Written Answers Nos. 716-739
716. Deputy Charlie McConalogue asked the Minister for Health the changes which were introduced in budget 2018 with respect to the fair deal scheme and the future treatment and possible discount on chargeable assets for farms and business. [46237/17]
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 amount of funding allocated to the NHSS in 2017 was €940 million. This amount was increased to €949.7 million in the recent budget.
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 examining the treatment of business and farm assets for the purposes of the financial assessment element of the scheme. The programme for a partnership Government has also committed to reviewing the NHSS to remove any discrimination against small businesses and family farms. It is important to remember that the NHSS is largely underpinned by primary legislation and changes to the NHSS will require legislative implementation.
On this basis, I have requested legal advice from the office of the Attorney General regarding potential changes to the legislation that will address this matter. My department has also been cognisant of this matter in the context of this years estimates process. I have recently met with representatives from the IFA to discuss various strategies that may assist with addressing their members concerns and have apprised them of the current progress. We agreed to meet again in the near future for further discussions. I am committed to this review of the position with regard to family farms and small businesses for the purposes of the financial assessment of the scheme and I hope to be able to clarify proposed changes before the end of this year.
717. Deputy Lisa Chambers asked the Minister for Health the reason the necessary treatment of HPV consisting of three separate gardasil injections for a person (details supplied) is not covered under their medical card; the reason they are being asked to pay €170 for each injection; if there is financial assistance available to the person in relation to this expense; and if he will make a statement on the matter. [46296/17]
View answerAvailability of the HPV vaccine to girls that have previously declined or missed the administration of the vaccine in school as part of the national immunisation programme is a service matter and they should contact the HSE directly. The vaccine is provided free of charge as part of the national immunisation programme. For women who did not receive the vaccine as part of the school programme it can be obtained privately from their GP. However, the cost of purchasing the vaccine privately is not covered by the medical card.
718. Deputy John Curran asked the Minister for Health his plans to provide a primary health care centre in a location (details supplied); and if he will make a statement on the matter. [46298/17]
View answerAs the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.
719. Deputy Pat Deering asked the Minister for Health the proposed changes to the school meals scheme (details supplied) whereby water will no longer qualify as a food item and an alternative food item such as orange juice will have to be selected; the reason this is the case; the estimated impact on healthy eating to pupils by this change; and if he will make a statement on the matter. [46302/17]
View answerThe School Meals Scheme is an administrative scheme, operated directly by the Department of Employment Affairs and Social Protection, which provides funding towards the provision of food to up to 1,700 schools and organisations benefitting up to 250,000 children at a total cost of some €47.5 million in 2017.
The Scheme aims to provide regular, nutritious food to children who are unable, by reason of lack of good quality food, to take full advantage of the education provided for them. The School Meals Programme is an important component of policies to encourage school attendance and extra educational achievement by children, particularly those from the most disadvantaged background. The scheme is not compulsory and should only be applied for if a genuine need exists.
The role of my Department has been the development of Nutrition Standards for School Meals to assist the Department of Employment Affairs and Social Protection in the implementation of the Scheme. An important outcome of the Nutrition Standards being implemented is that more children will have nourishing food in line with national Healthy Eating Guidelines as well as helping to ensure that the State gets the best value for its financial investment.
The minimum requirement for breakfast club funding is two food items and for lunch or after-school meal is four items and water cannot be substituted for one of the food items. Drinking water should be available to all students throughout the day, and should not be dependent on the school operating the School Meals Scheme. Milk and unsweetened fruit juices are acceptable on breakfast club menus, but neither is specifically required. Other options include cereal, yogurt, cheese and toast. The full range of food options can be seen at the following weblink: www.welfare.ie/en/downloads/NutritionalStandardsForSchoolMeals.pdf.
