Niamh Smyth
Question:523. Deputy Niamh Smyth asked the Minister for Health his plans to help persons with multiple sclerosis (details supplied); and if he will make a statement on the matter. [24574/17]
View answerHealth Services
Questions (523)
Written answers
Health and personal social services for people with a neurological illness or injury, including people with Multiple Sclerosis, are provided across a range of settings, by different organisations and by many health professionals and carers. Services include acute hospitals, specialist services at the National Rehabilitation Hospital, primary care, community services, long-term assisted living supports and rehabilitative training services.
The Health Service Executive's (HSE's) National Service Plan for 2017 contains a priority to finalise and progress implementation of the framework for the Neuro-Rehabilitation Strategy. Full implementation of the Strategy will, of necessity, be a longer term project. The Department of Health has agreed with the HSE that the focus initially will be on implementation of the Strategy in the community, which is in keeping with the Programme for a Partnership Government commitment. The HSE has committed to undertake a mapping and gap identification exercise for the country as a whole, in order to establish a clear picture of where specialist rehabilitation services are currently being delivered and where the demands are for these services. The HSE's Social Care Division and the Rehabilitation Medicine Clinical Programme will work together to form an action plan, under the HSE's Clinical Strategy and Programme Division. A National Steering Group made up of stakeholders representing all interested parties will be responsible for the governance and implementation of the action plan.
With regard to Home Support, in 2017 the HSE is committed to the provision of 2.75 million Home Support Hours to people with disabilities, which is an increase of 150,000 hours over the target for 2016 of 2.6 million hours.
I am conscious of the impact of long waiting times on people's lives. Reducing waiting times for the longest waiting patients is one of this Government's key priorities. The National Clinical Programme for Neurology (NCPN) Model of Care document recommends an increase in the number of consultant neurologists, nurse specialists, including clinical nurse specialist, and other health care professionals which would address waiting time issues. The programme also proposed implementation of these recommendations over a period of 5 years. This will significantly improve access for all Neurology patients. The Model of Care was launched by the Director General of the Health Service Executive (HSE) on the 27 September 2016 and the HSE is now working towards its implementation.
With regard to the Deputy's question regarding employment supports, the Department of Social Protection operates a number of specific schemes to promote employment of people with disabilities, including the Wage Subsidy Scheme, the Employability Service and the Workplace Equipment and Adaptation Grant. Social welfare payments such as the Disability Allowance or the Partial Capacity Benefit may also be applicable, depending on an individual's circumstances.
Nursing Homes Support Scheme Appeals
Questions (524)
Caoimhghín Ó Caoláin
Question:524. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if there is an appeal process through the HSE or fair deal office in the case of a nursing home provider introducing an additional monetary demand or redesignating particular services or particular needs as requiring additional contributions from the service user directly that is outside the calculation of the fair deal support approved; and if he will make a statement on the matter. [24584/17]
View answerWritten answers
The Nursing Homes Support Scheme (NHSS), commonly referred to as A Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost.
The NHSS covers the cost of the standard components of long-term residential care which are:
- Nursing and personal care appropriate to the level of care needs of the person;
- Bed and board;
- Basic aids and appliances necessary to assist a person with the activities of daily living; and
- Laundry service.
A person's eligibility for other schemes, such as the medical card scheme or the drugs payment scheme, is unaffected by participation in the NHSS or residence in a nursing home. In determining the services covered by the NHSS it was considered very important that the care recipient and the taxpayer would be protected and would not end up paying for the same services twice. For this reason, medications and aids that are already prescribed for individuals under an existing scheme are not included in the services covered by the NHSS, as this would involve effectively paying twice for the same service.
Although the NHSS covers core living expenses, residents can still incur some costs in a nursing home, such as social programmes, newspapers or hairdressing. In recognition of this, anyone in receipt of financial support under the NHSS retains at least 20% of their income. The minimum amount that is retained is the equivalent of 20% of the State Pension (Non-Contributory). An operator should not seek payment from residents for items which are covered by the NHSS, the medical card or any other existing scheme.
