Written Answers Nos. 109-119
109. Deputy Brendan Griffin asked the Minister for Health the position regarding the approval of the cystic fibrosis drugs Orkambi and Kalydeco for the long-term illness scheme; and if he will make a statement on the matter. [12036/17]
View answerThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
With regard to Orkambi for the treatment of cystic fibrosis patients aged 12 and older, an application to the HSE from the manufacturer was received in March 2016. The application was considered and not recommended for reimbursement at the submitted price by both the National Centre for Pharmacoeconomics – the NCPE – and the HSE’s Drugs Committee. In December, the HSE Directorate took the decision not to reimburse at the submitted price. The HSE called on the company to re-enter negotiations, with a view to significantly reducing the cost of the treatment.
Further meetings were held with the manufacturer in December and early January. The discussions with the company have broadened to include Orkambi, Kalydeco and further treatments for CF patients. The matter is currently under consideration by the HSE Directorate and by officials in my Department.
I expect that this process will conclude in a period of weeks. However, given the scale of the investment, the potential benefits for Irish patients and the impact of this decision on the health service overall, I would call on all deputies to allow this statutory process to be concluded.
I am acutely aware that the last number of months have been a stressful and worrying time for CF patients and their families. However, the Government’s priority is to achieve the best outcome for Irish patients and the health system overall.
111. Deputy Ruth Coppinger asked the Minister for Health his views on allowing access to the abortion pill; and if he will make a statement on the matter. [12073/17]
View answerNo medicines indicated for the termination of pregnancy are authorised in Ireland.
It is illegal to procure an abortion in Ireland , whether by surgical, medication or other means, outside of the circumstances specified in the Protection of Life During Pregnancy Act, 2013, which regulates access to lawful termination of pregnancy in accordance with the X case and the judgement in the European Court of Human Rights in the A, B and C v Ireland case.
112. Deputy Martin Ferris asked the Minister for Health the investment required in the Health Service Executive, HSE, information technology budget to bring it up to the OECD average; the projects that are being held up as a result of lower levels of investment in the HSE information technology budget; the investment that would be required in HSE information technology in order to modernise and bring benefits to the health system; the additional resources that are needed to deliver the digital solutions for waiting list challenges in respect of the approach to funding that has been agreed within the HSE office of the chief information officer; and if he will make a statement on the matter. [11897/17]
View answerThe Government acknowledges the need to improve the investment profile for ICT and eHealth in healthcare in Ireland and in the Programme for Partnership Government it is clearly stated that “we will mandate the HSE to engage strategic partners to help with the planning, financing and roll out of a 21st century ICT health infrastructure, working towards the universal use of data to improve integrated care and outcomes across primary and secondary care”.
In order to give a strategic focus to improving the use of eHealth and ICT technology in Irish health care my Department published an eHealth strategy in 2013. Since 2012, the actual capital and revenue expenditure (excluding salaries) on healthcare ICT has risen from €110.0m to €167.3m in 2016. While significant improvements have taken place it is recognised that Ireland's expenditure in this area is below the amount needed to provide the optimum contribution that eHealth and ICT can make and that is why there is now a strategic approach underpinning these investments. The estimated current HSE ICT expenditure for 2017 is around 1.2% (inclusive of capital and revenue but excluding salaries) of all HSE health expenditure. International experience would indicate that a figure between 2% and 3% of total health expenditure would be required, in this strategic area, to provide the requisite investment for modern health environments. Based on 2017 gross vote figures a 2% spend on ICT would amount to a figure €292.0m and 3% of around €438.0m p.a.
In terms of planning the future deployment of ICT the HSE has developed a strategic programme for the rollout of a national electronic health care record that outlines how an improved investment profile could build on the current investments made to date and provide the necessary systems environment to improve patient care and efficiency and also support new models of care. The key areas of focus for these additional systems would be in the acute, primary and community sectors where there is a need to have a shared care record so that GP's and Community Care can see what is happening with patients in a timely way for scheduling and care planning and to maximise improved information sharing across the continuum of the patient journey. In the acute care setting, systems are needed to improve safety and efficiency such as Order Communications and Results Reporting on wards, clinical note taking, closed loop medication and other critical departmental systems for specialist areas such as oncology, nephrology and surgical care. These are the core components that comprise an electronic health care environment and are not currently available in most Irish hospitals.
In relation to the ICT supports for managing waiting list challenges, the Office of the Chief Information Officer of the HSE outlined a number of possible technology solutions that might assist in improving the efficiency of the current arrangements. My understanding is that those specific proposals were capable of being funded within current resources. If there is any further business or technology improvements that can be brought forward by HSE and the National Treatment Purchase Fund then my Department will give these careful consideration and prioritisation when we receive the proposals.
113. Deputy Frank O'Rourke asked the Minister for Health the action being taken to address the inadequate resourcing of adult degenerative spine services at Tallaght and Naas hospitals; the further action being taken to address the long delays for persons awaiting spinal surgery; the action being taken to address the growing numbers on the outpatient list awaiting assessment; and if he will make a statement on the matter. [11827/17]
View answerReducing waiting times for the longest waiting patients is one of this Government's key priorities. Consequently, Budget 2017 allocated €20 million to the NTPF, rising to €55 million in 2018.
I wish to assure the Deputy that action is being taken to address the number of persons awaiting spinal surgery throughout the country. The €40 million Winter Initiative 2016/2017 includes a €7m fund for a targeted waiting list programme for orthopaedics, spinal and scoliosis procedures. Specific actions included provision of €3m for additional orthopaedic procedures at the National Tertiary Referral Centre at Cappagh for patients referred from Tallaght, Tullamore, Beaumont and St. James Hospitals and it is of note that 521 additional orthopaedic patients received treatment in Cappagh by year end 2016 as a result of this funding.
