Written Answers Nos. 638-652
638. Deputy Aindrias Moynihan asked the Minister for Health his plans for paediatric neurologists here to have access to training and prescribing medicinal cannabis products; and if he will make a statement on the matter. [12176/17]
View answerIn November 2016 I initiated a review of policy on the use of cannabis for medical purposes and asked the Health Products Regulatory Authority (HPRA) to provide expert advice on the matter. On 10th February I published the HPRA’s report ‘Cannabis for Medical 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;
- Severe, refractory (treatment-resistant) epilepsy that has failed to respond to standard anticonvulsant medications.
My Department is now progressing the establishment of this access programme as a priority. However, it is important to understand that patients accessing cannabis through this programme will need to be recommended for it by their medical consultant.
The next steps being taken to implement this decision are:
- The report has been referred to the Joint Oireachtas Committee on Health for consideration;
- Officials from my Department and the HPRA will consult with stakeholders on how the access programme will operate.
- Department of Health officials are examining legislative changes that will be required to underpin the access programme.
Until such time as the necessary legislative amendments have been made to facilitate the implementation of the Cannabis Access Programme, it is within my power to grant a licence for access to cannabis for a named patient once the application is supported by relevant clinicians involved in the patient's care. One such application has been granted. The application process remains open and I have asked my officials to treat any and all applications with the utmost priority.
639. Deputy Michael McGrath asked the Minister for Health when a person (details supplied) in County Cork will have an assessment of need carried out; and if he will make a statement on the matter. [12181/17]
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.
640. Deputy Pat Buckley asked the Minister for Health if his attention has been drawn to the difficulty many parents are having in accessing child and adolescent mental health services for their children even when in severe and urgent circumstances; and his plans to ensure services are in place to avoid further use of adult services for children. [12182/17]
View answerImproving access to Child and Adolescent Mental Health services, including maximising placements in age-appropriate acute units, are priorities for improvement under the HSE Service Plan 2017.
Additional resources over recent years mean that we now have 67 CAMHS teams, and 3 Paediatric Liaison Teams, supported by 66 operational CAMHS beds across the country. A lack of funding for the mental health care programme is not a difficulty at present for the HSE, but there are acknowledged staff recruitment and retention difficulties across the health care system, including CAMHS, that the Executive is addressing. A new Standard Operating Procedures introduced in June 2015 has provided greater clarity and consistency on how this specialist mental health service for children should be delivered nationally. Despite increasing demands overall on CAMHS, irrespective of the source of referrals, individual cases professionally assessed as requiring urgent access to services receive priority.
The HSE Service Plan 2017 provides for further development of the CAMHS service, including better out-of-hours liaison and seven-day response cover, against a background where the population of children is expected to increase by around 8,500 over 2016-17. Around 18,500 children will attend the HSE CAMHS service this year, including around 14,000 referrals. Detailed activity data on access to CAMHS, and also on age-appropriate admissions to care units, is published by the Executive in its monthly Performance Reports available on the HSE website. This shows, for example, 68% of children referred are seen within twelve weeks.
In regard to admission of child and adolescent cases to adult units, there has been significant progress on age appropriate admissions since 2008 when there were 247 such admissions to adult units in that year. This declined to 68 admissions in 2016, despite increasing demands overall. The number of admissions does not necessarily equate to the actual number of children involved, as an individual child may be admitted on more than one occasion in any given year. Performance generally continues to be above the HSE Service Plan target figure of 95%, and indications also are that where a child has been admitted to an adult acute in-patient unit, the length of stay has been kept to a minimum. There has to be some operational flexibility surrounding emergency placements in Adult Units, particularly where very short-term placements occur, and where full account is taken of all relevant factors such as the preferences of all those involved, or geographical factors relating to access or visiting. The HSE closely monitors on a weekly basis all child admissions to adult units, with a view to minimising these.
Work is underway by the HSE to review existing levels of service provision generally, and to examine international models of best practice on the most appropriate models of delivery for use in the Irish context in order to enhance access to mental health care, including CAMHS. My objective, and that of the HSE, is to further improve all aspects of mental health care nationally for those under age 18, including those relating to access and age-appropriate care settings.
641. Deputy Ruth Coppinger asked the Minister for Health if his Department will support a settlement with nurses and other health care workers who are due to take industrial action on 7 March 2017; and if he will make a statement on the matter. [10625/17]
View answerI am pleased to confirm that industrial action by support staff grades scheduled for today (7th March) was averted following an agreement reached between SIPTU and the HSE on 24th February, with the support of my Department.
