Tuesday, 15 Nov 2016

Written Answers Nos. 479-491

Blood Donations

Questions (479)

Louise O'Reilly

Question:

479. Deputy Louise O'Reilly asked the Minister for Health when he plans to defer the lifetime MSM blood donation ban to the one year deferral period; and if he will make a statement on the matter. [34553/16]

Written answers

Minister for Health

In June of this year, I accepted a recommendation from the Irish Blood Transfusion Service that (a) the lifetime deferral policy for men who have sex with men (MSM) from donating blood should be reduced to a period of one year following their last sexual encounter with a man and (b) all donors who have had a sexually transmitted infection (STI) should be deferred from donating blood for a period of at least five years from that infection (current deferral periods vary depending on the STI concerned).

The IBTS advise that these changes will be implemented by the end of January 2017.

Health Services Provision

Questions (480)

John Lahart

Question:

480. Deputy John Lahart asked the Minister for Health if his attention has been drawn to the serious issues facing a health centre (details supplied) due to understaffing; his plans to deal with the chronic understaffing; and if he will make a statement on the matter. [34568/16]

Written answers

Minister for Health

As 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.

Nursing Homes Support Scheme Eligibility

Questions (481)

Michael Moynihan

Question:

481. Deputy Michael Moynihan asked the Minister for Health if he will consider changing the financial assessment method for the nursing home support scheme in relation to the assessment of family farms as assets; if he will extend the existing three year cap to include family farms; and if he will make a statement on the matter. [34578/16]

Written answers

Minister of State at the Department of Health

The Nursing Homes Support Scheme (NHSS) is a system of financial support for those in need of long-term nursing home care. Participants contribute to the cost of their care according to their income and assets while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings. A financial assessment is carried out by the HSE to determine how much a participant in the Scheme will contribute to the cost of their care.

A person's Principal Private Residence (PPR) is only included in the financial assessment for the first three years of the NHSS participants' time in care. A farm or relevant business can also qualify for the three year cap where unexpected health events prevent early succession arrangements. This applies where:

a) The applicant has suffered a sudden illness or disability which caused them to require care services and

b) A substantial part of the working day of the applicant or their partner was regularly and consistently applied to the farming of the farm or carrying on of the relevant business until the onset of the sudden illness or disability, and

c) A family successor certifies in writing that he or she will on a consistent and regular basis apply a substantial part of his or her working day to the farming of the farm or the carrying on of the relevant business.

The Programme for a Partnership Government has committed to reviewing the NHSS to remove any discrimination against small business and family farms.

Furthermore, when the NHSS commenced in 2009, a commitment was made that it would be reviewed after three years. The Report of the Review was published in July 2015. Arising out of the Review, a number of key issues have been identified for more detailed consideration across Departments and Agencies, including the treatment of business and farm assets for the purposes of the financial assessment element of the Scheme. This work is currently underway and the IFA has made a submission in this context to the Interdepartmental Group which is overseeing the Review. Changes arising from this Review may require legislative implementation.

Drug and Alcohol Task Forces

Questions (482)

Niall Collins

Question:

482. Deputy Niall Collins asked the Minister for Health if he will provide new additional funding to drugs and alcohol task forces to allow these groups to deal with alcohol within their remit; his views on the importance of this issue; and if he will make a statement on the matter. [34580/16]

Written answers

Minister of State at the Department of Health

In line with the National Drugs Strategy, the Government is committed to continuing support for initiatives to tackle the drug problem. Drug and Alcohol Task Forces play a key role in assessing the extent and nature of the drug problem in their areas and in coordinating action at local level, so that there is a targeted response to the problem of substance misuse in local communities.

Following the 2011/12 Review of Drug Task Forces, increased responsibilities were given to Task Forces in relation to addressing the alcohol problem. In light of this expanded role, over €900,000 in additional funding has been made available to Drug and Alcohol Task Forces from the Dormant Accounts Fund for substance misuse initiatives. This initiative aims to promote healthier lifestyle choices throughout society in relation to alcohol, by influencing and raising awareness of alcohol harm among the general population and specific risk groups. In addition, through the Alcohol Forum, training has been provided to a number of Task Forces in developing local alcohol action plans.

Every effort has been made to protect the budgets of Drug and Alcohol Task Forces in recent years. The overall allocation to Drug and Alcohol Task Forces for community-based drugs initiatives this year is in excess of €27.6 million, the same amount provided in 2014 and 2015. The Department of Health will shortly be writing to Task Forces to invite them to submit their recommendations for funding of drugs initiatives in 2017. It is a matter for Task Forces to ensure that their budget is effectively deployed to address current priorities and locally identified needs.

Hospital Services

Questions (483)

Brendan Griffin

Question:

483. Deputy Brendan Griffin asked the Minister for Health his views on a matter (details supplied) regarding University Hospital Kerry; and if he will make a statement on the matter. [34585/16]

Written answers

Minister for Health

As this is a service matter, I have asked the HSE to respond to you directly.

Hospital Services

Questions (484, 485, 486)

Mattie McGrath

Question:

484. Deputy Mattie McGrath asked the Minister for Health further to Parliamentary Question No. 433 of 18 October 2016, the number of persons that are accessing services (details supplied) at Our Lady's Hospital, Cashel, County Tipperary. [34589/16]

Mattie McGrath

Question:

485. Deputy Mattie McGrath asked the Minister for Health further to Parliamentary Question No. 433 of 18 October 2016, the number of staff in the administrative services and catering services of Our Lady's Hospital, Cashel, County Tipperary; and if he will make a statement on the matter. [34590/16]

Mattie McGrath

Question:

486. Deputy Mattie McGrath asked the Minister for Health the role HIQA has in determining the suitability of using Our Lady's Hospital, Cashel, County Tipperary as a step-down bed facility; and if he will make a statement on the matter. [34591/16]

Written answers

Minister of State at the Department of Health

I propose to take Questions Nos. 484 to 486, inclusive, together.