720. Deputy Catherine Murphy asked the Minister for Health the number of cases of tuberculosis (TB) reported to the HSE by the Irish Prison Service in the past 10 years by year and the prison which reported cases' the procedure and or protocols the HSE follows when a TB case from the Irish Prison Service is reported to it; and if he will make a statement on the matter. [46304/17]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
721. Deputy Mary Butler asked the Minister for Health when an occupational therapist be appointed to replace the person that recently left CAMHS in Waterford; when the therapist will be appointed; if the position has been advertised; and if he will make a statement on the matter. [46306/17]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
722. Deputy Billy Kelleher asked the Minister for Health if his attention has been drawn to concerns regarding the way the European Medicines Agency 2014 recommendation that sodium valproate should not be prescribed for girls and women of childbearing age is being implemented [46307/17]
View answer723. Deputy Billy Kelleher asked the Minister for Health when sodium valproate was first prescribed here; and if there are estimates of the number of children who have been adversely impacted by it [46308/17]
View answer725. Deputy Billy Kelleher asked the Minister for Health if his attention has been drawn to the fact that an organisation (details supplied) has conducted a number of surveys of women taking valproate and found that while doctor-patient communication is improving since 2014, only 56% of women surveyed in December 2016 indicated that they have had discussions on this issue with their health care professionals and the attention of 1 in 5 has not been drawn to the new restrictions in place since 2014 [46310/17]
View answer726. Deputy Billy Kelleher asked the Minister for Health his views on whether the use of valproate information resources should be mandatory and informed consent should be obtained when using the drug in women and girls; his further views on whether a valproate register should be established and properly resourced public awareness campaigns need to happen; and his views on whether warnings should be displayed on the external packaging of the drug and that valproate medication should not be dispensed without original internal and external packaging [46311/17]
View answer748. Deputy Thomas P. Broughan asked the Minister for Health the work his departmental officials are undertaking in relation to the prescribing of medicines containing sodium valproate; the number of families that have been affected by foetal anticonvulsant syndrome due to the use of this medicine; the supports being provided to these families; the measures being taken to curb use of this drug particularly in women and girls; and if he will make a statement on the matter. [46520/17]
View answer771. Deputy Róisín Shortall asked the Minister for Health if his attention has been drawn to concerns raised by the EMA regarding the implementation of its 2014 recommendations on the prescription of valproate to women of childbearing age; the actions the HSE will take to address these concerns; and if he will make a statement on the matter. [46628/17]
View answerI propose to take Questions Nos. 722, 723, 725, 726, 748 and 771 together.
Sodium valproate has been licensed for use in Ireland since 1983. Valproate medicines have been authorised in all EU Member States and in Norway and Iceland for the treatment of epilepsy; valproate-containing medicines are also approved nationally in Ireland to treat bipolar disorder.
Valproate medicines should be initiated and supervised by a specialist experienced in the management of epilepsy or bipolar disorder. It is also recommended that valproate should not be used in women of child-bearing potential unless other treatments are ineffective or not tolerated because of the risk of congenital malformations and developmental disorders in infants exposed to valproate in utero. Women who could become pregnant should be given medical advice on the benefits and risks of treatments before valproate is prescribed and use effective contraception during treatment. Clinicians, in consultation with their patient, may consider the therapeutic benefit of valproate to outweigh any possible risks for individual patients where discontinuation of therapy or switching to alternative therapies is not possible or poses an unacceptable risk to the health of that patient and consequentially to the health of the unborn child.
In March of this year, the Pharmacovigilance Risk Assessment Committee (PRAC) of the European Medicines Agency (EMA) initiated a new review of the use of valproate-containing medicines in the treatment of women and girls who are pregnant or of childbearing age. This review is examining the available evidence and consulting with relevant stakeholder groups. The most recent component of the current review was a public hearing held at the London offices of the EMA on 26 September.
It is anticipated that the PRAC’s current review of valproate will be concluded before the end of this year. As soon as the review is concluded, the Health Products Regulatory Authority (HPRA), which is the competent authority for the regulation of medicines in Ireland, will communicate the outcome and recommendations of the review to Irish patients, healthcare professionals and relevant stakeholders, including the HSE.
A previous EMA review of valproate, in 2014, resulted in measures to strengthen the warnings and restrictions on the use of valproate medicines in women and girls, due to the risk of malformations and developmental problems in babies who are exposed to valproate in the womb. The HPRA has highlighted the results of previous reviews of valproate and provided revised educational materials for both healthcare professionals and patients. A warning label for the outer packaging of Epilim (sodium valproate) products was introduced in Ireland earlier this year; products carrying the new external warning label are now being supplied to retail pharmacies.
In October 2016, the HSE's Medicines Management Programme (MMP) launched its ‘Valproate Toolkit’, an online resource consisting of a patient information booklet, summary guide for prescribers and a patient/prescriber checklist. This information highlights that sodium valproate should not be prescribed to girls or women of childbearing age or pregnant women unless other treatments are ineffective or not tolerated. The MMP continues to monitor the use of valproate by women of childbearing age. The MMP is also in regular contact with the HPRA regarding the EMA's current review of valproate, and will consider any recommendations arising from the review.
