Written Answers Nos. 282-299
282. Deputy Pearse Doherty asked the Minister for Health further to Parliamentary Question No. 564 of 15 November 2016, the reason the subsequent response issued by the Ambulance Service does not include the data requested in respect of staff turnover rates within the service; if this information will be provided specifically within the past five-year period, by year, in tabular form; and if he will make a statement on the matter. [38299/16]
View answerAs this is a service matter, I have asked the HSE to respond to you directly.
283. Deputy Niamh Smyth asked the Minister for Health if he will review the case of a person (details supplied); and if he will make a statement on the matter. [38319/16]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply.
284. Deputy Jack Chambers asked the Minister for Health the reason for the delay by the HSE in responding to a submitted representation (details supplied); and if he will make a statement on the matter. [38326/16]
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.
285. Deputy Tony McLoughlin asked the Minister for Health the advertising budget for the years 2010 to 2015 for immunisation programmes by sector (details supplied). [38332/16]
View answerAs the question being asked by the Deputy relates to a service matter I have referred the question to the Health Service Executive for attention and direct reply.
286. Deputy Tony McLoughlin asked the Minister for Health the cost of the Gardasil vaccination programme administered by the HSE on behalf of his Department for each of the years 2010 to 2016 to date. [38333/16]
View answerAs the question being asked by the Deputy relates to a service matter I have referred the question to the Health Service Executive for attention and direct reply.
287. Deputy Tony McLoughlin asked the Minister for Health the projected number of persons annually that will be saved as a result of the Gardasil vaccination programme and any research documents to support any claims; and if he will make a statement on the matter. [38334/16]
View answerThe 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. This independent 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 and there are approximately 70 deaths per year. 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.
288. Deputy Tony McLoughlin asked the Minister for Health his views on whether the success of the current smear test as administered by the HSE may be interpreted as justifying the success of the Gardasil vaccine. [38335/16]
View answerIn 2009 the National Immunisation Advisory Committee (NIAC) recommended HPV vaccination for all 12 year old girls to reduce their risk of cervical cancer and in September 2010 the HPV vaccination programme was introduced for all girls in first year of second level schools. The programme provides vaccination for all first year girls. In September 2011 a catch up programme started for all girls in second level school and the 2013/2014 campaign was the final year of this programme.
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.
Cervical Check is a national screening programme to prevent and control cervical cancer. The programme provides smear tests to women between the ages of 25 and 60. As the girls vaccinated under this programme have not reached the age of 25 it is not possible yet to assess the success of the HPV vaccine in reducing the incidence of cervical cancer in Ireland.
289. Deputy Jack Chambers asked the Minister for Health the status of his plans to extend the entitlement to a medical card for all children in receipt of the domiciliary care allowance; and if he will make a statement on the matter. [38343/16]
View answer335. Deputy James Browne asked the Minister for Health when children who are recipients of domiciliary care allowance will be approved for full medical cards without assessments, as promised in July 2016; and if he will make a statement on the matter. [38545/16]
View answer386. Deputy Mattie McGrath asked the Minister for Health the position regarding the provision of medical cards for persons in receipt of the domiciliary care allowance; when they will receive their medical cards; and if he will make a statement on the matter. [38827/16]
View answerI propose to take Questions Nos. 289, 335 and 386 together.
I have recently received permission from Government for my Department to prepare the Heads and General Scheme of a Bill to give children in receipt of DCA automatic entitlement to a medical card. This new legislation will effectively mean that all children in respect of whom a DCA payment is made will automatically qualify for a medical card and, therefore, no longer be subject to the medical cards means test at any point in the future while in receipt of DCA. It is my objective to have this legislation prepared and brought before the Oireachtas as quickly as possible. In addition to the preparation of the legislation, I have asked the HSE, so that the proposal can be implemented in a smooth and efficient manner, to commence the process of planning for the requirements of the scheme and how the cards will issue.
