Mick Barry
Question:87. Deputy Mick Barry asked the Minister for Health his views on industrial action by nurses and the pay and conditions faced by nurses in public hospitals; and if he will make a statement on the matter. [12060/17]
View answerIndustrial Disputes
Questions (87)
Written answers
I am pleased that the INMO and SIPTU reached an understanding on nursing recruitment and retention issues by engaging with management through the State's industrial relations mechanisms and welcome the deferral of the threatened industrial action by the INMO that was scheduled to commence on the 7th March. I am pleased that the INMO will be recommending that their membership accept the proposals developed with the assistance of the Workplace Relations Commission and respect the process the INMO is now undertaking to ballot its members. If the membership accepts the management proposal it allows them to remain within the Lansdowne Road Agreement and benefit from it.
The initial conclusions of the Public Service Pay Commission, expected in Quarter 2 2017, will form the basis for discussions between parties to the Lansdowne Road Agreement on a successor to that Agreement. Arrangements are already in place to commence partial restoration of public service pay in 2017, reflecting the Government's recognition of the need to address pay and, at the same time, manage the public finances in a prudent manner. The first stage of the pay restoration will take effect from 1st April.
During recent engagement between this Department, the Department of Public Expenditure and Reform, the HSE, INMO and SIPTU to avert the proposed industrial action by the INMO scheduled for the 7th March, the management side supplied a joint proposal document setting out a number of specific measures to attract and retain nursing staff. The proposal includes extensive education and personal development opportunities for nurses and midwives to upskill, and a pilot pre-retirement initiative as a method of retaining the expertise of experienced nursing/midwifery staff. It also includes 127 promotional posts for staff nurses/midwives to Clinical Nurse/Midwife Manager 1. The management side is also positively disposed to a proposal from the union side for the restoration of a number of allowances for new entrant nurses and this consideration will be concluded in the upcoming pay talks in the summer.
I wish to reiterate my commitment to working with the staff unions to further improve and invest in the Irish health service and those who work within it in a fair and equitable manner.
Question No. 88 answered with Question No. 51.
HSE Waiting Lists
Questions (89)
Brendan Smith
Question:89. Deputy Brendan Smith asked the Minister for Health his plans to reduce waiting lists for orthopaedics in the north-east region with particular reference to the delays for patients in counties Cavan and Monaghan accessing assessments and treatment; and if he will make a statement on the matter. [11821/17]
View answerWritten answers
Reducing waiting times for the longest-waiting patients is one of the Government’s key priorities. It is for this reason that €20 million was allocated to the NTPF in the Budget 2017, rising to €55 million in 2018.
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. The NTPF expects that patients will start to receive their appointments in March.
In order to reduce the numbers of patients waiting long periods of time for inpatient and daycase treatment, including patients waiting for orthopaedic treatment, the HSE was asked to develop a Waiting List Action Plan for 2017. The HSE has now submitted a draft Action Plan and my Department is currently reviewing the draft plan and is engaging with the HSE with a view to its finalisation.
Medicinal Products Prices
Questions (90)
Ruth Coppinger
Question:90. Deputy Ruth Coppinger asked the Minister for Health his plans to reduce the high prices charged by pharmaceutical companies for essential medicines; if any additional leverage can be exerted on companies with operations here; and if he will make a statement on the matter. [12075/17]
View answerWritten answers
The issue of affordability and access to medicines is a major challenge for the Irish health service and for systems internationally. It is important that we take steps to ensure a sustainable supply of medicines. This Government is committed to reducing the cost of medicines for Irish patients and a number of actions are currently reducing medicine costs.
In relation to new medicines, the Health (Pricing and Supply of Medical Goods) Act 2013 sets out the conditions under which new medicines can be reimbursed in the community drugs schemes. Before approving reimbursement of a new medicine, the HSE is required to consider a number of criteria, including the potential or actual impact of a medicine, its cost-effectiveness, the health needs of the public and the resources available to the HSE. The HSE therefore undertakes a robust analysis of the pricing points of new medicines and this is factored into negotiations with manufacturers. In the negotiation process, the HSE will often seek significant price reductions so that medicines reimbursed are both cost-effective and affordable.
The pricing arrangement agreed with IPHA last year is providing ongoing and increasing savings, both for the taxpayer and for patients in pharmacies. Under the 2016 Framework Agreement, medicines are now subject to an annual downward only price realignment. In addition, the price will ensure that the State achieves better value for money on the cost of medicines as prices in the reference countries are adjusted downwards over time. It also ensures that the prices paid by Ireland remain in line with other member states. The agreement, which also includes a rebate of 5.25% is estimated to reduce expenditure on medicines by up to €750 million over 4 years.
