Tuesday, 7 Mar 2017

Disability Support Services

Questions (623)

Brendan Griffin

Question:

623. Deputy Brendan Griffin asked the Minister for Health his views on a matter (details supplied) regarding a nursing package; and if he will make a statement on the matter. [11967/17]

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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.

Hospitals Funding

Questions (624)

Kevin O'Keeffe

Question:

624. Deputy Kevin O'Keeffe asked the Minister for Health the position regarding the provision of funding to a hospital (details supplied) in County Cork. [11974/17]

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Written answers

Minister of State at the Department of Health

As this is a service matter it has been referred to the Health Service Executive for direct reply.

HSE Reports

Questions (625)

Pat Deering

Question:

625. Deputy Pat Deering asked the Minister for Health the information the HSE has in respect of a foster care home (details supplied); if follow-up interviews were conducted; if there are matters of concern outstanding; and if he will make a statement on the matter. [11975/17]

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Written answers

Minister of State at the Department of Health

The reports in question relate to an allegation of abuse concerning a person with an intellectual disability who resided in a foster home in the South East for a period of 20 years from 1989 to 2009. Two reviews were commissioned by the HSE into the case. The HSE procured the services of Conal Devine to investigate the case and the services of Resilience Ireland to conduct a tracing and looking-back exercise in relation to all clients who had contact with the foster family concerned. Both reports were published in a redacted format by the HSE on the 28th February last. As part of the inquiry process, the assessed needs of all those affected have been reviewed and will continue to be reviewed on an ongoing basis.

Following consideration of the seriousness of the matters raised and public interest in the outcome of the reviews, the Government decided to establish a Commission of Investigation to investigate these matters further.

The HSE has also put in place a number of changes to take account of the service and management deficiencies identified. This includes the publication, in December 2014, of its national policy: Safeguarding Vulnerable Persons at Risk of Abuse – National Policy and Procedures. The implementation of the National Policy on Safeguarding Vulnerable People and the system-wide change programme across social care services is led by a National Task Force which is focused on ensuring quality and safety of all services through empowering and safeguarding vulnerable people.

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.

Medical Card Eligibility

Questions (626)

Mary Lou McDonald

Question:

626. Deputy Mary Lou McDonald asked the Minister for Health the reason a person (details supplied) has been refused a discretionary medical card despite the fact that the person has provided extensive medical documentation to the primary care reimbursement service; and if he will make a statement on the matter. [11982/17]

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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 Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible. The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information was issued to Oireachtas members.

Hospital Appointments Status

Questions (627)

Fiona O'Loughlin

Question:

627. Deputy Fiona O'Loughlin asked the Minister for Health if he will review the medical case of a person (details supplied); and if he will make a statement on the matter. [11993/17]

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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.

Vaccination Programme

Questions (628)

Thomas P. Broughan

Question:

628. Deputy Thomas P. Broughan asked the Minister for Health his views on Gardasil; if treatment plans have been worked out for the cohort of girls affected by adverse reactions; and if he will make a statement on the matter. [12000/17]

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Written answers

Minister for Health

The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). NIAC is a committee of the Royal College of Physicians of Ireland comprising of experts in a number of specialties including infectious diseases, paediatrics and public health. The committee's recommendations are informed by public health advice and international best practice. The Health Products Regulatory Authority (HPRA) and the European Medicines Agency (EMA) in Europe continually monitor adverse events to vaccination. All relevant and appropriate information is taken into account when deciding to make changes to the State's immunisation programmes.

Each year in Ireland around 300 women are diagnosed with cervical cancer. The HPV vaccine protects against two high risk types of HPV (16 & 18) that cause 73% of all cervical cancers. Vaccinated women and girls will still be at risk from other high risk types of HPV that can cause cervical cancer and will therefore need to continue to have regular cervical smear tests. NIAC recommended that the human papillomavirus (HPV) vaccine be given to all girls aged 12-13 in 2009 and in September 2010 the HPV vaccination programme was introduced for all girls in first year of second level schools.

Gardasil is the HPV vaccine used in Ireland in the context of the HSE schools immunisation programme. In Ireland more than 660,000 doses of Gardasil have been administered and almost 250,000 girls have been vaccinated against HPV. Over 205 million doses of the HPV vaccine Gardasil have been distributed worldwide, either as part of national immunisation programmes or by private doctors. Gardasil is currently used in over 25 European countries, the United States, Canada, Australia and New Zealand.

I am aware of claims of an association between HPV vaccination and a number of conditions experienced by a group of young women. An illness that occurs around the time a vaccine is given and is already known to be common in adolescence does not imply the vaccine caused the problem. It appears that some girls first suffered symptoms around the time they received the HPV vaccine, and understandably some parents have connected the vaccine to their daughter’s condition. It is important to reassure people that anyone who is suffering ill health is eligible to seek medical attention, and to access appropriate health and social care services, irrespective of the cause of their symptoms. The individual nature of the needs of some children may require access to specialist services and the HSE are currently working to put in place a clinical care pathway appropriate to the medical needs of this group. As there is no scientific evidence that the vaccine causes long term illnesses, the HPV vaccine cannot be held responsible for these illnesses.