290. Deputy David Cullinane asked the Minister for Health the purpose of his visit to University Hospital Waterford on 28 November 2016; the reason it was an unannounced visit; the detail of the persons who accompanied him on his visit; the detail of the persons he met and the topics discussed; and if he will make a statement on the matter. [38357/16]
View answerSince taking office I have embarked on a series of hospital visits and have found them extremely beneficial. I had announced many times my intention to visit University Hospital Waterford and was pleased to be able to do so on the 28th November. Along with my Government colleague, Minister Halligan, I met with the Executive Management Board, a group of cardiologists and a broad range of staff with whom I discussed a number of the services provided at the hospital including the increased attendances at the Emergency Department and the additional support being made available to the hospital under this year's Winter Initiative, cardiology services and plans for the new palliative care unit as well as recruitment efforts currently underway. I was accompanied by senior officials from my Department's Acute Hospitals Policy Division and Press Office, my Special Adviser and HSE senior officials.
291. 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. [38370/16]
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.
292. Deputy Catherine Murphy asked the Minister for Health the reason a psychologist has not been appointed to County Kildare for children requiring such services; if his attention has been drawn to the large demand for such services in an area with a disproportionately large young population; if his attention has been further drawn to the fact that County Kildare is now the fourth most populated county; if his attention has been further drawn to the fact that no philological services have been available for at least 18 months and many urgent cases are being neglected; the number of such posts and the locations that are vacant; the waiting list for such services by area; and if he will make a statement on the matter. [38371/16]
View answerAs this is a service issue, this question has been referred to the HSE for direct reply.
293. Deputy James Browne asked the Minister for Health the longest period for which children in County Wexford are waiting on occupational therapy services; the average length of time children in County Wexford are on the waiting list for occupational therapy; if there are guidelines for waiting lists for children awaiting occupational therapy; if so, if the guidelines are currently being met; and if he will make a statement on the matter. [38374/16]
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.
294. Deputy Frank O'Rourke asked the Minister for Health the policies he and his Department are pursuing to ensure that the drug Orkambi will be available for cystic fibrosis patients here; and if he will make a statement on the matter. [38375/16]
View answerThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines in the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
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 that it may have sought 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:
- the health needs of the public;
- the cost-effectiveness of meeting health needs by supplying the item concerned rather than providing other health services;
- the availability and suitability of items for supply or reimbursement;
- 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;
- the potential or actual budget impact of the item or listed item;
- the clinical need for the item or listed item;
- the appropriate level of clinical supervision required in relation to the item to ensure patient safety;
- 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
- the resources available to the HSE.
I am advised that, at the HSE’s request, the NCPE carried out an assessment of the manufacturer's economic dossier, submitted in March 2016, on the cost effectiveness of Orkambi. This dossier included details on all relevant costs and cost offsets, such as those associated with hospitalisation, disease management costs, intravenous antibiotics, adverse events and any additional costs arising in patients not taking Orkambi.
The NCPE has completed its health technology assessment. This was submitted to the HSE in June 2016 and is available on the NCPE website. The NCPE determined, following an evaluation of the economic dossier, that the manufacturer failed to demonstrate cost-effectiveness or value for money from using the drug. The NCPE has confirmed that all relevant costs were included in the analysis.
The HSE has recently completed its most recent round of negotiations with the manufacturer. On foot of this, the HSE’s Drugs Committee, having considered the NCPE recommendation and other expert advice, is in the process of sending its latest recommendation on the cost-effectiveness of Orkambi to the HSE Directorate. The HSE Directorate will then make a decision, taking into consideration the manufacturer’s latest price offer. This decision will be made on objective scientific and economic grounds, in line with the 2013 Act.
I share the HSE's disappointment that the manufacturer in this case has maintained a very high price in negotiations on the potential reimbursement of Orkambi for Irish patients.
I appreciate that this is a very stressful time for cystic fibrosis patients and their families. However, I want to assure them that I do not consider this to be the end of the process. I would strongly urge the manufacturer in this case to fundamentally reconsider its position and to table a pricing proposal that can facilitate the provision of Orkambi for Irish patients, at a price that represents value for money for the health service and the taxpayer.
