Tuesday, 21 Mar 2017

Written Answers Nos. 863-87

Drugs Payment Scheme Administration

Questions (863)

Fiona O'Loughlin

Question:

863. Deputy Fiona O'Loughlin asked the Minister for Health if he will review the case of a person (details supplied); and if he will make a statement on the matter. [13410/17]

Written answers

Minister for Health

The HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

Medical Card Applications

Questions (864)

Éamon Ó Cuív

Question:

864. Deputy Éamon Ó Cuív asked the Minister for Health when a decision will be made on a medical card application by a person (details supplied); if he will take into consideration the urgency in processing this application due to the fact that the person is applying on a discretionary basis due to their medical condition; and if he will make a statement on the matter. [13418/17]

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.

Speech and Language Therapy Provision

Questions (865)

Mary Lou McDonald

Question:

865. Deputy Mary Lou McDonald asked the Minister for Health when a person (details supplied) in Dublin 7 will receive an appointment for speech and language therapy. [13422/17]

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.

Drug Treatment Programmes Availability

Questions (866)

Paul Kehoe

Question:

866. Deputy Paul Kehoe asked the Minister for Health the status of a new pilot scheme for an MS drug; the procedure to get on such a scheme; and if he will make a statement on the matter. [13426/17]

Written answers

Minister for Health

My officials have sought further clarification from the Deputy's office regarding the drug and the scheme in question, and will respond directly to the Deputy once this clarification has been provided.

Health Services Staff Data

Questions (867)

Louise O'Reilly

Question:

867. Deputy Louise O'Reilly asked the Minister for Health the current registered nurse-to-patient ratios and doctor-to-patient ratios, respectively; the safe levels required; and if he will make a statement on the matter. [13427/17]

Written answers

Minister for Health

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

National Maternity Strategy

Questions (868)

Louise O'Reilly

Question:

868. Deputy Louise O'Reilly asked the Minister for Health the cost of implementing the national maternity strategy; the current funding allocated for same; the funding earmarked to implement it across the next couple of years; and if he will make a statement on the matter. [13428/17]

Written answers

Minister for Health

The National Women & Infants Health Programme has recently been established in the HSE and will lead the implementation of Ireland's first National Maternity Strategy - Creating A Better Future Together 2016 - 2026. The programme is currently drawing up a detailed action plan for the implementation of the Strategy on a phased basis. This work will include the identification of both capital and revenue funding requirements which will in turn inform the annual Estimates process over the lifetime of the Strategy.

€3 million development funding provided for maternity services in 2016 was allocated in line with the Strategy, and included funding for additional staff, including 100 midwives, the development of specialist bereavement teams and for the implementation of the Maternal and Newborn Clinical Management System. Increased funding of €6.8m is being provided for maternity services in 2017 which will allow for the continued implementation of the Strategy.

Midwifery Services

Questions (869)

Louise O'Reilly

Question:

869. Deputy Louise O'Reilly asked the Minister for Health the current standard (details supplied) for midwifery staffing; the cost of bringing the current Irish levels in line with this; and if he will make a statement on the matter. [13429/17]

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 Staff

Questions (870)

Louise O'Reilly

Question:

870. Deputy Louise O'Reilly asked the Minister for Health the current international and best practice standards for consultant obstetricians and gynaecologists; the cost of bringing the current Irish levels in line with this; and if he will make a statement on the matter. [13430/17]

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.

Medicinal Products Regulation

Questions (871)

Louise O'Reilly

Question:

871. Deputy Louise O'Reilly asked the Minister for Health the details of the orphan medicinal products regulation; if his attention has been drawn to the monopoly that pharmaceutical companies can hold for orphan medicines; and if he will make a statement on the matter. [13431/17]

Written answers

Minister for Health

Orphan medicinal products are those products intended for the diagnosis, prevention or treatment of life-threatening, or very serious, rare conditions that affect no more than 5 in 10,000 people in the European Union.

EC Regulation No 141/2000 on orphan medicinal products was adopted to encourage the development and authorisation of medicines for rare conditions. The main objective of the Regulation is to ensure that patients suffering from rare conditions have the same quality of treatment as any other patient in the EU, where previously research on such conditions and development of treatments was not considered to be economically viable.

The Regulation lays down a procedure for the designation of ‘orphan status’ and provides incentives for research and development of such products and placing them on the market.

The European Commission has designated 1825 products in development as orphan medicinal products. Those companies responsible for these orphan medicines can benefit from incentives such as protocol assistance- scientific advice to facilitate the development and authorisation of innovative medicines; 10 years of market exclusivity - where similar medicines for the same condition cannot be placed on the market; and fee waivers for regulatory procedures may also be available.

The number of products available to treat rare diseases remains low but has grown significantly over the years. An assessment of the impact of the European Union's orphan drug regulation 10 years after it was enacted, concluded that it had boosted research and led to the increased availability of drugs to treat rare diseases. To date, the European Commission has authorised 136 orphan medicines for the benefit of patients suffering from rare diseases, whereas before the adoption of the Regulation there were only 8 treatments marketed for rare conditions. The incentives of the orphan drug legislation are therefore essential to facilitate the development of treatments for rare diseases.

