Written Answers Nos. 219-244
219. Deputy Imelda Munster asked the Minister for Health if he has received correspondence from a person (details supplied) regarding an ongoing issue concerning bus and cab operators in County Louth and their arrangements with the HSE. [3392/17]
View answer220. Deputy Imelda Munster asked the Minister for Health if he can confirm that the HSE had been operating bus services in County Louth with local operators without contracts between the years 2005 to 2016; and if he will make a statement on the matter. [3393/17]
View answer221. Deputy Imelda Munster asked the Minister for Health if his attention has been drawn to the fact that local bus operators without contracts in County Louth were fulfilling services for the HSE for as little as €1 per mile on the promise that prices would improve in future; and if he will make a statement on the matter. [3394/17]
View answer222. Deputy Imelda Munster asked the Minister for Health his views on the grievances felt by local operators who were unable to fulfil tender criteria in view of the loyal services they had provided based on a verbal agreement with the HSE; the remedies that might be available to them; and if he will make a statement on the matter. [3395/17]
View answerI propose to take Questions Nos. 219, 220, 221 and 222 together.
I wish to inform the Deputy that I have not received the correspondence referred to regarding bus and cab operators in County Louth.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
223. Deputy Thomas P. Broughan asked the Minister for Health the steps he is taking to address the recent misdiagnosis of cancer in patients in Wexford General Hospital; the measures his officials are undertaking to ensure that such misdiagnosis does not occur again in any area of health screening across the country; and if he will make a statement on the matter. [3398/17]
View answerThe report of the HSE Serious Incident Management Team published last week outlines the look-back process and actions taken by the HSE following the identification of probable missed cancers at Wexford General Hospital. In line with good practice, an external review will now be undertaken as a follow-up to the Serious Incident Management Team report. This review will examine how the incident was identified, escalated and managed, and its outcome will include recommendations relating to governance, accountability and authority at each level involved.
While the BowelScreen programme has led to the early diagnosis of cancers and better outcomes for patients, a number of actions have been identified to ensure the quality of the service provided. These include the development of a professional competency framework for all colonoscopists and endoscopists in screening units, the implementation of a new policy for managing adverse incidents within the National Screening Service and the review of BowelScreen's quality assurance indicators to ensure that all units, and the individual clinicians delivering colonoscopy services on behalf of BowelScreen, are doing so at the highest standard.
224. Deputy John Brady asked the Minister for Health if he will provide a full list of health centre locations in County Wicklow and a breakdown of the services provided in each of the health centres; and if he will make a statement on the matter. [3400/17]
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.
225. Deputy John Brady asked the Minister for Health if he will provide a full list of the services available at the three district hospitals in County Wicklow; and if he will make a statement on the matter. [3401/17]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
226. Deputy John Brady asked the Minister for Health the current ambulance response times for County Wicklow; and if he will make a statement on the matter. [3402/17]
View answer227. Deputy John Brady asked the Minister for Health the number of ambulance bases in County Wicklow; the number of ambulances stationed at each of these bases; and if he will make a statement on the matter. [3403/17]
View answerI propose to take Questions Nos. 226 and 227 together.
As this is a service matter, I have asked the HSE to respond to you directly.
228. Deputy John Brady asked the Minister for Health the number of persons on outpatient waiting lists with a County Wicklow address; and if he will make a statement on the matter. [3404/17]
View answerThe National Treatment Purchase Fund (NTPF) has advised that as of 30 December 2016 there were 9811 outpatients on the waiting list (with status of "Has Appointment" or "No Appointment") with a patient area of residence of Wicklow.
As the Deputy may be aware, in December 2016, I granted approval to the NTPF for the first tranche of funding, in the region of €5m, for an initiative focusing on daycase procedures. The NTPF anticipates that around 3,000 of the longest waiting daycase patients will be treated under this initiative with the aim that no patient would be waiting over 18 months for a daycase procedure by June 2017. It is expected that the outsourcing of treatment will commence shortly.
In December 2016, the Department wrote to the HSE requesting that it submit in January, a Waiting List Action Plan for 2017 in respect of both the Inpatient/Daycase Waiting List and the Outpatient Waiting List. The focus of these plans should be to ensure that no patient is waiting more than 15 months on either list by the end of October 2017. The HSE has been requested to develop the Inpatient/Daycase Waiting List Action Plan in conjunction with and supported by, the NTPF's proposal for utilisation of the remaining €10m of 2017 funding for patient treatment. I expect to make known the details of both plans in the coming weeks.