I would also like to inform the Deputy that I have written to the Health Ministers in England, Scotland, Canada and Australia, asking them to collaborate to try and make progress on accessing Orkambi at a cost effective price for cystic fibrosis patients in each of their countries.
295. Deputy Billy Kelleher asked the Minister for Health the number of reports that have been commissioned by him since his appointment; the number that have been received by him; the number outstanding; and if he will make a statement on the matter. [38377/16]
View answer296. Deputy Billy Kelleher asked the Minister for Health the number and cost of all reports commissioned by him, his predecessors, or his Department, in each of the years 2011 to date in 2016 in tabular form; the topics they are investigating; the date of completion; the date of publication; and if he will make a statement on the matter. [38378/16]
View answerI propose to take Questions Nos. 295 and 296 together.
Since my appointment as Minister for Health I have not directly commissioned any reports.
The Department does not collect data in a manner which would allow the Deputy’s second question to be answered in full. Published reports for the years in question are available on the Department’s website at: http://health.gov.ie/publications-research/publications/. Presented in the table below are details from the Department's A7 expenditure for consultant reports commissioned by the Department from March 2011 to December 2015 together with associated costs and publication status as of the latter date. Data for 2016 are not yet available and will be collated and forwarded as soon as possible.
It is the policy in my Department only to engage the services of external consultants where it is felt to be appropriate and cost-effective, taking account of Government decisions and policy including procurement protocols on the matter. Should the Deputy have a particular report for which details are required please provide details to my office and I will arrange for the matter to be followed up.
|
Year Commenced |
Organisation/ Consultants |
Name of Report |
Status as at December 2015 |
Cost to December 2015 |
|
2015 |
Amarach Research |
Alcohol Labelling Research |
Report being drafted. |
€86,138 |
|
2015 |
NUIG |
Suite of Literature Reviews to support National Clinical Guidelines |
Work commenced |
€159,645 |
|
2015 |
UCC |
Systematic literature review National Early Warning Score update |
Ongoing |
€22,743 |
|
2015 |
ICF Consulting Services/DKM Economic Consultants |
An assessment of the economic costs of smoking in Ireland |
Ongoing |
€12,449 |
|
2015 |
Prospectus |
Code of Conduct for Health and Social Service Providers |
Extracts will be published within clinical guidelines |
€86,138 |
|
2015 |
UCD |
Clinical Handover Guideline |
Work ongoing |
€86,292 |
|
2015 |
DCU |
Management of the Acute Adult Asthma Patient – provision of research |
Extracts to be published within clinical guideline |
€9,973 |
|
2015 |
DCU |
Paediatric Early Warning Score – Pre-implementation research |
Extracts to be published within clinical guideline |
€24,000 |
|
2015 |
INDECON Economic Consultants |
Analysis of potential measures to encourage the provision of Primary Care facilities |
Work ongoing |
€0 |
|
2015 |
DKM Economic Consultants |
Analysis of potential measures to encourage the provision of Nursing Homes and Community Nursing Unit facilities |
Work ongoing |
€40,221 |
|
2014 |
DCU School of Nursing |
Report to support the Taskforce on Staffing and Skill mix for nursing |
Will be used to inform the final Report on the Taskforce on Staffing and Skill Mix |
€7,418 |
|
2014 |
DCU School of Nursing |
Literature Review and Nursing Workforce Evaluation to Support the Taskforce on Staffing and Skill Mix |
Will be used to inform the Report of the Taskforce on Staffing and Skill Mix |
€19,845 |
|
2014 |
Crowe Horwath |
Thematic Analysis of Submissions in response to a Public Consultation on the White Paper for Universal Health Insurance |
Published on Department’s website |
€39,176 |
|
2014 |
NUI Galway |
Systematic literature review Maternity Early Warning Score |
Extracts published within clinical guideline |
€23,935 |
|
2014 |
DCU |
Systematic literature review Paediatric Early Warning Score |
Extracts will be published within clinical guideline |
