Tuesday, 15 Nov 2016

Written Answers Nos. 615-26

Services for People with Disabilities

Questions (615)

Seán Fleming

Question:

615. Deputy Sean Fleming asked the Minister for Health when a person (details supplied) will receive a needs assessment by a multidisciplinary team; and if he will make a statement on the matter. [35138/16]

Written answers

Minister of State at the Department of Health

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.

Hospital Appointments Delays

Questions (616)

John Brassil

Question:

616. Deputy John Brassil asked the Minister for Health if he will expedite hospital appointments in respect of a person (details supplied); and if he will make a statement on the matter. [35153/16]

Written answers

Minister for Health

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.

Pharmacy Services

Questions (617)

Michael Moynihan

Question:

617. Deputy Michael Moynihan asked the Minister for Health if his Department has a structure in place to provide weekend pharmacy cover in rural areas where the only pharmacy stores are often closed from Saturday afternoon until Monday morning; and if he will make a statement on the matter. [35159/16]

Written answers

Minister for Health

Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration and operation of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

HSE Documents

Questions (618)

Róisín Shortall

Question:

618. Deputy Róisín Shortall asked the Minister for Health if he will report on the circumstances which led to the production of a reported memo issued to nurses regarding the removal of public patients from hospital beds; the person or persons responsible for approving the issuing of this memo; the steps which will be taken to establish accountability for this error; and if he will make a statement on the matter. [35171/16]

Written answers

Minister for Health

On 27 October it came my attention that a memo of legal advice had been issued within the HSE, regarding the removal of patients who no longer require acute hospital beds. This memo was provided by the HSE’s legal advisors to the National Director for Acute Hospitals. Immediately on becoming aware of the existence of this memo, the Department contacted the HSE who confirmed that it had been rescinded. I have already stated publicly that the memo was offensive and unacceptable and is utterly out of line with Government policy with respect to the care of patients and our vision for the health service.

The HSE has apologised and confirmed that the memo does not reflect the policy of the HSE. It is not in accordance with the HSE's espoused values of care, compassion and trust. It was written as legal advice and should never have been circulated at hospital and staff level.

The HSE is focussed on implementing the Winter Initiative 2016-2017, which it published on 9 September last. The Initiative provides €40 million of additional funding to manage the expected winter surge in demand for hospital care. The Initiative is primarily focussed on facilitating timely discharge from hospital, striking a balance between hospital avoidance measures, such as community intervention teams, supporting patient flow through acute hospitals and increasing the availability of social care services.

Pharmaceutical Sector

Questions (619)

Róisín Shortall

Question:

619. Deputy Róisín Shortall asked the Minister for Health further to a media report (details supplied) if he will report on all moneys paid by the pharmaceutical industry to the HSE, the Department of Health or any agencies under the auspices, in each of the past five years; and the circumstances and purpose of these payments. [35172/16]

Written answers

Minister for Health

The only payments received by my Department from the pharmaceutical industry over the past five years are licence fees under the Misuse of Drugs Acts as set out below:

Year - €

2011 -101,483.01

2012 - 79,219.20

2013 - 106,512.75

2014 - 66,181.05

2015 - 127,974.05

I have requested the HSE and the other agencies under the auspices of my Department to reply directly to the Deputy with this information.

Pharmaceutical Sector

Questions (620)

Róisín Shortall

Question:

620. Deputy Róisín Shortall asked the Minister for Health his views on the appropriateness or otherwise of the pharmaceutical industry providing payments to doctors within the public health service; his views on whether such payments constitute a significant conflict of interest; his views on the Government policy in this regard; and if he will make a statement on the matter. [35173/16]

Written answers

Minister for Health

I am aware of recent media reports on this issue and have asked my Department to consider whether any additional guidance or measures may be merited, in order to ensure that the public interest is safeguarded in all respects. I have also asked the Director General of the HSE to remind all senior health service staff of their legal obligations, particularly under the Ethics in Public Office Acts and also of their obligations under the Code of Practice for the Governance of State Bodies and to consider whether any additional guidance may be merited in respect of interaction between individual employees, their employing authority and commercial interests.

It is important, nonetheless, to appreciate that that engagement between clinicians and the pharmaceutical industry is a necessity and is central to excellence in clinical care as well as research. Such engagement must of course comply with the relevant regulations, ethical guidance and public service codes of conduct.

