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Tuesday, 21 Feb 2017

Written Answers Nos. 467-491

Ambulance Service Provision

Questions (467)

Clare Daly

Question:

467. Deputy Clare Daly asked the Minister for Health his views on the recently revealed plans by the HSE to withdraw the Dublin Fire Brigade from delivering ambulance services in north County Dublin. [8505/17]

View answer

Written answers (Question to Health)

Dublin Fire Brigade (DFB) provides emergency ambulance services in Dublin city and county, by arrangement between Dublin City Council and the HSE. The HSE National Ambulance Service provides some emergency capacity in the greater Dublin area, as well as non-emergency patient transport.

I am not aware of any plans the HSE has to withdraw DFB ambulance services in north County Dublin, I have therefore asked the HSE to respond to the Deputy directly regarding this issue.

Medicinal Products Licensing

Questions (468)

Michael Healy-Rae

Question:

468. Deputy Michael Healy-Rae asked the Minister for Health if he will address concerns with regard to the use of medical marijuana (details supplied); and if he will make a statement on the matter. [8506/17]

View answer

Written answers (Question to Health)

The HPRA Report did not recommend the inclusion of chronic pain in the access programme. However, this position will be kept under review, and if better clinical evidence becomes available in future, the inclusion of chronic pain can be reconsidered.

Until such time as the necessary legislative amendments have been made to facilitate the implementation of the access programme, it remains open for an Irish registered doctor to apply for a licence for such preparations for an individual, named-patient under their care.

As Minister for Health I have a responsibility to patients to make decisions around healthcare based on the best scientific and clinical evidence available. When I initiated the review of policy on the use of cannabis and cannabis-based products for medicinal purposes I requested that the Health Products Regulatory Authority (HPRA) provide expert advice on the issue. The HPRA’s statutory role is to protect and enhance human health by regulating medicines and other health products and it has the necessary clinical and scientific expertise to provide advice on this issue.

I requested that the HPRA provide advice on recent developments in the use of cannabis for medical purposes including an overview of products that have been authorised in other countries and an overview of the wider on-going and emerging clinical research in new indications and evidence of efficacy. The HPRA convened an expert working group as part of their review which comprised experts from various medical fields, including a Consultant Anaesthetist/Pain Specialist, a Consultant in Palliative Medicine and a Palliative Care Pharmacist.

On 10th February I published the HPRA’s Report “Cannabis for Medicinal Use – A Scientific Review” and announced my decision to establish an access programme for cannabis-based treatments for the following conditions, spasticity associated with multiple sclerosis resistant to all standard therapies and interventions, intractable nausea and vomiting associated with chemotherapy, despite the use of standard anti-emetic regimes and severe, refractory (treatment-resistant) epilepsy that has failed to respond to standard anticonvulsant medications. Patients accessing cannabis through the programme will be under the care of a medical consultant.

The HPRA Report did not recommend the inclusion of chronic pain in the access programme. However, this position will be kept under review, and if better clinical evidence becomes available in future, the inclusion of chronic pain can be reconsidered.

Until such time as the necessary legislative amendments have been made to facilitate the implementation of the access programme, it remains open for an Irish registered doctor to apply for a licence for such preparations for an individual, named-patient under their care.

Mental Health Services Provision

Questions (469)

Tom Neville

Question:

469. Deputy Tom Neville asked the Minister for Health the position regarding the provision of Jigsaw facilities in Limerick as per an announcement in recent months. [8507/17]

View answer

Written answers (Question to Health)

As this is a service issue, this question has been referred to the HSE for direct reply.

Hospital Appointments Status

Questions (470)

Michael Healy-Rae

Question:

470. Deputy Michael Healy-Rae asked the Minister for Health the status of an operation for a person (details supplied); and if he will make a statement on the matter. [8540/17]

View answer

Written answers (Question to 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 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.