€20,095 |
|
2014 |
UCC |
Systematic literature review Clinical Practice Guidance |
Published on Department’s website |
€20,712 |
|
2014 |
Sinéad Shannon |
Review of the international evidence and literature on selection criteria for the Outcomes Framework |
Ongoing |
€5,000 |
|
2013 |
Prospectus Strategy Consultants |
Review of Staffing Resources and Organisational Structure of the Department of Health |
Report completed but not published, for Department's use only |
€72,940 |
|
2013 |
Deloitte and Touche Consultants Ltd |
Review of the Nursing Homes Support Scheme |
Ongoing |
€36,900 |
|
2013 |
Matheson Ormsby Prentice |
Legal Research and advisory services on the design and implementation of an insurance based health system providing universal coverage in Ireland |
Not Published |
€123,000 |
|
2013 |
Prof Oonagh Walsh |
Report on symphysiotomy in Ireland, 1944-1984 |
Not published |
€49,500 |
|
2013 |
Ernst & Young |
Reports relating to the development of the Programme Management Office (cost includes a range of consultancy services) |
Ongoing – internal reports |
€79,212 |
|
2013 |
Dr Sinead Hanafin & Associates |
Review of the Traveller Health Advisory Committee |
Finalised |
€6,150 |
|
2013 |
Prospectus |
Overview of the development of the Health & Wellbeing Programme |
Finalised |
€15,156 |
|
2013 |
Research Matters |
Provision of Research Management Services |
Ongoing |
€74,490 |
|
2013 |
Institute of Public Health |
Analysis re Consultation (Tobacco Products Directive) |
Completed - not yet published |
€5,000 |
|
2013 |
Professor Hammond |
Research on Standardised Packaging- Irish Context |
Ongoing |
€5,000 |
|
2013 |
CJP Consultants |
Preparation of report on the efficacy of minimum pricing and other public policies for alcohol. |
Published on website |
€31,488 |
|
2013 |
Advertising Standards Authority of Ireland |
Annual Report of the Alcohol Marketing Communications Monitoring Body (AMCMB) |
Published |
€21,115 |
|
2012 |
McGee Pharma International |
Labelling of Medicinal Products in both Irish and English |
Completed |
€13,644 |
|
2012 |
Goodbody Stockbrokers and Matheson Ormsby Prentice Solicitors |
Further Analysis of Options in relation to the restructuring of the Irish Private Health Insurance Market |
Report completed |
€62,349 |
|
2012 |
Department of Public Expenditure and Reform with the assistance of PwC |
Review of the Department of Health's Parliamentary and Legislative Processes |
Report completed but not published - for Department's use only |
€18,020 |
|
2012 |
Department of Public Expenditure and Reform |
A survey of experience and qualifications in the Department of Health |
Report completed but not published - for Department's use only |
None |
|
2012 |
Michael Collins Associates |
Supplementary Report and Addendum on Cost Comparison for the Dolphin Review Group |
Completed not published, commercially sensitive |
€12,423 |
|
2012 |
John Martin |
Further assessment of planning issues in relation to proposed sites for the Dolphin Review Group |
Published |
€6,000 |
|
2012 |
Simon Clear |
Further assessment of planning issues in relation to proposed sites for the Dolphin Review Group |
Published |
€9,475 |
|
2012 |
The Department of Epidemiology and Public Health, UCC, in conjunction with the Centre for Health Policy and Management, TCD. |
The Efficiency Review of the BreastCheck Screening Programme |
Published |
€71,270 |
|
2012 |
Mr Gerard Mullaly |
Reforming Chronic Care: Financing and Delivering Integrated Chronic Care |
Not published |
€5,227 |
|
2012 |
Mr Gerard Mullaly |
The Integrated Continuing Care System (ICCS): Reforming Elderly Care in Ireland |
Not published |
€7,558 |
|
2012 |
Matheson Ormsby Prentice |
Options Appraisal of multi-payer universal health insurance models: Preliminary advice |
Not Published |
€6,150 |
|
2012 |
Department of Health / SIRA Consulting |
Report on the baseline measurement of the administrative burden from the Department of Health (as part of a cross Departmental project coordinated by Department of Jobs, Enterprise and Innovation) |
Published 2013 |
€14,000 |
|
2011 |
Goodbody Stockbrokers and Matteson Ormsby Prentice Solicitors |
Commissioned to undertake a review of the Irish Private Health Insurance Market in relation to the options which may exist for re-balancing |
