Written Answers Nos. 463-486
463. Deputy David Cullinane asked the Minister for Health the status of plans to develop a 100-bed community nursing unit on the grounds of St. Patrick's Hospital; the start time for construction and proposed completion date; and if he will make a statement on the matter. [39755/16]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
464. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) has not received an urgent appointment for cataract removal; if an appointment can be arranged as soon as possible; and if he will make a statement on the matter. [39768/16]
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.
465. Deputy Bernard J. Durkan asked the Minister for Health if he will facilitate an appointment with a dermatologist in the case of a person (details supplied) who has been referred by their GP; and if he will make a statement on the matter. [39769/16]
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.
466. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Questions Nos. 204 of 30 June 2016, 412 of 27 January 2015, 120 of 2 December 2015 and 334 of 2 February 2016, the status of the response by the Health Service Executive to this issue; if he will request an update from the pharmacy interface project; his plans with regard to resolving this anomaly; and if he will ensure that a final answer is issued without further delay. [39782/16]
View answerAs this is a service matter, it has been referred to the HSE for reply to the Deputy.
467. Deputy Pat Buckley asked the Minister for Health if his attention has been drawn to instructions given to nurses to physically remove patients from beds; the details of such instructions, if they are still in place; the rationale for these instructions; and if he will make a statement on the matter. [39789/16]
View answerI became aware of a memo of legal advice, issued by the HSE’s legal advisors, to the National Director for Acute Hospitals on 27 October. Immediately, my Department contacted the HSE, and the HSE confirmed that it had been rescinded.
I have stated publicly that the memo was offensive and unacceptable and is utterly out of line with Government policy on the care of patients and its vision for the health service. The HSE has 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.
A core aim of our health service is to ensure that every person can access safe, compassionate and high quality healthcare. With that in mind, the HSE are implementing measures under the Winter Initiative Plan 2016/17 that are reducing delayed discharges, by increasing capacity within our Healthcare system. The Initiative provides €40 million of additional funding to manage the expected winter surge in demand for hospital care.
Under the Winter Initiative to date, over 3,343 patients have availed of aids and appliances, enabling them to be discharged from hospital sooner. Over 475 additional home care packages have been made available, and over 251 additional transitional care beds have been approved. In addition, 18 step-down beds, and 10 acute beds have been opened to date. Community Intervention Teams, as a whole, have received almost 25,000 referrals by end November, with 262 additional referrals enabled by the Winter Initiative.
The HSE are on target to meet the target of less than 500 delayed discharges by 1 January 2017. Delayed discharges are currently at 553 as of 6 December 2016. In order to maintain a tight focus on implementation, I am meeting the HSE on a weekly basis to monitor progress on the Initiative.
468. Deputy Pat Buckley asked the Minister for Health the position regarding the licensing of the drug naltrexone; and when it will be available on the GMS scheme to a person (details supplied). [39790/16]
View answerThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for reply to the Deputy.
469. Deputy Pat Buckley asked the Minister for Health his plans to provide funding for alpha-1 patients to receive treatment with Respreeza or Zemaira; if he will reimburse those that have already started treatment; and if he will make a statement on the matter. [39791/16]
View answer516. Deputy Brendan Griffin asked the Minister for Health his views on a matter (details supplied) regarding the drug Respreeza; and if he will make a statement on the matter. [40043/16]
View answer530. Deputy Mattie McGrath asked the Minister for Health if he will support urgent funding for the Respreeza or Zemaira drug for alpha-1 patients; and if he will make a statement on the matter. [40094/16]
View answer533. Deputy Alan Kelly asked the Minister for Health the status of the situation with the Respreeza drug; and if he will deal with this urgent situation immediately (details supplied); and if he will make a statement on the matter. [40160/16]
View answerI propose to take Questions Nos. 469, 516, 530 and 533 together.
The 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 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 Respreeza for maintenance treatment of emphysema in adults with documented severe alpha-proteinase inhibitor deficiency.
In June of this year the HSE asked the NCPE to carry out a health technology assessment on the cost effectiveness of this treatment. The NCPE completed its assessment and made a recommendation on 9 December 2016. The NCPE determined that the manufacturer failed to demonstrate cost-effectiveness of the drug and did not recommend it for reimbursement.