The Medicinal Products (Control of Advertising) Regulations 2007 govern the advertising of medicines, and provide for a range of restrictions on gifts, hospitality and sponsorship of meetings. 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. Breaches of the Regulations may be prosecuted in the courts under section 32 of the Irish Medicines Board Acts 1996 and 2006.

Regulation of the medical profession is undertaken by the Medical Council, which updated its Guide to Professional Conduct and Ethics for Registered Medical Practitioners in May 2016. While the Guide is not a legal code, it sets out the principles of professional practice and conduct that all doctors registered with the Medical Council are expected to follow.

The Guide advises that doctors "should not accept gifts (including hospitality) from pharmaceutical, medical devices or other commercial enterprises". However, it further states that this does not prevent practitioners attending educational meetings or receiving payment of reasonable fees for professional services to commercial enterprises". The Guide directs doctors to tell patients and any other relevant party about any professional relationship they may have with pharmaceutical companies in order to show that they are acting without influence from commercial enterprise. It also gives advice on how any funding received should be channelled to avoid conflict of interest.

All State Bodies under the aegis of my Department, including the HSE and voluntary hospitals established under the Health (Corporate Bodies) Act 1961, must comply with relevant legislation such as the Ethics in Public Office Acts 1995 to 2001, which set out statutory obligations that apply to Board members and public sector employees. In addition, they must comply with the Department of Public Expenditure and Reform’s Code of Practice for the Governance of State Bodies.

Nursing Homes Support Scheme Administration

Questions (621)

Eamon Scanlon

Question:

621. Deputy Eamon Scanlon asked the Minister for Health the details of the changes to the nursing home support scheme in budget 2017, particularly in respect of farm assets; when the new measures are to be implemented; and if he will make a statement on the matter. [35191/16]

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

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 under way 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.

Forestry Sector

Questions (622)

Bobby Aylward

Question:

622. Deputy Bobby Aylward asked the Minister for Agriculture, Food and the Marine if he will investigate the feasibility and potential benefits of implementing a system by which a private company may purchase carbon credits from private forestry owners for the purpose of reducing their carbon credit rating; and if he will make a statement on the matter. [34497/16]

Written answers

Minister for Agriculture, Food and the Marine

Under the European Commission’s LULUCF proposal (COM 479) flexibility to use credits from the land use, land-use change and forestry is envisaged to meet Member State’s compliance targets under the proposed Effort Sharing Regulation for the period 2021-2030. This use would apply at national level. There is no proposal to extend the use of LULUCF credits for compliance by individual companies who fall within the scope of the Emissions Trading Scheme (ETS). In order for such use to occur it would require agreement at EU level to change and extend the current proposals. At individual forest level it would entail considerable measurement and monitoring of forest carbon stocks over an extended period of several decades, including the need to track levels of harvest and account for emissions associated with these removals. At present carbon stock change estimates for the forest sector are based on national data sources including the sample-based National Forest Inventory.

My Department therefore does not envisage the introduction of such a scheme as that described by the Deputy for individual companies falling within the ETS. The UK Woodland Carbon Code for example is one such scheme that my Department has been examining. This model provides a mechanism whereby industry can invest in the creation of new forests and be associated with the climate mitigation benefits this delivers. The Department will continue to look at the possibilities that might exist in this area.

Single Payment Scheme Data

Questions (623)

Pearse Doherty

Question:

623. Deputy Pearse Doherty asked the Minister for Agriculture, Food and the Marine the number of single farm payment entitlements currently held under lease agreement in tabular form; the number of agreements entered into in 2016 to date; the total value of these payments; and if he will make a statement on the matter. [34913/16]

Written answers

Minister for Agriculture, Food and the Marine

The information sought is set out in tabular form below.

-	Number of Entitlements	Value of Entitlements
Total number of Basic Payment Scheme Entitlements currently held under lease agreements to date.	133,148	€26.8m
Entitlements entered into under the 2016 Basic Payment Scheme to date. This is based on 5,977 lease agreements processed to date.	88,026	€18.5m

Beef Industry

Questions (624)

Charlie McConalogue

Question:

624. Deputy Charlie McConalogue asked the Minister for Agriculture, Food and the Marine the input Ireland has made or submitted to the European Commission to the cumulative impact assessment being undertaken on all EU beef offers in trade agreements; and if he will make a statement on the matter. [34408/16]

Written answers

Minister for Agriculture, Food and the Marine

The European Commission did not seek formal input from Member States to its cumulative impact assessment, although officials from my Department, together with Teagasc colleagues, met the Commission early in the process to gain an understanding of the approach to be taken in conducting the analysis and to offer our advice.

