Tony McLoughlin
Question:314. Deputy Tony McLoughlin asked the Minister for Health the treatment options available for patients here with Lyme disease; and if he will make a statement on the matter. [33376/16]
View answerDisease Management
Questions (314)
Written answers
Lyme disease (also known as Lyme borreliosis) is an infection transmitted to humans by bites from ticks infected with the bacterium Borrelia burgdorferi. The infection is generally mild affecting only the skin, but can occasionally be more severe and debilitating. Many infected people have no symptoms at all. The commonest noticeable evidence of infection is a rash called erythema migrans that is seen in about 80-90% of patients. This red, raised skin rash (often called a bulls-eye rash) develops between 3 days and a month after a tick bite and spreads outwards from the initial bite site. People can also complain of 'flu-like symptoms such as headache, sore throat, neck stiffness, fever, muscle aches and general fatigue. Occasionally, there may be more serious symptoms involving the nervous system, joints, the heart or other tissues. Lyme Disease is the commonest cause of tick-borne infection in Europe.
Lyme borreliosis is a notifiable infectious disease, the notifiable entity being the more severe neurological form, Lyme neuroborreliosis. The Health Protection Surveillance Centre (HPSC) collects and collates surveillance data on the condition. The Weekly Infectious Disease Report, published by the HPSC on 26 October 2016, indicated that for week 42-2016 (16/10/16-22/10/16) there have been 16 cases notified so far in 2016 - an increase of 5 on the same period last year. However, the diverse and unspecific nature of the symptoms means that a number of the less serious cases may not be diagnosed, leading to an underreporting of cases. Recent estimates suggest that there may be up to 50-100 cases in Ireland per year.
Lyme disease can be very successfully treated using common antibiotics. These antibiotics are effective at clearing the rash and helping to prevent the development of complications. Antibiotics are generally given for up to three weeks. If complications develop, intravenous antibiotics may be considered. In Ireland, treatment by most clinicians is based on that laid out in evidence-based guidelines for the management of patients with Lyme disease, human granulocytic anaplasmosis (formerly known as human granulocytic ehrlichiosis), and babesiosis published by the Infectious Diseases Society of America (IDSA) in 2006. This pharmacological regime can be summarised thus:
- Doxycycline, amoxicillin or cefuroxime for the treatment of adults with early localised or early disseminated Lyme disease associated with erythema migrans, in the absence of specific neurologic manifestations (ceftriaxone in early Lyme disease for adults with acute neurologic disease manifested by meningitis or radiculopathy);
- Doxycycline, amoxicillin, or cefuroxime for adults with Lyme arthritis but without clinical evidence of neurologic disease;
- For late neurological disease in adults - intravenous ceftriaxone, cefotaxime or Penicillin G.
The Scientific Advisory Committee of the HPSC has established a Lyme Borreliosis Sub-Committee, the aim of which is to develop strategies to undertake primary prevention in order to minimise the harm caused by Lyme Borreliosis in Ireland. In addition to staff from the HPSC, the membership of the Sub-Committee includes specialists in Public Health Medicine, Consultants in Infectious Diseases, Clinical Microbiology, Occupational Health an Entomologist from the Parks and Wildlife Service, a representative from the Local Government Management Agency and an Environmental Health Officer. Representation has also been sought from a Lyme Disease advocacy group.
The Terms of Reference of the Sub-Committee are:
- To raise awareness in Ireland of Lyme Borreliosis amongst clinicians and the general public;
- To identify and highlight best international practice in raising awareness about Lyme Borreliosis for the general public;
- To develop policies of primary prevention of Lyme Borreliosis in Ireland based on best international practice;
- To explore ways in which to improve surveillance of neuroborreliosis in Ireland;
- To develop strategies to raise awareness among the general public particularly in areas of higher tick populations;
- To produce a Final Report covering all the above areas.
The initial work of the Lyme Borreliosis Sub-committee involves a survey of laboratory methods for the diagnosis of Lyme borreliosis in Ireland, the development of Lyme borreliosis guidance for general practitioners, the publication of medical media articles to highlight diagnostics and laboratory methods relating to Lyme borreliosis available in Ireland for general practitioners, and ongoing work in drawing together the Final Report of the Sub-committee. The Sub-Committee is expected to report in 2017.