Medical Card Administration

Questions (471)

Richard Boyd Barrett

Question:

471. Deputy Richard Boyd Barrett asked the Minister for Health if he will consider making the application and review process for medical cards less onerous for persons with mental health issues; and if he will make a statement on the matter. [8542/17]

View answer

Written answers (Question to Health)

Under the Health Act, 1970, medical cards are provided to persons who are, in the opinion of the HSE, unable without undue hardship to arrange GP services for themselves and their dependents and every application must be assessed on that basis. In accordance with the Act, the assessment for a medical card is determined primarily by reference to the means, including the income and expenditure, of the applicant and his or her partner and dependents. Where deemed appropriate in particular circumstances, the HSE may exercise discretion and grant a medical card even though an applicant exceeds the income guidelines but where they may face difficult financial circumstances, such as extra costs arising from illness.

It should be noted that every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines.

Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE affords applicants the opportunity to furnish supporting information and documentation to fully take account of all the relevant circumstances that may benefit them in the assessment, including medical evidence of cost and necessary expenses. Assistance in completing the forms can be obtained from the nearest Local Health Office or by calling 1890 252 919.

It should be noted that a priority within the 2017 HSE National Service Plan is to improve health outcomes for the most vulnerable in society including those with addiction issues, the homeless, refugees, asylum seekers, Traveller and Roma communities. Within this priority it details an aim to improve health outcomes for people experiencing or at risk of homelessness, particularly those with addiction and mental health needs, by providing key worker, case management, general practitioner (GP) and nursing services.

Nursing Staff Recruitment

Questions (472)

Róisín Shortall

Question:

472. Deputy Róisín Shortall asked the Minister for Health if consideration will be given to ending the mandatory retirement age for those persons involved in nursing in the public sector in order to help improve staffing levels in view of the current shortage of nurses within the health service and the difficulties in recruiting; and if he will make a statement on the matter. [8554/17]

View answer

Written answers (Question to Health)

I will first address the general issue of retirement age. An Interdepartmental Working Group, chaired by the Department of Public Expenditure and Reform, was established in early 2016. This Group was to examine the issues arising from prevailing retirement ages for workers in both the public and private sectors, in the context of the increase in the State Pension age from 65 to 66 in 2014 and the scheduled further increases to the State Pension age in 2021 and 2028.

The Group, whose Report was agreed by Government last August, considered policy around retirement age in both the public and private sectors, examining implications arising from retirement ages now and in the future. The Group identified a set of framework principles to underpin policy in the area and made a number of recommendations assigned to Government Departments and Employer bodies for follow-up in that regard. A copy of the Report is available online at

http://www.per.gov.ie/en/report-of-the-interdepartmental-group-on-fuller-working-lives/.

On foot of one of the recommendations of the Report, the Department of Public Expenditure and Reform, with Public Service employers, was tasked to review the current statutory and operational considerations giving rise to barriers to extended participation in the public service workforce up to and including the current age of entitlement to the Contributory State Pension. This review is currently underway and is expected to be completed by Q2 2017.

In relation to the specific matter of the recruitment and retention of nursing staff there are many initiatives currently underway to improve nursing and midwifery staffing levels throughout the country. In September 2016 the HSE set up a Project Group to review nursing workforce planning, recruitment and retention. The main objectives of this Project Group include identifying current recruitment black spots in a coordinated way and developing measures to incentivise and attract nurses to these essential posts. The HSE is continually running open recruitment campaigns with no closing date to ensure that all eligible applicants for nursing posts can apply at any time to work in public hospitals around the country. The number of nursing and midwifery staff increased by 1,650 whole time equivalents between December 2013 and December 2016, notwithstanding intense global competition for our nurses and midwives and the HSE is committed to increasing the number of permanent nursing and midwifery posts by over 1,200 in 2017.

Given recruitment difficulties in psychiatric nursing special arrangements were introduced last summer to enable retiring nurses return to employment at the rate of pay at which they had retired, rather than the 1st point of the scale rule that generally applies across the public service. A similar arrangement for other nursing categories is under consideration at present, recognising that recruitment is an issue across categories.

National Children's Hospital Location

Questions (473)

Ruth Coppinger

Question:

473. Deputy Ruth Coppinger asked the Minister for Health if he will revise the location of the children's hospital in view of the increase in costs for the hospital at the St. James's site; and if he will make a statement on the matter. [8556/17]

View answer

Written answers (Question to Health)

The project to develop the new children’s hospital is an extraordinary opportunity to enhance paediatric services for children. The Government decision in 2012 to locate the hospital on St James’s Hospital campus was made in the best interests of children from a clinical perspective. St. James's has the broadest range of national specialties of all our acute hospitals, in addition to a strong and well-established research and education infrastructure, making it the hospital that best meets the criteria to enable the children’s hospital achieve our vision of excellence in modern paediatric practice.