Part 7 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 stipulates that the registered provider of the nursing home must agree a contract in writing with each resident on their admission to the nursing home. This contract must include details of the services to be provided to that resident and the fees to be charged. Residents should never be charged fees which are not set out in the contract. The Department of Health and the HSE are not a party to such contracts which are concluded between each resident and the private or voluntary nursing home.
Registered providers of nursing home care are obliged to provide an accessible and effective complaints procedure. Concerns about additional charges should in the first instance be taken up with the nursing home provider. The Office of the Ombudsman can examine complaints about the actions of a range of public bodies and, from 24 August 2015, complaints relating to the administrative actions of private nursing homes. The Office of the Ombudsman normally only deals with a complaint once the individual has already gone through the complaints procedure of the private nursing home concerned.
Hospital Waiting Lists
Questions (525)
Anne Rabbitte
Question:525. Deputy Anne Rabbitte asked the Minister for Health when a person (details supplied) will receive an appointment; and if he will make a statement on the matter. [24586/17]
View answerWritten answers
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.
Bullying in the Workplace
Questions (526)
John McGuinness
Question:526. Deputy John McGuinness asked the Minister for Health if he will initiate an independent investigation into allegations of bullying and harassment in the workplace regarding a person (details supplied) in view of the fact that all actions taken to date were not independent and have not yielded resolution; and if he will expedite the matter. [24635/17]
View answerWritten answers
Under the Health Act 2004, the HSE has responsibility for operational issues which includes the determination of the terms and conditions of employment for its employees. I advised the Deputy recently that the HSE are dealing with this matter in accordance with the HSE HR policies and procedures and that the HSE continues with its efforts to bring the matter to a conclusion which will involve direct engagement with the employee.
Hospital Records
Questions (527)
John McGuinness
Question:527. Deputy John McGuinness asked the Minister for Health further to Parliamentary Question No. 453 of 4 April 2017, if part of the response to this will be issued directly by HIQA (details supplied); and if he will make a statement on the matter. [24636/17]
View answerWritten answers
The Health Information and Quality Authority (HIQA) is the independent authority established to promote high-quality and safe care for people using health and social care services in Ireland. Information on the quality, safety and experience of people using services is vital to HIQA’s work. The Authority receives, analyses and risk assesses information from a range of sources, including residents and their families. All information is used to inform the on-going monitoring and inspection programme.
HIQA received information from the persons concerned, and responded accordingly. The interested party was made aware of HIQA’s statutory remit and that the Authority does not have the legal power to investigate individual concerns or complaints.
Nursing Homes Support Scheme Review
Questions (528)
Dara Calleary
Question:528. Deputy Dara Calleary asked the Minister for Health his plans to review the fair deal scheme (details supplied). [24637/17]
View answerWritten answers
The Nursing Homes Support Scheme (NHSS) is a system of financial support for those in need of long-term nursing home care. Participants contribute to the cost of their care according to their income and assets while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.
When the NHSS commenced in 2009, a commitment was made that it would be reviewed after three years. The Report of the Review was published in July 2015. Arising out of the Review, a number of key issues have been identified for more detailed consideration across Departments and Agencies.
An Interdepartmental/Agency Working Group has been established to progress the recommendations contained in the Review. This Group is chaired by the Department of Health and includes representatives from the Department of the Taoiseach, the Department of Public Expenditure and Reform, the HSE, the Revenue Commissioners, and when required, the National Treatment Purchase Fund (NTPF). These recommendations include:
- The implementation of administrative reforms to the Scheme;
- A review by the NTPF of present pricing arrangements in private residential facilities; and
- A Value For Money and Policy Review of the differences in the comparative cost of public and private long-term residential care.
This work is currently underway. The Value for Money and Policy Review will commence in 2017 and will assess reasons for and components of current cost differentials.
An initial report on the progress of the NHSS Review recommendations was submitted to the Cabinet Committee on Health in September 2016.
Once all of the relevant Review recommendations have been considered, any amendments required to the Scheme will be identified. Changes which require legislative implementation will be addressed collectively, and it is important to remember that the NHSS is largely underpinned by primary legislation.