A summary of the health technology assessment has been published on the NCPE website and is available at: www.ncpe.ie/wp-content/uploads/2016/02/NCPE-website-summary_Final.pdf .
The HSE will consider the NCPE assessment, and other expert advice, as part of its decision-making process for reimbursement. This decision will be made on objective, scientific and economic grounds by the HSE in line with the 2013 Act.
I understand that the NCPE is arranging to meet the patient representative group, the Alpha One Foundation, as soon as possible to provide them with an update in relation to the recommendation of the NCPE.
In relation to compassionate access schemes, I have previously asked manufacturers to show compassion and to maintain access compassionate access schemes for patients during the assessment process by the HSE and this remains the position. However, the operation of these schemes is at the discretion of manufacturers. My Department has asked the NCPE to contact the company to seek clarification for those patients currently receiving this drug.
470. Deputy John McGuinness asked the Minister for Health if an early appointment for an assessment at the orthopaedic department of Waterford regional hospital will be arranged for a person (details supplied); and if he will make a statement on the matter. [39843/16]
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.
471. Deputy Michael Harty asked the Minister for Health if he will expedite a response for a person (details supplied) in County Clare; and if he will make a statement on the matter. [39850/16]
View answerThe 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 referred the question to the Health Service Executive (HSE) for direct reply to the Deputy.
472. Deputy Éamon Ó Cuív asked the Minister for Health the progress made to date with preparing and evaluating the business plan for a second MRI scanner at Galway University Hospital; when it is expected to provide this necessary resource; and if he will make a statement on the matter. [39856/16]
View answerIn relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
473. Deputy Peadar Tóibín asked the Minister for Health if his Department has been involved in any court proceedings that involved non-disclosure agreements in the past five years; and if so, if the specific court ruling prevented knowledge of the court proceeding being known and knowledge of the participants to the court proceeding from being made known for each of these agreements. [39869/16]
View answerTo the best of my knowledge I am not aware of any court proceedings that involved non-disclosure agreements.
The State Claims Agency, within the National Treasury Management Agency, which is under the aegis of the Department of Finance, manages personal injury, property damage and clinical negligence claims brought against certain State authorities, including Government ministers and health enterprises. The vast majority of claims under the remit of the State Claims Agency are resolved without confidentiality/non disclosure agreements attaching. Confidentiality/non disclosure agreements typically apply to claims in respect of minors or claims associated with abuse or specific medical negligence issues. The agreements, where entered into at the behest of either party, preclude the disclosure of settlement details by either party.
474. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) can expect an appointment for learning supports from the early intervention unit, Riverside, Tullamore, County Offaly. [39890/16]
View answerThe 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 service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
475. Deputy Catherine Murphy asked the Minister for Health the process in respect of prescribing and dispensing Ritalin; the duration of usual prescriptions; the restrictions there are on pharmacists dispensing numbers of individual Ritalin doses; if this varies by region in respect of dispensing or prescribing; and if he will make a statement on the matter. [39894/16]
View answerRitalin contains the active ingredient methylphenidate hydrochloride. Methylphenidate is indicated as a part of a comprehensive treatment programme for attention deficit hyperactivity disorder (ADHD) in children aged 6 years and over when remedial measures alone prove insufficient. Treatment must be under the supervision of a specialist in childhood and/or adolescent behavioural disorders.
Under the Misuse of Drugs Acts 1977, as amended, methylphenidate is a schedule 2 controlled drug and as such can only be supplied on foot of an original valid prescription which must be physically presented to and reviewed by the pharmacist prior to dispensing to the patient. The prescription must be signed and dated by the prescriber. The prescriber must be a registered practitioner with an address within the State. The prescription must specify, in the prescribers own handwriting: full name and address of the person for whom the prescription is issued; form and strength, where appropriate, of the preparation; amount/total quantity prescribed in words and figures and the dose to be taken. Methylphenidate prescriptions must also contain the name, address and telephone of the practitioner and detail the type of practitioner.
