Tuesday, 21 Mar 2017

Home Help Service Provision

Questions (692)

Michael Healy-Rae

Question:

692. Deputy Michael Healy-Rae asked the Minister for Health his views on a matter (details supplied) with regard to part-time home help; and if he will make a statement on the matter. [12876/17]

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Written answers

Minister for Health

I have asked the HSE to respond to the Deputy directly on this matter.

Commissions of Investigation

Questions (693)

Thomas P. Broughan

Question:

693. Deputy Thomas P. Broughan asked the Minister for Health the person or bodies at all levels that will be held accountable for the Grace case and the findings of the subsequent Devine and Resilience reports; and if he will make a statement on the matter. [12936/17]

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Written answers

Minister of State at the Department of Health

The Commission of Investigation into certain matters relative to a disability service in the South East and related matters i.e. the Commission being established into the care of "Grace" (pseudonym) and others, will be tasked with establishing the facts regarding the role of public authorities in the care and protection of Grace and the other vulnerable individuals who resided with the former foster family.

It is important to emphasise that the Health Service Executive (HSE) has put in place a number of changes in recent years to take account of the service and management deficiencies identified in the Conal Devine report, and in particular the Safeguarding Vulnerable Persons at Risk of Abuse – National Policy and Procedures.

With regard to the HSE’s internal human resource (HR) management process into the failings identified in the Devine and Resilience reports, following the publication of the reports all HR matters can now be immediately progressed. As this aspect of the Deputy's question relates to service matters, I have arranged for the question to be referred to the HSE for direct reply to the Deputy.

Commissions of Investigation

Questions (694)

David Cullinane

Question:

694. Deputy David Cullinane asked the Minister for Health if it is the fact that any statement, admission or document given or sent to a commission of investigation is not admissible as evidence against a person in any criminal or other proceedings except proceedings regarding an offence under section 18; if this will apply to the proposed commission of investigation into the Grace case; and if he will make a statement on the matter. [13191/17]

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Written answers

Minister of State at the Department of Health

The Commission of Investigation into certain matters relative to a disability service in the South East and related matters i.e. the Commission established into the care of "Grace" (pseudonym) and others, is being established under the Commissions of Investigation Act 2004, which is under the aegis of the Minister for Justice and Equality. The Commissions of Investigation Act contains the following provision, which applies to all Commissions established under the Act:-

19.—(1) None of the following is admissible as evidence against a person in any criminal or other proceedings, except proceedings in relation to an offence against section 18:

(a) a statement or admission made by the person to a commission or to a person appointed under section 8;

(b) a document given or sent to a commission pursuant to a direction or request of the commission to the person;

(c) a document specified in an affidavit of documents made by the person and given to a commission pursuant to a direction or request of the commission.

Abortion Legislation

Questions (695)

Mattie McGrath

Question:

695. Deputy Mattie McGrath asked the Minister for Health his views on the actions of an organisation (details supplied) that has been openly advertising and distributing abortion pills at various locations here contrary to the provisions of the Protection of Life During Pregnancy Act 2013; the measures he is taking to address this matter; and if he will make a statement on the matter. [13401/17]

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Written answers

Minister for Health

The Protection of Life During Pregnancy Act 2013 restates the general prohibition on abortion in Ireland while regulating access to lawful termination of pregnancy in accordance with the X case and the judgment of the European Court of Human rights in the A, B and C v Ireland case. Its purpose is to confer procedural rights on a pregnant woman who has a life-threatening condition, so that she can have certainty as to whether she requires this treatment or not. The Act does not regulate the advertising or distribution of medicines.

Abortion Legislation

Questions (696)

Mattie McGrath

Question:

696. Deputy Mattie McGrath asked the Minister for Health the details of all confiscations and seizures of illegal abortion inducing pills over the past five years; and if he will make a statement on the matter. [13402/17]

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Written answers

Minister for Health

The Health Products Regulatory Authority (HPRA) is the competent authority responsible for the regulation of human medicines in Ireland. The HPRA employs enforcement actions, in cooperation with the Revenue Commissioners and An Garda Síochána, to identify the unauthorised supply of prescription only medicines, including those containing abortifacients, to the public. The HPRA uses a range of enforcement powers to tackle this activity including seizing product and taking prosecutions.