Hospitals Data
Questions (529)
Dara Calleary
Question:529. Deputy Dara Calleary asked the Minister for Health the average length of stay in each hospital, in tabular form, on a county basis. [24638/17]
View answerWritten answers
In response to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
Disability Services Provision
Questions (530)
Pat Deering
Question:530. Deputy Pat Deering asked the Minister for Health the steps that can be taken to assist an organisation (details supplied) which is facing closure on 25 May 2017 due to historical governance issues which have not been addressed; and if he will make a statement on the matter. [24648/17]
View answerWritten answers
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 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.
Hospital Appointments Status
Questions (531)
Brendan Griffin
Question:531. Deputy Brendan Griffin asked the Minister for Health the status of an operation for a person (details supplied) in County Kerry; if the case will be prioritised; and if he will make a statement on the matter. [24687/17]
View answerWritten answers
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.
Question No. 532 answered with Question No. 473.
National Children's Hospital
Questions (533)
Aindrias Moynihan
Question:533. Deputy Aindrias Moynihan asked the Minister for Health the extent and nature of the use of the hospital inpatient inquiry in the work of the review group that reported to him in June 2012; and if he will make a statement on the matter. [24710/17]
View answerWritten answers
In 2012, following the refusal of planning permission for the new children’s hospital project at the Mater campus the Minister for Health established the Dolphin Review Group to advise on next steps.
The Dolphin Review Group, as part of its own research, reviewed the reports already prepared on the new children’s hospital including McKinsey 2006, Joint Task Group 2006, KPMG 2008, and the Independent Review 2011, and considered their analysis and opinions. A clinicians' sub-group of the Dolphin Group examined issues relating to clinical specialties and sub-specialties, transitional care for adolescents, and the integration of paediatric health research and education in the new children's hospital.
The Group received a number of proposals and submissions from hospitals, the National Paediatric Hospital Development Board and other interested parties. The Group also sought further detailed information from the various hospitals, representative groups and individual experts as the need arose. Material was provided for the Group from multiple sources including CSO data, HSE data, Hospital In-patient Enquiry data (HIPE) and data collected from individual services.
The Group’s consideration of the complex issues involved was greatly facilitated by meetings with a large number of groups and individuals with relevant expertise and/or involvement in paediatric healthcare and research.
Nursing and Midwifery Board of Ireland
Questions (534)
Aindrias Moynihan
Question:534. Deputy Aindrias Moynihan asked the Minister for Health the number of nurses who were removed from the active register for non-payment of a registration fee who have sought to be reinstated; the number who have requested refunds; the number of refunds that have been approved; and if he will make a statement on the matter. [24711/17]
View answerWritten answers
The Department has received a report on the matter from the Nursing and Midwifery Board of Ireland (NMBI).
The NMBI advised that a renewal notice and a reminder notice were issued to registrants on 6 November 2016 and 15 February 2017 respectively. Consideration of removal of names from the register is not considered by the Board until at least 28 days has elapsed from the date of the reminder notice. In addition, a final reminder was sent to registrants on 8 March 2017. The Board decided on 21 March 2017 that 2,258 people who had not paid their ARF would be removed from the register. The NMBI have advised that the final reminder which issued on 8 March 2017 indicated that the Board would consider removals from the register at its meeting on 21st March. Registrants were informed that the fee must be paid with immediate effect to avoid removal.
Of those who were removed from the Register, the NMBI advised that to date a total of 1,123 (almost 50% of those removed) have regularised their registration status with NMBI. This figure includes:
- 737 nurses and midwives who paid a restoration fee; and
- 237 were granted a waiver from the restoration to register fee - in this regard, 340 nurses and midwives applied for such a waiver;
- 149 nurses and midwives had their nurses placed on the inactive file.
