Written Answers Nos. 384-405
384. Deputy Maureen O'Sullivan asked the Minister for Health his plans to introduce cancer trial research units in hospitals to complement the current number of 14 located nationally; and if he will make a statement on the matter. [35708/16]
View answerSince 2005, the Health Research Board (HRB), a statutory agency under the aegis of my Department, has invested approximately €53 million in the development of a network of cancer clinical trials in hospitals across Ireland. The HRB funding is provided to Cancer Trials Ireland (CTI) to support clinical trials at hospital sites.
CTI is the largest collaborative cancer research infrastructure in Ireland. The majority of oncologists and haematologists in Ireland are active participants, as well as research specialists such as research nurses and translational researchers. Decisions on participation in cancer clinical trials are made by CTI following discussions with clinicians in relevant hospitals.
385. Deputy Pat Casey asked the Minister for Health the progress of the proposed new primary health care centre for Rathdrum; the proposed completion date; and if he will make a statement on the matter. [35735/16]
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.
386. Deputy Pat Casey asked the Minister for Health the progress of the primary health care centre for Arklow, County Wicklow; the estimated completion date; and if he will make a statement on the matter. [35736/16]
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.
387. Deputy Mary Butler asked the Minister for Health the estimated mortality rate for dementia in each of the years since 2006, in tabular form; and if he will make a statement on the matter. [35738/16]
View answer388. Deputy Mary Butler asked the Minister for Health if his Department or the HSE has projections on the likely dementia-related mortality rate for 2021, 2030 and 2040; and if he will make a statement on the matter. [35739/16]
View answerI propose to take Questions Nos. 387 and 388 together.
The Central Statistics Office has provided the following information on deaths attributable to dementia:
|
Year |
Male |
Female |
Total |
|
2007 |
266 |
547 |
813 |
|
2008 |
257 |
482 |
739 |
|
2009 |
304 |
637 |
941 |
|
2010 |
369 |
682 |
1051 |
|
2011 |
276 |
515 |
791 |
|
2012 |
535 |
978 |
1513 |
|
2013 |
573 |
1212 |
1785 |
|
2014 |
662 |
1282 |
1944 |
|
2015* |
734 |
1425 |
2159 |
*Note 2015 is provisional data only and is subject to revision. Source Vital Statistics CSO.
Comparable estimates for the other years mentioned by the Deputy are not available.
Projections of the number of people with dementia in Ireland in five yearly intervals up to 2046 are as follows:
|
Age group |
2011 |
2016 |
2021 |
2026 |
2031 |
2036 |
2041 |
2046 |
|
30-59 |
2,866 |
2,935 |
2,934 |
2,869 |
2,854 |
2,864 |
2,889 |
2,991 |
|
60-64 |
1,200 |
1,301 |
1,449 |
1,615 |
1,738 |
1,906 |
2,044 |
1,896 |
|
65-69 |
2,776 |
3,287 |
3,827 |
4,020 |
4,485 |
4,876 |
5,315 |
5,645 |
|
70-74 |
4,604 |
5,532 |
7,013 |
7,442 |
8,367 |
9,378 |
10,211 |
11,188 |
|
75-79 |
7,475 |
8,213 |
11,298 |
12,560 |
14,055 |
15,928 |
17,968 |
19,692 |
|
80-84 |
10,958 |
12,265 |
16,099 |
17,868 |
22,348 |
25,364 |
29,102 |
33,196 |
|
85+ |
17,970 |
21,260 |
25,595 |
31,085 |
40,195 |
52,512 |
64,654 |
77,549 |
|
Total |
47,849 |
54,793 |
68,216 |
77,460 |
94,042 |
112,828 |
132,182 |
152,157 |
These should be interpreted with caution. The international evidence is that the age of onset of dementia is increasing in high income countries and the illness duration is reducing. It is hypothesised that this is due to better treatment to reduce recurrence of vascular diseases, such as heart disease and stroke. At this point it is uncertain whether or to what extent this positive trend may be offset in the future due to the higher prevalence of excess weight, obesity and diabetes. However, the increasing population of older people in Ireland means that the number of cases of people who have dementia is likely to increase.
It is a priority of the 2014 National Dementia Strategy to ensure that dementia is better recorded in primary and secondary care and that data from the Single Assessment Tool (an IT-based system to access health statists and care need of older people which is at an advanced stage of development) is used in future research to inform dementia care in Ireland.
