Written Answers Nos. 1250-1277
1250. Deputy Timmy Dooley asked the Minister for Health when there will be an outcome to the full system analysis review into the circumstances surrounding an incident (details supplied); and if he will make a statement on the matter. [25459/16]
View answerAt the outset I would like to offer my sincerest condolences to the family involved in this case. The Deputy will appreciate that I have a limited role in individual cases and do not have access to individual patient files or personal information.
The Deputy will be aware that it would be inappropriate for me to comment other than to acknowledge with regret the distress and upset the family have experienced throughout this difficult time. With regard to the specific information sought by the Deputy, as this is a service matter, I have asked the HSE to respond to you directly.
1251. Deputy John Brassil asked the Minister for Health the reason targets for monthly home help hours are not being met in County Kerry; the action he will take to ensure that this issue is addressed; and if he will make a statement on the matter. [25460/16]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
1252. Deputy Clare Daly asked the Minister for Health the respective roles of the National Centre for Pharmacoeconomics and Irish Platform for Patients' Organisations in Science and Industry in making decisions regarding the drugs that will be reimbursed by the HSE. [25470/16]
View answer1253. Deputy Clare Daly asked the Minister for Health the source of the National Centre for Pharmacoeconomics funding. [25471/16]
View answer1254. Deputy Clare Daly asked the Minister for Health the process involved in the HSE agreeing to reimburse any given drug. [25472/16]
View answerI propose to take Questions Nos. 1252 to 1254, inclusive, together.
The Health (Pricing and Supply of Medical Goods) Act 2013 governs the processes and procedures which apply when the HSE receives an application to add a new medicine to its Reimbursement List. These processes and procedures are set out in Schedule 1 of the Framework Agreement on the Supply and Pricing of Medicines, which is published on the Department of Health website and can be accessed at http://health.gov.ie/blog/publications/framework-agreement-on-the-supply-and-pricing-of-medicines/.
As part of the assessment process for new medicines, the HSE may, at its sole discretion, commission the National Centre for Pharmacoeconomics (NCPE) to conduct a Rapid Review assessment and/or a Health Technology Assessment (HTA) of the medicine in question. Based on the results of these independent, clinical and scientific assessments, which are conducted according to Health Information and Quality Authority (HIQA) guidelines, the NCPE can make recommendations on reimbursement to assist the HSE in its decision-making process. The NCPE's assessment reports represent an important input to assist the HSE in its decision-making process regarding the reimbursement of new medicines.
Reimbursement decisions taken by the HSE are also informed by the requirements of the 2013 legislation, which includes consideration of the opportunity cost of the treatment and resources available to the HSE as allocated by Dáil Eireann.
The NCPE receives the majority of its funding from St James’s Hospital, and receives a separate fee from the HSE for each pharmacoeconomic assessment commissioned by the Executive. The NCPE receives no funding from the pharmaceutical industry.
The Irish Platform for Patient Organisations, Science and Industry (IPPOSI) does not have a role in HSE decisions on the reimbursement of new medicines.
1255. Deputy Joan Burton asked the Minister for Health the progress that has been made in progressing the previous Government's plans for a 100-bed unit at Connolly hospital for older and infirm patients; if he is aware of the recent census data confirming the significant population growth of such patients and the dearth of nursing home beds on the northside of Dublin and of home care packages; the capital allocation for the project; the estimated completion date; and if he will make a statement on the matter. [25477/16]
View answerThe beds provided by public nursing homes are an essential part of our healthcare infrastructure, and without them many older people would not have access to the care that they need. These beds will continue to be very much needed over the coming years as the number of older people increases in line with demographic trends. It is therefore essential that they are put on a sustainable footing and that the fabric of the buildings from which they operate is modernised and improved.
The Capital Programme announced earlier this year provides for the replacement and refurbishment of 90 public nursing homes across the country over the next five years. Significant work was undertaken by the HSE in determining the most appropriate scheduling of projects over the five-year period from 2016 to 2021, within the phased provision of funding, to achieve compliance and registration with HIQA.
Under this Capital Programme it is proposed to deliver a 100 bed CNU at Connolly Hospital by 2021. This will replace 40 existing beds where the physical environment requires significant improvement. The additional 60 beds to be provided will assist in addressing the future needs of the catchment area. All healthcare infrastructure developments, including this development, must comply with DPER Guidelines and EU Directives and will require a lead-in time to complete the various stages. This includes appraisal, project brief, design feasibility, detailed design, some of which may overlap, finalisation of financing and review of costing estimates.
