the family involved in this case. While I can confirm that University Hospital Kerry has an ultrasonography service and provides anatomy scans if clinically indicated, I cannot comment on individual cases. The Deputy will appreciate that I have a limited role in such cases and do not have access to individual patient files or personal information.
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. In relation to the specific queries raised by the Deputies, as these are service matters I have asked the HSE to respond to you directly.
1244. Deputy Peter Burke asked the Minister for Health the way in which services at Mullingar Midlands Regional Hospital compare to those at Portlaoise, Wexford and Kilkenny hospitals in relation to number of births, staff ratios and funding allocations; and if he will make a statement on the matter. [25399/16]
View answerIn relation to the specific query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.
1245. Deputy Louise O'Reilly asked the Minister for Health if his attention has been drawn to the fact that a person (details supplied) is waiting over nine months for an in-patient orthopaedic procedure as a result of the staff shortages and lengthy waiting lists in orthopaedic services in Our Lady's Hospital for Sick Children; and if he will make a statement on the matter. [25403/16]
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 is a matter for the hospital to which the patient has been referred. Should a patient’s general practitioner consider 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.
1246. Deputy Pearse Doherty asked the Minister for Health the landlords that his Department or bodies under his aegis paid rent to in each of the past three years; and the sums paid in each case. [25419/16]
View answerNo rent is paid by the Department of Health. The Department is currently housed in Hawkins House which forms part of the estate portfolio for the Office of Public Works. Details of such expenditure for bodies under the aegis of the Department are operational matters for the bodies concerned and the Deputy should contact the relevant Director/CEO/Registrar directly.
I have asked the Health Service Executive to respond directly to the Deputy regarding rents paid by it.
1247. Deputy Pearse Doherty asked the Minister for Health if his attention has been drawn to 56 cases in which persons have been on waiting lists for either day case or in-patient treatment at Letterkenny University Hospital, County Donegal for more than the maximum permissible waiting time; the measures being taken to expedite treatment with respect to these persons; and if he will make a statement on the matter. [25432/16]
View answerAs this is a service matter, I have asked the HSE to respond to you directly.
1248. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment for a person (details supplied). [25435/16]
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 is a matter for the hospital to which the patient has been referred. Should a patient’s general practitioner consider 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.
1249. Deputy John Brassil asked the Minister for Health if there are plans to approve the Abbot's Libre monitoring system for blood glucose monitoring of diabetes patients; if so, the time line; and if he will make a statement on the matter. [25456/16]
View answerAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
