Written Answers Nos. 415-438
415. Deputy Michael Healy-Rae asked the Minister for Health the reason the HSE has not circulated the package information leaflet in the HPV vaccine information packs in order that parents may make an informed consent on the vaccine; and if he will make a statement on the matter. [39339/17]
View answerCervical cancer is the fourth most common cancer in women worldwide. Each year in Ireland around 300 women are diagnosed with cervical cancer and 90 die from the disease. All cervical cancers are linked to high risk Human Papillomavirus (HPV) types. In 2009 the National Immunisation Advisory Committee (NIAC) recommended HPV vaccination for all 12 year old girls to reduce their risk of cervical cancer and in September 2010 the HPV vaccination programme was introduced for all girls in first year of second level schools.
The HSE is committed to providing accurate information for parents about diseases, the vaccines to prevent them and side effects to allow them to choose whether to give consent to vaccination. All the information provided to parents about vaccination is prepared from the available licensed documentation for each vaccine, the Summary of Products Characteristics (SPC) and Patient Information Leaflet (PIL). The information is presented in clear simple language and approved by the National Adult Literacy Agency (NALA) so that it can be understood by all adults. The Health Information and Quality Authority (HIQA) Guide ‘Communicating in plain English’ (2015) developed in partnership with NALA states that “One in six people find reading and understanding everyday texts difficult: for example, reading a health leaflet, bus timetable or medicine instructions”. Therefore, like other countries providing school immunisation programmes, the Patient Information Leaflet (PIL) is replaced by this information leaflet and like other countries the HSE information leaflet provides the same information on side effects of the vaccine.
Prior to all school immunisations, parents receive an information pack in a sealed package with an information leaflet, consent form and cover letter. The information packs for all immunisations are standardised nationally. The information booklets include information on all the known side effects that can occur after each vaccination. All the known side effects of the HPV vaccine Gardasil are outlined in the information booklet given to parents. Parents are also given contact details for their local immunisation office and advised to speak to a member of the school immunisation team if they have any further questions.
Parents are not being denied the information on the Patient Information Leaflet. The HSE parent information leaflet refers parents to the website www.hpv.ie where links to additional information including the licensing documentation, the SPC and the PIL for each vaccine can be found.
I 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. The diverse nature of these symptoms, which can have both physical and psychological causes, are shared by many conditions which has implications for both diagnostic and treatment services. The individual nature of the needs of some children may require access to specialist services and the HSE are currently working to put in place clinical care pathways appropriate to the differing medical needs of this group. As there is no scientific evidence that the vaccine causes long term illnesses, the HPV vaccine cannot be held responsible for these illnesses.
It is important that people receive accurate information from reliable sources in relation to the safety of vaccines, and to increase the uptake rates of all vaccines in the State’s immunisation programmes. The HSE recently launched their information campaign for HPV vaccination as part of the 2017/18 Schools Immunisation Programme. This launch is part of an extensive media campaign coinciding with the start of the programme in September 2017. The focus remains on providing accurate information in relation to the safety of the HPV vaccine, and to increase the uptake rate in girls as part of the schools immunisation programme. It includes a comprehensive range of materials for parents, schools and medical practitioners.
I fully support the information campaign and its aim to increase uptake of this important vaccine.
416. Deputy Michael Healy-Rae asked the Minister for Health the reason there is a shortage of ICU beds in Crumlin hospital particularly in view of the case of a person (details supplied); and if he will make a statement on the matter. [39340/17]
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.
In relation to the queries raised, as they are service matters, I have asked the HSE to respond to you directly.
417. Deputy Michael Healy-Rae asked the Minister for Health if he will expedite a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [39344/17]
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 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.
418. Deputy David Cullinane asked the Minister for Health if his attention has been drawn to the case of a person (details supplied) who was not paid their salary at the end of August 2017 as scheduled; and if he will make a statement on the matter. [39345/17]
View answerIn relation to the query raised by the Deputy, as this is a service issue, I have asked the HSE to respond to you directly.
