Tuesday, 24 Jan 2017

Services for People with Disabilities

Questions (393)

Kevin O'Keeffe

Question:

393. Deputy Kevin O'Keeffe asked the Minister for Health if suitable long-term accommodation will be provided for a person (details supplied) in County Cork. [2535/17]

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Written answers

Minister of State at the Department of Health

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Hospital Waiting Lists

Questions (394)

Seamus Healy

Question:

394. Deputy Seamus Healy asked the Minister for Health if, in view of the fact that the urology outpatient waiting list at Waterford University Hospital is now 48-plus months, the proposals he has to rectify the situation. [2541/17]

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Written answers

Minister for Health

In relation to this particular query, as this is a service matter, I have asked the HSE to respond to you directly.

Hospital Appointments Status

Questions (395)

Peter Burke

Question:

395. Deputy Peter Burke asked the Minister for Health if he will expedite an appointment with the orthodontic service for a person (details supplied). [2561/17]

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Written answers

Minister for Health

As this is a service matter it has been referred to the HSE for reply to the Deputy.

Services for People with Disabilities

Questions (396)

Aengus Ó Snodaigh

Question:

396. Deputy Aengus Ó Snodaigh asked the Minister for Health when a person (details supplied) will be granted a date for an assessment of needs to be carried out. [2564/17]

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Written answers

Minister of State at the Department of Health

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Health Services Expenditure

Questions (397)

Billy Kelleher

Question:

397. Deputy Billy Kelleher asked the Minister for Health the expenditure incurred by the Health Service Executive, HSE, in hiring consultants in each of the years 2011 to 2016, in tabular form; the specific projects for which consultants were hired; the expenditure incurred on each project; and the payment per project to consultants. [2571/17]

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Written answers

Minister for Health

As this is a service matter, I have asked the HSE to respond to you directly.

Health Services Expenditure

Questions (398)

Brendan Griffin

Question:

398. Deputy Brendan Griffin asked the Minister for Health if the Health Service Executive, HSE, is funding the provision of accommodation at a location (details supplied) in County Kerry; and if he will make a statement on the matter. [2582/17]

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Written answers

Minister of State at the Department of Health

My Department has been advised by the Health Service Executive that it is not involved in the provision of accommodation at the location mentioned.

Taxi Licences

Questions (399)

Catherine Murphy

Question:

399. Deputy Catherine Murphy asked the Minister for Health if he will amend tendering arrangements for taxis to ensure that greater weighting is given to the availability of wheelchair-accessible taxis; and if he will make a statement on the matter. [2584/17]

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Written answers

Minister for Health

As this is a service matter, I have asked the HSE to respond to you directly.

Health Services

Questions (400)

Louise O'Reilly

Question:

400. Deputy Louise O'Reilly asked the Minister for Health the status of the review of international public funding models for fertility treatment; when the general scheme of legislative provisions dealing with assisted human reproduction, AHR, will be published; the timeframe for the legislation dealing with AHR; and if he will make a statement on the matter. [2585/17]

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Written answers

Minister for Health

As the Deputy will be aware, in February 2016, the Health Research Board (HRB) was engaged to conduct a comprehensive review of international public funding models. This HRB evidence review is due to be finalised in the coming months. The HRB evidence review will then be analysed by officials in my Department in the context of considering policy options for a potential public funding model for assisted human reproduction (AHR) treatment. It is envisaged that the final evidence review will be published both on my Department’s website and on the HRB’s own website at the earliest opportunity.

Officials in my Department are currently drafting the General Scheme of legislative provisions on AHR and associated research, and it is envisaged that the General Scheme will be completed in the first half of 2017. This comprehensive piece of legislation will regulate a range of practices for the first time, including: gamete (sperm or egg) and embryo donation for AHR and research; surrogacy; pre-implantation genetic diagnosis (PGD) of embryos; posthumous assisted reproduction; and stem cell research. Once the General Scheme has been completed, and has been approved by Government for publication it will be uploaded on the Department’s website and be submitted to the Joint Oireachtas Committee on Health and Children for pre-legislative scrutiny.

Disease Management

Questions (401, 459)

Billy Kelleher

Question:

401. Deputy Billy Kelleher asked the Minister for Health if he will provide a date to meet with a group (details supplied) to discuss Lyme disease; and if he will make a statement on the matter. [2586/17]

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John McGuinness

Question:

459. Deputy John McGuinness asked the Minister for Health his views on the issues raised at a meeting on 2 August 2016 between officials from his Department and advocates for support and services for Lyme disease patients; his plans to assist persons seeking diagnosis relative to Lyme disease; and if he will make a statement on the matter. [2830/17]

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Written answers

Minister for Health

I propose to take Questions Nos. 401 and 459 together.