A major milestone was achieved in this long awaited, much needed project when An Bord Pleanála granted planning permission in April 2016 to build a state of the art hospital on a campus shared with St. James’s Hospital, together with two Paediatric Outpatients and Urgent Care centres at Tallaght Hospital and Connolly Hospital. The first phase of construction (site clearing works) on the site of the new children’s hospital began in August 2016 and will be substantially completed within a matter of weeks. Following decades of discussions and debates, Ireland is about to get the new children’s hospital that it badly needs and deserves. A world class design, with child-friendly, high spec, modern interiors and acres of outdoor space has been completed. Hundreds of staff from the three children’s hospitals continue to input into the fit out and internal design to ensure that the children, young people and their families can be treated in the best possible environment – helping to improve clinical outcomes as well as overall well-being and patient experience.

The National Paediatric Hospital Development Board was appointed in 2013 to design, build and equip the new children’s hospital for children, young people and families in Ireland. An internationally recognised design team supported by an experienced Board and Project Team are in place, have followed best international design, planning and procurement process at each stage of the project and are now in a position, subject to Government approval, to appoint a contractor to deliver this long awaited hospital. The new children’s hospital will open and provide services to children and young people in Ireland in 2021, and the Urgent Care Centres at Tallaght Hospital and Connolly Hospital will open on a phased basis from 2018.

The Project Team, during the design, planning and tendering phases, has constantly monitored the external environment – tracking construction inflation and market costs. The cost estimate for the core construction elements of the new children’s hospital and the Paediatric Outpatients and Urgent Care centres at Tallaght and Connolly Hospitals was prepared in early 2014. This estimate, prepared at a time when annual construction inflation predicted at 3% per annum, was €650m.

The recently concluded tendering process for the main construction works determined the actual market cost of the construction elements of the project. Due to annual construction inflation rising from 3% in 2013 to more than 9% in 2017 and the lengthened project timeline in the planning, design and procurement process, the cost of the core construction of the hospital and Paediatric Outpatients and Urgent Care Centres has increased from the original estimate. The increase reflects the increasing volume of activity in the Irish construction industry which is having a significant impact on construction inflation. However, I understand that the final construction elements of the project compare favourably to the costs of international projects of a similar size and scale.

The NPHDB and the Children’s Hospital Group Board continue to work closely with the HSE and the Department of Health to deliver this much-needed world-class hospital. My priority, as I have stated before, is to make progress on the new hospital as soon as possible so we can ensure children, young people and their families have the facilities they need and deserve.

Hospital Appointments Status

Questions (474)

Pearse Doherty

Question:

474. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) in County Donegal will receive a date for a spinal operation at Our Lady's Children's Hospital, Crumlin; and if he will make a statement on the matter. [8570/17]

View answer

Written answers (Question to 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.

Patient Data

Questions (475)

John Brassil

Question:

475. Deputy John Brassil asked the Minister for Health the number of public patients who are waiting for ophthalmology assessment and the number that are waiting for cataract operations at Cork University Hospital and South Infirmary-Victoria University Hospital, Cork; the number of these that are patients from Counties Kerry and Cork; the current waiting times for cataract patients without admission dates for cataract assessment and cataract operations detailing total numbers and the numbers from Counties Kerry and Cork, in tabular form; and if he will make a statement on the matter. [8577/17]

View answer

Written answers (Question to Health)

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

Mental Health Services Provision

Question No. 477 answered with Question No. 413.

Question No. 478 answered with Question No. 465.

Questions (476)

Niamh Smyth

Question:

476. Deputy Niamh Smyth asked the Minister for Health the extra supports that are being put into schools to deal with an issue (details supplied); and if he will make a statement on the matter. [8578/17]

View answer

Written answers (Question to Health)

Education is key to improving the mental health, resilience and emotional well-being of our young people. Last year saw the launch of the first Action Plan for Education by the Department of Education. This included a section on Mental Health and Wellbeing. The aims in this section were to roll out a national programme to support the implementation of Well-being Guidelines to all primary and post-primary schools; to implement Well-being at Junior Cycle; and to publish the 2015 Lifeskills survey, providing information on how schools cater for the well-being of their students. This plan outlines hundreds of actions and sub-actions to be implemented across 2016-2019, with timelines and lead responsibility assigned. I will be working closely with my colleague the Minister for Education on this issue to ensure these actions are implemented.