In addition, in November, the HSE launched the Strategy for the Design of Integrated Outpatient Services 2016-2020. This strategy seeks to improve waiting times for outpatient services in the long term by restructuring referral pathways and utilising technology to improve service delivery. The HSE has also significantly progressed the development of a draft Outpatient Waiting List Action Plan. In this Plan, the HSE will identify proposals to reduce the number of patients waiting long periods of time for outpatient appointments across all hospitals including Tallaght and Naas Hospitals. I expect to make known the details of the HSE's Outpatient Waiting List Action Plan in the coming weeks.
114. Deputy Bernard J. Durkan asked the Minister for Health the extent to which waiting lists for the various procedures are likely to be improved in the course of 2017, having regard to the demographics and the improvements made or to be made in terms of improving staffing levels and facilities and the maximisation of the utilisation of theatre facilities; and if he will make a statement on the matter. [12041/17]
View answerAs the reduction of waiting times for the longest waiting patients is one of the Government’s key priorities, €20 million has been allocated to the NTPF in the Budget 2017, rising to €55 million in 2018. This funding will be dedicated to the provision of daycase and inpatient treatment to patients. Under the NTPF Daycase Initiative 2017, patients will commence receiving appointments for treatment during March.
During 2016, there has been evidence of a considerable increase in demand for health services, as our population grows and ages. In order to reduce the numbers of long-waiting patients, the HSE is currently developing Waiting List Action Plans for 2017 in the area of Inpatient Daycase, Scoliosis and Outpatient Services. Draft Waiting List Action Plans for Inpatient Daycase and Scoliosis have been submitted. My Department is currently reviewing these plans and engagement is ongoing with the HSE and the NTPF. The HSE has also significantly progressed the development of a draft Outpatient Waiting List Action Plan. In this Plan, the HSE will identify proposals to reduce the number of patients waiting long periods of time for outpatient appointments across all hospitals.
In terms of increasing staffing, from 31st January 2016 - 2017, 135 additional hospital consultants, 216 extra non-consultant hospital doctors and 415 additional nurses and midwives have been employed by the HSE.
More generally, as the Deputy is aware, my Department has commenced a capacity review in line with the Programme for Government commitments. The intention is that this review will be broader than previous exercises that focused solely on acute bed capacity. While the exact parameters of the review are still subject to considerations, I expect that it will seek to take into account, to some degree, other aspects of hospital capacity, including theatres.
115. Deputy Gino Kenny asked the Minister for Health the changes since the Minister of State, Deputy Finian McGrath, confirmed to Dáil Éireann on 15 November 2016 that compassionate access to cannabis-based medicine should be prescribed by an Irish-registered doctor and recent comments by himself and the Taoiseach on 28 February 2017 and 1 March 2017 that this medicine now needs to be prescribed by a consultant neurologist; and if he will make a statement on the matter. [12070/17]
View answerThe granting of an individual licence under the Misuse of Drugs Act for the use of cannabis for medical purposes sets aside the usual regulatory processes which are in place to protect the public and which ensure that only those medications which have been found to be both effective and safe are made available to the public.
Applications for controlled drugs licences are considered on a case by case basis. The Chief Medical Officer has advised me that it is crucial that the granting of any such licence takes due care and consideration of the potential unintended consequences associated with the prescription of cannabis, a schedule 1 controlled drug, for medical purposes, and that its use is endorsed by a consultant who is familiar with and responsible for the care of the individual for whom the licence application is being made and who is prepared to monitor the effects of the treatment over time.
116. Deputy Thomas Pringle asked the Minister for Health the way in which he plans to improve ambulance response times for rural areas such as County Donegal; and if he will make a statement on the matter. [12063/17]
View answerThe National Ambulance Service (NAS) has been undertaking a significant and ongoing reform programme, to reconfigure the management and delivery of pre-hospital care services. This programme will ensure a clinically driven, nationally co-ordinated system, supported by improved technology.
The Capacity Review, published last year, makes it clear that a very significant programme of investment in our ambulance services is needed. In that context, a phased investment in a multi annual programme involving manpower, vehicles and technology is required. The Programme for a Partnership Government commits to additional annual investment in terms of ambulance personnel and vehicles. In that regard an additional €3.6m has been made available to the NAS in 2017, which includes €1m to fund new developments.
The review identifies particular difficulties serving rural areas on the basis that population density in Ireland is significantly different to that of many other countries. The only practical way to provide an initial response within the 8 minute window in rural areas is through voluntary Community First Responders i.e. members of the community, equipped with a defibrillator and supported by the ambulance service. Where such schemes exist, they can provide a high level of initial response to their local community.
In relation to your specific query in relation to the ambulance services in Donegal, I have asked the HSE to respond to you directly.
118. Deputy Catherine Connolly asked the Minister for Health the status of the primary care programme; the number and location of primary care centres in Galway city, county and the islands; the status of the roll-out of primary care centres for 2017 and each of the next five years in Galway city, county and the islands; and if he will make a statement on the matter. [11886/17]
View answerThe HSE has responsibility for the provision, maintenance and operation of Primary Care Centres. Therefore, as this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
119. Deputy Aindrias Moynihan asked the Minister for Health his plans to have nurses on site in special needs schools (details supplied). [11830/17]
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 issues, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