In November 2016 the Commission published new guidance on how specific provisions of the Regulation should be applied. This guidance provides procedures and legal predictability for pharmaceutical companies on a number of aspects of the Regulation, including when more than one application for a marketing authorisation for an orphan medicinal product is received for the same condition; and clarity over determinations of significant benefit over existing treatments and similar medicinal products for the same condition.

Prescriptions Charges

Questions (872)

Louise O'Reilly

Question:

872. Deputy Louise O'Reilly asked the Minister for Health the estimated cost of abolishing prescription charges; the estimated cost of lowering the drug payment scheme threshold in €20 intervals; and if he will make a statement on the matter. [13432/17]

Written answers

Minister for Health

I am informed by the HSE that the estimated full year cost of abolishing prescription charges is €120m. The estimated full year cost of reducing the charge for the over 70s is €12m. Therefore, taking account of the reduction in the charge for over 70s which has been introduced on an administrative basis from 1 March, the additional cost of abolishing the charge is approximately €108m in a full year.

In regards to the estimated cost of lowering the drug payment scheme threshold, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

Medical Card Data

Questions (873)

Louise O'Reilly

Question:

873. Deputy Louise O'Reilly asked the Minister for Health the current average cost of a GP visit card; the current average cost of a GP visit card for under six years of age; the current average cost of a GP visit card for over 70 years of age; the current average cost of a GP visit element of medical cards; and if he will make a statement on the matter. [13433/17]

Written answers

Minister for Health

The PCRS Financial Management Reports are configured on the basis of age groups. The average cost of a Medical Card and GP Visit Card for the under 6's is included in the 0 - 4 years and 5 - 15 years categories.

The data below represents the relevant indicative annualised costs for the period 2016.

Indicative Annual Cost per card

Age Group	GP Visit Card	GP Visit Card – GP Cost	Medical Card	Medical Card – GP Cost
0 – 4 Yrs	€235	€231	€366	€85
5 – 15 Yrs	€161	€159	€218	€51
Aged 70 and over	€485	€477	€2,128	€494

As the cost of GP Visit Cards and Medical Cards varies significantly with the age of the cardholder, a ‘blanket’ average cost of either card does not provide a true cost representation.

Hospital Transfers

Questions (874)

Eamon Scanlon

Question:

874. Deputy Eamon Scanlon asked the Minister for Health the way in which a person (details supplied) will be transported to University Hospital Galway for an emergency procedure if not by the HSE national ambulance service; and if he will make a statement on the matter. [13434/17]

Written answers

Minister for Health

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

Ambulance Service

Questions (875)

Timmy Dooley

Question:

875. Deputy Timmy Dooley asked the Minister for Health the reason a concluded review on the HSE's ambulance service handling a 999 call on 28 October 2010 (details supplied) will not be published by the HSE; and if he will make a statement on the matter. [13435/17]

Written answers

Minister for Health

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

General Practitioner Services

Questions (876)

Jackie Cahill

Question:

876. Deputy Jackie Cahill asked the Minister for Health if he will encourage the HSE to support the innovative plan put together by the general practitioners in Thurles, County Tipperary to maintain the patient list of a retiring general practitioner (details suppled) as a separate practice, in view of the fact the general practitioners are unable to facilitate the HSE's plan to divide the patient list with the other general practitioners in the town due to over-capacity in their practices; and if he will make a statement on the matter. [13448/17]

Written answers

Minister for Health

As this question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive for direct reply.

General Practitioner Services Provision

Questions (877)

Jackie Cahill

Question:

877. Deputy Jackie Cahill asked the Minister for Health the progress in the sourcing of a replacement general practitioner for the retiring general practitioner in Cappawhite, County Tipperary; and if he will make a statement on the matter. [13451/17]

Written answers

Minister for Health

As this question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive for direct reply.

General Practitioner Services

Questions (878)

Jackie Cahill

Question:

878. Deputy Jackie Cahill asked the Minister for Health the progress being made in negotiations with general practitioners that will see the problem of replacing retiring rural general practitioners resolved; and if he will make a statement on the matter. [13452/17]

Written answers

Minister for Health

The Government is committed to ensuring that patients throughout the country continue to have access to GP services and that general practice is sustainable in all areas into the future. I want to ensure that existing GP services are retained and that general practice remains an attractive career option for newly-qualified GPs.

The development of a new modernised contract for the provision of general practitioner services will be a key element in facilitating this process. Previous engagements have resulted in a number of service developments including the introduction of a Diabetes Cycle of Care for adult patients with Type 2 Diabetes, an enhanced support framework for rural GPs, and a revised list of special items of service under the contract to encourage the provision of more services in the primary care setting. These measures, combined with the under-6s and over-70s universal GP care initiatives, have increased the financial support for general practice.

