Written Answers Nos. 1128-1147
1128. Deputy Louise O'Reilly asked the Minister for Health his plans to design and implement a structured care programme for heart failure in general practice, drawing on the success of the model for diabetes and asthma; and if he will make a statement on the matter. [37922/17]
View answerThe development of primary care is central to the Government's objective to deliver a high-quality, integrated and cost effective health service. The Programme for Government commits to a decisive shift within the health service towards primary care in order to deliver better care close to home in communities across the country. The development of a new, modernised contract for the provision of general practitioner services will be a key element in facilitating this process.
The aim is to develop a contract which has a population health focus, providing in particular for health promotion and disease prevention and for the structured ongoing care of chronic conditions. A new contract should be flexible and be able to respond to the changing nature of the GP workforce. It should also include provisions in relation to service quality and standards, performance, accountability and transparency. I think this will be key in making general practice a more attractive career.
Since 2015, negotiations have resulted in a number of service developments including the provision of free GP care to under 6's and over 70's, the introduction of a Diabetes Cycle of Care for adult GMS patients with Type 2 Diabetes and enhanced supports for rural GPs. The next phase of discussions on a new GP contract is under way and officials from my Department and the HSE meet with GP representatives on a regular basis to discuss a wide range of issues. Proposals around further structured programmes for the management of chronic diseases are being discussed in this context.
I understand that the discussions taking place are wide ranging and definitely ambitious in their scope. I think it is important to acknowledge that, as with any negotiation-type process, and given the range and complexity of the issues to be discussed, these engagements take time. It would not be appropriate at this stage to comment on progress to date. While there will be challenges for all parties involved, I would hope that everyone will remain focused on our common goal of putting suitable new arrangements in place that will work for patients, GPs, and other health care providers in primary care. I look forward to continued ongoing positive engagement with GP representatives in the months ahead.
1129. Deputy Louise O'Reilly asked the Minister for Health his plans to invest in public health campaigns to raise awareness of heart failure and its risk factors; and if he will make a statement on the matter. [37923/17]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
1130. Deputy Louise O'Reilly asked the Minister for Health the staffing requirements for the stroke register; the governance of the stroke register; his plans to change responsibility for the governance of the register; if he will ensure necessary resources to ensure the stroke register is maintained; and if he will make a statement on the matter. [37924/17]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
1131. Deputy Louise O'Reilly asked the Minister for Health the staffing and configuration deficits in each of the early supported discharge teams; and if he will make a statement on the matter. [37925/17]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
1132. Deputy Louise O'Reilly asked the Minister for Health the rates of thrombolysis nationally and in hospitals in Ireland; the way in which these rates compare with the national key performance indicator, KPI, for thrombolysis; and if he will make a statement on the matter. [37926/17]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
1133. Deputy Louise O'Reilly asked the Minister for Health the consideration being given to telemedicine and telestroke to improve levels of support and quality of care; and if he will make a statement on the matter. [37927/17]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
1134. Deputy Louise O'Reilly asked the Minister for Health if his attention has been drawn to the age restrictions on access to inpatient rehabilitation in a number of sites dealing with stroke patients; and if he will make a statement on the matter. [37928/17]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
1135. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [37929/17]
View answerAs this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.
1136. Deputy Kevin O'Keeffe asked the Minister for Health if he will assist in having a person (details supplied) placed in a specific facility. [37946/17]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1137. Deputy Kevin O'Keeffe asked the Minister for Health if he will expedite an appointment for a person (details supplied). [37947/17]
View answerAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
1138. Deputy Clare Daly asked the Minister for Health if he will meet with persons (details supplied) regarding the reimbursement of the Respreeza drug. [37953/17]
View answerThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
The HSE has considered the issue of reimbursement of Respreeza for maintenance treatment of emphysema in adults with documented severe alpha1-proteinase inhibitor deficiency.
