Written Answers Nos. 473 - 488
473. Deputy Martin Kenny asked the Minister for Health the reason a person (details supplied) had to privately seek a diagnosis of autism, attention deficit hyperactivity disorder and sensory processing disorder. [11235/17]
View answer474. Deputy Martin Kenny asked the Minister for Health the reason a person (details supplied) is not receiving the appropriate therapy and treatment for autism, attention deficit hyperactivity disorder and the sensory processing disorder associated issues they are experiencing. [11236/17]
View answerI propose to take Questions Nos. 473 and 474 together.
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.
475. Deputy Seamus Healy asked the Minister for Health the current position regarding the shortage of the BCG vaccine here; and if he will make a statement on the matter. [11240/17]
View answerThere is currently a worldwide shortage of BCG vaccine. The vaccine has not been available in Ireland since the end of April 2015. Consequently, BCG vaccination clinics in HSE Clinics and Maternity hospitals have been postponed.
There is only one licensed supplier of BCG vaccine to Ireland and to other countries within the EU. The manufacturer has had difficulties in the production of the BCG vaccine. Since this problem became apparent, the HSE National Immunisation Office has been in regular contact with the manufacturer of BCG vaccine to ascertain when the vaccine might be available. The HSE has also asked the Health Products Regulatory Authority (HPRA), which licenses and regulates all human medicines in Ireland, to source an alternate supplier of the BCG vaccine. Efforts have been made to find a company who can provide the vaccine for use in Ireland which satisfies all the HPRA requirements on safety and efficacy. There has been a worldwide shortage for over two years and to date no suitable alternative BCG product has been found. Therefore the HSE has been unable to procure the BCG vaccine from any other source and still awaits the product from the HPRA licensed supplier of the vaccine.
The supplier has indicated that supplies of the vaccine are not expected to be delivered into Ireland later in 2017. When there is confirmation of the date of new supply, the HSE will be guided by the recommendations of the National Immunisation Advisory Committee on its administration.
476. Deputy Michael Healy-Rae asked the Minister for Health the current status of medical cards being issued to children in receipt of the domiciliary care allowance; and if he will make a statement on the matter. [11241/17]
View answerThe Health (Amendment) Bill 2017 was published last Thursday 2nd March 2017. This bill will enable the granting of full eligibility for general practitioner and other health services to all children in respect of whom a Domiciliary Care Allowance (DCA) is paid. Granting a medical card to all children in respect of whom a DCA payment is made will benefit approximately 9,800 children in this cohort who do not currently qualify for a medical card. The legislation is scheduled to enter the Dail tomorrow, Wednesday, 8th March 2017, and it is hoped to complete all stages before the end of March.
The HSE is also finalising the administration processes that need to be in place so that the proposal can be implemented in a smooth and efficient manner.
477. Deputy Thomas Pringle asked the Minister for Health the status of an application by a company (details supplied) for the FreeStyle Libre to be considered by the HSE for inclusion on the long-term illness scheme; and if he will make a statement on the matter. [11242/17]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
478. Deputy Tom Neville asked the Minister for Health if he will review a matter (details supplied) regarding the removal of the subsidy for blood test strips; and if he will make a statement on the matter. [11246/17]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
479. Deputy Michael Moynihan asked the Minister for Health if his attention has been drawn to the difficulties experienced by persons applying to the nursing home support scheme who have transferred assets within the past five years in view of the fact that these assets would have been transferred long before there was any need for nursing home care; if there are any exemptions to the five year rule in these situations; and if he will make a statement on the matter. [11247/17]
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.
In order to determine how much an applicant will contribute to the cost of their care, a financial assessment is carried out by the HSE which takes account of a person's income and assets. As part of this assessment, the HSE identifies any income or assets that the applicant and his/her partner may have deprived themselves of in the five years leading up to their application, or at any time on or subsequent to the date on which the application for financial support under the Scheme is first made. Such assets are defined in the Nursing Homes Support Scheme Act, 2009 as 'transferred assets' and 'transferred income'. Under the legislation there are no exemptions in relation to transferred assets.
It should be noted that a person's principal private residence is only included in the financial assessment for the first three years of the applicant's time in care.
480. 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. [11255/17]
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.
481. Deputy Pearse Doherty asked the Minister for Health the status of a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [11272/17]
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 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.
482. Deputy Pearse Doherty asked the Minister for Health the details of the care plans, including the weekly hours allocated, which have been identified as being required by each child who was formally assessed as part of a service user evaluation (details supplied); and if he will make a statement on the matter. [11273/17]
View answer483. Deputy Pearse Doherty asked the Minister for Health the details of the method employed to evaluate care needs, including details of the scoring scale used, as part of a formal testing (details supplied); and if he will make a statement on the matter. [11274/17]
View answerI propose to take Questions Nos. 482 and 483 together.
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.
484. Deputy Charlie McConalogue asked the Minister for Health when a response will issue to an interim reply (details supplied) regarding urology; and if he will make a statement on the matter. [11284/17]
View answerWith regard to the specific complaint raised by the Deputy, the Quality and Safety Department at University Hospital Galway are responding to the patient concerned directly. A detailed response to the Deputy will be issued as soon as possible.
With regard to urology services at Letterkenny University Hopsital, the Saolta University Healthcare Group advises that the Urology Specialty Lead at University Hospital Galway (UHG) is currently providing services in LUH, with 2 outpatient sessions per month, supported by a Urology Locum who provides 50% day surgery and 50% intermediate surgery sessions, including day-case cystoscopy, on 4 days per month in total. All complex or Urgent Urology cases are referred to Galway.