During the period from 1st January 2012 to 31st December 2016 the total numbers of abortifacient tablets detained were 3,042 Misoprostol tablets and 286 Mifepristone tablets. The breakdown of these per year is as follows:

- 2016: 536 tablets detained from 44 importations. Of these, 436 contained misoprostol and 100 contained mifepristone

- 2015: 850 tablets detained from 81 importations. Of these, 739 contained misoprostol and 111 contained mifepristone

- 2014: 1,017 tablets detained from 60 importations. Of these, 972 contained misoprostol and 45 contained mifepristone

- 2013: 438 tablets detained from 25 importations. Of these, 424 contained misoprostol and 14 mifepristone

- 2012: 487 tablets detained from 25 importations. Of these, 471 contained misoprostol and 16 mifepristone

Water Fluoridation

Questions (697, 698)

John Lahart

Question:

697. Deputy John Lahart asked the Minister for Health if he will report on fluoride in water and the research the Government relies upon that justifies the use of fluoride in water. [13504/17]

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John Lahart

Question:

698. Deputy John Lahart asked the Minister for Health the reason Ireland is not in the majority of countries that continue to use fluoride in their drinking water systems. [13505/17]

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Written answers

Minister for Health

I propose to take Questions Nos. 697 and 698 together.

The Health (Fluoridation of Water Supplies) Act, 1960 provides for the fluoridation of public piped water supplies. The local authorities, acting on behalf of Irish Water, act as agents for the HSE in providing, installing and maintaining equipment for fluoridation and in adding the fluoride to water and testing the fluoride content of water to which fluoride has been added.

Water fluoridation is the adjustment of the natural concentration of fluoride in drinking water to the optimal recommended level for the prevention of dental caries (tooth decay). Many countries have water fluoridation schemes, including the United States, Canada, the United Kingdom, Spain, Australia and New Zealand. Water fluoridation is less common in Europe. However, fluoride is an essential part of oral health policy in all countries in Europe. This can mean fluoridation of salt or provision of community fluoridation through other means.

Water fluoridation is a key element of public health policy in Ireland in the prevention and management of tooth decay.

A research project "Fluoride and Caring for Children's Teeth" (FACCT) is being conducted by UCC and supported by the HSE. Preliminary results indicate that children's oral health has been improving overall since the previous survey of children's oral health in 2002. Fluoridated communities continue to have lower levels of tooth decay than non-fluoridated communities. The results of this research project are due to be published this year.

The Department of Health keeps the policy of water fluoridation under constant review. As part of this ongoing work, a review of evidence on the impact of water fluoridation at its current level on the health of the population was conducted by the Health Research Board (HRB) on behalf of the Department. This review was published by the HRB in June 2015. The HRB has found no evidence that community water fluoridation is associated with negative health effects.

The Irish Expert Body on Fluorides and Health was established in 2004, to oversee the implementation of the recommendations of the Forum on Fluoridation Report. The Body monitors new and emerging issues on fluoride and its effects on health and related matters. It advises that the balance of scientific evidence worldwide confirms that water fluoridation, at the optimal level, is a safe and effective method of protecting the oral health of the population.

Now that the Forum recommendations have been implemented, I have decided to appoint a new Expert Body on Fluorides and Health with new Terms of Reference. Expressions of interest will be sought in the near future. The Body will have a key role in advising me on all issues relating to the fluoridation of public water supplies and its impact on other aspects of policy.

Non-Consultant Hospital Doctors Remuneration

Questions (699)

Dara Calleary

Question:

699. Deputy Dara Calleary asked the Minister for Health the total cost of the deal reached between the Health Service Executive and the Irish Medical Organisation for the restoration of the living out allowance for non-consultant doctors; the source from which this money will be allocated; if he or the HSE consulted with the Minister for Public Expenditure and Reform in this regard; and if he will make a statement on the matter. [12790/17]

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Written answers

Minister for Health

The Living Out Allowance was abolished for new entrant non-consultant hospital doctors (Intern, Senior House Officer and Registrar grades) in 2012. Following the agreement reached between the IMO, Department of Health and the Department of Public Expenditure and Reform last month, the allowance will be incorporated in to the basic salary of these doctors from 1 July 2017. It is estimated that this will cost approximately €16 million in a full year and €8 million in 2017. This restoration will be implemented and funded in the context of the forthcoming Public Sector Pay Talks.