I can also confirm that the INMO Executive Council decided on Saturday 4th March to ballot all members on expanded proposals which emerged following extensive engagement with officials from the HSE, my Department and the Department of Public Expenditure and Reform at the Workplace Relations Commission. The industrial action due to commence today has been deferred by the INMO to facilitate the ballot. I respect the process the INMO is now undertaking and I understand that the result of the ballot will be known by the end of this month.
642. Deputy Niamh Smyth asked the Minister for Health if his attention has been drawn to the delays in assessments for children attending school who have developmental issues and may require specialised support; the efforts being taken by him to clear this backlog; and if he will make a statement on the matter. [10128/17]
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.
643. Deputy Maureen O'Sullivan asked the Minister for Health the level of funding for home care packages; the additional funding that is required to help alleviate pressures on hospitals by allowing patients to return home in a timely manner; and if he will make a statement on the matter. [11905/17]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
644. Deputy Eugene Murphy asked the Minister for Health his views on a situation whereby a person (details supplied) was subject to a set of circumstances; and if he will make a statement on the matter. [11794/17]
View answerIn relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
645. Deputy Eugene Murphy asked the Minister for Health the measures he is taking to ensure that beds are not being taken up at weekends by persons who are physically fit to go home on a Friday but due to the lack of consultants on site over the weekend to sign them fit to leave are being kept in hospital beds until Monday morning; and if he will make a statement on the matter. [11831/17]
View answerIn September 2016, the HSE launched the ‘Winter Initiative Plan 2016-2017’ which provided €40 million of additional funding for winter preparedness and to assist hospitals to deal with increased demand.
A key element of the Winter Initiative is to support hospitals to improve process in relation to patient flow. This includes supporting hospitals through access to social care and community measures to discharge patients, when deemed clinically appropriate, to return home or to a more appropriate community setting. Since the start of the Winter Initiative delayed discharges have reduced nationally from 638 to 517, freeing up hospitals beds to alleviate ED pressures. In addition under the Initiative, since October: over 4,260 patients have availed of aids and appliances; over 1,050 additional homecare packages and 615 additional transitional care beds have been provided, enabling patients to be discharged from hospital sooner.
The Special Delivery Unit in the HSE works with individual hospitals to drive process improvements and support hospitals in ensuring that effective discharge procedures are put in place. Within this context hospitals are required to ensure that a predicted date of discharge is assigned to every patient and that regular ward rounds are conducted by senior clinical decision-makers, including at weekends as appropriate, to enable discharge of patients fit to go home. Also a number of hospitals have established discharge lounges to support early discharging. Further, the Winter Initiative supported the expansion of Community Intervention Teams, including where possible the provision of a 7 day service to enable discharge home over the weekends.
As part of this oversight role, the HSE works with hospitals to ensure that appropriate senior cover, at management and consultant level, is provided at all times including at weekends and during public holidays.
646. Deputy Eugene Murphy asked the Minister for Health his Department's position on vaping; if there are any measures to introduce regulation of vaping in public places; if so, the details of these measures; and if he will make a statement on the matter. [11832/17]
View answerVaping is a relatively new occurrence. While the market share for electronic cigarettes and refill containers is growing, the long-term effects of vaping on public health are not yet known. Electronic cigarettes are regulated by the European Union (Manufacture, Presentation and Sale of Tobacco and Related Products) Regulations 2016. These Regulations transposed the European Tobacco Products Directive and came into effect on 20 May 2016.
The introduction of the workplace smoking ban was based on clear and unequivocal evidence that second hand smoke is harmful to non-smokers. That evidence base does not exist for the aerosol generated from e-cigarettes. However, individual organisations/companies are free to introduce an e-cigarette free policy if they so choose.
My Department will continue to monitor the emerging research on these products, so as to inform decisions around any future additional regulation in this area.
647. Deputy Eugene Murphy asked the Minister for Health the reason there has been such a significant delay in the publication of the external review into mental health services in County Roscommon, in view of the fact that the report was commissioned over two years ago and the services are in crisis mode without a clear service plan; and if he will make a statement on the matter. [11833/17]
View answerAs this is a service issue, this question has been referred to the HSE for direct reply.