Report completed |
€300,000 |
297. Deputy Billy Kelleher asked the Minister for Health the number of meetings that have taken place with the chief executive officer of the HSE, or other senior HSE directors, since his appointment; the decisions taken as a result of those meetings; and if he will make a statement on the matter. [38379/16]
View answerThere is daily engagement between senior Departmental Staff and their counterparts in HSE. I personally have taken part in over thirty meetings with the HSE, the majority of which have focussed on the implementation of Winter Initiative and Emergency Department overcrowding, and the implementation of the Waiting List action plan. These meetings include the Director General and the relevant National Directors. I also attend meetings of the ED Taskforce with the Director General and National Directors.
In addition, my Department has a monthly meeting with senior HSE staff to review ongoing performance issues and effective implementation of remedial actions.
298. Deputy Billy Kelleher asked the Minister for Health if he will provide a report on the current activities being undertaken as part of the 2016-2017 winter initiative; the amount that has been expended to date; the amount that remains from the originally allocated budget; the progress that has been made in terms of reducing the number of persons waiting on trolleys; and if he will make a statement on the matter. [38380/16]
View answerIt is unacceptable that patients wait on trolleys for long periods especially elderly and vulnerable patients. Over the coming months it is essential that the health service plans effectively for expected surges in emergency care demand. My Department, working with the HSE, has been driving a range of measures to improve patient ED experience times.
Following the formation of Government an additional €40 million was provided to assist in the management of winter pressures. Utilising this additional funding the HSE developed the Winter Initiative Plan 2016 – 2017 which was published in September. Key aspects of this plan are being implemented at hospital and community services level across the country.
I have been advised by the HSE that as of 2 December 2016, the remaining balance of the winter initiative to be spent is €6.6m. The HSE are confident the remainder of the funding will be fully spent by the end of the year in order to help as many patients as possible.
One of the key targets of the Winter Initiative is to reduce delayed discharges nationally from 638 at the commencement of this initiative to less than 500 by the end of the year. The HSE is on course to meet this target with the number of delayed discharges nationally now at 525, as of end November. Over 4,100 patients have availed of Community Intervention Team services, meaning that these patients were able to avoid hospital or be discharged earlier from hospital.
Also under the Initiative, over 3,300 patients have availed of aids and appliances, enabling them to be discharged from hospital sooner. 420 additional homecare packages have been made available and 190 additional transitional care beds have been approved since early October. These have enabled patients to be discharged from hospital back to their homes or to alternative transitional care centres. In addition, 18 step-down beds have opened in the Mercy Hospital in Cork.
On 1 December the HSE convened a Winter Initiative Health Summit where I met with Hospital Group CEOs, as well as hospital and Community Health Organisation managers, to reinforce the importance of driving key performance improvements across primary, acute and social care to reduce ED overcrowding and to plan for expected surges in demand in our EDs in the New Year.
I can assure the Deputy that there is a very strong focus on reducing ED overcrowding in all my interactions with the HSE, hospitals and the wider health service.
299. Deputy James Browne asked the Minister for Health the number of children in County Wexford on a waiting list for occupational therapy; the number of children in County Wexford awaiting occupational therapy services for up to 12 months, up to 24 months and up to 36 months; and if he will make a statement on the matter. [38381/16]
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.
