Written Answers Nos. 399-420
399. Deputy Róisín Shortall asked the Minister for Health the details of each of the expenditure savings that have been earmarked for his Department in 2017; the value of the saving in each case; the basis on which the value was estimated; and the way it differs from the 2016 mid-year expenditure report. [31543/16]
View answerThe 2017 funding level for the health services announced on Budget Day 2017 relates to expenditure for both my Department and the HSE.
The specific savings measures included within the Budget Day figures relate to drug price reductions associated with the agreement reached with the Irish Pharmaceutical Healthcare Association (IPHA) earlier this year and the initiatives implemented under the Medicines Management Programme. These savings measures were not included in the 2016 Mid-Year Expenditure Report position for the Health Vote.
In addition, as the 2017 approved level of funding is based on ongoing cost containment and efficiencies being achieved, it is expected that additional savings measures will be identified as part of the 2017 National Service Plan process.
The estimated value of all savings measures built into the 2017 approved level of funding will be identified in the published 2017 National Service Plan.
400. Deputy Micheál Martin asked the Minister for Health the number of persons with disabilities currently in receipt of a personal assistant service; the number of hours currently being provided in 2016; if any persons previously receiving a personal assistant service have had it discontinued or their hours of service reduced in 2016; and the number of persons that have been impacted. [31550/16]
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.
With regard to assisted living services, the Health Service Executive's (HSE's) priority in the 2016 National Service Plan is to protect the level of services provided in 2015 and to provide 1.3 million hours of Personal Assistant services to 2,000 people with a physical/sensory disability and 2.6 million hours of Home Support to 7,300 people with a range of disabilities. The provision of Personal Assistant services has an annual cost of €30 million, with an annual cost of €52 million for Home Support services.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the HSE for direct reply to the Deputy.
401. Deputy Declan Breathnach asked the Minister for Health the way in which he plans to address the deficit in staffing requirements in nursing, occupational therapists, physiotherapists and other disciplines using the extra funding announced in the budget; if he will consider a possible sponsorship scheme whereby graduates would guarantee to work in the public service in return for college fees or training; if his attention has been drawn to the fact that graduates are being enticed abroad with attractive packages; and if he will make a statement on the matter. [31558/16]
View answerIt is recognised that there is an international nursing and medical manpower shortage, leading to difficulties in recruiting nurses and doctors. Ireland is experiencing intense competition globally and from private providers for nursing and medical personnel due to this shortage, and the international standing of Irish nursing and medical graduates. While a number of innovative measures have been taken to support recruitment and retention of health employees, it is not considered feasible to give effect to the Deputy's proposal given employees' rights to free movement.
The ability of the HSE and the health service to attract and retain high quality frontline staff shapes the extent to which the HSE can maintain and develop the health services. The MacCraith Group, established in 2013 to carry out a strategic review of medical training and career structures, made a series of recommendations aimed at improving the retention of medical graduates in the public health system and planning for future needs. The implementation of the Group's recommendations is being actively pursued and monitored. Doctors in training actively participate in the implementation and monitoring of these recommendations through the Forum of Irish Medical Postgraduate Training Bodies Trainee Sub Committee.
A number of specific measures have been taken in relation to pay that will support the recruitment and retention of Irish nursing and midwifery graduates. Measures to date include the first stage of pay restoration under the Lansdowne Road Agreement, additional pay in return for taking on some duties from doctors and an increase in the rate of pay for the student nursing placement to 70% of the first point of the staff nurse pay scale.
This month the Government approved restoration of incremental credit for all nurses in respect of the 36 week clinical placement undertaken by fourth year student nurses in the context of the 2017 Estimates. This decision means that all nurses and midwives will have incremental credit for the 36 week placement restored from 1 January 2017, restoration of the credit to 2016 and future graduates having been approved earlier this year. It is estimated that the inclusion of 2011 to 2015 graduates will benefit around 4,000 nurses who are currently working within the public health service and potentially another 3,000 who may wish to return to the public system in the future.
The HSE is focused on offering graduating nurses and midwives permanent posts and on replacing agency staff with permanent staff. Recruitment of additional nurses is the subject of considerable ongoing activity by the HSE and voluntary hospitals. Recruitment campaigns are underway in Ireland and abroad with a relocation package of up to €1,500 available to nurses who return from overseas. Campaigns include recent and ongoing international, national and local interviewing of General Nurses, Mental Health, Intellectual Disability and Children's nurses and midwives.
There was an increase of 3,661 personnel employed in the public health service (101,917 to 105,578) between August 2015 and August 2016. The total budget for the health service in 2017 is €14.6 billion, the highest budget ever allocated to the health service and this will allow for recruitment of additional frontline staff.
402. Deputy Louise O'Reilly asked the Minister for Health the exact opening date for the primary care centre in Balbriggan; and if he will list the services that will be available when this service opens. [31559/16]
View answerAs this 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.
403. Deputy Louise O'Reilly asked the Minister for Health if the new primary care centre in Balbriggan will offer scans; and if so, the precise type of scanning which will be available, for example, MRI, ultrasound and so on. [31560/16]
View answerAs this 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.