1256. Deputy Dara Calleary asked the Minister for Health the financial allocation of the €40 million extra allocated to home care services in June 2016; the number of home help extra hours achieved by this money versus those that were in place at 31 May 2016; the number of extra home care packages, broken down by county; and if he will make a statement on the matter. [25478/16]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
1257. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) is continuing to wait on an assessment when it states in correspondence that the HSE is in breach of its own legislation. [25480/16]
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.
1258. Deputy Alan Farrell asked the Minister for Health the total spending by his Department, including details of all increases or decreases on an annual basis for each of the years 2013 to date in 2016, in tabular form; and if he will make a statement on the matter. [25482/16]
View answerThe total expenditure for the health services (Department of Health and HSE combined) for 2013, 2014, 2015 and to-date in 2016 is set out in the table below.
The Vote of the HSE was disestablished on 31 December 2014 and the funding transferred to the Vote of the Office of the Minister for Health (Vote 38) from which, with effect from 1 January 2015, Vote grants are paid to the HSE in line with the Health Service Executive (Financial Matters) Act 2014. The 2014 Estimate was restated for comparison purposes in the revised vote format.
Total expenditure is based on net current expenditure as published in the Revised Estimates Volume for 2013 to 2015 and August 2016 Vote 38 Forecast Issues for 2016. Net current expenditure is used to aid comparison because as a consequence of the disestablishment of the HSE Vote, €1.043 billion previously accounted for as Appropriations-in-aid in the HSE Vote is collected directly by the HSE and shown in the HSE accounts but no longer incorporated in Vote terms.
|
- |
2013 |
2014 |
2015 |
YTD 2016 |
|
- |
€'000 |
€'000 |
€'000 |
€'000 |
|
DoH - Vote 38 |
227,742 |
12,052,305 |
12,439,041 |
8,932,932 |
|
HSE - Vote 39 |
11,939,471 |
0 |
0 |
0 |
|
Total Health Vote |
12,167,213 |
12,052,305 |
12,439,041 |
8,932,932 |
|
% Increase/(Decrease) |
0.59% |
-0.94% |
3.21% |
1259. Deputy Michael Healy-Rae asked the Minister for Health the status of a dental appointment in respect of a person (details supplied); and if he will make a statement on the matter. [25488/16]
View answerAs this is a service matter it has been referred to the HSE for reply to the Deputy.
1260. Deputy James Lawless asked the Minister for Health the number of part time general practitioners and the number of full time general practitioners practising in County Kildare, for each of the years 2011 to 2016, in tabular form; and if he will make a statement on the matter. [25489/16]
View answerAs this is a service issue, it has been referred to the Health Service Executive for direct reply to the Deputy.
1261. Deputy James Lawless asked the Minister for Health the number of part time general practitioners and the number of full time general practitioners practising nationally for each of the years 2011 to 2016 in tabular form; and if he will make a statement on the matter. [25490/16]
View answerAs this is a service issue, it has been referred to the Health Service Executive for direct reply to the Deputy.
1262. Deputy James Lawless asked the Minister for Health the efforts made by his Department to date to secure a general practitioner for a health centre (details supplied); and if he will make a statement on the matter. [25491/16]
View answerAs this is a service issue, this question has been referred to the Health Service Executive for direct reply to the Deputy.
1263. Deputy James Lawless asked the Minister for Health the efforts made by his Department to provide a full-time general practitioner to an area (details supplied); and if he will make a statement on the matter. [25492/16]
View answerAs this is a service issue, it has been referred to the Health Service Executive for direct reply to the Deputy.
1264. Deputy James Lawless asked the Minister for Health the number of general practitioners employed the HSE approaching 60 years of age; and if he will make a statement on the matter. [25493/16]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
1265. Deputy James Lawless asked the Minister for Health the efforts his Department have made to recruit new general practitioners with particular focus on rural areas; and if he will make a statement on the matter. [25494/16]
View answerThe Government is committed to ensuring that patients throughout the country continue to have access to GP services, especially in remote rural areas and also in certain disadvantaged urban areas, and that general practice is sustainable in such areas into the future. It is imperative that existing GP services in these areas are retained and that general practice remains an attractive career option for newly-qualified GPs.