State Investments
Questions (315)
Jack Chambers
Question:315. Deputy Jack Chambers asked the Minister for Health his views on the fact that taxpayer funds are currently invested in three separate tobacco companies as part of the Ireland Strategic Investment Fund, managed through the National Treasury Management Agency, NTMA; his views on the appropriateness of this investment; if he has expressed any concerns regarding this matter directly to the NTMA, the Minister for Finance and the Minister for Public Expenditure and Reform; his views on calls to add tobacco companies to the list of prohibited investment categories; and if he will make a statement on the matter. [33381/16]
View answerWritten answers
The Minister for Finance informs me that as at 31 October 2016 the Ireland Strategic Investment Fund (ISIF) had equity holdings in three tobacco companies with a value of €1.5m or 0.02 per cent of its total assets.
I understand from my colleague, the Minister for Finance, that the Fund operates to high international standards and invests in line with both the UN-sponsored Principles for Responsible Investment (PRI) and the Santiago Principles, which are the globally accepted best practice principles for sovereign investment funds such as ISIF. ISIF commits to reviewing all of its investments for exposures to sectors and/or companies with potentially controversial business exposures and associated reputational risks. Exclusion has not been part of ISIF's Responsible Investment strategy – with the only exclusions from the Fund being mandated by legislation. ISIF’s senior management and the NTMA Board's Investment Committee have agreed to review their current policy on exclusions. This review is underway and is expected to be completed by the end of the first quarter of 2017. Separately, a review of ISIF's investment strategy, due to take place 18 months after the establishment of the ISIF, is also underway.
The NTMA (Amendment) Act 2014 provides that the Minister for Finance may consult with other Government Ministers as appropriate in relation to this review. I will, in consultation with my colleague Minister Harris, express my concerns to the Minister for Finance about the appropriateness of these investments in tobacco companies in the context of the review of the investment strategy and exclusions policy.
Services for People with Disabilities
Questions (316)
Dara Calleary
Question:316. Deputy Dara Calleary asked the Minister for Health the additional funding available for persons who have undertaken selective dorsal rhizotomy surgery for aftercare services; and if he will make a statement on the matter. [33384/16]
View answerWritten answers
The 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.
The particular issue raised by the Deputy is a service matter for the HSE. Accordingly I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
Emergency Services
Questions (317)
David Cullinane
Question:317. Deputy David Cullinane asked the Minister for Health if his attention has been drawn to an internal HSE audit into management and work practices at the NEOC emergency call centres; if it has been furnished to the director general and him; when it will be published; and if he will make a statement on the matter. [33388/16]
View answerWritten answers
As this is a service matter I have asked the HSE to reply directly to you.
Medical Aids and Appliances Provision
Questions (318)
Micheál Martin
Question:318. Deputy Micheál Martin asked the Minister for Health if a person (details supplied) has had their entitlement to medical equipment reduced; and if so, the reason for such a reduction. [33392/16]
View answerWritten answers
As this is a service matter it has been referred to the HSE for reply to the Deputy.
Hospital Appointments Status
Questions (319)
Robert Troy
Question:319. Deputy Robert Troy asked the Minister for Health if he will expedite a hospital appointment for a person (details supplied). [33395/16]
View answerWritten answers
Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The 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.
Hospital Appointments Status
Questions (320)
Michael Healy-Rae
Question:320. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [33399/16]
View answerWritten answers
Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The 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.
Hospital Services
Questions (321)
Pearse Doherty
Question:321. Deputy Pearse Doherty asked the Minister for Health the reason no MRI scanning service is available to persons during weekend periods at Letterkenny University Hospital; if additional staffing resources will be allocated to the facility to ensure that weekend cover is in place for patients requiring access to radiology services; and if he will make a statement on the matter. [33405/16]
View answerWritten answers
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
Hospital Staff
Questions (322)
Jack Chambers
Question:322. Deputy Jack Chambers asked the Minister for Health if he will clarify the situation concerning the payment of Christmas bonuses to HSE staff working in hospitals on Christmas Day in 2016 as this falls on a Sunday; and if he will make a statement on the matter. [33406/16]
View answerWritten answers
I have asked the HSE to respond to the Deputy directly on this matter.