389. Deputy Michael Healy-Rae asked the Minister for Health the status of a full-time general practitioner service in Rathmore, County Kerry (details supplied); and if he will make a statement on the matter. [35745/16]
View answerAs this is a service issue, it has been referred to the Health Service Executive for direct reply to the Deputy.
390. Deputy Micheál Martin asked the Minister for Health if he or his Department has been requested to introduce an electronic bed management system in acute hospitals; if he has considered same; if it will receive investment; his views on whether an electronic bed management system would improve bed management; if so, when it will be introduced in all acute hospitals; and if he will make a statement on the matter. [35751/16]
View answerThe HSE is responsible for bed management in acute hospitals and, as this is a service matter, I have asked the HSE to respond to you directly.
391. Deputy Micheál Martin asked the Minister for Health if he or his departmental officials have recently met the HSE to discuss the nursing shortages, particularly since the latest recruitment drive has failed to fill the 1,000 vacancies across the acute hospital system; his views on whether this is having a negative impact on morale and productivity; the actions he will take to address the shortages in the short, medium and long-term futures; and if he will make a statement on the matter. [35752/16]
View answerI am committed to making terms and conditions for all nurses and midwives working in the Irish public health system as attractive as possible.
There is ongoing engagement between officials of my Department and the HSE on recruitment and retention of nursing and other front line staff. Nursing and midwifery recruitment and retention is a priority for the health service. There are many initiatives currently underway to improve staffing levels throughout the country in the short, medium and long term. The HSE is offering permanent posts to 2016 degree programme graduates, and full time permanent contracts to those in temporary posts. The HSE is also focused on converting agency staffing to permanent posts. The HSE's National Recruitment Service is actively operating rolling nursing recruitment campaigns. The campaigns encompass General, Mental Health, Intellectual Disability and Registered Children's Nurses, and also Midwives. In addition, a relocation package of up to €1,500 continues to be available to nurses who return from overseas.
A number of specific measures have also 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. Last month the Government approved restoration of incremental credit for all nurses in respect of the 36 week clinical placement undertaken by 4th year student nurses in the context of the 2017 Estimates. This decision means that all nurses and midwives will receive 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.
There has been an increase of almost 1,200 nurses employed in the public health service (34,336 to 35,534) from September 2014 to September 2016, numbers having fallen by almost 4,600 from 2007 to 2014. 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 the recruitment of additional nursing staff to meet service needs. Given recognised difficulties in filling psychiatric nursing vacancies, an additional 60 undergraduate places have been put in place this autumn with a further 70 additional places to be provided next year.
392. Deputy Micheál Martin asked the Minister for Health the position regarding the reported shortages of the BCG vaccine; and if he will make a statement on the matter. [35753/16]
View answerThere 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.
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, the HSE will be guided by the recommendations of the National Immunisation Advisory Committee on its administration.
393. Deputy Mary Butler asked the Minister for Health when a person a person (details supplied) will receive an appointment for an operation; and if he will make a statement on the matter. [35766/16]
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.
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.
394. Deputy Pearse Doherty asked the Minister for Health the waiting times for inpatient and outpatient urology appointments at Galway university hospital, specifically in respect of those waiting for three months, six months, nine months, 12 months, 15 months and all periods in similar increments thereafter, in tabular form; and if he will make a statement on the matter. [35772/16]
View answerThe NTPF publishes the updated public waiting list figures each month on its website (www.NTPF.ie) and the most recent figures as of 27 October were published on 4 November. The figures relating to Urology in-patient and day case and outpatient waiting lists can be viewed in tabular form by the Deputy on this website.
In the 2016 National Service Plan, the HSE has set out the following targets for in-patient day case and outpatient targets; 95% of patients should wait less that 15 months for an in-patient or day case procedure and 85% of patients should wait less than 12 months for their first appointment.
There are currently a total of 7,884 patients waiting for an in-patient or day case urology appointment (of whom 89% are within the 15% target) and 2,102 waiting on an out-patient appointment for Urology in Galway University Hospital (of whom 85% are within the 12 month target).
At my request, in August, the HSE developed an Action Plan to reduce, by year end, the number of patients currently waiting 18 months or more for an in-patient/daycase procedure.