I am cognisant of the need for a new GP services contract which will help modernise our health service and develop a strengthened primary care sector, and health service management have already progress a number of significant measures through engagement with GP representatives. The GP contracts review process will, inter alia, seek to introduce further measures aimed at making general practice an attractive, fulfilling and rewarding career option into the future.
Progress to date includes:
- Changes to the entry provisions to the GMS scheme to accommodate flexible/shared GMS/GP contracts, and to the retirement provisions for GPs under the GMS scheme, allowing GPs to hold GMS contracts until their 72 birthday.
- An enhanced supports package for rural GP practices has been introduced in 2016 and includes a change in the qualifying criteria for rural supports and an increase in the financial allowance from €16,216 to €20,000. The number of GPs benefitting from such rural practice supports has increased from 167 to around 300.
- The annual number of GP training places has increased from 157 to 172 as of July 2016.
I anticipate that further measures will be tabled for discussion by the parties to the next phase of engagement on the GP contract review, which I expect to progress with GP representatives and other stakeholders over the coming period.
1266. Deputy Sean Sherlock asked the Minister for Health the number and geographical location of privately contracted occupational therapists by the HSE by county from 2013 to 2016 to date. [25499/16]
View answerAs this is a service issue, this question has been referred to the Health Service Executive for direct reply to the Deputy.
1267. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for speech therapy in respect of a person (details supplied); and if he will make a statement on the matter. [25503/16]
View answerAs this is a service issue, this question has been referred to the Health Service Executive for direct reply to the Deputy.
1268. Deputy Pat Breen asked the Minister for Health further to Parliamentary Question No. 188 of 13 July 2016, when a person (details supplied) will be facilitated with an appointment; and if he will make a statement on the matter. [25504/16]
View answerAs this is a service matter, I have asked the HSE to respond to you directly.
1269. Deputy Michael Healy-Rae asked the Minister for Health the status of an application by a person (details supplied) for HSE equipment; and if he will make a statement on the matter. [25505/16]
View answerAs this is a service matter, it has been referred to the HSE for reply to the Deputy.
1270. Deputy Stephen S. Donnelly asked the Minister for Health the status of the implementation of the national maternity strategy; and if he will make a statement on the matter. [25513/16]
View answer1271. Deputy Stephen S. Donnelly asked the Minister for Health if an implementation group has been put in place with regard to the national maternity strategy; if this group has met to date; and if he will make a statement on the matter. [25514/16]
View answerI propose to take Questions Nos. 1270 and 1271 together.
The National Women & Infants Health Programme will lead the implementation of Ireland's first National Maternity Strategy - Creating A Better Future Together 2016 - 2026. Work to establish the Programme Leadership Team continues. The Programme will lead the management, organisation and delivery of maternity, gynaecology and neonatal services, across primary, community and secondary care, strengthening such services by bringing together work that is currently undertaken across a number of divisions.
Work to facilitate the implementation of the Strategy is ongoing. For example, the €3 million development funding provided for maternity services in the 2016 HSE Service Plan is being allocated in line with the Strategy and includes the establishment of the National Women & Infants Health Programme and maternity networks, appointment of additional staff, development of specialist bereavement teams and implementation of the Maternal and Newborn Clinical Management System. Such development follows the additional €2 million allocated in 2015. The need for further additional resources to support the implementation of the Strategy is acknowledged and will be considered in the context of the annual Estimates process.
In addition, work to implement the Strategy's recommendation that the National Clinical Effectiveness Committee (NCEC) prioritise and quality assure a set of National Clinical Guidelines for maternity services is progressing. The NCEC, in partnership with the National Clinical Advisor & Group Lead Acute Hospitals HSE, is at an advanced stage in the appointment of the Chair of the Guideline Development Group and agreeing the scope of work for the guidelines.
I have asked the HSE to respond to you directly to provide further detail on the implementation of the Strategy.
1272. Deputy Michael Healy-Rae asked the Minister for Health his views on a matter (details supplied) regarding Kerry University Hospital; and if he will make a statement on the matter. [25534/16]
View answerAs this is a service matter, I have asked the HSE to respond to you directly.
