Maureen O'Sullivan
Question:42. Deputy Maureen O'Sullivan asked the Minister for Health if the drug Kuvan will be made available for sufferers of PKU through the HSE; and if he will make a statement on the matter. [48132/17]
View answerMedicinal Products Availability
Questions (42)
Written answers
The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
In reaching a decision, the HSE will take into account such expert opinions and recommendations which may have been sought by the HSE, including, for example, advice from the National Centre for Pharmacoeconomics - the NCPE.
Sapropterin (Kuvan) was previously considered under the pricing and reimbursement processes in 2009. At that time, insufficient evidence was available to support the application submitted by Merck Serono.
In December 2015, Merck Serono advised the HSE that the market authorisation for sapropterin was transferring to Biomarin in 2016. The HSE met with the new market authorisation holder in May 2016 and was advised that it would be submitting a health technology assessment dossier in relation to sapropterin.
The NCPE assessment was completed on the 15 September 2017. The NCPE did not recommend Kuvan for reimbursement as it was not deemed cost effective.
The HSE assessment process is ongoing and the HSE will take into account any relevant expert advice when making its decision, in line with the 2013 Act.
Disability Support Services
Questions (43)
Mick Wallace
Question:43. Deputy Mick Wallace asked the Minister for Health if he is satisfied with the overall level of support provided by the HSE to families in County Wexford with children suffering with intellectual disabilities and complex needs, including autism; his views on the over-reliance of the private sector in this area; and if he will make a statement on the matter. [48145/17]
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 HSE wants to assure the public that its community services are there to care and support. The welfare of patients, clients, service users and their families in Co. Wexford is important to the HSE, and the community services in Co. Wexford are doing their best within available resources to ensure that people have access to their services.
Children with intellectual disability are normally seen in the first instance by the Early Intervention Team which forms part of the Wexford Disability Services.
With regard to children with complex needs, priority is given to these children.
International research has shown that early intervention leads to better outcomes for such children. It is recognised that early intervention services and services for school-aged children with disabilities need to be improved and organised more effectively and this process is well under way. The HSE is currently engaged in a reconfiguration of existing therapy resources to geographic based teams for children (0-18 years). The objective of the new model of assessment and intervention is to provide one clear referral pathway for all children, irrespective of their disability, where they live or the school they attend.
Currently there are a number of key vacancies in the Disability Services in Co. Wexford. All posts are approved and are with the National Recruitment Services for permanent filling.
With regard to Autism specifically, at the request of the Minister for Health, the HSE is conducting a review of services across the country to identify existing models of best practice.
Mental Health Services
Questions (44)
Bríd Smith
Question:44. Deputy Bríd Smith asked the Minister for Health if he will report on the situation and staffing at a facility (details supplied). [48152/17]
View answerWritten answers
The HSE Linn Dara Child and Adolescent Mental Health In-patient Unit, based at Cherry Orchard in west Dublin, provides in-patient treatment, on a regional geographic basis, for children under the age of 18 years. Linn Dara is a 24 bed unit that has been operational since December 2015.
Referrals are accepted for persons under the age of 18, where the severity and complexity of the presenting mental health disorder is such that treatment at primary care service level has been unsuccessful.
The service provides assessment and treatment through a multi-disciplinary team for young people, and their families, who are experiencing mental health difficulties. On 2nd June 2017, due to previous difficulties in recruiting Psychiatric Nursing staff, and taking into account other factors such as quality and safety, a decision was made to temporarily reduce the operational capacity at Linn Dara to 11 beds. During the time of reduced capacity, all young persons were discharged based on appropriate clinical decisions, and with a detailed Care Plan and appropriate Community Child and Adolescent Mental Health Team follow-up.
The HSE has actively engaged in a recruitment process for nursing staff for this facility. Every effort was made to re-open beds at the earliest opportunity. The Executive continues to work with all the key stakeholders, including Unions, regarding innovative ways of ensuring provision of this vital service.
In September 2017, following a recruitment campaign, graduate Psychiatric Nurses were recruited for Linn Dara. As of 31st October 2017, there are the required number of staff in place to return the Unit to its approved capacity. Currently, 22 beds in Linn Dara have been re-opened, and 2 High Observation beds are also available for referrals.
Constitutional Amendments
Questions (45, 88)
Ruth Coppinger
Question:45. Deputy Ruth Coppinger asked the Minister for Health his plans for constitutional referenda in 2018. [47720/17]
View answerRuth Coppinger
Question:88. Deputy Ruth Coppinger asked the Minister for Health if he will report on his progress in assisting with the drafting of abortion legislation; and if he will make a statement on the matter. [48173/17]
View answerWritten answers
I propose to take Questions Nos. 45 and 88 together.