Hospitals Data

Questions (700, 701, 729, 730, 731, 732, 733, 734, 735, 736, 737, 738, 739, 740, 741, 742, 743, 744, 855)

View answer

Mary Lou McDonald

Question:

855. Deputy Mary Lou McDonald asked the Minister for Health the number of patients, both public and private, currently waiting for MRI scans, x-rays, CT scans and PET scans in the Mater Misericordiae University Hospital in tabular form; the length of time they have been waiting; and if he will make a statement on the matter. [13391/17]

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Written answers

Minister for Health

I propose to take Questions Nos. 700, 701, 729 to 744, inclusive, and 855 together.

The Deputy's question relates to service delivery matters and accordingly I have asked the HSE to respond directly to her.

Services for People with Disabilities

Questions (702)

Michael McGrath

Question:

702. Deputy Michael McGrath asked the Minister for Health when a person (details supplied) in County Cork can expect to have an assessment of need carried out. [12810/17]

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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 questions relate to service matters, I have arranged for the questions to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Hospital Appointments Status

Questions (703)

Michael Healy-Rae

Question:

703. Deputy Michael Healy-Rae 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. [12813/17]

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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.

Health Reports

Questions (704)

Colm Brophy

Question:

704. Deputy Colm Brophy asked the Minister for Health his plans on publishing the primary eye care services report; if he will be publishing a national strategy to deal with the unacceptable levels of ophthalmology waiting lists, particularly with diabetic retinopathy, macular degeneration and cataract which are among the worst waiting lists in the country; and if he will make a statement on the matter. [12814/17]

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Written answers

Minister for Health

Reducing 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.

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 2000 daycases will be managed through this process and outsourcing of treatment will commence from March. The focus of this initiative will be those lists with large numbers of long waiting patients including Ophthalmology.

In addition to this Daycase Initiative, the NTPF has been working closely with my Department and the HSE to agree an approach to the remaining 2017 allocation. The HSE is currently developing a 2017 Waiting List Action Plans for Inpatient/Daycase procedures and Outpatient appointments to reduce the number of patients waiting more than 15 months by the end of October. The Inpatient/Day case Plan is being developed in conjunction with the NTPF's approach to the utilisation of its remaining €10m funding for patient treatment in 2017.

The HSE has now submitted Draft Waiting List Action Plans for Inpatient Daycases and Scoliosis. My Department is currently reviewing and evaluating these plans and engagement is ongoing with the HSE and the NTPF towards the finalisation of the former. The Outpatients Plan has been significantly progressed and I expect that it will be submitted shortly.

The HSE is currently finalising the Report of the Primary Care Eye Services Review Group. The overall aim of the Review Group is to shift management of many eye conditions from acute care services to primary care and community services, as appropriate.

Services for People with Disabilities

Questions (705)

Michael McGrath

Question:

705. Deputy Michael McGrath asked the Minister for Health when a person (details supplied) in County Cork will have an assessment of need; the number of persons currently ahead of them on the list; and if he will make a statement on the matter. [12827/17]

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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 questions relate to service matters, I have arranged for the questions to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Medical Card Eligibility

Questions (706)

Jack Chambers

Question:

706. Deputy Jack Chambers asked the Minister for Health the status of plans to grant automatic qualification to a medical card for children in receipt of domiciliary care allowance; and if he will make a statement on the matter. [12831/17]

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Written answers

Minister for Health

The Health (Amendment) Bill 2017 was published 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 currently being debated by the Houses of the Oireachtas. It is hoped to complete all stages before the end of March 2017.

Pre-registration with the HSE for the DCA medical card will be available from 1st May 2017. This can be done on-line or paper-based. These medical cards will be certified for use from 1st June 2017.

Health Services Provision

Questions (707)

Kevin O'Keeffe

Question:

707. Deputy Kevin O'Keeffe asked the Minister for Health the reason a service which had been available to a person (details supplied) for a number of years is no longer available; and if he will arrange to have this service reinstated without delay. [12834/17]

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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.

Hospital Appointments Status

Questions (708)

Michael Healy-Rae

Question:

708. Deputy Michael Healy-Rae 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. [12837/17]

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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.

