Robert Troy
Question:142. Deputy Robert Troy asked the Minister for Health the status of a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [39945/17]
View answerHospital Appointments Status
Questions (142)
Written 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 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.
Hospital Appointments Status
Questions (143)
Michael Healy-Rae
Question:143. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [39946/17]
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 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.
Hospital Accommodation Provision
Questions (144)
Maurice Quinlivan
Question:144. Deputy Maurice Quinlivan asked the Minister for Health if he has given consideration to using the old accident and emergency department at University Hospital Limerick in order to alleviate the overcrowding situation in the new emergency department; and if he will make a statement on the matter. [39954/17]
View answerWritten answers
As this is a service matter, I have asked the HSE to respond to you directly.
Hospital Services
Questions (145)
Maurice Quinlivan
Question:145. Deputy Maurice Quinlivan asked the Minister for Health the number of times the full capacity protocol was initiated at University Hospital Limerick to date in 2017; and if he will make a statement on the matter. [39955/17]
View answerWritten answers
As this is a service matter, I have asked the HSE to respond to you directly.
Drugs Payment Scheme Coverage
Questions (146)
Seán Sherlock
Question:146. Deputy Sean Sherlock asked the Minister for Health if the drug Pregabalin is prescribed under the GMS; if so, his views on its misuse; and if his attention has been drawn to adverse outcomes for persons who use it. [39956/17]
View answerWritten answers
The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for reply to the Deputy.
Hospital Charges
Questions (147)
Richard Boyd Barrett
Question:147. Deputy Richard Boyd Barrett asked the Minister for Health his views on whether it is acceptable or fair that persons suffering from haemochromatosis are being charged €80 per visit for treatment when these persons need to attend regularly for treatment and that this represents an intolerable financial burden on persons that must have this treatment; and if he will make a statement on the matter. [39966/17]
View answerWritten answers
The Health Act 1970 (as amended) provides that all people ordinarily resident in the country are entitled, subject to certain charges, to public in-patient hospital services including consultant services and to public out-patient hospital services. Under the Health (In-Patients Charges) (Amendment) Regulations 2008, a person who has been referred to a hospital for an in-patient service, including that provided on a day case basis, will have to pay the statutory daily charge, currently €80 per day, up to a maximum of €800 per year. On this basis, where venesection is classed as a day case procedure and is not carried out in an out patient setting, the public in-patient charge applies. There are no plans at present to exclude haemochromatosis patients from this charge.
The following revised reply was received on 15 November 2017
The Health Act 1970 (as amended) provides that all people ordinarily resident in the country are entitled, subject to certain charges, to public in-patient hospital services including consultant services and to public out-patient hospital services. Under s52 of the Health Act 1970, as amended by s12 of the Health (Amendment) Act 2013, a person who has been referred to a hospital for an in-patient service, including that provided on a day case basis, will have to pay the statutory daily charge, currently €80 per day, up to a maximum of €800 per year. On this basis, where venesection is classed as a day case procedure and is not carried out in an out- patient setting, the public in-patient charge applies. There are no plans at present to exclude hemochromatosis patients from this charge.
Health Services Provision
Questions (148)
Paul Kehoe
Question:148. Deputy Paul Kehoe asked the Minister for Health if there will be extra positions allocated in areas (details supplied); if so, the timeframe for same; the number of positions; and if he will make a statement on the matter. [39972/17]
View answerWritten answers
I have asked the HSE to respond to the Deputy directly on this matter.
Medicinal Products Licensing
Questions (149)
Clare Daly
Question:149. Deputy Clare Daly asked the Minister for Health if he will make medicinal cannabis available without first passing legislation to do so; if medicinal cannabis can, under current legislation, be prescribed via the compassionate access for medicines programme; and if he will make a statement on the matter. [39974/17]
View answerWritten answers
Currently medical practitioners who wish to prescribe cannabis-based products containing THC may apply to me, as Minister for Health, for a licence under the Misuse of Drugs Act.
The Chief Medical Officer has advised that the granting of such a licence must be premised on an appropriate application being submitted to the Department of Health, which is endorsed by a consultant who is responsible for the management of the patient and who is prepared to monitor the effects of the treatment over time.
Ultimately it is the decision of the clinician, in consultation with their patient, to prescribe or not prescribe a particular treatment for a patient under their care. As Minister for Health I have no role in this clinical decision-making process.
Where consultants require information or clarification in relation to the licence application process, he or she should contact my Department directly.
In February, I published the Health Products Regulatory Authority’s (HPRA) report ‘Cannabis for Medical Use – A Scientific Review’. On foot of the HPRA’s conclusions I announced that I would establish a cannabis for medical use access programme, for patients under the care of a consultant, for the following medical conditions:
- spasticity associated with multiple sclerosis resistant to all standard therapies;
- intractable nausea and vomiting associated with chemotherapy, despite the use of standard anti-emetic regimes;
- severe, refractory (treatment-resistant) epilepsy.
An expert group, chaired by Dr Mairín Ryan from HIQA was established in March to develop the operational, clinical and practice guidelines for this access programme.