In addition to this Budget 2017 provides for the treatment of our longest-waiting patients. €20m is being allocated to the NTPF, rising to €55m in 2018. Planning of this initiative is at an advanced stage by the NTPF, my Department and the HSE.
395. Deputy Carol Nolan asked the Minister for Health the waiting times for both appointments and assessments in the early intervention and school age psychology services in County Mayo; and if he will make a statement on the matter. [35777/16]
View answerAs this is a service issue, this question has been referred to the HSE for direct reply.
396. Deputy Carol Nolan asked the Minister for Health the current waiting times for appointments, assessments and treatment under the child and adolescent mental health services in County Tipperary, in tabular form; the number of staff employed by the service; the number of referrals to the service on average per month; and if he will make a statement on the matter. [35778/16]
View answerAs this is a service issue, this question has been referred to the HSE for direct reply.
The referred reply under Standing Order 42A was forwarded to the Deputy.
397. Deputy Carol Nolan asked the Minister for Health the number of persons who have been treated for mental health difficulties under the child and adolescent mental health services in County Tipperary; and if he will make a statement on the matter. [35779/16]
View answerAs this is a service issue, this question has been referred to the HSE for direct reply.
398. Deputy Bernard J. Durkan asked the Minister for Health the progress to date in the determination of an application for the fair deal scheme for a person (details supplied); and if he will make a statement on the matter. [35789/16]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
399. Deputy Pearse Doherty asked the Minister for Health further to Parliamentary Question No. 1203 of 16 September 2016, when a reply will issue from the HSE. [35790/16]
View answerI understand that a reply issued from the HSE on 30 September 2016. A copy of this response has been forwarded to the Deputy.
400. Deputy Brian Stanley asked the Minister for Health when a person (details supplied) will be called to have a procedure carried out at St. James's Hospital, Dublin. [35796/16]
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.
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.
401. Deputy Brendan Griffin asked the Minister for Health his views on a matter (details supplied) regarding the drug Kalydeco; and if he will make a statement on the matter. [35797/16]
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.
402. Deputy Gino Kenny asked the Minister for Health the number of persons who have been treated in the past 12 months for whom data are available, using NTPF funding, by a consultant doctor who also had persons on his or her waiting list who had been treated in the same period by a different consultant doctor using NTPF funding; the number of persons who were treated using NTPF funding by a consultant doctor working solely in private practice; the number who were treated in total; and if he will make a statement on the matter. [35800/16]
View answerIn the past 12 months the NTPF has only funded diagnostic gastroenterology (GI) tests for patient. These procedures are all provided in a day care setting.
Two such GI scope NTPF initiatives have taken place. One in 2015 and another is currently in progress for 2016. In total 8,388 public patients are expected to benefit from these two initiatives (2,687 in 2015 and 5,701 in 2016).
In the two GI scope initiatives referred to, a list of private hospitals were contracted to provide the GI scope tests. The agreed contract states that the same medical consultant used by the private hospital will not carry out tests if they have also referred GI scope patients from a public hospital.
The NTPF has advised that it does not collect information about employees or contractors used by those hospitals other than requiring the hospital to ensure that consultants are on the medical register and that they do not self-refer.
My Department is working with the NTPF and the HSE to develop a waiting list initiative for 2017.
403. Deputy Michael Healy-Rae asked the Minister for Health the status of a dental appointment in respect of a person (details supplied); and if he will make a statement on the matter. [35805/16]
View answerAs this is a service matter it has been referred to the HSE for reply to the Deputy.
404. 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. [35814/16]
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.
The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
405. Deputy Mattie McGrath asked the Minister for Health his plans to privatise home help hours; the position regarding current home help staff; if their positions are guaranteed; and if he will make a statement on the matter. [35818/16]
View answerHomecare services provided either directly by the HSE or through service agreements with private and voluntary sector providers are intended to assist older people to live independently in their own homes. In addition to the mainstream Home Help Service which offers up to 5 hours per week of personal care and help with domestic chores, enhanced home care is provided through the Home Care Package (HCP) Scheme. Services are provided on the basis of assessed health-care need and services are free.
HSE employed home help workers have traditionally been, and remain, mainly part-time workers due to the nature and flexibility of the work involved and the care needs of clients. In 2014, new contracts were issued to HSE employed home helps providing them with guaranteed hours and a guaranteed income each week with assignments provided to meet the needs of clients over the course of 12 months.
There are no plans to privatise home care services currently provided directly by the HSE.