The Department of Health and the Department of Education have a strong history of working together to support youth mental health. In 2013, the Department of Education and Skills, the HSE, and the Department of Health jointly developed Well-Being in Post Primary Schools Guidelines for Mental Health Promotion and Suicide Prevention. This was followed in 2015 by the publication of Guidelines setting out a framework for mental health promotion in primary schools.

In 2015, the Government launched Connecting for Life, Ireland's National Strategy to Reduce Suicide with the aim of reducing suicide and self-harm over 2015-2020. The Strategy sets out a vision where fewer lives are lost through suicide, and where communities and individuals are empowered to improve their mental health and well-being. It will provide community-based organisations with guidelines, protocols and training on effective suicide prevention.

One of the main goals in Connecting for Life is to target approaches to reduce suicidal behaviour and improve mental health among priority groups, including young people. Several key actions have been identified to further this goal in the Education sector, including:

- Support the implementation of the relevant guidelines for mental health promotion and suicide prevention across primary and post-primary schools;

- Guide and encourage the implementation of the relevant policies and plans in schools, including support for Student Support Teams and for critical incident management;

- Work with the HSE to develop national guidance for higher education institutions in relation to suicide risk and critical incident response;

- Implement the National Anti-bullying Action Plan including online and homophobic bullying;

- Support all junior and senior schools to implement a new Wellbeing programme; and

- Deliver early intervention and psychological support service for young people at primary care level.

These actions are part of the overall policy objectives of the Department of Education and Skills. They are supported by my Department and the HSE through the inter-agency implementation arrangements provided for in Connecting for Life and overseen by the Cabinet Committee on Social Policy and Public Service Reform.

Question No. 477 answered with Question No. 413.
Question No. 478 answered with Question No. 465.

Medicinal Products Availability

Questions (479)

Billy Kelleher

Question:

479. Deputy Billy Kelleher asked the Minister for Health for the position regarding the negotiations with a company (details supplied) over the provision of Orkambi; when a decision will be made by the HSE in respect of the latest proposal from the company; the timeframe he envisages for the negotiations; and if he will make a statement on the matter. [8602/17]

View answer

Written answers (Question to Health)

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, following a request from the HSE, 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 relevant cost offsets including 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 and this is available on its website. It was submitted to the HSE in June 2016. 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 have confirmed that all relevant costs were included in the analysis. In line with the HSE's assessment process, the HSE Drugs Committee considered the NCPE recommendation, the manufacturers submissions and commercial offer and other information. Following this consideration the Drugs Committee did not recommend reimbursement at the current price. The HSE Directorate considered the Drugs Committee’s recommendation in December and the Directorate took the decision not to reimburse at the current price offered by the company.

The HSE has since re-entered into negotiations with Vertex, the manufacturer of Orkambi, with a view to significantly reducing the cost of Orkambi. A meeting was held in December and again in early January. Following completion of the negotiation process, I am advised that the HSE’s Drugs Committee met at the end of January and considered the manufacturer's latest price offerings. The matter is currently under consideration by the HSE Directorate, in accordance with the criteria set out in the 2013 Act.

Services for People with Disabilities

Questions (480)

John Brassil

Question:

480. Deputy John Brassil asked the Minister for Health if he will request the HSE immediately to carry out a risk assessment with regards to a person (details supplied) and to make the results available to their parents as soon as possible; and if he will make a statement on the matter. [8608/17]

View answer

Written answers (Question to 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 an individual, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Hospital Appointments Status

Questions (481)

Michael Healy-Rae

Question:

481. Deputy Michael Healy-Rae asked the Minister for Health when a cataract operation will be scheduled for a person (details supplied); and if he will make a statement on the matter. [8611/17]

View answer

Written answers (Question to 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 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.