The HSE has decided not to support reimbursement of the medicine at the price sought by the applicant indicating that it did not consider the evidence for its clinical benefit to be sufficiently strong, in the context of the proposed cost and budget impact. I instructed the HSE to engage with patient groups directly in relation to this decision.
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 patient access 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 patient access schemes and reimbursement decisions and manufacturers should be open with patients and clinicians from the outset.
1139. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [37954/17]
View answerUnder 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.
1140. Deputy Bobby Aylward asked the Minister for Health further to Parliamentary Question No. 531 of 11 April 2017, the position regarding the work being undertaken by the Health Service Executive to put in place clinical care pathways appropriate to the differing medical needs of some children that may require access to specialist services, in view of claims of an association between HPV vaccination and a number of medical conditions; and if he will make a statement on the matter. [37961/17]
View answerI am aware of claims of an association between HPV vaccination and a number of conditions experienced by a group of young women. An illness that occurs around the time a vaccine is given and is already known to be common in adolescence does not imply the vaccine caused the problem. It appears that some girls first suffered symptoms around the time they received the HPV vaccine, and understandably some parents have connected the vaccine to their daughter’s condition. It is important to reassure people that anyone who is suffering ill health is eligible to seek medical attention, and to access appropriate health and social care services, irrespective of the cause of their symptoms. As there is no scientific evidence that the vaccine causes long term illnesses, the HPV vaccine cannot be held responsible for these illnesses.
As the development of a clinical care pathways for children who require access to specialist services is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
1141. Deputy Bobby Aylward asked the Minister for Health if the Health Service Executive subvention provided to a care home (details supplied) for the elderly in County Kilkenny can be increased as part of budget 2018; and if he will make a statement on the matter. [37962/17]
View answer1142. Deputy Bobby Aylward asked the Minister for Health if the Health Service Executive administered additional funds to supported care homes can be increased by at least 10% during the three-year lifetime of the Government in addition to the current annual allowance as part of budget 2018; and if he will make a statement on the matter. [37963/17]
View answer1143. Deputy Bobby Aylward asked the Minister for Health if a working group consisting of representatives of HIQA, supported care homes for the elderly and the Health Service Executive can be established to examine the inspection guidelines that can be applied to supported care homes for the elderly (details supplied); and if he will make a statement on the matter. [37964/17]
View answerI propose to take Questions Nos. 1141 to 1143, inclusive, together.
The level of funding available for the Health Service Executive is being considered as part of the national Estimates and budgetary process for 2018 which is currently underway. Pending completion of this process it is not appropriate for me to comment further at this stage.
Under the Health Act 2007, statutory responsibility is given to the Chief Inspector of Social Services, part of the Health Information and Quality Authority for the independent inspection and registration of certain categories of designated centres. This includes residential care settings for older people. As the Deputy is aware, the Office of the Chief Inspector is independent in its function. As such the type of working group suggested by the Deputy may not be the most appropriate vehicle for considering this issue.
However, in the first instance I will ask officials from my Department to open dialogue with the HSE to discuss the relevant issues of the supported care homes referred to by the Deputy.
The Department will also discuss the concerns of the supported care homes with HIQA in the course of its regular meetings with the Authority.
1144. Deputy Sean Fleming asked the Minister for Health if full-time residential care can be provided for a person (details supplied); and if he will make a statement on the matter. [37967/17]
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 an individual case, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
1145. Deputy Sean Fleming asked the Minister for Health his plans to establish a forum involving representatives of his Department, the HSE, organisations representing the elderly and representatives of the nursing homes so that matters of concern across the area can be addressed, in view of the large number of persons in private nursing homes throughout the country; and if he will make a statement on the matter. [37968/17]
View answerThere are no plans to establish a forum as suggested by the Deputy. However I am pleased to inform the Deputy that the Department of Health has formulated new arrangements to implement and monitor the implementation of the 2013 National Positive Ageing Strategy. The National Positive Ageing Strategy provides a framework for cooperation to address age-related policy and service delivery across Government and society in the years ahead. The Strategy highlights that ageing is not just a health issue, but rather requires a whole of Government approach to address a range of social, economic and environmental factors that affect the health and wellbeing of our ageing citizens. The revised arrangements were approved by the Cabinet Committee on Social Policy and Public Service Reform on 27 October, 2016.