Lyme borreliosis can be asymptomatic or have a range of clinical presentations. Current best advice is that diagnosis should be made only after careful examination of the patient's clinical history, physical findings, laboratory evidence and exposure risk evaluation. Exposure to ticks prior to disease manifestations is necessary for the diagnosis of Lyme borreliosis. Since an awareness or recollection of a tick-bite is not always present, however, this should not exclude the diagnosis of Lyme borreliosis. Later stages require the use of antibody detection tests (or advanced DNA detection techniques). Testing for Lyme Disease is undertaken in most of the larger hospitals in Ireland. In undertaking Lyme testing, it is essential that the results are interpreted in the light of the clinical condition of the patient. If the result of this initial screen is equivocal, the patient's samples are referred to the U.K.'s Public Health England Porton Down facility which uses a two-tier system recommended by American and European authorities. This involves a screening serological test followed by a confirmatory serological test.

I understand that representatives from Tick Talk met with Minister of State Marcella Corcoran Kennedy on 2nd August, 2016.

A member of the Group has been invited to be the patient representative on a Lyme Borreliosis Sub-Committee which has been established by the Scientific Advisory Committee of the Health Protection Surveillance Centre (HPSC). The aim of this Sub-Committee is to develop strategies to undertake primary prevention in order to minimise the harm caused by Lyme Borreliosis in Ireland. In addition to staff from the HPSC, the membership of the Sub-Committee includes specialists in Public Health Medicine, Consultants in Infectious Diseases, Clinical Microbiology, Occupational Health an Entomologist from the Parks and Wildlife Service, a representative from the Local Government Management Agency and an Environmental Health Officer.

The initial work of the Lyme Borreliosis Sub-committee involves a survey of laboratory methods for the diagnosis of Lyme borreliosis in Ireland, the development of Lyme borreliosis guidance for general practitioners, the publication of medical media articles to highlight diagnostics and laboratory methods relating to Lyme borreliosis available in Ireland for general practitioners, and ongoing work in drawing together the Final Report of the Sub-committee.

Medicinal Products Licensing

Questions (402)

Jonathan O'Brien

Question:

402. Deputy Jonathan O'Brien asked the Minister for Health the Health Products Regulatory Authority plans to have cannabidiol made available by prescription for treatment of epilepsy. [2587/17]

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Written answers

Minister for Health

Cannabidiol (CBD) is derived from cannabis. However, since it does not have psychoactive properties it is not controlled under the Misuse of Drugs Acts.

While I am aware that CBD oil is sometimes marketed as a nutritional or dietary supplement, it should be noted that it is not authorised as a medicinal product in Ireland. Under European and Irish legislation, before a medicine can be placed on the Irish market, the manufacturer must seek an authorisation from the Health Products Regulatory Authority (HPRA) or, in the case of certain medicinal products, the European Medicines Agency. A determination on an application for authorisation of a medicinal product is based on a rigorous scientific assessment of the application against the criteria of safety, quality, efficacy, legal and regulatory requirements. I have no role in the process of authorising medicinal products.

No application has been received from any company for any products containing CBD. The HPRA are open to receiving such applications.

Elsewhere products containing CBD are undergoing clinical trials for the treatment of a number of medical conditions, including severe, intractable (treatment-resistant) epilepsy. There is no prohibition on an Irish registered doctor recommending CBD for a patient under his/her care if they deem that treatment option to be clinically appropriate for their patient.

Medical Card Eligibility

Questions (403)

Robert Troy

Question:

403. Deputy Robert Troy asked the Minister for Health his plans to issue a generic medical card that may be used by vulnerable persons to allow them to attend a doctor's surgery not in his or her locality (details supplied). [2605/17]

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Written answers

Minister for Health

A person who is in receipt of a medical card must register with a General Practitioner. If they move temporarily from their official postal address , and are resident in a place not ordinarily served by their medical card GP, they will be regarded as a "temporary resident" and can avail of medical services with any GP registered to provide GMS services.

The question of a person submitting a change of doctor request may arise if the cardholder intends to relocate to a new area for longer than three months and/or on a permanent basis.