404. Deputy Louise O'Reilly asked the Minister for Health if free parking will be made available for the users of the new primary care centre in Balbriggan. [31561/16]
View answerAs this 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.
405. Deputy Louise O'Reilly asked the Minister for Health if the new primary care centre in Balbriggan will offer maternity care; and the specific type of care available. [31562/16]
View answerAs this 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.
406. Deputy Louise O'Reilly asked the Minister for Health if a referral has been made by the orthopaedic department in Crumlin hospital in respect of a person (details supplied) and if so, the hospital and consultant to which the person was referred; and if he will make a statement on the matter. [31564/16]
View answerAs this is a service matter, I have asked the HSE to respond to you directly.
407. Deputy James Lawless asked the Minister for Health if his Department can backdate the fair deal scheme application for a person (details supplied); and if he will make a statement on the matter. [31567/16]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
408. Deputy Mattie McGrath asked the Minister for Health the number of children transferred from maternity hospitals and maternity units across the country to the children's hospitals in Dublin (details supplied) each year for the past five years; and if he will make a statement on the matter. [31575/16]
View answerAs this is a service matter, I have asked the HSE to respond to you directly.
409. Deputy Noel Rock asked the Minister for Health his plans to remove the age limit for mental illness under the long-term illness scheme (details supplied). [31577/16]
View answerThe Long Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act 1970 (as amended). The conditions covered by the scheme are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide. Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
There are no plans to amend the Long Term Illness Scheme.
410. Deputy Richard Boyd Barrett asked the Minister for Health if there are guidelines in the cross-Border initiative regarding a timeframe for which a patient has to wait from the time of diagnosis in order for the treatment to be authorised in another EU country; and if he will make a statement on the matter. [31578/16]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
411. Deputy Michael Healy-Rae asked the Minister for Health if any scheme is available to elderly persons who must attend follow-up appointments in hospital and must get a taxi to take them; and if there is any scheme available for them to get a refund. [31591/16]
View answerAs this is a service matter, I have asked the HSE to respond to the Deputy directly.
412. Deputy Richard Boyd Barrett asked the Minister for Health the reason for the delay in the application for surgery via the cross-border initiative by a person (details supplied); and if he will make a statement on the matter. [31597/16]
View answerAs this is a service issue, the Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
413. Deputy Charlie McConalogue asked the Minister for Health the funding which will be available to support the implementation of the obesity policy and action plan (details supplied); and if he will make a statement on the matter. [31598/16]
View answerThe Obesity Policy provides an opportunity to work collectively, across Government, in different sectors, from the national level and down to community actions to support healthy lifestyles and reduce obesity. The Healthy Ireland Fund of 5 million euro will provide for projects in a variety of settings including education, local authorities, workplaces and communities. This will support actions taken across the education, environment, transport, social protection and agriculture sectors, all designed to create a healthier Ireland. These will be evidence based and targeted at disadvantaged communities and children.
The Obesity Policy and Action Plan contains 60 actions which will be implemented, monitored and evaluated. The policy acknowledges that obesity prevention services in the community as well as specialist hospital services will need to be strengthened. A key element is the appointment of a Clinical Lead for Obesity in the HSE. The allocation of increased funding to Health and Well-being in the HSE will reflect that Obesity is a priority for the health services and included in the HSE service plan for 2017.
414. Deputy Alan Kelly asked the Minister for Health the criteria used in assessing a medical card application for a patient with motor neurone disease; if a medical card for a patient with motor neurone disease is automatically granted; and if he will make a statement on the matter. [31601/16]
View answerUnder the Health Act, 1970, medical cards are provided to persons who are, in the opinion of the Health Service Executive (HSE), unable without undue hardship to arrange GP services for themselves and their dependents and every application must be assessed on that basis. In accordance with the Act, the assessment for a medical card is determined primarily by reference to the means, including the income and expenditure, of the applicant and his or her partner and dependents. Where deemed appropriate in particular circumstances, the HSE may exercise discretion and grant a medical card even though an applicant exceeds the income guidelines but where they may face difficult financial circumstances, such as extra costs arising from illness.
It should be noted that every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines.
Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE affords applicants the opportunity to furnish supporting information and documentation to fully take account of all the relevant circumstances that may benefit them in the assessment, including medical evidence of cost and necessary expenses.
It is important that people with medical needs are able to access necessary assistance in a straight forward manner. It is clear greater discretion is being exercised by the HSE because the number of discretionary medical cards in circulation has increased from about 52,000 in mid-2014 to over 110,453 as of 1 September this year. This followed the measures announced by my predecessor Minister Varadkar, when the "Keane" Report of the Expert Panel on Medical Need for Medical Card Eligibility was published. The "Keane" Report found that it is not feasible, desirable or ethically justifiable to list medical conditions for medical card eligibility. On foot of the publication of the report, the HSE established a Clinical Advisory Group to develop clinical oversight and guidance for the operation of a more compassionate and trusted medical card system. Its establishment followed the completion of the work of the Expert Panel on Medical Need for Medical Card Eligibility and demonstrates the HSE's commitment to the development of a medical system which is responsive and considerate of an applicant's particular circumstances.
