Written Answers Nos. 216 - 228
216. Deputy Gino Kenny asked the Minister for Health if he will recommend a public consultation on the issue of fluoridation of public water (details supplied) and consider a plebiscite to ensure a public mandate to continue the policy of fluoridation; and if he will make a statement on the matter. [35614/16]
View answerWater fluoridation is the adjustment of the natural concentration of fluoride in drinking water to the optimal recommended level for the prevention of dental decay. In 2002 the Forum on Fluoridation, which was established to review this policy, concluded that the fluoridation of public piped water supplies should continue as a public health measure. More recently, a review of evidence on the impact of water fluoridation at its current level on the health of the population was conducted by the Health Research Board (HRB) on behalf of the Department. This review was published by the HRB in June 2015. The HRB found no definitive evidence that community water fluoridation is associated with negative health effects. A research project "Fluoride and Caring for Children's Teeth" (FACCT) is being conducted by UCC and supported by the HSE. Preliminary results indicate that children's oral health has been improving, fluoridated communities have lower levels of dental caries.
The Irish Expert Body on Fluorides and Health, established in 2004, monitors new and emerging issues on fluoride and its effects on health and related matters. It has already considered the specific issues raised by the Deputy and advises that the balance of scientific evidence worldwide confirms that water fluoridation, at the optimal level, is a safe and effective method of protecting the oral health of the population. Given that the policy has already been reviewed and is under constant review, a further public consultation is not considered necessary. Fluoridation policy is provided for in the Health (Fluoridation of Water Supplies) Act, 1960. There are no plans to consider a plebiscite.
217. 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. [35618/16]
View answerUnder 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.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
218. Deputy Peter Burke asked the Minister for Health the status of a business proposal brought forward to him by the HSE relating to a centre (details supplied) being designated as a centre for an acquired brain injury unit; and if he will make a statement on the matter. [35630/16]
View answerThe Programme for Partnership Government places a particular focus on a number of key programmes and strategies, including publishing a plan for advancing Neuro-rehabilitation services in the community. Currently a National Steering Group, chaired by the Health Service Executive (HSE) Head of Disability Reform, is considering feedback on a draft implementation framework which was circulated for consultation to wider stakeholder interest groups. The revised framework will guide and oversee the reconfiguration and development of Neuro-rehabilitation structures and services at national and local level from a non-acute perspective. Proposals for specialised residential services for people with acquired brain injury will be considered in the broader context of the finalisation of the implementation framework for neuro-rehabilitation services.
With regard to this specific business proposal, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
219. Deputy Joan Burton asked the Minister for Health his plans to continue the pilot funding, under the dormant accounts programme, measure 4, in 2017, to assist the Tallaght drugs and alcohol task force and other task forces to develop an alcohol strategy and the delivery of same; and if he will make a statement on the matter. [35634/16]
View answerIn 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 coordinating action at local level, so that there is a targeted response to the problem of substance misuse in local communities.
Following a review of Task Forces completed in 2012, increased responsibilities were given to Drug and Alcohol Task Forces to address the alcohol problem. In light of their expanded role, a substance misuse measure was included in the Dormant Accounts Action Plan 2014 and the Task Forces were identified as the key structures through which the measure would be implemented. In excess of €930,000 in additional funding was recommended for disbursement to Drug and Alcohol Task Forces from the Dormant Accounts Fund for substance misuse initiatives, including over €35,800 for the Tallaght Drug and Alcohol Task Force. The grants to Task Forces were provided from the Dormant Accounts Fund on a once-off basis to undertake a range of coordinated activities aimed at raising awareness of drug and alcohol-related harm in local communities in line with the National Drugs Strategy. There are no further grants available for this purpose under this round of funding.
In addition, a number of Task Forces, including Tallaght Drug and Alcohol Task Force, have benefitted from training provided by the Alcohol Forum for the development of local alcohol action plans.