The Expert Group conducted a targeted consultation on the draft guidelines and is due to finalise these guidelines shortly. Officials in my Department are working on secondary legislation to underpin the programme and on the logistics of sourcing suitable cannabis-based product supplies for the Irish market place. This work will take a number of months to complete but the Access Programme will be operational later this year.
Medicinal Products Reimbursement
Questions (150)
Darragh O'Brien
Question:150. Deputy Darragh O'Brien asked the Minister for Health the status of the reimbursement of the drug Respreeza/Zemaira; and if he will make a statement on the matter. [39975/17]
View answerWritten answers
The HSE has carefully considered the pricing and reimbursement of human alpha1-proteinase inhibitor (Respreeza) through its decision making processes which were aligned with the statutory criteria set out in the Health (Pricing and Supply of Medical Goods) Act 2013. It should be noted that human aplha1-proteinase inhibitor does not strictly speaking come within the scope of the above act as it is not intended for this drug to be included on the HSE's reimbursement list as defined in section 17 of the Act.
The HSE Drugs Group considered the clinical information in relation to Respreeza. The HSE was unable to recommend reimbursement as they concluded that there is not enough evidence to suggest that patients will derive a clinically meaningful benefit from this treatment.
The HSE was also required to consider cost effectiveness and deemed that the current price was not a cost effective use of resources.
I am aware that there are a number of patients on a compassionate access scheme which is operated by CSL Behring. Following a number of media reports, it appears that the company may be planning to terminate access to this treatment scheme.
The HSE has not received any formal notification from the manufacturer of its intention to terminate access to this scheme.
I consider this action by the company as unethical and as I have stated previously, there should be no link between compassionate use schemes and reimbursement decisions and manufacturers should be frank with patients and clinicians on the operation of such schemes.
On my request, the HSE has sought assurances from the hospital that appropriate care arrangements are in place in the event that the access programme is discontinued, and that appropriate ethical guidelines have been and continue to be followed in relation to all aspects of the clinical trial and access programme. I would expect that the company would honour any commitments made to patients in this regard.
Hospital Appointments Status
Questions (151)
Robert Troy
Question:151. Deputy Robert Troy asked the Minister for Health if an appointment for a person (details supplied) can be expedited; and if he will make a statement on the matter. [39977/17]
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 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.
Hospital Appointments Status
Questions (152)
Robert Troy
Question:152. Deputy Robert Troy asked the Minister for Health if an appointment will be scheduled for a person (details supplied); and if he will make a statement on the matter. [39979/17]
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 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.
Hospital Appointments Status
Questions (153)
Robert Troy
Question:153. Deputy Robert Troy asked the Minister for Health if an appointment will be scheduled for a person (details supplied); and if he will make a statement on the matter. [39980/17]
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 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.
Services for People with Disabilities
Questions (154)
Seán Fleming
Question:154. Deputy Sean Fleming asked the Minister for Health the position regarding funding for a project (details supplied); and if he will make a statement on the matter. [39995/17]
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.
The Programme for Partnership Government states that the Government wishes to provide more accessible respite care to facilitate full support for people with a disability.
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.
Ambulance Service Provision
Questions (155)
Seán Fleming
Question:155. Deputy Sean Fleming asked the Minister for Health the position regarding the ambulance services in a region (details supplied); and if he will make a statement on the matter. [39996/17]
View answerWritten answers
As this is a service matter, I have asked the HSE to respond to you directly.
Occupational Therapy Expenditure
Questions (156)
Robert Troy
Question:156. Deputy Robert Troy asked the Minister for Health when additional funding will be made available to occupational therapy services in counties Westmeath and Longford in order to reduce the current eight month waiting list; and if he will make a statement on the matter. [40010/17]
View answerWritten answers
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.
Mental Health Services Provision
Questions (157)
Michael Healy-Rae
Question:157. Deputy Michael Healy-Rae asked the Minister for Health the status of an assessment appointment for a person (details supplied); and if he will make a statement on the matter. [40016/17]
View answerWritten answers
As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
Medicinal Products Availability
Questions (158, 159)
Gerry Adams
Question:158. Deputy Gerry Adams asked the Minister for Health if persons in County Louth can access versatis lidocaine 5% medicated plaster under GMS services; and if he will make a statement on the matter. [40027/17]
View answerGerry Adams
Question:159. Deputy Gerry Adams asked the Minister for Health if the HSE has implemented changes to the reimbursement of versatis lidocaine 5% medicated plaster; the date on which these changes commenced; and the way in which this now affects persons that previously had access to this drug via GMS services [40028/17]
View answerWritten answers
I propose to take Questions Nos. 158 and 159 together.
Medicines play a vital role in improving the overall health of Irish patients. Securing access to existing and new and innovative medicines, is a key objective of the Irish health service. However, the challenge is to deliver this objective in an affordable and sustainable manner. The medicines bill for the community drugs schemes – primarily the GMS, Long Term Illness, Drugs Payment as well as the High Tech Arrangement – including fees and ingredient costs, is forecast at just over €1.7 billion in 2017. To ensure that patients receive the highest quality care, it is essential that these resources invested in medicines are used efficiently and effectively. This requires an integrated approach to secure best value for money for all treatments, to deliver greater efficiencies across the supply chain and also to promote the use of the most cost-effective treatments.