National Children's Hospital
Questions (323)
Jan O'Sullivan
Question:323. Deputy Jan O'Sullivan asked the Minister for Health if his attention has been drawn to concerns that there may not be adequate affordable parking spaces for the families of children in the proposed new national children's hospital in the St. James's Hospital site; the way these concerns are being addressed; and if he will make a statement on the matter. [33407/16]
View answerWritten answers
The campus at St. James’s hospital benefits from a full suite of transport options including private car, national rail, Luas, bus, bicycle, pedestrian and taxi.
Notwithstanding the public transport accessibility of the site, the need of most parents to access the hospital by car is recognised, and ample parking has been provided for families based on current and projected future demand. 1,000 car parking spaces are being provided, with a minimum of 675 of these dedicated to family parking. This is based on an assessment of the level of parking demand, developed in consultation with the medical planning team. The National Paediatric Hospital Development Board (NPHDB), the statutory body responsible for planning, designing, building and equipping the new children's hospital has confirmed, that this level of parking provision will facilitate 100% car parking provision for inpatient, daycase and emergency attendances, and 65% car parking provision for outpatient attendances. The car parking stock and appointment schedules will be actively managed to ensure that all patients wishing to avail of parking will be facilitated. In addition, a condition of the planning permission granted by An Bord Pleanála is that a minimum of 20 spaces be marked and designated as “parent and child” spaces and reserved for parents of children with specific needs (equipment etc.).
In regard to parking costs, these will be considered in due course having regard to the needs of patients and families, including families of long-stay patients.
Services for People with Disabilities
Questions (324)
Michael Healy-Rae
Question:324. Deputy Michael Healy-Rae asked the Minister for Health the status of an application for home support in respect of persons (details supplied); and if he will make a statement on the matter. [33414/16]
View answerWritten answers
The 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 an individual case, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
Home Help Service Provision
Questions (325)
Éamon Ó Cuív
Question:325. Deputy Éamon Ó Cuív asked the Minister for Health if he will provide sufficient home help hours for a person (details supplied) in order for the person to be able to remain at home in view of the fact that they were previously told they would be allocated 32 hours weekly and that they were a high dependency case; and if he will make a statement on the matter. [33416/16]
View answerWritten answers
As this is a service matter it has been referred to the Health Service Executive for direct reply.
Hospital Appointments Status
Questions (326)
John Brassil
Question:326. Deputy John Brassil asked the Minister for Health if he will examine and expedite a hospital appointment in respect of a person (details supplied); and if he will make a statement on the matter. [33419/16]
View answerWritten answers
Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The 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.
Medical Aids and Appliances Provision
Questions (327)
Dara Calleary
Question:327. Deputy Dara Calleary asked the Minister for Health the status of an application for a prosthetic limb in respect of a person (details supplied). [33422/16]
View answerWritten answers
As this is a service matter it has been referred to the HSE for reply to the Deputy.
Vaccination Programme
Questions (328)
Niamh Smyth
Question:328. Deputy Niamh Smyth asked the Minister for Health if he will provide parents in counties Cavan and Monaghan an update regarding the delay in providing the BCG vaccine; if their babies are at risk of TB due to this; if it will become a routine vaccine again when stocks are restored; and if he will make a statement on the matter. [33430/16]
View answerWritten answers
There is currently a worldwide shortage of BCG vaccine. In 2015 the United Nations Children's Funds (UNICEF) estimated a worldwide shortage of 65 million doses of BCG. The vaccine has not been available in Ireland since the end of April 2015. The manufacturer has had difficulties in the production of the BCG vaccine. The manufacturer has informed the HSE there will be no supply of BCG until 2017. Consequently, BCG vaccination clinics in HSE Clinics and Maternity hospitals have been postponed until new stock arrives.
There is only one licensed supplier of BCG vaccine to Ireland and to other countries within the EU. Since this problem became apparent, the HSE National Immunisation Office has been in regular contact with the manufacturer of BCG vaccine to ascertain when the vaccine might be available. The HSE has also asked the Health Products Regulatory Authority (HPRA), which licenses and regulates all human medicines in Ireland, to source an alternate supplier of the BCG vaccine. Efforts have been made to find a company who can provide the vaccine for use in Ireland which satisfies all the HPRA requirements on safety and efficacy. To date no suitable alternative BCG product has been found. Therefore the HSE has been unable to procure the BCG vaccine from any other source and still awaits the product from the HPRA licensed supplier of the vaccine.