415. Deputy John Brassil asked the Minister for Health if he will provide additional funding for a service (details supplied); and if he will make a statement on the matter. [31602/16]
View answerOn 12 October 2016, I announced the allocation of an additional €3 million in the 2017 Budget to increase support for interventions aimed at improving the health outcomes of the most vulnerable in our society, including Traveller and Roma communities, and those affected by addiction issues.
The additional funding will be used to address my key priorities in 2017, which include addressing gaps in addiction service provision for under 18s and providing more detox places in community and residential settings next year. I have asked the Health Service Executive to develop proposals on these priorities for consideration in the context of the Executive's 2017 National Service Plan.
I understand from the Health Service Executive that the addiction services in Community Health Organisation 5 is currently working with Aiséirí to review the model of services provided in Aislinn.
As the specific issue raised by the Deputy relates to a service issue I have referred it to the Health Service Executive for attention and direct reply to the Deputy.
416. Deputy Bernard J. Durkan asked the Minister for Health the progress to date in the determination of an application for a medical card in the case of a person (details supplied); and if he will make a statement on the matter. [31607/16]
View answerThe 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 was issued to Oireachtas members.
417. Deputy John McGuinness asked the Minister for Health the arrangements that were put in place by the SEHB and the HSE to manage the affairs, financial and otherwise, of a person (details supplied); if a social worker was appointed in 1991; and if that arrangement continued. [31615/16]
View answerAs this is a service issue, this question has been referred to the HSE for direct reply.
418. Deputy Niamh Smyth asked the Minister for Health if there is a timeframe as to when a drug (details supplied) will have gone through the National Centre for Pharmacoeconomics, NCPE, process; when it is likely to be on the Irish market; and if he will make a statement on the matter. [31622/16]
View answerThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. Prior to deciding whether to reimburse a medicine, the HSE considers a range of statutory criteria, including clinical need, cost-effectiveness and the resources available.
The decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds by the HSE, on the advice of the National Centre for Pharmacoeconomics (NCPE). The NCPE conducts health technology assessments (HTAs) of pharmaceutical products for the HSE, and can make recommendations on reimbursement to assist the HSE in its decision-making process.
At the request of the HSE, the NCPE is currently conducting an assessment of Vimizim for the treatment of mucopolysaccharidosis, type IVa (also known as Morquio A syndrome) in patients of all ages. The NCPE completes all phamacoeconomic evaluations within the 180 day timeline set out in the Health (Pricing and Supply of Medical Goods) Act 2013. The Act allows for stop clocks where companies are required to provide additional data. Once this assessment is completed, a summary report will be published on the NCPE website. The HSE will then consider the NCPE assessment as part of its decision-making process when considering the drug for reimbursement.
As the NCPE's assessment of Vimizim is ongoing, it is not possible to provide further details at this time.
419. Deputy Michael Healy-Rae asked the Minister for Health the status of a full-time general practitioner service in Rathmore, County Kerry; if there has been a new recruitment drive in recent times; and if he will make a statement on the matter. [31626/16]
View answerAs this is a service issue, it has been referred to the Health Service Executive for direct reply to the Deputy.
420. Deputy Clare Daly asked the Minister for Health if there is a dedicated investigations unit within the Health Products Regulatory Authority, HPRA, which examines complaints regarding products advertised or marketed as medicinal products but which have no marketing authorisation from either the HPRA or the European Medicines Agency, as for example, in the case of products marketed as a cure for autism. [31641/16]
View answerUnder the Medicinal Products (Control of Placing on the Market) Regulations 2007, as amended, a medicinal product cannot be placed on the market in Ireland unless it has a marketing authorisation or certificate of traditional-use registration from the Health Products Regulatory Authority (HPRA) or a community marketing authorisation from the European Medicines Agency (EMA). Any product which makes a medicinal claim to treat a medical condition, such as autism, is considered to be a medicinal product and requires an authorisation under this legislation.
The Medicinal Products (Control of Advertising) Regulations 2007 prohibit the advertising of medicinal products which are not the subject of a marketing authorisation or certificate of traditional-use registration.
The HPRA is responsible for the implementation and oversight of this legislation. The Authority has an Enforcement section, of which one of its roles is, to investigate potential breaches of this legislation and, where necessary, to take corrective action including legal proceedings. This can include investigation into complaints regarding products advertised or marketed as medicinal products but which have no marketing authorisation or certificate of traditional-use registration. The HPRA's investigations are prioritised on the basis of perceived risk to public health.
I understand the Deputy to be referring to the product known as “Mineral Miracle Solution” (MMS), otherwise known as Chlorine Dioxide or “the CD Protocol”. This product is not authorised as a medicinal product for sale or supply in Ireland. Any manufacture, supply or sale of this product for the purposes of treating a medical condition is illegal.
The HPRA continues to advise consumers not to seek to purchase or take this product and I reiterate this advice.