National Treatment Purchase Fund Eligibility

Questions (482)

Brendan Howlin

Question:

482. Deputy Brendan Howlin asked the Minister for Health if a person (details supplied) can access treatment through the National Treatment Purchase Fund; and if he will make a statement on the matter. [8619/17]

View answer

Written answers (Question to Health)

In December 2016, I granted approval to the NTPF to dedicate €5m to a daycase waiting list initiative with the aim of ensuring that no patient will be waiting more than 18 months for a daycase procedure by 30 June 2017. In excess of 2,000 daycases will be managed through this process and outsourcing of treatment will commence from March.

The HSE is currently developing a 2017 Waiting List Action Plan for inpatient/daycase procedures to ensure that no patient is waiting more than 15 months by the end of October. This Plan is being developed in conjunction with the NTPF's proposal for utilisation of its remaining €10m funding for patient treatment in 2017.

During 2017 the €15m of funding allocated to the NTPF for patient treatment will be dedicated to inpatient and daycase procedures.

With regard to the specific services required in this case, as this is a service matter, I have asked the HSE to respond to you directly.

Services for People with Disabilities

Questions (483)

John Brassil

Question:

483. Deputy John Brassil asked the Minister for Health the total number of persons who are registered as visually impaired as of December 2016. by county in tabular form; and if he will make a statement on the matter. [8621/17]

View answer

Written answers (Question to Health)

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

Nursing Homes Support Scheme

Questions (484)

Brendan Griffin

Question:

484. Deputy Brendan Griffin asked the Minister for Health if he will consider extending the fair deal scheme to allow persons to remain in their homes; and if he will make a statement on the matter. [8622/17]

View answer

Written answers (Question to Health)

It is Government policy that long-term nursing home care should be a last resort and we want to develop home care services to provide a more viable alternative to nursing home care for a greater number of people.

It is my view, and that of the Government, that we need a stand-alone funding scheme designed for homecare that recognises its particular characteristics together with regulation of homecare services. The development of a regulatory and funding model for homecare services is a complex undertaking involving very significant legislative, operational and financial resources.

A significant amount of detailed preparation needs to be done before final decisions are taken on the form of a home care scheme and the regulation of these services. In 2016 the Department commissioned the Health Research Board to carry out an evidence review of international approaches to the regulation and financing of home care services. This will be published shortly. The Department will also undertake a mapping exercise of current service provision nationally, taking into account the scale and diversity of services funded by the HSE. This work will be used to identify major policy options for a new homecare scheme-around the areas of regulation, financing, assessment and eligibility.

Once this is complete a public consultation will be launched to allow stakeholders, including older people themselves, their families and healthcare workers to express their views regarding a new homecare scheme. It is my hope and intention at this stage that this consultation on this important issue can be launched in May of this year.

Nursing Staff Recruitment

Questions (485)

Charlie McConalogue

Question:

485. Deputy Charlie McConalogue asked the Minister for Health the status of a panel for mental health nurses (details supplied); and if he will make a statement on the matter. [8624/17]

View answer

Written answers (Question to Health)

I have asked the HSE to respond to the Deputy directly on this matter.

National Postcode System Implementation

Questions (486)

Catherine Murphy

Question:

486. Deputy Catherine Murphy asked the Minister for Health the cost of upgrading information technology systems and or databases to incorporate the use of Eircode; if the use of Eircode is mandatory in his Department; and if he will make a statement on the matter. [8634/17]

View answer

Written answers (Question to Health)

There were no costs to the Department to incorporate the use of the Eircode on the information technology systems or databases. The Department uses its own Eircode on official stationery and emails, and encourages staff to use Eircodes on outgoing mail.

HIV-AIDS Programmes

Questions (487)

Gino Kenny

Question:

487. Deputy Gino Kenny asked the Minister for Health the measures he is taking to support the use of the combination of the drugs emtricitabine and tenofovir for pre-exposure prophylaxis as part of a comprehensive prevention strategy in respect of HIV infection (details supplied); and if he will make a statement on the matter. [8648/17]

View answer

Written answers (Question to Health)

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. Any decision concerning the availability of PrEP will be made following the completion of this work.