These new arrangements establish mechanisms that will give stakeholder groups effective and on-going access to Government Departments and State Agencies relevant to older people. This includes an annual Forum for stakeholders to identify what they consider to be their key priorities for Government for the coming year and the next three years; and establishing clear channels of communications between stakeholders and relevant Government Departments. In this regard, stakeholder representatives will engage with a named senior official on issues relevant to their remit, in order that the priorities identified by the stakeholders at the Forum can be pursued.
The inaugural stakeholder Forum took place on 30th March 2017, and was attended by civic society organisations who are representative of the needs and views of older people in Ireland. Following on from this successful Forum, the Department of Health has opened a dialogue with each of the Government Departments identified as having responsibility for the priorities agreed by stakeholders to advise them of the issues for discussion prior to them being contacted by the stakeholder representative group. The Department of Health has met with this stakeholder representative group, and will meet with them again in late 2017 to establish progress made and assist with any issues arising.
1146. Deputy Sean Fleming asked the Minister for Health the situation and the matters taken into account by the National Treatment Purchase Fund, NTPF, that carry out the negotiations for the State in respect of the payments to nursing homes for persons (details supplied); the consideration the NTPF is giving to the State-imposed increase in costs in terms of it being reflected in the payment they will make to nursing homes to ensure their continued viability, in view of the number of elderly persons in nursing homes; and if he will make a statement on the matter. [37969/17]
View answerThe 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.
The legislation underpinning the Nursing Homes Support Scheme requires each private nursing home to negotiate and agree a price for long-term residential care services with the National Treatment Purchase Fund (NTPF) should they wish to be an approved nursing home for the purposes of the Scheme. The NTPF has statutory independence in the performance of its function, and negotiates with each nursing home on an individual basis. The NTPF may examine the records and accounts of nursing homes as part of the process with the objective of setting a fair price which delivers value for money to the individual and the State. In negotiating with nursing homes, the NTPF has regard to:
- Costs reasonably and prudently incurred by the nursing home and evidence of value for money;
- Price(s) previously charged;
- Local market price; and
- Budgetary constraints and the obligation on the State to use available resources in the most beneficial, effective and efficient manner to improve, promote and protect the health and welfare of the public.
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. A number of issues have been identified for more detailed consideration, including a review of pricing mechanisms by the NTPF, with a view to:
- Ensuring value for money and economy, with the lowest possible administrative costs for clients and the State and administrative burden for providers;
- Increasing the transparency of the pricing mechanism so that existing and potential investors can make as informed decisions as possible; and
- Ensuring that there is adequate residential capacity for those residents with more complex needs.
A Steering Committee has been established to oversee the review of the pricing system for private long-term residential care facilities. This Steering Committee is chaired by the NTPF and includes representatives from the Department of Health, the Department of Public Expenditure and Reform, and the NTPF, and work in this area is ongoing and well advanced.
1147. Deputy Thomas Pringle asked the Minister for Health the unit responsible within the HSE for releasing medical reports under the Freedom of Information (Amendment) Act 2003; the number of staff dedicated to facilitating these requests; the reasons for delays in responses and releasing of medical reports under FOI requests; if his attention has been drawn to the frequent lack of acknowledgements of receipt of such FOI requests; and if he will make a statement on the matter. [37970/17]
View answerStatutory responsibility for the Health Service Executive's compliance with the provisions of the Freedom of Information Act rests entirely with the Health Service Executive. If a person does not receive an acknowledgement to their FOI request within 10 working days of it having been received by the relevant FOI Body, they should contact the Body in question to establish it's receipt and the status of their request.
The Freedom of Information legislation provides for the right of appeal, by requesters, in cases where the statutory time frames have not been met.