The focus for the HPV programme in 2017 is to counter misinformation in relation to the safety of the HPV vaccine, and to increase the uptake rate in girls as part of the schools immunisation programme. The benefits of HPV vaccines outweigh the known side effects. The safety of these vaccines, as with all medicines, will continue to be carefully monitored and will take into account any future new evidence of side effects that becomes available. I encourage the parents of all eligible girls to ensure that their daughters receive this important cancer-preventing vaccine.

Dental Services

Questions (629)

Thomas P. Broughan

Question:

629. Deputy Thomas P. Broughan asked the Minister for Health the number of claims under the dental treatment service scheme in each of the years 2014 to 2016 and to date in 2017; and if he will make a statement on the matter. [12014/17]

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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.

Chronic Disease Management Programme

Questions (630)

Louise O'Reilly

Question:

630. Deputy Louise O'Reilly asked the Minister for Health if his attention has been drawn to the intense struggle endured by many persons suffering from chronic Lyme disease; his plans to support the affected persons adequately; and if he will make a statement on the matter. [12021/17]

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Written answers

Minister for Health

Lyme disease (also known as Lyme borreliosis or LB) is an infection caused by a spiral-shaped bacterium called Borrelia burgdorferi that is transmitted to humans by bites from ticks infected with the bacteria. The infection is generally mild affecting only the skin, but can occasionally be more severe. Lyme disease is the commonest cause of tick-borne infection in Europe.

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.

Lyme disease can be very successfully treated using common antibiotics. These antibiotics are effective at clearing the rash and helping to prevent the development of complications. Antibiotics are generally given for up to three weeks. If complications develop, intravenous antibiotics may be considered. In Ireland, treatment by most clinicians is based on that laid out in evidence-based guidelines for the management of patients with Lyme disease, human granulocytic anaplasmosis (formerly known as human granulocytic ehrlichiosis), and babesiosis published by the Infectious Diseases Society of America (IDSA) in 2006.

This pharmacological regime can be summarised thus:

- Doxycycline, amoxicillin or cefuroxime for the treatment of adults with early localized or early disseminated Lyme disease associated with erythema migrans, in the absence of specific neurologic manifestations (ceftriaxone in early Lyme disease for adults with acute neurologic disease manifested by meningitis or radiculopathy);

- Doxycycline, amoxicillin, or cefuroxime for adults with Lyme arthritis but without clinical evidence of neurologic disease;

- For late neurological disease in adults - intravenous ceftriaxone, cefotaxime or Penicillin G.

Since 2013, the HPSC has held an annual ‘Lyme Awareness Week’ at the beginning of the tick biting season, the purpose of which is to draw attention - particularly in the media - to Lyme disease and the ticks that can spread this disease. Lyme cases tend to appear in Ireland with greater frequency after April, hence the choice of this time of year for Lyme Awareness Week. Both the Health Protection Surveillance Centre and Tick Talk Ireland provide guidance on protection against contracting Lyme borreliosis. The best protection is to prevent tick bites, when walking in grassy, bushy or woodland areas, particularly between May and October. Further advice can be obtained from the HPSC website (www.hpsc.ie) and the HPSC produced a leaflet on “Protecting Yourself Against Tick Bites and Lyme Disease” which is available for the public to download.

My colleague, Minister of State Corcoran Kennedy, who has responsibility for health protection, met with representatives from Tick Talk last summer, and listened to their experiences and the impact of this condition. Their stories showed the need for additional awareness of Lyme disease, both by the public and the health services.

A Lyme Borreliosis Sub-Committee of the Scientific Advisory Committee of the HPSC has been established to look at methods of raising awareness especially in those areas (including recreation areas) where Lyme-carrying ticks can be most expected to be found. 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, an Environmental Health Officer, and member of Tick Talk has been invited to be the patient representative on the Sub-Committee. The initial 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.

Disease Management

Questions (631)

Louise O'Reilly

Question:

631. Deputy Louise O'Reilly asked the Minister for Health if his attention has been drawn to the difficulties encountered by persons living with Ménière's disease; if his attention has been further drawn to the growing evidence of the role that upper cervical chiropractic treatment can play in mitigating the vertigo and other debilitating symptoms endured by the affected persons; and if he will ensure that supports will be provided for the affected persons to avail of this treatment. [12022/17]

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Written answers

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 Waiting Lists

Questions (637)

Joan Collins

Question:

637. Deputy Joan Collins asked the Minister for Health the number of persons who have been on the waiting lists for scoliosis surgery in Our Lady's Children's Hospital, Crumlin, for six, 12, 18 and 24 months. [12167/17]

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Written answers

Minister for Health

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