648. Deputy Eugene Murphy asked the Minister for Health if he will source some level of State funding towards the remuneration of a centre manager and full-time office administrator for a vital cancer support centre (details supplied) in County Galway, in view of the fact that over 140 persons a week use the centre and a range of vital therapies and support is provided on an entirely voluntary basis; and if he will make a statement on the matter. [11836/17]
View answer649. Deputy Eugene Murphy asked the Minister for Health the reason a vital cancer support centre (details supplied) in County Galway did not receive funding under the national lottery grant scheme despite the fact that a full-time service is run on an entirely voluntary basis; and if he will make a statement on the matter. [11837/17]
View answer650. Deputy Eugene Murphy asked the Minister for Health the alternative avenues of funding applicable to a cancer support centre (details supplied) in County Galway, apart from the national lottery grant scheme; and if he will make a statement on the matter. [11838/17]
View answerI propose to take Questions Nos. 648 to 650, inclusive, together.
The Department of Health no longer operates a National Lottery Fund. However, the HSE operates a National Lottery funded scheme under which it provides grants to health agencies and other organisations. Details of the scheme are available on the HSE website at: http://www.hse.ie/eng/services/list/1/schemes/natlotterygrants/.
651. Deputy Maureen O'Sullivan asked the Minister for Health if he will treat with urgency the outstanding issues preventing the Misuse of Drugs (Amendment) Act, relating to tablets, from being implemented and thus enforced by gardaí. [7646/17]
View answerThe Misuse of Drugs (Amendment) Act 2016 was passed by the Oireachtas on the 27th July 2016. Controlling the substances in the Act was part one of a two-step process and Regulations and various Orders are also required to allow legitimate users (e.g. patients with a prescription, health professionals) to possess the substances.
Drafting of the Misuse of Drugs Regulations and Orders is complex and technical in nature and involved consultation with a number of State Agencies. However, since Autumn 2016 significant resources in the Medicines, Controlled Drugs and Pharmacy Unit within the Department have had to be allocated to drafting of the Misuse of Drugs (Supervised Injecting Facilities) Bill and also dealing with various issues in relation to the use of cannabis for medicinal purposes.
It was also necessary to notify to the European Commission under the Technical Standards Directive. Under this Directive Member States are required to inform the Commission of any new regulations or standards which may create a barrier to the free movement of goods. Since these draft Regulations have the potential to affect trade, in particular because of the introduction of a requirement for import licences, they must be notified to the EU whilst they are in draft form and before they are adopted in national law. This process has now been completed.
It is therefore expected that various sections of the 2016 Act will be commenced in the coming weeks when the drafting of the various Regulations and Orders is complete.
652. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he remains satisfied that the various initiatives taken to address overcrowding at accident and emergency departments throughout the country are adequate and sufficient to address the issue now and in the future; and if he will make a statement on the matter. [12040/17]
View answerRecent data from the HSE indicates that in 2016 there was a circa 5% increase in Emergency Department attendances nationally. In addition, early January 2017 saw continued significant pressure on our EDs due to high demand, increased incidence of flu mainly affecting older people, as well as ongoing bed capacity constraints due to staff shortages.
The Emergency Department Taskforce (EDTF) was convened in December 2014 to provide focus and momentum in dealing with the challenges presented by ED overcrowding. The EDTF Implementation Oversight Group has met seven times over the course of 2016 and into 2017, most recently on the 6th January 2017.
As the Deputy may be aware, in September 2016, the HSE launched the ‘Winter Initiative Plan 2016-2017’ which provided €40 million of additional funding for winter preparedness and to assist hospitals to deal with increased demand. In January 2017, in response to significant pressures in our EDs in the early New Year, a series of enhanced measures were added to this Initiative.
So far, the Initiative has delivered 90 newly-opened additional beds. Also, as of 28 February, delayed discharges have reduced nationally to 517, freeing up hospitals beds to alleviate ED pressures. In addition under the Initiative, since October: over 4,260 patients have availed of aids and appliances; over 1,050 additional homecare packages and 615 additional transitional care beds have been provided, enabling patients to be discharged from hospital sooner. The work of the EDTF and Implementation of the Winter Initiative is supported by the work of the Special Delivery Unit (SDU) of the HSE on the ground supporting process improvement and the delivery of key targets at sites throughout the country.
A key element of the Winter Initiative has been for the HSE to work with hospitals to develop key improvement actions and Winter Plans at each site aimed at preparing for the expected increased demand during the winter period. This essential work continues and there are indications that some of our larger hospitals have harnessed Winter Initiative measures and improved processes, to decrease the number of patients waiting on trolleys, whilst contending with increased demand. Learning from this Winter Initiative will be used to improve planning for future years and along with my Department, every week, I meet with senior officials from the HSE, including the Director General, to monitor progress on the Winter Initiative and ED Performance.