1273. Deputy Clare Daly asked the Minister for Health if he will intervene to resolve the issue of general practitioners charging GMS patients for routine blood tests that has been tabled at HSE national level for discussion, but has remained unresolved for well over a year. [25549/16]
View answer1306. Deputy Clare Daly asked the Minister for Health the reason the issue of general practitioners charging GMS patients for routine blood tests is under discussion by the HSE nationally and deemed to be unresolved, and patients not reimbursed despite clear correspondence previously making it clear that this practise was not permitted (details supplied). [25660/16]
View answerI propose to take Questions Nos. 1273 and 1306 together.
Persons covered by the General Medical Services (GMS) scheme should not be charged for routine phlebotomy services provided by their GP, or the Practice Nurse on behalf of the GP, which are required to either assist in the diagnosis of illness or the treatment of a condition.
The issue of GPs charging medical card or GP visit card holders for routine blood tests has been addressed by the HSE and it has clearly stated its position to GPs. Any proven instances of eligible patients being asked to pay for a routine service of this nature by their GP will be viewed as a serious matter by the HSE.
If a patient who holds a medical card or GP visit card believes they have been incorrectly charged for routine phlebotomy services by their GP, they may wish to make a complaint to the HSE Local Health Office who will deal with the matter in accordance with the HSE’s Complaints Policy. Contact details for all Local Health Offices can be found on the HSE’s website.
1274. Deputy Clare Daly asked the Minister for Health his plans to introduce a position of assistant psychologist on the HSE's pay scale, given that over 50% of early career psychologists are employed in a voluntary capacity, completely undermining the quality of service to patients and undermining the profession. [25550/16]
View answerThe HSE employs professionally trained psychologists - including clinical psychologists, counselling psychologists and educational psychologists - in a range of roles across the health service.
The Department has received a business case proposal, submitted by the HSE, in relation to the possible introduction of paid Assistant Psychologists (AP), who will be Psychology graduates employed on a two-year fixed term contract; based on its evaluation of a recent local pilot AP project. This business case is currently being considered by my Department and engagement between the HSE and the Department is ongoing in relation to these proposals.
Any decisions regarding a future role for Assistant Psychologists, in the public health system, would need to be taken in the context of the national integrated strategic framework for health workforce planning, and will require approval from the Department of Public Expenditure and Reform.
1275. Deputy Clare Daly asked the Minister for Health his plans to conduct an independent review of the Gardasil HPV vaccine. [25551/16]
View answer1314. Deputy John Brassil asked the Minister for Health if he will request the HSE provide a full and complete information leaflet outlining all possible side effects of Gardasil as per the manufacturers leaflet through the schools to parents of teenage girls due to be vaccinated against HPV; and if he will make a statement on the matter. [25698/16]
View answerI propose to take Questions Nos. 1275 and 1314 together.
The HPV vaccine, Gardasil which was introduced in 2010, protects girls from developing cervical cancer when they are adults. It is available free of charge from the HSE for all girls in the first year of secondary school.
Each year in Ireland around 300 women are diagnosed with cervical cancer. The HPV vaccine protects against two high risk types of HPV (16 & 18) that cause 73% of all cervical cancers. Vaccinated women and girls will still be at risk from other high risk types of HPV that can cause cervical cancer and will therefore need to continue to have regular cervical smear tests. The Health Products Regulatory Authority (HPRA) is the regulatory authority for medicines in Ireland. There are two licensed HPV vaccines available in Ireland (Gardasil and Cervarix). Gardasil is the vaccine used by the HSE in the School Immunisation Programme and over 100,000 girls have received this vaccine since its introduction.
The HSE provides information for parents about diseases, the vaccines to prevent them and side effects to allow them to choose whether or not to give consent to vaccination. All vaccination information provided to parents is prepared from the available licensed documentation for each vaccine, the Summary of Products Characteristics and Patient Information Leaflet. The information booklets include information on the most common adverse events that can occur after each vaccination. Seizures, muscle weakness, leg pain, joint pain and chronic fatigue are not mentioned as known side effects to Gardasil in the Patient Information Leaflet. There are no known long term side effects to the vaccine Gardasil. The information is presented in clear simple language and approved by the National Adult Literacy Agency so that it can be understood by all adults as the average reading age in Ireland is 12 years of age. Parents are also given contact details for their local immunisation office and advised to speak to a member of the school immunisation team if they have any further questions.