However, Ireland was instrumental in bringing about the impact assessment in the first place, as it played a leading role in calling for such a study to be carried out, and in ensuring that no beef tariff rate quota was included in the exchange of offers between the EU and the Mercosur bloc in May of this year. I was very active at that time in highlighting the potentially very damaging impact of a Mercusor deal on the European agriculture sector, and on the beef sector in particular. I raised the issue continuously with Commissioners Malmström and Hogan, both within the Council of Agriculture Ministers and in written form.

I will continue with these efforts as required, and I will ensure that the results of the Commission's impact assessment are fully taken into account in the approach to future FTA negotiations.

Agriculture Industry

Questions (625)

Charlie McConalogue

Question:

625. Deputy Charlie McConalogue asked the Minister for Agriculture, Food and the Marine the input Ireland has made or submitted to the European Commission to the agricultural markets task force to improve the position of farmers in the food chain; and if he will make a statement on the matter. [34409/16]

Written answers

Minister for Agriculture, Food and the Marine

In the context of Ireland’s ongoing response over the last eighteen months to the difficulties experienced on agricultural markets, I have made our position clear at Agriculture Council on the range of issues considered by the Agricultural Markets Task Force. In terms of direct input, officials from my Department, along with those from other Member States, met with the Task Force in September to reiterate these points and to respond to questions from the Task Force on issues such as the operation of market safety net measures and the means by which greater transparency could be brought to the functioning of the food supply chain.

We highlighted the fact that free and fair competition must be the prerequisite for a sustainable food supply chain, accompanied by balanced relationships between all of the entities along the chain. We also emphasised that operators along the supply chain should acknowledge their interdependence with each other, and to work together to develop a model which sustains agricultural production, without which none of the downstream industrial or service sectors could exist.

With regard to unfair trading practices, we considered that an EU-wide legislative framework would be a very useful step, as voluntary arrangements in our experience had proven to be of limited effectiveness, and the Single Market required legislative frameworks in order to function well and freely. We also considered that measures to reduce cost, improve competitiveness and support innovation would be required in order to improve the longer-term sustainability of the food supply chain.

On price observatories and market transparency, we drew attention to the fact that knowledge of market pricing in the EU is quite limited. Producer returns at primary level are quite well publicised, retail prices are also known but there is little data on the basis on which they are constructed. We said we would welcome efforts to improve transparency at processer and retailer levels in this regard.

I took the opportunity to highlight these points during the informal Agriculture Ministers meeting in Bratislava in September, which also focused on the question of how to improve farmers’ position in the food supply chain.

EU Agreements

Questions (626)

Charlie McConalogue

Question:

626. Deputy Charlie McConalogue asked the Minister for Agriculture, Food and the Marine the steps that have been taken at European Council of Ministers level to agree a common EU framework on rules governing the food chain, considering the recent failure to find agreement on a definition of an unfair trading practice; and if he will make a statement on the matter. [34410/16]

Written answers

Minister for Agriculture, Food and the Marine

The issue of a common EU framework to help deal with unfair trading practices has been discussed in recent months by the Council of Agriculture Ministers in the context of strengthening the position of farmers in the food supply chain, which has in turn been raised repeatedly by EU Member States as we have dealt with the difficulties that have beset agricultural markets over the last eighteen months. Indeed, the importance of the need to strengthen farmers’ position in the food supply chain led to the establishment last January of the Agricultural Markets Task Force, which presented its report to the Agri-Fish Council in Brussels earlier today.

More particularly as regards unfair trading practices, the Slovak Presidency made “strengthening the position of farmers in the food supply chain” the topic of its informal meeting in Bratislava in September. I took the opportunity to again emphasise Ireland’s view in relation to the usefulness of having an EU-wide legislative framework governing unfair trading practices.

While many of the points raised by Ireland, including in relation to unfair trading practices, appear to have been addressed in the Task Force’s report, I look forward to considering its contents in detail in due course. I also look forward to the Commission’s follow-up actions over the coming period.