Reference pricing for generics is also an important pricing mechanism. Medicines which are off patent are subject to generic substitution and reference pricing. The list of medicines approved for substitution, which allows pharmacies to dispense the most cost effective version of a drug to patients continues to expand.
The introduction of biosimilars, the equivalent of generics for very expensive and complex biologic products, will free up significant resources to allow more people to be treated across the health system. The estimated expenditure in Ireland on six biologic medicines that are due to lose exclusivity over the next 3 years was approximately €170 million in 2015. My department is developing a biosimilars policy in order to maximise the benefit of these products throughout clinical decision making and supply. Recognising the importance of biosimilar medicines, the 2016 framework agreement included a 30% reduction on the price of a biologic medicine when a biosimilar is launched in Ireland.
International co-operation on pricing and reimbursement of new medicines is also an opportunity to secure better value for individual medicines. In June 2016, the Employment, Social Policy, Health and Consumer Affairs Council adopted conclusions on strengthening the balance in the pharmaceutical systems in the EU and its member states. Those conclusions invited member states to explore opportunities for cooperation on pricing and reimbursement of medicines and to identify areas for cooperation which could contribute to affordability and better access to medicines. I have indicated my support for these measures and I welcome the opportunity for member states to cooperate by sharing information, so that we can achieve affordable and sustainable access to medicines.
In addition, I used the opportunity at the second Round Table meeting for European Health Ministers and heads of Europe-based pharmaceutical companies in Portugal last December, and the recent OECD meeting in January, to engage with Ministers from other countries on how to address the challenge of securing access to new medicines for citizens at an affordable price.
The commitment to reduce the cost of medicines includes reducing prescription charges for medical card holders. I have begun this process by reducing the prescription charge and monthly cap for medical card holders over 70, and their dependants, on an administrative basis, pending the enactment of the required legislation.
My department continues to examine new ways to achieve efficiencies in the cost of medicines. The HSE keeps the price of medicines under ongoing review, and works continuously to achieve greater efficiencies in the areas of drug pricing, supply and distribution. The Executive has a number of initiatives already underway or in development, particularly under the National Drug Cost Management Programme and the Medicines Management Programme, which provides national leadership relating to issues such as the quality of the medicines management process, access to medicines and overall expenditure on medicines.
HSE Investigations
Questions (91)
Thomas P. Broughan
Question:91. Deputy Thomas P. Broughan asked the Minister for Health the number of investigations ongoing into the care of vulnerable adults in foster care, residential settings or any other State care setting; the number of investigations into the care of vulnerable adults in foster care, residential settings or any other State care setting in each of the years from 2013 to 2016,inclusive; and if he will make a statement on the matter. [11899/17]
View answerWritten answers
The safety and protection of vulnerable people in the care of the State is paramount. This Government’s primary concern is that the needs of the residents are being prioritised and addressed.
As the particular issues raised by the Deputy are service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
Maternity Services Provision
Questions (92)
Robert Troy
Question:92. Deputy Robert Troy asked the Minister for Health when anomaly scans will be provided to expectant mothers at the Midland Regional Hospital, Mullingar. [12085/17]
View answerWritten answers
I am advised that foetal anomaly scans are available in all Hospital Groups. Those hospitals/maternity units currently providing anomaly scans accept referrals from other maternity units, if requested. This occurs where the medical team in the referring maternity unit consider that an anomaly scan is clinically indicated.
The National Maternity Strategy is very clear that all women must have equal access to standardised ultrasound services and, consequently, the issue of anomaly scanning is a priority issue for the newly established HSE National Women and Infants Health Programme (NWIHP). An early priority for the Programme will be to develop clinical guidance regarding routine detailed scans at 20 weeks. In the meantime, the NWIHP will continue to work with the six Hospital Groups to assist in increasing access to anomaly scans for those units with limited availability.
One of the current challenges to increase access to anomaly scans is the recruitment of ultra-sonographers. In this context it is expected that the establishment of maternity networks across hospital groups will assist in developing a sustainable model that ensures that all women within each hospital group can access anomaly scans.
In relation to your specific query regarding the Midland Regional Hospital, Mullingar, I have asked the HSE to reply to you directly.