A prescription for a methylphenidate is valid for 14 days from the date of issue indicated on the prescription. Repeat prescriptions are not permitted. However, prescriptions may be prescribed and dispensed in instalments, if the practitioner specifies the amount of the instalment and the intervals at which the instalments is to be dispensed. The first instalment must be dispensed within 14 days and no instalment may be supplied later than two months after the date specified on the prescription. A pharmacist supplying a controlled drug must be satisfied as to the identity of the patient and the signature of the practitioner. Dispensed medication may only be supplied to the patient or to a bona fide representative of the patient.
All prescriptions for Ritalin are required to comply with the legislative requirements outlined above.
476. Deputy Maurice Quinlivan asked the Minister for Health when the new emergency department proposed for University Hospital Limerick is scheduled to be opened [39895/16]
View answerAs this is a service matter, I have asked the HSE to respond to you directly.
477. Deputy Catherine Murphy asked the Minister for Health the number of staff members and the grades at which they are employed to provide services in respect of child and adolescent mental health services per region in tabular form; and if he will make a statement on the matter. [39897/16]
View answerDetailed information in respect of HSE mental health services is published on a regular basis by the Executive. The most relevant Report in this regard would be "Delivering Specialist Mental Health Services 2014-15", which was produced by the HSE Mental Health Division, and is available on the HSE website at www.hse.ie/eng/services/publications/.
While this report indicates data such as staffing levels for community based CAMHS Teams versus those recommended in A Vision for Change, along with other comprehensive staffing details for community or in-patient units, this is broken down by CAMHS grades rather than by region. The report also includes significant information, by each CHO area, relating to CAMHS such as catchment populations, referrals, attendances, waiting lists, in-patient statistics, etc. Detailed information in respect of Mental Health staffing numbers is also available in the monthly Performance Reports, also published on the HSE website, but this is in respect of Whole Time Equivalent figures overall for the care programme, rather than CAMHS specific.
Separate to the above, the HSE collate information on staffing in CAMHS Community Teams according to Community Health Organisation. The latest available figures are for September last, as outlined as follows:
|
CHO |
Consultant Psychiatrist |
Senior Registrar |
Registrar/ SHO |
Nurse |
Social Worker |
Clinical Psychologist |
Speech & Language Therapist |
Occupational Therapist |
Other Staff |
Other Therapist |
Child/ Social Care Worker |
Non Nursing |
Administrative Support Staff |
Total |
|
1 |
4.85 |
0.00 |
5.00 |
13.35 |
7.90 |
6.00 |
3.80 |
5.90 |
0.00 |
0.00 |
4.70 |
0.00 |
8.60 |
60.10 |
|
2 |
5.90 |
2.00 |
9.00 |
9.10 |
8.80 |
5.60 |
5.00 |
4.90 |
0.00 |
2.40 |
5.64 |
0.00 |
10.50 |
68.84 |
|
3 |
5.80 |
0.00 |
5.00 |
11.00 |
8.80 |
7.40 |
3.00 |
3.00 |
0.00 |
0.00 |
3.00 |
0.00 |
7.00 |
54.00 |
|
4 |
6.89 |
1.10 |
7.49 |
7.71 |
12.77 |
11.32 |
6.45 |
7.19 |
1.50 |
0.00 |
6.89 |
0.00 |
10.99 |
80.30 |
|
5 |
6.00 |
0.00 |
3.70 |
8.80 |
5.90 |
4.20 |
7.80 |
3.00 |
1.50 |
0.45 |
2.80 |
1.00 |
7.45 |
52.60 |
|
6 |
6.54 |
1.42 |
4.60 |
12.00 |
6.80 |
6.92 |
8.60 |
4.50 |
0.00 |
0.00 |
2.00 |
0.00 |
12.10 |
65.48 |
|
7 |
7.10 |
1.50 |
6.00 |
9.10 |
5.30 |
3.12 |
5.60 |
4.20 |
0.00 |
0.20 |
6.50 |
0.00 |
8.00 |
56.62 |
|
8 |
10.80 |
4.00 |
12.00 |
23.70 |
11.14 |
9.60 |
3.45 |
6.60 |
0.00 |
3.60 |
7.00 |
0.00 |
12.38 |
104.27 |
|
9 |
10.00 |
1.00 |
10.60 |
8.30 |
8.00 |
12.30 |
8.30 |
6.40 |
0.20 |
0.20 |
0.00 |
0.00 |
7.20 |
72.50 |
|
10 |
63.88 |
11.02 |
63.39 |
103.06 |
75.41 |
66.46 |
52.00 |
45.69 |
3.20 |
6.85 |
38.53 |
1.00 |
84.22 |
614.71 |
The HSE indicate the Whole Time Equivalent (WTE) figures above remain to be finalised in respect of four Community Health Organisation areas, but the Executive estimates that this would relate to an additional 4 WTE’s in CHO 4; 11 in CHO 5; 8 in CHO 7; and 10 in CHO 9. Therefore, the total WTE figure for HSE CAMHS staff nationally would be in the region of 648 posts (i.e. 615 plus 33).