The next phase of discussions on a new GP contract is under way. The GP contracts review process will seek to arrive at further measures aimed at making general practice an attractive, fulfilling and rewarding career option into the future.

As with any negotiation-type process, and given the range and complexity of the issues to be discussed, the engagement may take some time. While I am of course anxious to see good progress made, it is not my intention to set a deadline for completion of discussions.

Services for People with Disabilities

Questions (879)

Michael Fitzmaurice

Question:

879. Deputy Michael Fitzmaurice asked the Minister for Health the estimated cost of providing a single property to accommodate a children's health facility, at which a school age team would deliver services, at the HSE's preferred location in Roscommon town; and if he will make a statement on the matter. [13457/17]

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.

Health Services Data

Questions (880)

Michael Fitzmaurice

Question:

880. Deputy Michael Fitzmaurice asked the Minister for Health the current cost of accommodating children's health services in Roscommon town at the multiple sites in which services are currently being delivered by school age teams; and if he will make a statement on the matter. [13458/17]

Written answers

Minister for Health

As this is a service matter it has been referred to the HSE for reply to the Deputy.

Long-Term Illness Scheme Coverage

Questions (881)

James Browne

Question:

881. Deputy James Browne asked the Minister for Health his plans to add pain amplification syndrome and chronic fatigue to the long-term illness scheme; and if he will make a statement on the matter. [13466/17]

Written answers

Minister for Health

The LTI Scheme was established under Section 59(3) of the Health Act 1970 (as amended). The conditions covered by the LTI are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide. Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.

There are no plans to extend the list of conditions covered by the Scheme.

Services for People with Disabilities

Questions (882, 884, 886, 887)

Michael Healy-Rae

Question:

882. Deputy Michael Healy-Rae asked the Minister for Health the resources he is providing to assist persons with Prader-Willi syndrome and their carers (details supplied); and if he will make a statement on the matter. [13467/17]

Michael Healy-Rae

Question:

884. Deputy Michael Healy-Rae asked the Minister for Health his plans to involve persons with Prader-Willi syndrome in service planning (details supplied); and if he will make a statement on the matter. [13470/17]

Michael Healy-Rae

Question:

886. Deputy Michael Healy-Rae asked the Minister for Health his plans to provide more specialist dietetic services for persons with Prader-Willi syndrome (details supplied); and if he will make a statement on the matter. [13472/17]

Michael Healy-Rae

Question:

887. Deputy Michael Healy-Rae asked the Minister for Health his plans to provide specific residential care places for persons with Prader-Willi syndrome (details supplied); and if he will make a statement on the matter. [13473/17]

Written answers

Minister of State at the Department of Health

I propose to take Questions Nos. 882, 884, 886 and 887 together.

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.

Mental Health Services Provision

Questions (883)

Michael Healy-Rae

Question:

883. Deputy Michael Healy-Rae asked the Minister for Health his plans to increase the number of mental health teams to assist persons with Prader-Willi syndrome (details supplied); and if he will make a statement on the matter. [13468/17]

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.

Question No. 884 answered with Question No. 882.

Medical Card Eligibility

Questions (885)

Michael Healy-Rae

Question:

885. Deputy Michael Healy-Rae asked the Minister for Health his plans to increase the provision of medical cards for persons with Prader-Willi syndrome (details supplied); and if he will make a statement on the matter. [13471/17]

Written answers

Minister for Health

In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. The Act obliges the HSE to assess whether a person is unable, without due hardship, to arrange general practitioner services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure and every application must be assessed on that basis. Under the legislation, having a particular illness, in itself, does not establish eligibility for a medical card and therefore, the medical conditions of applicants for this scheme are not monitored on that basis. Where the person claiming the allowance's income is within the income guidelines, a medical card or GP visit card will be awarded.

Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. In certain circumstances, the HSE may exercise discretion and grant a medical card, even though an applicant exceeds his or her income threshold, where he or she faces difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE affords applicants the opportunity to furnish supporting information and documentation to fully take account of all the relevant circumstances that may benefit them in the assessment, including medical evidence of cost and necessary expenses.

The HSE has a system in place for the provision of medical cards in response to an emergency situation for persons with a serious medical condition in need of urgent or on-going medical care that they cannot afford and persons in palliative care, who are terminally ill. With the exception of terminally ill patients, all medical cards, granted on an emergency basis, are issued on the basis that the patient is eligible for a medical card on the basis of means or undue hardship, and will follow up with a full application within a number of weeks of receiving the medical card eligibility. These cards are issued within 24 hours of receipt of the required patient details and a letter which confirms the medical condition from a doctor or consultant.

In addition, 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, which, in turn, may benefit those children with Prader-Willi Syndrome. Any child with Prader-Willi Syndrome, whose Guardian is in receipt of a DCA payment for them, will be eligible for a medical card upon enactment of the legislation. It is expected that this will be in place for 1st June 2017.

Questions Nos. 886 and 887 answered with Question No. 882.