In 2013, the HSE established the Medicines Management Programme (MMP). It is headed by the National Medicines Information Centre (NMIC) and the National Centre for Pharmacoeconomics (NCPE) in collaboration with the HSE-Primary Care Reimbursement Service (HSE-PCRS) and provides sustained national leadership relating to issues such as the quality of the medicines management process, access to medicines and overall expenditure on medicines.
The Medicines Management Programme has undertaken a number of initiatives aimed at enhancing evidence-based and cost-effective prescribing nationally and the review of Versatis is an example of this.
Versatis 5% medicated plaster is licensed for the symptomatic relief of neuropathic pain associated with previous herpes zoster (shingles) infection, known as post-herpetic neuralgia (PHN), in adults.
Following a review by the MMP of the evidence available to support the use of Versatis, the HSE has introduced a new system for the reimbursement of Versatis from 1 September 2017. This process will support the appropriate use of this medication while ensuring those with an indication of post-herpetic neuralgia (PHN) continue to have access to this treatment.
The product has been reimbursed under the community drugs schemes in Ireland since 2010. Initially, the projected budget impact was low due to the specific licensed indication. However, total expenditure has increased significantly, from €9.4 million in 2012 to over €30 million in 2016, due primarily to off-license use i.e. prescribing Versatis as a general treatment for pain not associated with shingles. Currently, there are over 25,000 patients in receipt of this item. The MMP prescribing and cost guidance report highlighted that the clinical evidence to support the use of Versatis 5% medicated plaster for PHN is limited due to lack of comparative data and its value is uncertain for all other types of pain.
The NCPE estimated that, in Ireland, between 5-10% of the prescribing of this product is for the licensed indication of PHN.
All patients who currently receive antivirals for shingles, or patients who are prescribed antivirals for the treatment of shingles by their GP in the future, will automatically be approved for Versatis for a period of three months. No action is required by the GP in this instance and the patient’s pharmacy will be notified in real time of the patient’s approval status.
All patients who are currently initiated on Versatis have been identified and automatically registered on the HSE-PCRS system for a period of three months and will continue to receive the treatment from their pharmacy until 30 November 2017.
From 1 December 2017, non-shingles patients will no longer be dispensed Versatis under the community drugs schemes. The HSE has produced patient information leaflets and advised GPs on treatment alternatives.
In exceptional circumstances, the product may be dispensed for unlicensed indications. In such circumstance, the GP will be required to make an application for reimbursement for unlicensed indications for new and existing patients through the online system.
Where the application is under exceptional circumstances, the application will be reviewed by the MMP before a decision is made and communicated to the GP.
Full details of the review of Versatis are available on the HSE website at
http://hse.ie/eng/about/Who/clinical/natclinprog/medicinemanagementprogramme/yourmedicines/lidocaine-plaster/lidocaine-medicated-plaster.html.
As this is a matter for the HSE, I have no role in this decision in relation to individual treatments. However, I fully support the objectives of the HSE Medicines Management Programme.
Hospital Waiting Lists Data
Questions (160)
Fergus O'Dowd
Question:160. Deputy Fergus O'Dowd asked the Minister for Health the waiting list for joint replacement operations in the Royal College of Surgeons hospital group, by individual hospital, for each of the past three years; the number of such replacement joint operations carried out in the hospitals; the location in which they were carried out for the same period; if persons were sent to other hospitals outside this region during this period; if so, the locations to which they were sent to; the cost of these operations; if a cap of 440 joint replacement operations per annum has been introduced; if so, the reason therefore; the date that it was introduced; if a report in the media (details supplied) on 18 September 2017 that one hospital in the region has the capacity to do well in excess of 700 per annum is correct; and if he will make a statement on the matter. [40029/17]
View answerWritten answers
I acknowledge that waiting times are often unacceptably long and I am conscious of the burden that this places on patients and their families.
Reducing waiting times for the longest waiting patients is one of this Government's key priorities. Consequently, Budget 2017 allocated €20 million to the NTPF, rising to €55 million in 2018.
In order to reduce the numbers of long-waiting patients, I asked the HSE to develop Waiting List Action Plans for 2017 in the areas of Inpatient/Daycase, Scoliosis and Outpatient Services. The Inpatient/Daycase Action Plan is being delivered through a combination of normal hospital activity, as well as insourcing and outsourcing initiatives utilising NTPF funding. Under the Inpatient/Daycase Plan, since early February, over 23,000 patients have come off the Inpatient/Daycase Waiting List.
The NTPF has advised that to date 5,295 patients have been authorised for treatment in private hospitals under its Initiatives, 2,126 patients have accepted an offer of treatment in a private hospital and that 1,016 patients have received their procedure. The NTPF has also indicated that 2,703 patients have been authorised for treatment in public hospitals under the Plan’s insourcing initiatives, 767 offers of treatment have been accepted and 177 patients have been treated.
Under the Outpatient Plan, since early February, almost 82,000 patients have come off the Outpatient Waiting List.
In response to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.