Should parents require additional information about vaccines the immunisation leaflet refers to the HSE’s national immunisation website (www.immunisation.ie). The national immunisation website has been accredited by the World Health Organisation for credibility, content and good information practices. The website allows members of the public to contact the National Immunisation Office to ask a question if they require further information. These questions, when possible, are answered by the staff of the National Immunisation Office within one working day.
No medicine, including vaccines, is entirely without risk, there is therefore on-going pharmacovigilance and monitoring of medicinal products once they are authorised for use. The safety profile of Gardasil has been continuously monitored since it was first authorised. As part of its monitoring of the safety of medicines, the HPRA operates an adverse reaction reporting system, where healthcare professionals and patients are encouraged to report adverse reactions they consider may be associated with their treatment, through the range of options in place for reporting. All reports received are evaluated and considered in the context of the safety profile of the product concerned, with reports followed up as necessary for further information, that may assist in the assessment of the case.
In November 2015 the European Medicines Agency completed a detailed scientific review of the HPV vaccine. The review, in which the HPRA participated, found no evidence of a causal link between the vaccine and the two conditions examined. The review recognised that, at that time, more than 80 million girls and women worldwide have now received these vaccines, and in some European countries they have been given to 90% of the age group recommended for vaccination. Use of these vaccines is expected to prevent many cases of cervical cancer (cancer of the neck of the womb, which is responsible for over 20,000 deaths in Europe each year) and various other cancers and conditions caused by HPV. The benefits of HPV vaccines therefore continue to outweigh the known side effects. The safety of these vaccines, as with all medicines, will continue to be carefully monitored and will take into account any future new evidence of side effects that becomes available. On 12 January 2016 the European Commission endorsed the conclusion of the European Medicines Agency stating that there is no need to change the way HPV vaccines are used or to amend the product information. This final outcome by the Commission is now binding in all member states.
My Department has no plans to conduct another review.
1276. Deputy Clare Daly asked the Minister for Health his views on potential conflicts of interest in relation to the Irish Cancer Society holding public talks supporting the use of certain drugs while at the same time receiving donations from the makers and licence holders of those drugs; his plans to regulate this situation; and if he will make a statement on the matter. [25552/16]
View answerThere is extensive legislation in place governing the advertising of medicines, including gift, sponsorship of meetings, and hospitality. The Medicinal Products (Control of Advertising) Regulations, 2007 provide for a range of restrictions on gifts and hospitality. For example, a gift must be inexpensive and relevant to the practice of medicine or pharmacy. Hospitality must be reasonable in level, strictly limited to the main purpose or scientific objective of the event, and not extended to persons other than health professionals. Health professionals are also prohibited from soliciting or accepting any prohibited inducement, hospitality or sponsorship.
The pharmaceutical industry operates a voluntary code of practice for the purpose of providing practical guidance to the Regulations. Any individual who believes that a particular promotional activity is in breach of the code may submit a complaint to the Irish Pharmaceutical Healthcare Association. Complaints are heard by committees consisting of industry representatives, independent lay members and chaired by an independent chairman. In addition to this self-regulatory system, breaches of the Regulations may be prosecuted in the courts under section 32 of the Irish Medicines Board Acts 1996 and 2006.
Furthermore, there are a range of legislative provisions in place to protect patients involved in clinical trials for medicines. Every clinical trial involving a patient in Ireland must be approved by the Health Products Regulatory Authority (HPRA), who carry out a scientific assessment, and by a recognised ethics committee whose role is to ensure that trials are ethical and that patients’ rights are protected.
Once a medicine has been authorised (licensed), a pharmaceutical company can make an application to have a medicine reimbursed under the community drugs schemes. 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 (NCPE). The NCPE conducts a health technology assessment of pharmaceutical products for the HSE, and can make recommendations on reimbursement to assist the HSE in its decision-making process. In the case of oncology drugs a report is also sent to the National Cancer Control Programme (NCCP).
In view of the above I am satisfied that the current system of regulation is effective in protecting patients and I hope that I have addressed the Deputy’s concerns.
1277. Deputy Peadar Tóibín asked the Minister for Health if there are different policies regarding the funding of wheelchairs and other OT services from county to county (details supplied); and if so, the details of these differences. [25569/16]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the primary care schemes; therefore, the matter has been referred to the HSE for attention and reply to the Deputy.