419. Deputy Michael McGrath asked the Minister for Health the status of the position of a person (details supplied) on a waiting list for additional home support and respite; and if he will make a statement on the matter. [39358/17]
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, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
420. Deputy Michael McGrath asked the Minister for Health if steps can be taken to appoint a social worker to liaise with the parents of a person (details supplied) to ensure their needs are met; and if he will make a statement on the matter. [39359/17]
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. Under the reconfiguration of children’s disability services, it is recommended that social workers will be ‘core’ members of the Children's Disability Network Teams. However, not every child with a disability would need the services of a social worker. In disability services, key workers/case managers are often assigned to individual service users to provide information and support to both the service user and their carer/family. The key worker/case manager would be part of a multi-disciplinary team and would work with the service user and other HSE/Voluntary agencies to facilitate a person-centred and a family-centred approach to the service user’s needs.
However, as the Deputy's question relates to service matters and an individual case, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
421. Deputy Louise O'Reilly asked the Minister for Health when his Department will move to its new headquarters (details supplied). [39364/17]
View answerDepending on the completion of the ongoing fit-out of the building, it is anticipated that the staff of my Department will move to the accommodation in Miesian Plaza during the first quarter of 2018.
422. Deputy Louise O'Reilly asked the Minister for Health when his Department started paying rent on its new headquarters (details supplied). [39365/17]
View answerI have no role in relation to the rent or lease arrangements in respect of the buildings concerned. This is a matter for the Office of Public Works.
423. Deputy Michael Healy-Rae asked the Minister for Health if he will address a matter (details supplied) regarding the testing of Lyme's disease; and if he will make a statement on the matter. [39369/17]
View answerLyme disease (also known as Lyme borreliosis) is an infection caused by a spiral-shaped bacterium called Borrelia burgdorferi. It is transmitted to humans by bites from ticks infected with the bacteria. The Health Protection Surveillance Centre (HPSC) of the HSE has extensive information concerning Lyme disease on its website.
Lyme borreliosis can be asymptomatic or have a range of clinical presentations. Current best advice is that diagnosis should be made only after careful examination of the patient's clinical history, physical findings, laboratory evidence and exposure risk evaluation. Exposure to ticks prior to disease manifestations is necessary for the diagnosis of Lyme borreliosis. Since an awareness or recollection of a tick-bite is not always present, however, this should not exclude the diagnosis of Lyme borreliosis. Later stages require the use of antibody detection tests (or advanced DNA detection techniques). Testing for Lyme Disease is undertaken in most of the larger hospitals in Ireland. In undertaking Lyme testing, it is essential that the results are interpreted in the light of the clinical condition of the patient. If the result of this initial screen is equivocal, the patient's samples are referred to the U.K.'s Public Health England Porton Down facility which uses a two-tier system recommended by American and European authorities. This involves a screening serological test followed by a confirmatory serological test.
Lyme disease can be very successfully treated using common antibiotics. These antibiotics are effective at clearing the rash and helping to prevent the development of complications. Antibiotics are generally given for up to three weeks. If complications develop, intravenous antibiotics may be considered. In Ireland, treatment by most clinicians is based on that laid out in evidence-based guidelines for the management of patients with Lyme disease, human granulocytic anaplasmosis (formerly known as human granulocytic ehrlichiosis), and babesiosis published by the Infectious Diseases Society of America (IDSA) in 2006. This pharmacological regime can be summarised thus:
- Doxycycline, amoxicillin or cefuroxime for the treatment of adults with early localised or early disseminated Lyme disease associated with erythema migrans, in the absence of specific neurologic manifestations (ceftriaxone in early Lyme disease for adults with acute neurologic disease manifested by meningitis or radiculopathy);
- Doxycycline, amoxicillin, or cefuroxime for adults with Lyme arthritis but without clinical evidence of neurologic disease;
- For late neurological disease in adults - intravenous ceftriaxone, cefotaxime or Penicillin G.
As testing and treatment for Lyme borreliosis is widely available in Ireland there is no requirement for people to travel to other EU Member States to access these services.