As the Deputy will be aware, the Government established a Citizens’ Assembly, in line with its Programme for Partnership Government commitment, to consider a number of matters including constitutional reform. The Assembly first considered the Eighth Amendment of the Constitution (Article 40.3.3), and submitted its final report, setting out its recommendations, to the Oireachtas on 29 June 2017.
The Joint Committee on the Eighth Amendment of the Constitution is now considering the report of the Citizens’ Assembly in order to recommend to the Oireachtas the policy direction it should consider on the issue. The first public meeting of the Joint Committee on the Eighth Amendment of the Constitution, chaired by Senator Catherine Noone, was on 20 September. The Committee is to report its conclusions and recommendations to both Houses of the Oireachtas within three months of its first public meeting, which would therefore be due on or before 20 December 2017.
The Government has agreed to hold a referendum on the Eighth Amendment in May or June 2018 subject to the timely passage of a Constitutional Amendment Bill on the matter by the Houses of the Oireachtas.
I wish to assure the Deputy that I have great regard for the important body of work with which the Special Joint Committee on the Eighth Amendment of the Constitution has been charged, and look forward to its report in due course. My Department, in conjunction with the Office of the Attorney General, is seeking to explore and research the issue so that, in so far as is feasible, as much preparation as possible can be drawn upon once the Special Joint Committee finalises its recommendations. This will be important if we are to complete the process in line with the timetable set out by Government.
HSE National Service Plan
Questions (46)
Billy Kelleher
Question:46. Deputy Billy Kelleher asked the Minister for Health when the 2018 HSE service plan will be published; and if he will make a statement on the matter. [48183/17]
View answerWritten answers
As provided for under the Health Act 2004, as amended, my Department wrote to the Health Service Executive to notify it of its allocation for 2018 on 26 October, 2017 which was within the 21 day time-line following the publication by the Government of the Estimates for Public Services. The legislation provides that, on receipt of the letter of determination, the HSE has 21 days to prepare and submit its National Service Plan for 2018 for my approval.
The Health Act allows me to extend the period provided to the HSE to prepare, adopt and submit its service plan, if required. I understand that intensive discussions are ongoing between the HSE and my Department on the 2018 service plan and that some additional time is required to close off all discussions and finalise the plan. To accommodate this, it has been agreed to grant the HSE an extension until Wednesday, 29 November for submission of the service plan for 2018.
Following the submission of the service plan, the legislation provides 21 days for me examine the proposed plan and either:
a) approve the service plan in the form it is submitted,
b) approve the service plan with such amendments as I, having consulted with the Executive, may determine, or
c) issue a direction to the Executive to amend the plan.
The National Service Plan must be laid before the Houses of the Oireachtas within 21 days of its approval. Once the service plan is laid before the Houses of the Oireachtas, the HSE will ensure it is published at the earliest possible time.
Hospitals Funding
Questions (47)
Bobby Aylward
Question:47. Deputy Bobby Aylward asked the Minister for Health if additional resources will be allocated to the existing cardiac catheterisation laboratory at University Hospital Waterford in order to increase the current capacity to accommodate the estimated 450 additional procedures that will be referred there through additional diagnostic angiograms set to be provided by a mobile catheterisation laboratory; and if he will make a statement on the matter. [48096/17]
View answerWritten answers
Funding of €0.5m was allocated in 2017 for Cardiology Services in University Hospital Waterford (UHW), as recommended in the Herity report, to increase planned Cath Lab sessions by 20%. I requested that the HSE maximise the benefit for patients from the €0.5m funding in respect of both additional sessions at the existing Cath Lab and the temporary use of a mobile Cath Lab for a specific period. The mobile Cath Lab was deployed for the short term provision of cardiac diagnostic angiogram services on the grounds of University Hospital Waterford from 02 October 2017 for a period of 20 weeks and is currently providing a scheduled diagnostic angiography service on a 3 day per week basis.
In regard to resources for University Hospital Waterford in 2018, the HSE is currently in the process of preparing its 2018 Service Plan.
Disability Services Data
Questions (48)
Margaret Murphy O'Mahony
Question:48. Deputy Margaret Murphy O'Mahony asked the Minister for Health the number of overdue assessments of need under the Disability Act 2005 in each Cork local health area; and if he will make a statement on the matter. [48230/17]
View answerWritten answers
The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
Medicinal Products Reimbursement
Questions (49, 51)
John Brassil
Question:49. Deputy John Brassil asked the Minister for Health if the drug Kuvan for persons with PKU will be reimbursed by the HSE; and if he will make a statement on the matter. [48189/17]
View answer
Gino Kenny
Question:51. Deputy Gino Kenny asked the Minister for Health the likely timescale of the conclusion of HSE negotiations with the manufacturer of the drug Kuvan; his views on the urgency of it being made available for persons with PKU here; and if he will make a statement on the matter. [48174/17]
View answerWritten answers
I propose to take Questions Nos. 49 and 51 together.