478. Deputy Catherine Murphy asked the Minister for Health his plans to increase the resources allocated to the child and adolescent mental health services; the improvements he has planned to increase capacity per region, in tabular form; and if he will make a statement on the matter. [39898/16]
View answerBudget 2017 provided significant additional funding for mental health, which means that the HSE funding for this key care programme will increase from around €826 million in 2016 to €851 million next year. New service initiatives on Child and Adolescent Mental Health services are being progressed in the context of finalising both the overall HSE Service Plan 2017 and the more detailed regional Operational Plan for Mental Health. These will be published by the HSE in the near future.
The agreed 2016 mental health development priorities cover improvement of counselling services; enhanced Community Mental Health teams; improved 7/7 response and Liaison Services; and Perinatal Mental Health. We have introduced also two new mental health clinical programmes - ADHD in Adults and Children, and Dual Diagnosis of those with Mental Illness and Substance Misuse. Priorities to be addressed in the new HSE Service Plan include Positive Mental Health and Early Intervention enhancements for youth mental health; improvements to Child & Adolescent community-based services; developing the Eating Disorders Clinical Programme for young people, and expanded CAMHS forensic mental health care. There will be continued enhancement of Out-of-Hours responses, and development of Primary Care counselling services for those under age 18. In addition, the HSE will continue to develop the existing 10 Jigsaw sites, and the development of new sites in Dublin, Cork and Limerick.
These initiatives are all relevant to supporting the wider objectives of the National Taskforce on Youth Mental Health. Development of service user and carer engagement at CHO level, including that relating to young people, and the Advancing Recovery Ireland programme with recruitment of peer support workers, is also being provided for over 2017.
479. Deputy Catherine Murphy asked the Minister for Health his plans to increase the resources allocated to the child and adolescent mental health services in County Kildare, in view of the fact there is no child psychologist in situ and referrals are only able to go through the service; the improvements he has strategically planned to increase capacity in the county; and if he will make a statement on the matter. [39899/16]
View answerAs this is a service issue, this question has been referred to the HSE for direct reply.
480. Deputy Fergus O'Dowd asked the Minister for Health the status of the proposed new 100 bed unit at the St Mary's site, Dublin Road, Drogheda; and if he will make a statement on the matter. [39900/16]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
481. Deputy Fergus O'Dowd asked the Minister for Health the status of the proposed primary care centre in Bettystown and Laytown, County Meath; and if he will make a statement on the matter. [39905/16]
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.
482. Deputy Fergus O'Dowd asked the Minister for Health the status of the proposed primary care centre for Drogheda, County Louth; and if he will make a statement on the matter. [39906/16]
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.
483. Deputy Michael Healy-Rae asked the Minister for Health his views on the loco parentis 30-minute rule; and if he will make a statement on the matter. [39909/16]
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.
484. Deputy Mattie McGrath asked the Minister for Health the status of the future of Our Lady's Hospital, Cashel, specifically, reports from the southern health forum that it will never be used to facilitate step-down bed facilities; and if he will make a statement on the matter. [39912/16]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
485. Deputy Pearse Doherty asked the Minister for Health if an application has been made by a hospital (details supplied) in County Donegal for an x-ray imagining machine; if so, if this application is currently under consideration; when it is anticipated that a decision will be made in respect of same; and if he will make a statement on the matter. [39913/16]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
486. Deputy Pearse Doherty asked the Minister for Health the status of the reinstatement of gynaecology services at Dungloe Community Hospital; when it is expected that services will resume for patients; and if he will make a statement on the matter. [39914/16]
View answerIn relation to this particular query, as this is a service matter, I have asked the HSE to respond to you directly.