Home Help Service Provision

Questions (709)

Kevin O'Keeffe

Question:

709. Deputy Kevin O'Keeffe asked the Minister for Health if home help will be provided to a person (details supplied) who is urgently in need of same. [12841/17]

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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 Legal Cases

Questions (710)

Dara Calleary

Question:

710. Deputy Dara Calleary asked the Minister for Health the amount of money spent by the Health Service Executive in settling legal claims, that is, the total amount of combined settlements; the total amount spent on legal costs regarding incidents at Mayo General Hospital in each of the years 2014 to 2016; and if he will make a statement on the matter. [12844/17]

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Written answers

Minister for Health

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

Health Services Provision

Questions (711)

Eoin Ó Broin

Question:

711. Deputy Eoin Ó Broin asked the Minister for Health the reason a person (details supplied) is not being provided with a nurse on call service; his views on whether it is acceptable that the person has remained in hospital for 13 months ready to be discharged but for the availability of the nurse on-call hours; if he will compare the cost of keeping a person in hospital for 13 months with the cost of providing adequate home based nurse on call support; the total amount of funding for nurse on call services for each year from 2012 to 2016 and to date in 2017; the number of persons in receipt of home help hours; the number of hours provided to those persons for each year from 2012 to 2016 and to date in 2017; and if he will make a statement on the matter. [12845/17]

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Written answers

Minister for Health

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.

Hospital Appointments Status

Questions (712)

Peter Fitzpatrick

Question:

712. Deputy Peter Fitzpatrick asked the Minister for Health when a person (details supplied) will receive an operation; and if he will make a statement on the matter. [12854/17]

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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 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.

Mental Health Policy

Questions (713)

Clare Daly

Question:

713. Deputy Clare Daly asked the Minister for Health if the practice of face down restraint is permitted in HSE-run mental health inpatient units; and if records are kept and collated as to each instance in which face down restraint is used. [12857/17]

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Written answers

Minister of State at the Department of Health

As this is a service issue, this question has been referred to the HSE for direct reply.

Medical Card Eligibility

Questions (714)

Eamon Scanlon

Question:

714. Deputy Eamon Scanlon asked the Minister for Health if a person that is ordinarily resident here but is currently a student in Hungary can qualify for a medical card; the reason a person studying in Hungary may no longer qualify for a medical card; the frequency with which this person must return home to be considered as ordinarily resident by the Health Service Executive; if it is sufficient to be here approximately five months of the year; and if he will make a statement on the matter. [12865/17]

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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.

National Lottery Funding Applications

Questions (715)

Jackie Cahill

Question:

715. Deputy Jackie Cahill asked the Minister for Health the lotto funding available through his Department that a centre (details supplied) can make an application for; the way this application can be made; and if he will make a statement on the matter. [12867/17]

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Written answers

Written answers

Minister for Health

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.

Medicinal Products Supply

Questions (719, 980, 981)

James Lawless

Question:

719. Deputy James Lawless asked the Minister for Health the position regarding the negotiations his Department is conducting with the relevant stakeholders for the provision of the Respreeza therapy for persons suffering from the alpha-1 deficiency; and if he will make a statement on the matter. [12880/17]

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Gerry Adams

Question:

980. Deputy Gerry Adams asked the Minister for Health if his attention has been drawn to the fact that persons that had been on a compassionate based programme of a drug (details supplied) can now no longer access same; if he will ensure a mechanism is put in place to ensure access is continued for those persons in receipt of the drug; and if he will make a statement on the matter. [14023/17]

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Gerry Adams

Question:

981. Deputy Gerry Adams asked the Minister for Health the status of negotiations with a company (details supplied) further to the decision made not to reimburse; and if he will make a statement on the matter. [14024/17]

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Written answers

Minister for Health

I propose to take Questions Nos. 719, 980 and 981 together.

The 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 eats 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 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 access scheme, the operation of such schemes is at the discretion of manufacturers. As Minister for Health I 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 open with patients and clinicians from the outset.

Accident and Emergency Services Provision

Questions (720)

Tom Neville

Question:

720. Deputy Tom Neville asked the Minister for Health when the new emergency department will open with regard to University Hospital Limerick; his plans for the recruitment of staff for this unit; the number of staff that will be employed in this unit.; and if he will make a statement on the matter. [12881/17]

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Written answers

Minister for Health

As this is a service matter, I have asked the HSE to respond to you directly.

Medicinal Products Availability

Questions (721)

James Lawless

Question:

721. Deputy James Lawless asked the Minister for Health when a decision will be made on whether to add the FreeStyle Libre flash glucose monitoring system to the reimbursement list; and if he will make a statement on the matter. [12884/17]

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Written answers

Minister for Health

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for reply to the Deputy.