The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
In reaching a decision, the HSE examines all the evidence which may be relevant in its view for the decision and will take into account such expert opinions and recommendations which may have been sought by the HSE, including, for example, advice from the National Centre for Pharmacoeconomics (NCPE).
Sapropterin (Kuvan) was previously considered under the national pricing and reimbursement processes in 2009. At that time, insufficient evidence was available to support the pricing and reimbursement application submitted by Merck Serono.
In December 2015, Merck Serono advised the HSE that the market authorisation for sapropterin was transferring to Biomarin in 2016. The HSE met with the new market authorisation holder in May 2016 and was advised that it would be submitting a health technology assessment dossier in relation to sapropterin.
The NCPE assessment of the new dossier was completed on the 15 September 2017 and the NCPE did not recommend sapropterin for reimbursement as it was not deemed cost effective.
The HSE assessment process is ongoing and the HSE will take into account any relevant expert advice when making its decision, in line with the Health (Pricing and Supply of Medical Goods) Act 2013.
Mental Health Services Provision
Questions (50)
Catherine Connolly
Question:50. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Question No. 467 of 20 September 2017, the opening date of the new 50-bed mental health unit at Galway University Hospital in view of the fact that the planned operational date for the new unit is Q4 2017; the complement of staff necessary to run this unit; if this number has been recruited; if the assignment of staff will mean a reduction in staff for other services; and if he will make a statement on the matter. [48089/17]
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.
Question No. 51 answered with Question No. 49.
Mental Health Services Staff
Questions (52)
Jackie Cahill
Question:52. Deputy Jackie Cahill asked the Minister for Health when he expects the number of community CAMHS posts in CHO 3 and CHO 5 to reach the level recommended under A Vision for Change. [48226/17]
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.
Mental Health Services Staff
Questions (53)
James Lawless
Question:53. Deputy James Lawless asked the Minister for Health when he expects the number of community CAMHS posts in CHO 7 to reach the level recommended under A Vision for Change. [48222/17]
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.
Hospitals Building Programme
Questions (54)
Anne Rabbitte
Question:54. Deputy Anne Rabbitte asked the Minister for Health the status of the proposed 50-bed extension for Portiuncula Hospital; and if he will make a statement on the matter. [48195/17]
View answerWritten answers
As this is a service matter, I have asked the HSE to contact you with regard to the project.
Psychological Services
Questions (55)
Timmy Dooley
Question:55. Deputy Timmy Dooley asked the Minister for Health the number of counselling psychologists recruited by the HSE to date in 2017; the number of clinical psychologists recruited to date in 2017; and if he will make a statement on the matter. [48235/17]
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.
General Practitioner Contracts
Questions (56)
Louise O'Reilly
Question:56. Deputy Louise O'Reilly asked the Minister for Health the position regarding the negotiations on a new general practitioner contract; when the negotiations are expected to be finalised; the substantive changes which the contract is expected to entail; and if he will make a statement on the matter. [48115/17]
View answerWritten answers
The 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 and Sláintecare commit to shifting the model of healthcare towards a more comprehensive and accessible primary care service 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. 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 the Department of Health and the HSE meet with GP representatives on a regular basis.
I am hopeful that agreement can be reached with GP representatives in the coming months on service developments that can be introduced during 2018. This will be the start of a multi-annual change process that will enhance the role of primary care as the foundation of a more accessible and effective health service.
State Claims Agency
Questions (57)
Clare Daly
Question:57. Deputy Clare Daly asked the Minister for Health the number of maternity cases involved in the State Claims Agency damages payouts in 2016; and the total damages paid in maternity cases in 2016. [48154/17]
View answerWritten answers
The State Claims Agency (SCA) has provided the following information in relation to the number of maternity cases and the total costs paid in 2016.
|
Year |
Number of Claims |
Total paid in damages €m |
|
2016 |
100 |
69.94 |
Note:
Maternity cases means all claims recorded under the location of 'Healthcare' and the speciality of 'Maternity Services' where costs were paid in 2016 and relates to acute hospitals and community care locations.
The SCA amended its reporting methodology from the start of Q2-2016. The reporting date is now payment date as opposed to transaction date.