Medicinal Products Supply
Questions (535)
Frank O'Rourke
Question:535. Deputy Frank O'Rourke asked the Minister for Health if his Department will consider sourcing additional pharmaceutical companies for chemotherapy drugs in view of the fact that the current supplier (details supplied) which has the monopoly on the market, has been unable to provide full supplies to hospitals over the past two weeks, due to a production constraint resulting in cancer patients treatment being reduced and compromised; and if he will make a statement on the matter. [24712/17]
View answerWritten answers
The recent chemotherapy supply issues relate to manufacturing problems experienced by the Irish supplier of these compounded chemotherapy preparations. These manufacturing issues caused the interruption in the supply of certain chemotherapy products to a number of hospitals. Under the direction of the NCCP, hospitals implemented a number of contingency measures in order to minimise the impact on patients. Production of chemotherapy products resumed on the 22 of May and the company are working closely with hospitals to fulfil all orders made for this week.
Medical oncology services are provided to patients in 26 hospitals across the country. The vast majority of anti-cancer medications are made in the pharmacy compounding units in hospitals. The production of compounded chemotherapy products is among the highest risk pharmaceutical manufacture that occurs in Ireland and requires specialist facilities. Unfortunately in the last number of years several compounding manufacturers have exited the market.
There is one external manufacturer based in Ireland who supplies approximately 15% of compounded chemotherapy preparations to Irish hospitals. A number of hospitals source some of these products from licensed manufacturers in the UK. The licensed manufacturer in Ireland is subject to regulatory oversight by the Health Products Regulatory Authority (HPRA).
The HSE has indicated it intends to conduct a needs assessment for local compounding requirements at the hospitals providing chemotherapy services. This will inform the options on improving internal HSE resilience in the short, medium and long term.
Home Care Packages Provision
Questions (536)
Pearse Doherty
Question:536. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) in County Donegal will have a home support package implemented; and if he will make a statement on the matter. [24716/17]
View answerWritten answers
As this is a service matter it has been referred to the Health Service Executive for direct reply
Questions Nos. 537 and 538 answered with Question No. 444.
Medicinal Products Licensing
Questions (539)
Colm Brophy
Question:539. Deputy Colm Brophy asked the Minister for Health the name of the drugs which have been licensed by the European Medicines Agency and have gone through the process of being approved by the Health Products Regulatory Authority that are waiting to be approved for reimbursement by the HSE; and the date they were added to the list in tabular form; and if he will make a statement on the matter. [24743/17]
View answerWritten answers
Under the Health (Pricing and Supply of Medical Goods) Act 2013, 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.
Medicinal Products Reimbursement
Questions (540)
Colm Brophy
Question:540. Deputy Colm Brophy asked the Minister for Health the average time it takes for a drug to go through the reimbursement assessment process; the reason a delay exists; and if he will make a statement on the matter. [24744/17]
View answerWritten answers
Under the Health (Pricing and Supply of Medical Goods) Act 2013, 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.
Medicinal Products Reimbursement
Questions (541)
Colm Brophy
Question:541. Deputy Colm Brophy asked the Minister for Health his views on whether the current manner in which drugs are assessed for reimbursement by the HSE is adequate and appropriate; and if he will make a statement on the matter. [24745/17]
View answerWritten answers
The 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. The Act specifies the criteria to be applied in the making of decisions on the reimbursement of medicines. The Act does not confer any powers on the Minister for Health in this regard and the HSE does not require the approval or consent of the Minister or Government when making a decision.
Decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds by the HSE, on the advice of the National Centre for Pharmacoeconomics (NCPE). The NCPE conducts health technology assessments (HTAs) of pharmaceutical products for the HSE, and makes recommendations on reimbursement to assist the HSE in decision-making. The NCPE uses a decision framework to systematically assess whether the drug is cost-effective as a health intervention.
A new Framework Agreement on the Supply and Pricing of Medicines 2016-2020 was signed on 20 July 2016. This Framework Agreement incorporates the statutory requirements of the 2013 Act for reimbursement decisions on new medicines.
I am satisfied that the current reimbursement process is open and transparent.
Hospital Procedures
Questions (542)
Brian Stanley
Question:542. Deputy Brian Stanley asked the Minister for Health the steps he will take to reduce the waiting times for children to see a consultant and to have a tonsillectomy in the ENT department in Tullamore hospital in view of the fact that waiting times are over two years. [24746/17]
View answerWritten answers
In relation to the query raised by the Deputy, as this is a service issue, I have asked the HSE to respond to you directly.