The Department of Health will shortly be inviting Task Forces to submit recommendations for the funding of projects from the Drugs Initiative budget 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.
220. Deputy Louise O'Reilly asked the Minister for Health if the HSE will provide pre-exposure prophylaxis medication in view of its effectiveness in preventing HIV infection. [35646/16]
View answerThe National Sexual Health Strategy 2015-2020 was launched in October 2015. The strategy was developed in response to a recommendation of the National AIDS Strategy Committee on the need to establish clear leadership within the health sector around the area of sexual health. The Strategy contains 71 recommendations that address all aspects of sexual health and a Sexual Health Action Plan for 2015-2016 contains 18 priority actions for immediate attention.
One of the priority actions identified in the Action Plan for 2016 is to 'Prioritise, develop and implement guidance to support clinical decision making for STI testing, screening and treatment and on the appropriate use of antiretroviral therapy in HIV prevention’. An Implementation Group has now been established within the HSE as an outcome of this action. This group will make recommendations on the appropriate use of HIV pre-exposure prophylaxis (PrEP) in the overall context of the national approach to HIV prevention. It is intended that work will start on a national demonstration project on PrEP in 2017.
222. Deputy Willie O'Dea asked the Minister for Health when a decision will be made regarding the drug Kalydeco and its availability for children aged two to five years of age with cystic fibrosis (details supplied); and if he will make a statement on the matter. [35648/16]
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.
In line with the 2013 Act, if a Company would like a medicine to be reimbursed by the HSE pursuant to the Community Drug Schemes or as a hospital medicine, the Company must first submit an application to the HSE to have the new medicine added to the Reimbursement List or to be priced as a hospital medicine.
Within 180 days of receiving the application (or such longer period which may arise if further information is sought from the Company), the HSE will decide to either:
- add the medicine to the Reimbursement List/agree to reimburse it as a hospital medicine, or
- will refuse to reimburse the medicine.
In reaching its decision, the HSE examines all the evidence which may be relevant in its view for the decision (including the information/dossier submitted by the Company) and will take into account such expert opinions and recommendations which may have been sought by the HSE at its sole discretion (for example, from the National Centre for Pharmacoeconomics).
In considering an application, the HSE will also have regard to Part 1 and Part 3 of Schedule 3 of the 2013 Act. Part 3 requires the HSE to have regard to the following criteria:
1. the health needs of the public;
2. the cost-effectiveness of meeting health needs by supplying the item concerned rather than providing other health services;
3. the availability and suitability of items for supply or reimbursement;
4. the proposed costs, benefits and risks of the item or listed item relative to therapeutically similar items or listed items provided in other health service settings and the level of certainty in relation to the evidence of those costs, benefits and risks;
5. the potential or actual budget impact of the item or listed item;
6. the clinical need for the item or listed item;
7. the appropriate level of clinical supervision required in relation to the item to ensure patient safety;
8. the efficacy (performance in trial), effectiveness (performance in real situations) and added therapeutic benefit against existing standards of treatment (how much better it treats a condition than existing therapies); and
9. the resources available to the HSE.
I am informed that the HSE received a request and economic dossier from the manufacturer of Ivacaftor, brand name Kalydeco, for the treatment of cystic fibrosis patients aged 2 years and older weighing less than 25kg. In March of this year the HSE asked the NCPE to carry out a health technology assessment of the applicant’s economic dossier on the cost effectiveness of this treatment.
The NCPE completed its assessment and made a recommendation in October 2016. The NCPE determined that the manufacturer failed to demonstrate cost-effectiveness of the drug for its intended cohort of patients and did not recommend that it should be reimbursed for this indication at the submitted price.
A summary of the health technology assessment has been published on the NCPE website and is available at: http://www.ncpe.ie/wp-content/uploads/2015/12/Ivacaftor-2-5-years-web-summary.pdf.
The HSE will enter into negotiations with the manufacturer in an effort to secure significant price reductions for Kalydeco.