HSE Waiting Lists
Questions (93)
Martin Kenny
Question:93. Deputy Martin Kenny asked the Minister for Health his plans to deal with the waiting lists for diagnosis by the child and adolescent mental health service in counties Sligo and Leitrim. [12136/17]
View answerWritten answers
As this is a service issue, this question has been referred to the HSE for direct reply.
Mental Health Services Provision
Questions (94)
Mick Wallace
Question:94. Deputy Mick Wallace asked the Minister for Health the services available in County Wexford for children and adolescents who present with suicidal ideation and are not deemed by CAMHS to have a psychiatric disorder; and if he will make a statement on the matter. [11903/17]
View answerWritten answers
As this is a service issue, this question has been referred to the HSE for direct reply.
HSE Waiting Lists
Questions (95)
John Brady
Question:95. Deputy John Brady asked the Minister for Health when the HSE action plan for scoliosis will be published; his plans for the implementation of the action plan; the funding put in place for this implementation; and if he will make a statement on the matter. [11815/17]
View answerWritten answers
While some progress has been made in 2016 as a result of investment in the scoliosis service, it is clear there is much more to do to provide the level service that is needed.
A draft Waiting List Action Plan for Scoliosis has been submitted by the HSE to my Department. The draft action plan for Scoliosis includes both measures to increase capacity for scoliosis treatments in the children's hospitals and proposals for the outsourcing of procedures. Officials are currently reviewing and evaluating the plan and engagement is ongoing with the HSE and the NTPF towards its finalisation. I expect to make known the details of the HSE's Waiting List Action Plan including the Action Plan for Scoliosis in the coming weeks.
In addition to the action plan, efforts have been made to improve access to scoliosis services. Our Lady’s Children’s Hospital Crumlin has undertaken an aggressive recruitment drive to attract new theatre nurses with the necessary paediatric training. As a result, four new nurses will be in place by April, and a further 16 international nurses have been offered posts and have commenced the registration process.
The recruitment of these nurses means that the new theatre will be used to provide the additional capacity for scoliosis procedures in Crumlin from April. This will allow an additional day of procedures to be carried out in the medium term.
In addition I am advised by the hospital that an orthopaedic surgeon post in Crumlin Hospital will be filled by June. This means that from July, the hospital expects that the theatre use will be further increased.
Hospitals Funding
Questions (96)
Bobby Aylward
Question:96. Deputy Bobby Aylward asked the Minister for Health if additional resources will be allocated to the existing cardiac catheterisation laboratory at University Hospital Waterford in order to increase the laboratory's current capacity to accommodate the estimated 450 additional procedures that will be referred there through additional diagnostic angiograms set to be provided by the mobile catheterisation laboratory; and if he will make a statement on the matter. [12067/17]
View answerWritten answers
I am pleased to confirm that, as recommended by Dr Niall Herity in his review of cath lab services at UHW, an additional €.5m funding has been provided to UHW in 2017 which will enable the hospital to provide 2 additional cath lab sessions (8 hours) per week. The UHW cath lab will now be funded to provide 12 sessions i.e. 48 hours activity per week.
As the Deputy may be aware, I have written to the HSE Director General requesting that consideration be given to a targeted Cardiology Waiting List initiative. Such an initiative would, I envisage, incorporate a range of measures including the sharing of facilities and resources within and between Hospital Groups, the use of any appropriate facilities in the private hospital sector, as well as the deployment of a mobile cath lab. I look forward to receiving the HSE's proposals in this regard.
General Practitioner Services
Questions (97)
Bríd Smith
Question:97. Deputy Bríd Smith asked the Minister for Health if he will report on the general practitioner service availability for parents of children under five years of age and address problems they have accessing this service. [12058/17]
View answerWritten answers
The introduction of GP care without fees to children under 6 years of age 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. To date, approximately 94% of GMS GPs have entered into agreements with the HSE for the provision of services to children under 6 and almost 364,000 children under 6 have access to GP care without fees through a medical card or GP visit card.
Nationally the HSE has recently written to those GMS GPs who have not yet signed up to the under 6 contract, and provided them with a copy of the contract and the Form of Agreement for their consideration. I would hope that those GPs who have not yet signed up to offer this improved and expanded primary care service will do so and so ensure that all children aged under 6 are easily able to access general practitioner services without their parent or guardian having to pay a fee. Where a GMS patient experiences difficulty in finding a GP to accept him/her as a patient, and has unsuccessfully applied to at least three GPs in the area who are contracted to provide services under the GMS, then the HSE will assign that person to a GP's GMS patient list.