Foetal Anti-Convulsant Syndrome (FACS) is the name of a syndrome that can affect some babies if they were exposed to certain anti-epileptic drugs while in the womb. FACS can manifest as physical malformations as well as developmental, behavioral and learning difficulties. Children with FACS can have a mixture of mild to more serious symptoms. The management of FACS usually involves a multidisciplinary approach with different specialties depending on the nature and severity of the symptoms. Children born with developmental delays may require specialist paediatric care, as well as speech and language therapy and physiotherapy. Information published by the HPRA indicates that children exposed in utero to valproate are at high risk of congenital malformations in approximately 10% of cases, and of serious developmental disorders in up to 30-40% of cases. There is also an increased risk of autistic spectrum disorder, childhood autism and attention deficit hyperactivity disorder (ADHD).
In October of this year, and in 2015, the Pharmaceutical Society of Ireland, as regulator for pharmacists and pharmacies in Ireland, again highlighted the risks of the use of valproate in women of child-bearing age to ensure that those patients are informed and understand:
- the risks associated with valproate use during pregnancy;
- the need to use effective contraception;
- the need for regular review of treatment; and
- the need to immediately consult a healthcare professional if they are planning a pregnancy or if they become pregnant.
Pharmacists were encouraged to bring these issues, and any other relevant educational materials, to the attention of patients presenting in their pharmacy.
The Irish Epilepsy and Pregnancy Register, based in Beaumont Hospital, was set up in 2001 for pregnant women with epilepsy in Ireland. The aim of this Register is to find out which type of epilepsy drugs women are taking while pregnant and to collect information on the health of their babies after delivery. Since 2007, the Irish Register has had a formal link to the United Kingdom Epilepsy and Pregnancy Register. Women with epilepsy who become pregnant, whether or not they are taking anti-epileptic drugs for their epilepsy, are eligible to register their pregnancy.
Patients currently taking valproate containing medicines are advised not to stop taking these medicines and, if they have any concerns about their specific drug treatment and management of their condition, to discuss these with a healthcare professional.
724. Deputy Billy Kelleher asked the Minister for Health the care pathways in place for children possibly impacted by sodium valproate; the process for getting a diagnosis; if his attention has been drawn to reports of the current waiting time being two years for a diagnosis; and if his attention has been further drawn to the fact that there is an urgent need to have the complex needs of children assessed and appropriate pathways for diagnosis and treatment put in place immediately [46309/17]
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 service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
727. Deputy Éamon Ó Cuív asked the Minister for Health the extra allocation of funding approved in the estimates recently for the national ambulance service in 2018; the improvements that will arise in the service as a result of the extra investment; and if he will make a statement on the matter. [46361/17]
View answerI can confirm that additional funding will be made available for the continued development of the National Ambulance Service in 2018. The detail of this additional funding will be outlined in the National Service Plan 2018.
728. Deputy David Cullinane asked the Minister for Health the contracts his Department or bodies under the aegis of his Department have with a company (details supplied) or its subsidiaries; the value of the contracts; the year in which the contracts were concluded; when the contracts will be up for renewal; and if he will make a statement on the matter. [46375/17]
View answerRecords indicate that since 2005, one payment was made to the company in question in June 2017 following a procurement exercise, in respect of an one year contract for maintenance and licensing in respect of Sophos Anti Virus protection in the amount of €40,811.40.
I have asked the HSE to reply directly to the Deputy regarding any contracts held with the company. Details for other bodies under the aegis of the Department are operational matters for the bodies concerned and the Deputy should contact the relevant Director/CEO/Registrar directly.
729. Deputy Éamon Ó Cuív asked the Minister for Health when an operation will be provided for a person (details supplied); the reason for the delay in issuing a date for this procedure; if the procedure can be provided under the National Treatment Purchase Fund scheme or through another scheme; and if he will make a statement on the matter. [46390/17]
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.
730. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) in County Donegal will receive an appointment to be seen by a consultant at Our Lady’s Hospital, Crumlin; and if he will make a statement on the matter. [46391/17]
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 particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
731. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) in County Donegal will receive an appointment to be seen by a consultant at Galway university hospital; and if he will make a statement on the matter. [46392/17]
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.
732. Deputy Bernard J. Durkan asked the Minister for Health when a procedure will be facilitated in the case of a person (details supplied); and if he will make a statement on the matter. [46402/17]
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 particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
733. Deputy Mary Lou McDonald asked the Minister for Health the number of persons in receipt of the long-term illness scheme card. [46418/17]
View answerUnder 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.