The HSE will consider the outcome of these engagements together with the NCPE recommendation, in making a final decision on reimbursement. This decision will be made on objective, scientific and economic grounds by the HSE in line with the 2013 Act.
As you will appreciate, I cannot comment on the case of any individual, or intervene in individual patient cases.
223. Deputy Michael McGrath asked the Minister for Health the details of all pension top-ups paid in respect of chief executives of semi-State companies under the aegis of his Department, including the name of the organisation, the name of the chief executive, the amount of the top-up, the date of payment, and if the top-up was approved by his Department in each of the years 2011 to 2016 to date, in tabular form; and if he will make a statement on the matter. [35930/16]
View answerIn relation to Non-Commercial State Agencies under the remit of the Department, this information is being sought and will be forwarded to the Deputy when collated.
224. Deputy Thomas P. Broughan asked the Minister for Agriculture, Food and the Marine the measures he is taking to ensure that the use of wild animals in circuses is banned here; and if he will make a statement on the matter. [35515/16]
View answerThe conditions under which circus animals are kept and managed come under the scope of the Animal Health and Welfare Act 2013, which contains rules relating to the welfare of all animals and requires a person having an animal under his or her control to safeguard and not endanger the health and welfare of the animal. My Department continues to engage with stakeholders, including circus groups, animal welfare organisations, in relation to the welfare of wild animals in circuses. According to the information available to my Department, there are in fact very few wild animals currently performing in Irish circuses.
225. Deputy Ruth Coppinger asked the Minister for Agriculture, Food and the Marine the number of inspections officials in his Department made into the welfare of animals in circuses over the past year; if any welfare issues were identified; and if he will make a statement on the matter. [35534/16]
View answer226. Deputy Ruth Coppinger asked the Minister for Agriculture, Food and the Marine his views on prohibiting the use of animals in circuses; and if he will make a statement on the matter. [35535/16]
View answerI propose to take Questions Nos. 225 and 226 together.
The conditions under which all species of animals in circuses are kept and managed come under the scope of the Animal Health and Welfare Act 2013, which contains rules relating to the welfare of all animals, including wild animals in circuses. Officials from my Department have inspected 4 circuses to date this year but no significant animal welfare issues were identified.
My Department continues to engage with stakeholders, including circus groups, animal welfare organisations, in relation to the welfare of wild animals in circuses. According to the information available to my Department, there are in fact very few wild animals currently performing in Irish circuses. I have no plans at this juncture to ban the use of wild animals in circuses.
227. Deputy Niamh Smyth asked the Minister for Agriculture, Food and the Marine the current regulation concerning the welfare of wild animals used in circuses here; if any animal welfare complaints that have been submitted to his office in this regard have resulted in investigations; and if he will make a statement on the matter. [35538/16]
View answerThe conditions under which circus animals are kept and managed come under the scope of the Animal Health and Welfare Act 2013, which contains rules relating to the welfare of all animals and requires a person having an animal under his or her control to safeguard and not endanger the health and welfare of the animal. My Department has received general complaints from members of the public with regard the welfare of circus animals and these complaints have been investigated. No welfare issues were detected.
If the Deputy is aware of any specific complaints relating to the welfare of animals currently performing in Irish circuses, she should bring them to my Department’s attention.
228. Deputy Michael Healy-Rae asked the Minister for Agriculture, Food and the Marine the status of an application for TAMS by a person (details supplied); and if he will make a statement on the matter. [35546/16]
View answerThe person named submitted an application for grant-aid under the Dairy Equipment Scheme, Tranche 4 of TAMS 11 on 5 September 2016. The application concerned has passed all the relevant administrative checks. All the applications received in a given tranche are examined and then go through the Ranking and Selection process.
Following that step the application will be forwarded to the local office and checked for technical issues before approval issues. It is anticipated that this stage will be reached within a matter of weeks.