As these are service matters they have been referred to the Health Service Executive for direct reply.

Vaccination Programme

Questions (487)

Clare Daly

Question:

487. Deputy Clare Daly asked the Minister for Health if he will consider that parents and guardians should be given the option of providing consent for each HPV vaccination and not as it is at present, that is, consenting for at the start of the series of jabs; if he will consider providing the parents the right to give consent individually for the two vaccinations; and his views on the fact that this would allow the parents to monitor the health of their daughters after each vaccination. [34594/16]

Written answers

Minister for Health

As this is a service matter, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.

Vaccination Programme

Questions (488, 489, 490, 491)

Clare Daly

Question:

488. Deputy Clare Daly asked the Minister for Health if there is a possibility of aluminium in Gardasil forms of HPV vaccines crossing the blood brain barrier; if he will publish any data held by his Department on this subject; and if he will make a statement on the matter. [34595/16]

Clare Daly

Question:

489. Deputy Clare Daly asked the Minister for Health if there is a possibility of potential synergistic toxicity of aluminium in HPV vaccines. [34596/16]

Clare Daly

Question:

490. Deputy Clare Daly asked the Minister for Health if pandemrix was at one time considered as safe as the HPV vaccines and that the benefits outweighed the risks; and if there is a possibility that the many autoimmune reactions being experienced by HPV vaccinated girls are following a similar pattern of neurological disturbances. [34597/16]

Clare Daly

Question:

491. Deputy Clare Daly asked the Minister for Health the data that the manufacturer submitted to the EMA which indicated that those pre-exposed to vaccine relevant HPV may experience a 44.6% increased risk of pre-cancerous lesions after vaccination with Gardasil; and the steps in place to monitor cervical cancer rates in the HPV vaccinated population. [34598/16]

Written answers

Minister for Health

I propose to take Questions Nos. 488 to 491, inclusive, together.

The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). NIAC is a committee of the Royal College of Physicians of Ireland comprising of experts in a number of specialties including infectious diseases, paediatrics and public health. The committee's recommendations are informed by public health advice and international best practice.

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. NIAC recommended that the human papillomavirus (HPV) vaccine be given to all girls aged 12-13 in 2009 and in September 2010 the HPV vaccination programme was introduced for all girls in first year of second level schools.

By January 2016, over 200 million doses of Gardasil had been distributed worldwide. In Ireland over 580,000 doses of Gardasil have been administered and over 220,000 girls have been fully vaccinated against HPV since it was introduced in 2010.

Aluminium has been used in vaccines for many decades to improve the body's response to vaccination. It is a component of Gardasil and several other vaccines. The World Health Organisation's (WHO) Global Advisory Committee on Vaccine safety (an expert clinical and scientific advisory body) has concluded that there is no evidence of a health risk from aluminium-containing vaccines.

The safety of the aluminium adjuvant used in Gardasil has been established in clinical studies and the level of aluminium present is tightly controlled as part of the quality control testing of the vaccine. Gardasil which contains amorphous aluminium hydroxyphosphate sulphate adjuvant was tested in nonclinical safety assessment studies where daily monitoring for physical signs did not reveal any notable effects on any physiological function. In addition, the safety of Gardasil was tested in human clinical studies and no signs of concern were identified. Apart from the expected immune response and local injection site reactions, there was no evidence of systemic effects (such as effects on CNS, respiratory, cardiovascular, and renal systems) caused by HPV L1 VLP vaccines such as Gardasil from study data and there is no data to suggest that Gardasil crosses the blood brain barrier. The pharmacological evaluation of Gardasil focused on the evaluation of primary pharmacodynamics (i.e. immunogenicity) as the vaccine did not show any effects apart from the expected immune response.

The European Medicines Agency (EMA) is a decentralised agency of the European Union responsible for the scientific evaluation, supervision and safety monitoring of medicines developed by pharmaceutical companies for use in the EU. It would not be appropriate to comment on data submitted by manufacturers of a medicinal product to the EMA as part of their market authorisation processes or monitoring of its safety following authorisation for use.

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 both nationally and at EU level. In Ireland, the Health Products Regulatory Authority (HPRA) is the statutory regulatory authority for medicines in Ireland.

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 of suspected adverse reactions submitted to the HPRA are reviewed and followed up as necessary to ensure all relevant information is available, prior to onward reporting to relevant stakeholders, including the EMA. At EU level, regulators continuously monitor this cumulative reporting experience as part of the ongoing assessment of the safety of HPV vaccines. In addition, pharmaceutical companies are obliged, as a condition of the authorisation to market a medicine, to submit reports of adverse reactions received directly, to the HPRA. In accordance with its reporting obligations, the HPRA provides anonymised details of reports received to the EMA, the WHO and to the relevant pharmaceutical companies. The fact that a suspected adverse reaction has been reported does not necessarily mean that the medicine has caused the observed effect, which may have also been caused by the condition being treated, a new condition the patient developed, or by another medicine that the patient is taking. Further data are usually needed to complete the picture.

I am aware of claims of an association between HPV vaccination and a number of conditions experienced by a group of young women. It appears that some girls first suffered symptoms around the time they received the HPV vaccine, and understandably some parents have connected the vaccine to their daughter’s condition. It is important to reassure people that anyone who is suffering ill health is eligible to seek medical attention, and to access appropriate health and social care services, irrespective of the cause of their symptoms. The individual nature of the needs of some children may require access to specialist services. The HSE are currently working to put in place a clinical care pathway appropriate to the medical needs of this group.

I encourage the parents of all eligible girls to ensure that their daughters receive this important cancer preventing vaccine.