229. Deputy Niamh Smyth asked the Minister for Health if he will meet with a person (details supplied) to discuss various issues pertaining to their case; and if he will make a statement on the matter. [3415/17]
View answerAt the outset, I would like to offer my sincerest condolences to the family involved for the traumatic situation they experienced and their loss.
As Minister for Health, I am always open to meeting individuals and organisations who request it; however, due to the busy nature of Oireachtas and Government business, it is not always possible. Should the family wish to request a meeting regarding their experience, they may wish to seek a meeting with the HSE.
The HSE National Service Plan 2016 committed to the planning and development of equitable access to antenatal anomaly screening in all maternity units in the context of emerging maternity networks.
In addition, the National Maternity Strategy is clear that all women must have equal access to standardised ultrasound services. The Strategy will be implemented on a phased basis over the coming years and this work will be led by the National Women & Infants Health Programme.
230. Deputy Brendan Smith asked the Minister for Health his proposals to improve the terms and conditions applicable to the fair deal scheme; and if he will make a statement on the matter. [3431/17]
View answerThe Nursing Homes Support Scheme (NHSS) is a system of financial support for those in need of long-term nursing home care. Participants contribute to the cost of their care according to their income and assets while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings. A financial assessment is carried out by the HSE to determine how much a participant in the Scheme will contribute to the cost of their care.
Participants in the Scheme contribute up to 80% of their assessable income and a maximum of 7.5% per annum of the value of assets held. In the case of a couple, the applicant’s means are assessed as 50% of the couple’s combined income and assets. The first €36,000 of an individual’s assets, or €72,000 in the case of a couple, is not counted at all in the financial assessment. The capital value of an individual’s principal private residence is only included in the financial assessment for the first three years of their time in care. This is known as the three year cap.
The Scheme has a number of important safeguards built into the financial assessment which ensures that:
- Nobody will pay more than the actual cost of care;
- An applicant will keep a personal allowance of 20% of his/her income or 20% of the maximum rate of the State Pension (non-Contributory), whichever is greater. This is in recognition of the fact that, although the NHSS covers core living expenses, residents can still incur some costs in a nursing home, such as social programmes, newspapers or hairdressing;
- If an applicant has a spouse/partner remaining at home, he/she will be left with 50% of the couple’s income or the maximum rate of the State Pension (non-Contributory), whichever is greater;
- If both members of a couple enter nursing home care, they each retain at least 20% of their income, or 20% of the maximum rate of the State Pension (non-Contributory), whichever is greater;
- Certain items of expenditure, called allowable deductions, can be taken into account for the financial assessment, including health expenses, payments required by law, rent payments and borrowings in respect of a person’s principal private residence;
- A person’s eligibility for other schemes, such as the Medical Card Scheme or the Drug Payment Scheme, is unaffected by participation in the Nursing Homes Support Scheme or residence in a nursing home.
In addition to these safeguards, where an applicant’s assets include land and property held in the State, the contribution based on such assets may be deferred and collected from their estate. This is known as the Nursing Home Loan (Ancillary State Support), the purpose of which is to ensure that a person does not have to sell their home during their lifetime to pay for long-term nursing home care. A nursing home resident can apply for this deferral at any stage.
When the Nursing Homes Support Scheme commenced in 2009, a commitment was made that it would be reviewed after three years. The Report of the Review was published in July 2015. A number of key issues have been identified for more detailed consideration across Departments and Agencies, including recommendations in relation to improving and simplifying the application process, and recommendations relating to the treatment of business and farm assets for the purposes of the financial assessment element of the Scheme.
An Interdepartmental/Agency Working Group has been established to progress certain recommendations contained in the Review. This Group is chaired by the Department of Health and includes representatives from the Department of the Taoiseach, the Department of Public Expenditure and Reform, the HSE, the Revenue Commissioners, and when required, the National Treatment Purchase Fund (NTPF).
Significant progress has already been made in relation to the implementation of recommendations relating to the administrative reforms to the Scheme. The IFA made a submission to the Working Group on the treatment of farms for the purpose of the Scheme. These proposals are currently being considered.