As part of its Strategic Plan, Saolta envisages operating a hub and spoke urology service model, with a sub-hub in the North West that will provide the majority of urology care locally, as a component of a Group-wide department.
With regard to urology services at UHG, there are a number of measures that are being taken by the Hospital, and at national level, which are intended to reduce current pressure and improve timely access to services at UHG. The UHG Urology Service is provided by 7.5 whole time equivalent Consultant Surgeons and has grown significantly in recent years.
However, Saolta advises that the non-cancer elective and emergency workload has been impacted by limited access to diagnostics, in-patient beds and operating room time; due in part to challenges associated with demand for unscheduled care and shortages of theatre nurses, both of which are currently being addressed. GUH has reinstated the Surgical Day Ward, which will facilitate the provision of day case treatment, including urology day cases.
Also, University Hospital Galway is one of the two national Patient Flow Project pilot sites; this project is assisting with improvements in patient flow, access and efficiency.
In terms of general capacity expansion in UHG, funding has been provided in the 2017 Capital Plan to progress the design of a new ED, as outlined in the Programme for a Partnership Government.
New Development and Winter Initiative funding have also been allocated, such that 28 beds in the new ward block have already been opened in early January in order to alleviate seasonal congestion. Recruitment is ongoing in order to facilitate the timely opening of further capacity within the new ward block.
485. Deputy Peter Burke asked the Minister for Health if he will order a review of the decision made by the NCPE not to fund a licensed drug which targets a genetic disorder (details supplied); and if he will make a statement on the matter. [11290/17]
View answerThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines in the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
In reaching its decision, the HSE examines all the evidence which may be relevant, in its view, for the decision (including information submitted by the company) and will take into account such expert opinions and recommendations which it may have sought at its sole discretion, for example from the National Centre for Pharmacoeconomics (NCPE).
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).
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 reimbursement of maintenance treatment of emphysema in adults with documented severe alpha1-proteinase inhibitor deficiency.
In June last 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 considers the NCPE assessment, and other expert advice, as part of its decision-making process for reimbursement, which is made on objective, scientific and economic grounds by the HSE in line with the 2013 Act.
The HSE has confirmed that the drug Respreeza was considered by the HSE Drugs Group, which did not make a recommendation for reimbursement on clinical grounds. The HSE Leadership team has accepted the Drugs Group recommendation of non-reimbursement.
Under the HSE statutory assessment process, the HSE is required to set out a notice of any proposed decision to an applicant company. The HSE is legally required to provide at least a 28 day period (from the formal written notice of proposal), to enable the pharmaceutical company to consider any such proposal not to reimburse and to make representations to the HSE if it wishes to do so. The HSE is required to consider any such representations in advance of a formal decision.
Therefore, as the statutory process is still ongoing, the company has an opportunity to have further discussions with the HSE.
In relation to the compassionate access scheme operated by the manufacturer, CSL Behring, I note the decision of the Company to extend the scheme by a further two months. However it is important to point out that the operation of such compassionate schemes is at the discretion of manufacturers. I as Minister for Health have no role in the operation of these schemes. There is no provision in Irish legislation for the approval of compassionate use programmes for specific groups of patients with an unmet medical need.
I have previously said that any attempts by manufacturers to link continued access for patients already being treated with a new medicine with decisions under the statutory reimbursement process is both inappropriate and unethical. Manufacturers should operate such schemes in a compassionate and not a commercially-motivated manner. There should be no link between compassionate use schemes and reimbursement decisions and manufacturers should be up front with patients and clinicians from the outset.
486. Deputy Mattie McGrath asked the Minister for Health if the FreeStyle Libre glucose monitoring system will be approved under the GMS and long-term illness scheme for use by diabetics; and if he will make a statement on the matter. [11295/17]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
487. Deputy Peter Burke asked the Minister for Health his plans to extend free general practitioner care, especially to children over six years of age; and if he will make a statement on the matter. [11296/17]
View answerUniversal GP care without fees for all children under the age of 6 years was successfully introduced in 2015. Shortly afterwards, the second phase implemented universal GP care without fees for all people aged 70 years and over. This has resulted in approximately 800,000 people now being eligible for GP care without fees, without having to undergo a means test and represents a major step forward in improving access, quality and affordability of health care in Ireland. The under-6s GP service contract, which includes age-based preventive checks focused on health and well-being and a cycle of care for children with asthma, underlines the Government’s commitment to enhancing primary care and keeping people well in their own community.
The Programme for Government commits to extending in phases, and subject to negotiation with GPs, free GP care to all children under 18 years of age. Legislative changes will be required for any such extension of GP care without fees to further cohorts of the population.
The extension of GP care without fees to children aged 6-11 years is one of the actions listed in the HSE's National Service Plan 2017, however the timetable is subject to the outcome of discussions with GP representatives on this and other contractual matters.
The next phase of discussions on a new GP contract is under way and engagement with GP representative bodies has commenced. As with any negotiation-type process, and given the range and complexity of the issues to be discussed, the engagement may take some time. While I am of course anxious to see good progress made, it is not my intention to set a deadline for completion of discussions.
488. Deputy Martin Kenny asked the Minister for Health the reason a person (details supplied) is not receiving autism services. [11308/17]
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.