Maternity Services Provision

Questions (488)

Gino Kenny

Question:

488. Deputy Gino Kenny asked the Minister for Health if he will ensure that every woman and baby has the right to high-quality care (details supplied); if he will further ensure that the governance of women’s health services is robust, independent and secure and not targeted for cuts by having a ring-fenced budget; and if he will make a statement on the matter. [8649/17]

View answer

Written answers (Question to Health)

I can assure the Deputy that the Government is committed to the progressive development of maternity services. Indeed, in the last 12 months alone we have launched the National Maternity Strategy, the HSE National Standards for Bereavement Care following Pregnancy Loss and Perinatal Death and the HIQA National Standards for Safe Better Maternity Services. In addition, each of our 19 maternity hospitals/units is now publishing Maternity Patient Safety Statements on a monthly basis. Such initiatives represent essential building blocks to provide a consistently safe and high quality maternity service.

I share the Deputy's desire for robust maternity service governance structures, and to this end a National Women & Infants Health Programme (NWIHP) has been established within the HSE to lead the management, organisation and delivery of maternity, gynaecological and neonatal services. The Programme will ensure the consistent delivery of high quality care in these services and oversee the development of Maternity Networks. The Maternity Strategy provides that all development funding for maternity services will be ring-fenced and allocated through the NWIHP. Thus the Programme will facilitate greater oversight and support for service providers and ensure the appropriate allocation and targeting of new resources. It is expected that the establishment of Maternity Networks across Hospital Groups will assist in the development of a sustainable service model that ensures that all women within each Hospital Group can access a full range of maternity-related services.

The Strategy will be implemented on an incremental basis, and work in this regard is ongoing. €3 million development funding provided for maternity services in 2016 was allocated in line with the Strategy and included funding for additional staff, including 100 midwives, the development of specialist bereavement teams and for the implementation of the Maternal and Newborn Clinical Management System. Increased funding of €6.8m will be provided for maternity services in 2017 which will provide for the continued implementation of the Strategy. My Department has asked the NWIHP to develop and submit a detailed Implementation Plan as a priority.

Hospital Deaths

Questions (489)

Richard Boyd Barrett

Question:

489. Deputy Richard Boyd Barrett asked the Minister for Health if he will assist a person (details supplied) to bring finality to a matter; and if he will make a statement on the matter. [8661/17]

View answer

Written answers (Question to Health)

I am aware of correspondence from the individual concerned and I have written to personally express my deepest sympathies to the family.

I understand that the death of the child occurred in Temple Street Hospital and Temple Street Hospital has been in contact with the family a number of times to discuss and clarify the circumstances of their child's death, post-mortem and burial, and has issued an apology. I hope that the information provided by the hospital has been of some assistance has provided some solace for the family.

I regret to say that my Department is not in a position to provide further information other than that already provided directly by Temple Street hospital. However, if the family wishes to pursue the matter further, it is open to them to contact the HSE Director of Advocacy and the Ombudsman/Ombudsman for Children, in line with the complaints process details, of which are on the HSE website, at

http://www.hse.ie/eng/services/yourhealthservice/feedback/complaints/.

Medicinal Products Licensing

Questions (490)

Fergus O'Dowd

Question:

490. Deputy Fergus O'Dowd asked the Minister for Health if he will address a matter raised by a person (details supplied) in relation to the HPRA report on cannabis for medical use [8664/17]

View answer

Written answers (Question to Health)

THC and CBD are both derived from cannabis. THC is a psychoactive substance and as such is strictly controlled under the Misuse of Drugs Act 1977, as amended, and Ministerial regulations made thereunder along with the cannabis plant.

However, since CBD does not have psychoactive properties it is not controlled under the Misuse of Drugs Acts. 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.

I am aware that CBD oil is sometimes marketed as a nutritional or dietary supplement, and it is reported that a number of Irish patients are accessing CBD Oil from shops or online and using it to self-medicate for a variety of medical conditions. However, 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 medicinal product authorisation.

Services for People with Disabilities

Questions (491)

Kevin O'Keeffe

Question:

491. Deputy Kevin O'Keeffe asked the Minister for Health if he will assist in having an adult day placement arranged for a person (details supplied) in County Cork; and if he will make a statement on the matter. [8666/17]

View answer

Written answers (Question to 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 an individual case, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

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