231. Deputy Brendan Griffin asked the Minister for Health his views on a matter (details supplied) regarding the Government's policy on drugs; and if he will make a statement on the matter. [3434/17]
View answerGovernment policy on tackling the drug problem is set out in the National Drugs Strategy 2009-2016. The Strategy is a cross cutting area of public policy and service delivery, which requires a coordinated response to tackling the drug problem, involving the statutory, community and voluntary sectors. The overall objective of the Strategy is to tackle the harm caused to individuals and society by the misuse of drugs through a concerted focus on the five pillars of supply reduction, prevention, treatment, rehabilitation and research. Prevention programmes constitute a significant part of the Government's response to the drug problem, particularly among young persons.
As the nature and extent of the drug problem has changed since the commencement of the current Strategy in 2009, Government is committed to putting a new drugs strategy in place this year, when the current policy expires. A Steering Committee has been established to advise me on a new Strategy, with a view to developing an integrated public health approach to substance misuse, defined as the harmful or hazardous use of psychoactive substances, including alcohol and illegal drugs.
Significant progress has been made in developing the evidence-base for the new Strategy. This includes a high level review of the current Strategy by an international panel of experts, a review of systematic evidence reviews of interventions to tackle the drug problem and a trends analysis of the drugs situation in the past 10 years. In addition, multi-stakeholder focus groups have given their views on measures to address gaps in the current response to the drugs problem and a public consultation process has taken place, which has resulted in over 2000 submissions.
It is envisaged that the new Strategy will be based on a health-led approach to the drug problem and build on progress achieved under previous drug strategies. I understand that the Steering Committee is continuing with its deliberations and is expected to submit its final report to me by the end of March. I hope to be in a position to bring my proposals to Government on the new Strategy thereafter.
232. Deputy Louise O'Reilly asked the Minister for Health if he will provide an update on eligibility criteria and guidelines for pre-exposure prophylaxis to be defined by the national sexual health strategy, either listed criteria or a release date for when the criteria will be released; and if he will make a statement on the matter. [3448/17]
View answer233. Deputy Louise O'Reilly asked the Minister for Health the details of the implementation group for the national sexual health strategy specifically pertaining to making pre-exposure prophylaxis (PrEP) available; the persons on the implementation group; the frequency they meet; the timeframe to their objective regarding PrEP; and if he will make a statement on the matter. [3449/17]
View answer234. Deputy Louise O'Reilly asked the Minister for Health the details of the demonstration project testing pre-exposure prophylaxis; the timeframe for same; the number of participants that will be involved; and if he will make a statement on the matter. [3450/17]
View answerI propose to take Questions Nos. 232 to 234, inclusive, together.
The National Sexual Health Strategy 2015-2020 was launched in October 2015. The strategy was developed in response to a recommendation of the National AIDS Strategy Committee on the need to establish clear leadership within the health sector around the area of sexual health. The Strategy contains 71 recommendations that address all aspects of sexual health and a Sexual Health Action Plan for 2015-2016 that contains 18 priority actions for immediate attention.
One of the priority actions identified in the Action Plan for 2016 is to 'Prioritise, develop and implement guidance to support clinical decision making for STI testing, screening and treatment and on the appropriate use of antiretroviral therapy in HIV prevention’. An Implementation Group has now been established within the HSE as an outcome of this action. This group will make recommendations on the appropriate use of HIV pre-exposure prophylaxis (PrEP) in the overall context of the national approach to HIV prevention.
As the matters referred are service issues, these questions have been referred to the HSE for direct reply.
235. Deputy Louise O'Reilly asked the Minister for Health the details of the State’s spend on HIV prevention since 2005, in tabular form; and if he will make a statement on the matter. [3451/17]
View answerAs this is a service issue, this question has been referred to the HSE for direct reply.
236. Deputy Louise O'Reilly asked the Minister for Health the details of the State’s subsidy to the gay men’s health service since 2005, in tabular form; and if he will make a statement on the matter. [3452/17]
View answerAs this is a service issue, this question has been referred to the HSE for direct reply.
237. Deputy Michael Healy-Rae asked the Minister for Health the status of an operation in respect of a person (details supplied); and if he will make a statement on the matter. [3456/17]
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.
238. Deputy Catherine Connolly asked the Minister for Health when the position of physiotherapist for south Connemara, County Galway will be filled; the reason for the delay in filling the position which has left the area without an essential service since August 2016; and if he will make a statement on the matter. [3457/17]
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.