424. Deputy Gerry Adams asked the Minister for Health further to Parliamentary Question No. 1199 of 11 September 2017, the number of new medical card applications awaiting processing by CHO area or county; and the number of these applications that have exceeded the 15-day turnaround by CHO area or county. [39376/17]
View answerThe 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.
425. Deputy Michael Healy-Rae asked the Minister for Health the status of an operation for a person (details supplied); and if he will make a statement on the matter. [39377/17]
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 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.
426. Deputy Kevin O'Keeffe asked the Minister for Health if he will arrange for the public health nurse to call to a person (details supplied) in County Cork. [39397/17]
View answerAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
427. Deputy Maurice Quinlivan asked the Minister for Health when funding will be provided to fund the 96 extra bed unit at university hospital Limerick; and the steps he is taking to alleviate the high level of overcrowding in the hospital. [39398/17]
View answerAs this is a service matter, I have asked the HSE to respond to you directly.
428. Deputy Louise O'Reilly asked the Minister for Health the number of pain management clinics in the Border, midlands and western regions by county and specific location; and if he will make a statement on the matter. [39406/17]
View answerIn response to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to you directly.
429. Deputy Louise O'Reilly asked the Minister for Health the number of HSE pain management clinics that have been closed since 2011; the locations of the closed clinics; the reason for their closure; and if he will make a statement on the matter. [39407/17]
View answerIn response to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to you directly.
430. Deputy Louise O'Reilly asked the Minister for Health the number of persons awaiting a first appointment to a pain management clinic, by county and specific location, in the Border, midlands and western regions as at 31 December 2015 and as at 31 August 2017; and if he will make a statement on the matter. [39408/17]
View answerIn response to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to you directly.
431. Deputy Micheál Martin asked the Minister for Health the status of the planning process for the delivery of the stroke unit in Bantry hospital; the stage it is at; if the value as reported of €4 million is accurate; the date on which work will commence; the timeframe for the project to be completed; and if he will make a statement on the matter. [39416/17]
View answerIn relation to the specific case raised, I have asked the HSE to respond to you directly
432. Deputy Micheál Martin asked the Minister for Health the waiting list for gynaecological procedures both day and inpatient cases since April 2017; and if he will make a statement on the matter. [39417/17]
View answerAs this is a service matter, I have asked the HSE to respond to you directly.
433. Deputy Micheál Martin asked the Minister for Health his plans to give families the choice and supports needed on a statutory basis to allow them keep older relatives at home instead of the fair deal scheme; and if he will make a statement on the matter. [39418/17]
View answerThe Department of Health is currently engaged in a detailed process to develop plans for a new statutory scheme and system of regulation for home care services.
The statutory scheme for home care will introduce clear rules in relation to what services individuals are eligible for and how decisions are made on allocating services. For that reason, developing a new statutory scheme will be an important step in ensuring that the system operates in a consistent and fair manner for all those who need home care services. It will also help to improve access to the home care services that people need, in an affordable and sustainable way. The system of regulation for home care will help to ensure that the public can be confident that the services provided are of a high standard.
I along with Minister Harris launched a public consultation on these matters on 6 July. The purpose of this consultation is to allow all those who have views on this topic to have their say, including home care users, their families, and healthcare workers. The Department wants to find out what people think about current home care services as well as the public’s views on what the future scheme should look like. I encourage all those with an interest in home care services to make a submission to the consultation which closes on 2 October.
A report of the findings of this consultation process will be published and the findings will be used by the Department in the development of the new home care scheme.
The development of a regulatory and funding model for home care services is a complex undertaking. While the public consultation is an important step in the process of developing the new scheme, a significant amount of additional preparation remains to be carried out before final decisions are taken on the form of home care scheme and system of regulation. This is required if the reforms are to be successful, affordable and sustainable. Every effort will be made to progress this matter as quickly as possible.