Hospital Appointments Status

Questions (404)

John Brassil

Question:

404. Deputy John Brassil asked the Minister for Health if he will expedite a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [2607/17]

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Written answers

Minister for Health

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, I have asked the HSE to respond to you directly.

Hospital Appointments Delays

Questions (405)

Robert Troy

Question:

405. Deputy Robert Troy asked the Minister for Health if he will expedite a hospital appointment for a person (details supplied). [2608/17]

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Written answers

Minister for Health

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, I have asked the HSE to respond to you directly.

Long-Term Illness Scheme Coverage

Questions (406, 474)

Mick Barry

Question:

406. Deputy Mick Barry asked the Minister for Health if the FreeStyle Libre device (details supplied) will be made available through Health Service Executive, HSE, funding; and if he will make a statement on the matter. [2614/17]

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Billy Kelleher

Question:

474. Deputy Billy Kelleher asked the Minister for Health if approval will be given for the FreeStyle Libre (details supplied) to be made available on the long-term illness scheme; and if he will make a statement on the matter. [2896/17]

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Written answers

Minister for Health

I propose to take Questions Nos. 406 and 474 together.

Under 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 to the Deputy.

Respite Care Services Provision

Questions (407)

Brendan Griffin

Question:

407. Deputy Brendan Griffin asked the Minister for Health the reason a person (details supplied) in County Kerry is being charged for long-term respite care services; and if he will make a statement on the matter. [2616/17]

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Written answers

Minister for Health

As the individual case referred to is a service matter for the Health Service Executive, I have asked the HSE to look into the particular matter raised and to reply directly to the Deputy.

On 1 January 2017, "long stay contributions" under sections 67A to 67D of the Health Act 1970 and the Health (Residential Support Services Maintenance and Accommodation Contributions) Regulations 2016 replaced the system of long stay charges for in-patient services, which was in place from July 2005 until 31 December 2016 under the now-repealed section 53 of that Act.

Long stay contributions apply to all forms of residential support services, other than acute in-patient services and nursing home services provided to those supported under the Nursing Homes Support Scheme (Fair Deal). In line with the previous long stay charges system:

- Long stay contributions apply to the maintenance and accommodation elements only of services which are provided by the HSE or by agencies funded to provide services on behalf of the HSE under section 38 of the Health Act 2004.

- Contributions become payable when a person has already received at least 30 days of such services during the immediately preceding 12-month period. Accordingly, many episodes of respite care would not result in a requirement to make a long stay contribution towards maintenance and accommodation costs.

The Health (Residential Support Services Maintenance and Accommodation Contributions) Regulations 2016 provide for three different schedules of income-based long stay contributions towards accommodation and maintenance costs in three accommodation categories:

- Category A refers to accommodation where full-time (24 hour) nursing and/or medical care is provided, subject to a maximum of €25 daily (€175 per week) for a person whose income is €208 per week or more.

- Category B relates to contributions payable by those in accommodation where part-time nursing and/or medical care is provided and is subject to a maximum of €18.57 daily (€130 per week) for a person whose income is €194 per week or more.

- Category C relates to all other non-nursing settings (such as independent living settings), subject to a maximum of €10 daily (€70 per week) for a person whose income is €188 per week or more.

Affordability and the avoidance of financial hardship are built-in features of the long stay contributions provisions. In all three accommodation categories, the contribution rate schedules are sliding scales, with proportionally lower contribution rates applying to those on lower incomes. Additionally, section 67D of the Health Act 1970 provides that the HSE may reduce or waive a contribution where appropriate, in order to:

- avoid undue financial hardship on the part of the service user and/or on the part of the service user’s dependants

- advance a service user’s identified needs (e.g. care plan objectives), or

- take account of separate contributions (if any) made by a service user towards his or her maintenance or accommodation costs.

To assist in the fair application of the framework, the HSE has published national guidelines for the correct determination of long stay contributions and comprehensive waiver guidelines (approved by the Ministers for Health and Public Expenditure and Reform) on the individual circumstances where such contributions may need to be reduced or waived. The guidelines specify that service providers must have regard to the individual circumstances of each service user and his or her dependants. The guidelines ensure that the applicable contribution may be reduced or waived where appropriate, taking account of each person’s income and necessary outgoings, including reasonable regular financial commitments, with a view to ensuring there is no unfair burden on the service user or on his or her dependants.

The features of the long stay contributions framework ensure that it is reasonable and fair and that each service user's contributions are based on what he or she can afford, taking account of the service user's individual circumstances.

Health Services