The supplier has indicated that supplies of the vaccine are not expected to be delivered into Ireland until early 2017. When there is confirmation of the date of new supply a decision will be made, guided by the recommendations of the National Immunisation Advisory Committee, on who should be prioritised to receive the vaccine. Arrangements will then be made to administer the vaccine, including to those prioritised in Cavan and Monaghan.
In Ireland the number of cases of tuberculosis (TB) has been falling. TB is a notifiable disease under the Infectious Diseases (Amendment) Regulations 2016 (S.I. No. 276 of 2016). In 2015, 318 cases of TB were notified to the Health Protection Surveillance Centre, giving a national TB notification rate of 6.9 per 100,000, the lowest rate reported since surveillance commenced. According to the World Health Organisation, the definition of a low incidence TB country is one with a national TB notification rate of less than 10 cases per 100,000, Ireland is in this category. The risk to babies remains unchanged, even allowing for delay in getting BCG vaccine in Ireland.
Rape Crisis Network Funding
Questions (329)
Peadar Tóibín
Question:329. Deputy Peadar Tóibín asked the Minister for Health if he will consider making funds available to facilitate the creation of a rape crisis outreach centre in Navan, County Meath (details supplied). [33435/16]
View answerWritten answers
As this is a service matter, I have asked the HSE to respond to you directly.
Voluntary Sector Funding
Questions (330)
Éamon Ó Cuív
Question:330. Deputy Éamon Ó Cuív asked the Minister for Health if he will provide funding to a voluntary organisation (details supplied) in order to buy defibrillators for the area under its remit; and if he will make a statement on the matter. [33436/16]
View answerWritten answers
Community groups may apply for lottery funding to help with the purchase of defibrillators and the HSE has also supported local community initiatives with this. In addition, one of the means to help improve health outcomes in this area is through the expansion of the National First Response Network. Community first responder groups comprise this national network. These are people from local communities who are trained in basic life support and the use of defibrillators that attend a potentially life threatening emergency in their area. They are then able to provide an early intervention in situations such as heart attack or cardiac arrest by providing, among other things, resuscitation and defibrillation.
Cardiac First Responders (CFR) Ireland, launched in 2015, is the national umbrella organisation for Community First Responders Groups. CFR Ireland works with the National Ambulance Service, Pre-Hospital Emergency Care Council and the Centre for Emergency Medical Science UCD. There are currently 141 Community First Responder groups tasked by the National Ambulance Service. If an emergency 999/112 call for cardiac arrest, choking, chest pain or breathing difficulties is made to the National Ambulance Service in an area where a CFR group is established, the on-duty CFR member gets a text from the National Ambulance Service at the same time that an ambulance is despatched with location and call details. The First Responder then goes straight to the scene and administers initial care (defibrillation if required) until the National Ambulance Service Emergency resources arrive.
Hospital Appointments Status
Questions (331)
Michael Healy-Rae
Question:331. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment in respect of a person (details supplied); and if he will make a statement on the matter. [33445/16]
View answerWritten answers
Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The 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.
Hospital Accommodation Provision
Questions (332)
Tony McLoughlin
Question:332. Deputy Tony McLoughlin asked the Minister for Health the progress on the development of the new hospital at St. Patrick's Hospital, Carrick on Shannon, County Leitrim; and if he will make a statement on the matter. [33450/16]
View answerWritten answers
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 including St Patrick's Hospital, Carrick-on-Shannon. Under this Programme it is proposed to deliver a new build 100 bed CNU at St Patrick's Hospital, Carrick-on-Shannon by 2021. This will replace existing beds where the physical environment requires significant improvement.
Significant work has been undertaken by the HSE in determining the most appropriate scheduling of projects over the 5 year period from 2016 to 2021, within the phased provision of funding, to achieve compliance and registration with HIQA. 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. These stages include appraisal, project brief, design feasibility, detailed design, some of which may overlap, the review of costing estimates and finalisation of financing.