239. Deputy Willie Penrose asked the Minister for Health if negotiations have taken place between his Department and a pharmaceutical company (details supplied) with a view to having the price of the drug Respreeza significantly reduced in order to ensure that it is made available to persons who suffer with emphysema caused by severe Alpha-1 here; and if he will make a statement on the matter. [3529/17]
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 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 alpha1-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: http://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.
240. Deputy Clare Daly asked the Minister for Agriculture, Food and the Marine if he has concluded his investigation into the matter of the felling of approximately 30 specimen oaks between 60 and 80 years old, with some older, in a heritage woodland (details supplied) in County Longford without a licence, which was indicated on 24 November 2016 was being undertaken; and if he will make a statement on the matter. [3454/17]
View answerMy Department Officials are currently completing an investigation into the matter and a more complete response will issue to the Deputy shortly.
The deferred reply under Standing Order 42A was forwarded to the Deputy.
241. Deputy Clare Daly asked the Minister for Agriculture, Food and the Marine if he will confirm that in a heritage woodland in which specimen oaks were felled (details supplied) the licensee was instructed, when issued with the licence on the basis of the National Parks and Wildlife Service conditions, to replant the field not with the Sitka spruce as planned but with broadleaves, in view of the fact the area was capable of carrying broadleaves but that the licensee did not do so, replanting again with Sitka spruce; and if he will make a statement on the matter. [3455/17]
View answerMy Department Officials are currently completing an investigation into the matter and a more complete response will issue to the Deputy shortly.
The deferred reply under Standing Order 42A was forwarded to the Deputy.
242. Deputy Éamon Ó Cuív asked the Minister for Agriculture, Food and the Marine when payment will issue under the 2016 basic payment scheme to a person (details supplied) in County Galway; the reason for the delay in issuing this payment; and if he will make a statement on the matter. [3295/17]
View answerThe person named submitted a 2016 Basic Payment/Areas of Natural Constraint schemes application on 9 May 2016. EU Regulations governing the administration of these schemes require that full and comprehensive administrative checks, including in some cases Remote Sensing (i.e. satellite) inspections, be completed before any payments issue.
The application of the person named was selected for a Remote Sensing inspection. The inspection was completed and no area over-declarations were determined. Payments due under the Basic Payment Scheme issued to the nominated bank account of the person named on 25 October and 1 December 2016. Processing of the application under the Areas of Natural Constraint Scheme is currently being finalised with the intention of issuing any monies due as soon as possible. In the event that any queries arise officials in my Department will be in contact with the person named.
243. Deputy Eugene Murphy asked the Minister for Agriculture, Food and the Marine the number of farmers in counties Roscommon and Galway that have received GLAS payments for 2016; the outstanding number that have yet to receive payment; and if he will make a statement on the matter. [3303/17]
View answerUnder the EU Regulations governing the Scheme and other area-based payment schemes, a comprehensive administrative check, including cross-checks with the Land Parcel Identification System, must be completed before any payment can issue.
The following table outlines the number of farmers in Roscommon and Galway actively participating in GLAS 1 and 2 that are due a payment in respect of the 2016 scheme year and the numbers of farmers that have not received a payment in respect of 2016.
|
Scheme |
Number of active applications for Roscommon |
Number of applications not paid for Roscommon |
Number of active applications for Galway |
Number of applications not paid for Galway |
|
GLAS 1 |
1,551 |
325 |
3,144 |
900 |
|
GLAS 2 |
566 |
128 |
1,350 |
522 |
Work on processing cases which did not pass the required pre-payment checks is on-going with a view to effecting payment as quickly as possible.
244. Deputy Eugene Murphy asked the Minister for Agriculture, Food and the Marine the status of an appeal against an administrative fine issued to a person (details supplied) in relation to the single farm payment; and when this payment for 2016 will issue. [3304/17]
View answerAn application under the 2015 Basic Payment Scheme (BPS) was received from the person named on 29 April 2015. During processing of the application, dual claim errors arose on three of the parcels declared. Following an examination of these errors, it was established that the person named did not have the right to declare this land.
The Terms and Conditions of the Basic Payment Scheme provide that where the difference between the area declared and the area found is greater than 50% of the area found no BPS payment is made for the scheme year in question and an additional penalty based on the payment that would have been payable on the rejected area, will be offset against any EU payment due to the applicant.
Following a review, the decision to apply an administrative fine still stands in this case and the person named has been advised of their right to appeal this decision to the Agriculture Appeals Office.