434. Deputy Micheál Martin asked the Minister for Health his plans to increase capacity in acute hospitals; and if he will make a statement on the matter. [39419/17]
View answerAs the Deputy is aware, my Department is currently undertaking a capacity review. The review is examining key elements of primary and community care capacity in addition to hospital capacity. The outcomes of the review will provide a basis for determining the extent of capacity requirements over the next 15 years and the type of capacity that is needed at a national and regional level. I expect the review to be advanced sufficiently to inform the mid-term review of the capital programme and the development of the new 10 year capital plan later this year.
435. Deputy Micheál Martin asked the Minister for Health if he will report on the filling of vacancies in mental health services; the steps that have been taken in 2017 to address this matter in the North and South Lee areas in Cork; and if he will make a statement on the matter. [39420/17]
View answerAs this is a service issue, this question has been referred to the HSE for direct reply.
436. Deputy Micheál Martin asked the Minister for Health his views on the reported 54% reduction in the number of elective surgeries in the past four years and in particular the cancellation of 41,000 elective surgeries in 2016; the actions that are being taken to address the matter; and if he will make a statement on the matter. [39421/17]
View answerOver recent years activity in acute hospitals has increased, with the total number of discharges of inpatients and daycases rising around 34% between 2006 and 2015. Last year alone there was a 4% increase in inpatient and daycase activity over 2015, and in 2016 1.69 million patients received inpatient or daycase treatment in our hospitals, an increase of almost 40,000 on the previous year.
It is important to recognise that, in order to improve efficiency in our hospital system, over the last number of years there has been a greater emphasis on increasing the number of procedures, previously carried out as inpatient procedures, which are now carried out on a daycase basis. Consequently, when comparing hospital elective activity for 2012 with 2016, it can be seen that, while inpatient elective discharges decreased, daycase discharges have increased.
In fact, taken together, elective inpatient discharges and daycase discharges increased from 1.02m in 2012 to 1.15m in 2016. HSE data for 2016 show that while elective inpatient discharges had reduced by 3.5% in comparison with the same period in 2015, daycase discharges increased by 3.1%. It is important to remember that this is the context of ever-growing demand with increased attendances at EDs, including by older persons.
Cancellation of elective procedures can occur for a variety of exceptional reasons including cancellations because a bed or the clinical team are not available, cancellations by the patient or because the patient may not be fit for surgery at the time.
Maintaining scheduled care access for all patients and managing emergency demand at times is challenging, however all efforts are made to limit cancellations particularly for clinically urgent procedures.
Based on data provided by the NTPF, collated from reports by hospitals, approximately 3,400 elective procedures, on average, are cancelled per month. In 2016, typically in a month, there were approximately 53,000 admissions to acute hospitals on a daycase and an inpatient basis.
It is essential that hospitals continue to improve how they manage, and balance, the demand for emergency care with the planning of elective procedures, to minimise the impact on patients. In addition, it is important that the HSE continues to improve its processes to minimise the number sessions lost when patients cancel or do not attend for their procedures.
The Department of Health has commenced a Health Service Capacity review in line with the Programme for Government commitment, the findings of which are due to be published before the end of the year.
437. Deputy Micheál Martin asked the Minister for Health his plans to meet the head of a programme (details supplied) in the UK when they visit Dublin in October 2017 to deliver an address on e-cigarettes; and if he will make a statement on the matter. [39422/17]
View answerI have not had a formal meeting request to meet with the head of a programme in the UK on this occasion.
438. Deputy Micheál Martin asked the Minister for Health his plans to introduce legislation to on the use of e-cigarettes inside public venues; and if he will make a statement on the matter. [39423/17]
View answerI have no plans to introduce legislation prohibiting the use of e-cigarettes in public places.
The introduction of the workplace smoking ban was based on clear and unequivocal evidence that second hand smoke is harmful to non-smokers. That evidence base does not exist for the aerosol generated from e-cigarettes. However, individual organisations/companies are free to introduce an e-cigarette free policy if they so choose.
My Department will continue to monitor the emerging research on these products, so as to inform decisions around any future additional regulation in this area.