734. Deputy Éamon Ó Cuív asked the Minister for Health when an operation will be provided for a person (details supplied); the reason for the delay in issuing a date for this procedure; if the person can undergo the procedure under the treatment purchase fund scheme or another way; and if he will make a statement on the matter. [46420/17]
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.
735. Deputy John Brady asked the Minister for Health if funding will be provided to roll out the winter initiative in County Wicklow; if not, the reason therefor; and if he will make a statement on the matter. [46426/17]
View answerTackling overcrowding in Emergency Departments (EDs) is a key commitment of this Government and I am delighted that €40 million in additional funding in 2017 has been made available as part of the 2018 Budget to address winter pressures and waiting lists over the rest of this year.
This funding will be aimed at reducing overcrowding in our hospitals in this period through the provision of extra capacity and additional supports.
In the meantime, I can inform colleagues that a total €5 million of this funding winter funding for 2017 will be focused on supporting older people to remain in their own homes by providing 45 additional home care packages and 20 additional transitional care beds per week over the Winter period. These measures will cost an additional €25 million in 2018 and this funding has been ring-fenced for allocation in 2018.
My Department continues to work intensively with the HSE to address the challenges and monitor performance in our EDs.
736. Deputy Peter Fitzpatrick 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. [46432/17]
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.
737. Deputy Eugene Murphy asked the Minister for Health the number of persons under 16 years of age waiting to see a paediatric rheumatologist in each of the years 2014 to 2016 and to date in 2017; the average waiting time, by LHO, in tabular form; and if he will make a statement on the matter. [46458/17]
View answerIn relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
738. Deputy Eugene Murphy asked the Minister for Health if a third paediatric consultant rheumatologist and a multi-disciplinary team at Our Ladies children's hospital, Crumlin will be funded in view of the significant waiting list and access issues for children with juvenile idiopathic arthritis; and if he will make a statement on the matter. [46459/17]
View answerIn relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
739. Deputy Pearse Doherty asked the Minister for Health the names of the special advisers employed in his Department; the names of special advisers to junior ministers in his Department; the annual salary of each adviser; if these persons were special advisers immediately prior to taking up their current role or immediately prior to the June 2017 Cabinet reshuffle; if so, the Minister to which they were appointed to; the date each special adviser was appointed with effect as stated in the Government order; the date of the Government order; if they received a salary for the period before the appointment order was signed in the case of special advisers whose appointment order date has an effect date earlier than the order date; if so, by whom they were paid; if a special adviser during a period later backdated by appointment order had access to confidential material and or Cabinet papers; if they were subject to the Official Secrets Act 1963 during this period; if any persons currently employed as special advisers have not yet been appointed by order since the Cabinet reshuffle of 2017; and if he will make a statement on the matter. [46470/17]
View answerThe information requested by the Deputy is set out as follows:
|
Minister / Minister of State |
Special Advisers |
Annual Salary |
|
Minister Simon Harris, T.D. |
Joanne Lonergan - was Special Adviser to Minister Harris prior to Cabinet reshuffle and re-appointed by Government Order SI No. 337 of 2017 with effect from 14 June 2017. Continued to receive a salary from Department of Health pending signature of the Order to re-appoint her. Kathyann Barrett - was not a Special Adviser to Minister Harris before the Cabinet reshuffle. Was appointed by Government Order SI No. 337 of 2017 with effect from 14 June 2017. Salary has been paid by the Department of Health backdated to the date of her appointment. |
€89,906.00 €81,767.00 |
|
Minister of State Finian McGrath, T.D. |
Gerry Maguire - was Special Adviser to Minister of State McGrath prior to Cabinet reshuffle and re-appointed by Government Order SI No. 338 of 2017 with effect from 14 June 2017. Continued to receive a salary from Department of Health pending signature of the Order to re-appoint him. Damian O'Farrell - was Special Adviser to Minister of State McGrath prior to Cabinet reshuffle and re-appointed by Government Order SI No. 338 of 2017 with effect from 14 June 2017. Continued to receive a salary from Department of Health pending signature of the Order to re-appoint him. |
€76,647.00 €81,767.00 |
The Department has arrangements in place for all advisers to sign the relevant declaration under Circular 15/79 relating to Official Secrecy and Integrity as soon as possible and does not wait for the Government Order of appointment in order to progress this. All advisers assigned to Ministers of this Department have done so.
The Department is currently preparing a Government Order to appoint a Special Adviser to Minister of State Jim Daly.