Health Services
Questions (58)
Bernard Durkan
Question:58. Deputy Bernard J. Durkan asked the Minister for Health the degree to which the bed and staff complement throughout the public health sector remains adequate to meet the demand with particular reference to all regions throughout the country without exception; the actions he plans to take in the event of a deficiency; and if he will make a statement on the matter. [48177/17]
View answerWritten answers
Work on the Health Service Capacity Review is continuing to progress. As I have previously stated, the Review will have a wider scope than previous exercises and will examine key elements of primary and community care infrastructure in addition to hospital facilities. A Steering Group is overseeing the project, with support from external consultants commissioned to provide technical, analytical and engagement expertise. An independent international peer review group is involved in ongoing review and validation of the methodology and approach. My Department has also undertaken a public consultation process to ensure that stakeholder views are fed into the process.
The findings from the Review will provide a basis for determining both the extent of capacity requirements over the next 15 years and the type of capacity that is needed at a national and regional level. The emerging findings from the review will inform the development of a new 10 year national capital plan later this year. I expect to receive the final report of the Capacity Review by the end of the year.
In terms of staffing, in line with our Statement of Strategy 2016-2019, my Department has developed a National Strategic Framework for Health and Social Care Workforce Planning in collaboration with a Cross-Sectoral Steering Group. The Framework, which I have launched this week, will support the recruitment and retention of the right mix of health workers across the health system to meet planned and projected service need.
Implementing the framework will be a multi-annual undertaking. The first action plan is for an 18-month period and focuses on the early actions needed to build health workforce planning capacity in the health sector.
Traveller Community
Questions (59)
Mick Barry
Question:59. Deputy Mick Barry asked the Minister for Health his views on the high number of Travellers affected by suicide (details supplied); and if he will make a statement on the matter. [48182/17]
View answerWritten answers
In 2015, the Government launched Connecting for Life, Ireland's National Strategy to Reduce Suicide with the aim of reducing suicide and self-harm over 2015-2020. The Strategy sets out a vision where fewer lives are lost through suicide, and where communities and individuals are empowered to improve their mental health and well-being. It provides community-based organisations with guidelines, protocols and training on effective suicide prevention.
Travellers have been identified as a priority group within Connecting for Life. One of the main goals in Connecting for Life is to target approaches to reduce suicidal behaviour and improve mental health among priority groups. Responsibility for monitoring and reporting systems to support the delivery of the Strategy has been assigned to the National Office for Suicide Prevention (NOSP). Some key achievements of this Strategy have included the on-going provision of free, evidence-informed suicide and self-harm training in communities nationwide with over 9,000 individuals completing training in 2016, and the successful delivery of the #littlethings mental health and wellbeing campaign. NOSP also support the work of 21 Resource Officers for Suicide Prevention across Ireland, guiding their strategic development of local Connecting for Life action plans.
In addition to this, in July 2017, the Department of Rural and Community Development announced the approval of the 2017 Dormant Accounts Action Plan. Additional funding of up to €3.46 million is being made available to the Department of Health in the period 2017-2019 to support a wide range of marginalised service users including refugees, transgender persons, Travellers, Roma, people with dementia and older people.
Under this is a specific mental health initiative for Travellers, which has been allocated €500,000. The aim of this measure is to develop Traveller mental health initiatives to reduce suicide and improve mental health outcomes for Travellers. These initiatives include maintaining and promoting positive mental health and wellbeing, and improving Traveller access to mainstream mental health services through the development of culturally appropriate services. This proposal is in line with the actions proposed in the National Traveller and Roma Inclusion Strategy, which was also launched this year.
Disability Support Services Provision
Questions (60)
Éamon Ó Cuív
Question:60. Deputy Éamon Ó Cuív asked the Minister for Health if extra funding will be provided in 2018 for respite care for persons with serious autistic and physical disabilities in view of the current significant shortfall in such services; and if he will make a statement on the matter. [48192/17]
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.
In the context of Budget 2018 I have secured an additional €75m for Disability Services, which will protect existing resources and go towards the requirement in 2018. This includes the provision of respite support services and the development of alternative models of respite care. My Department is currently engaged in discussions with the HSE regarding the National Service Plan for 2018. Pending the conclusion of these discussions, I am not in a position to comment on the specific level of funding that will be available for respite care in 2018.
Health Services Staff
Questions (61)
Bríd Smith
Question:61. Deputy Bríd Smith asked the Minister for Health if he will report on the recruitment of line staff in the public health service, particularly general hospital nursing staff; and his plans to retain newly qualified staff. [48153/17]
View answerWritten answers
The need to increase the numbers of consultants, doctors, nurses and midwives in the public health service is a priority for this Government despite a backdrop of global shortages in health professionals. The Government has allocated an additional €646 million in current expenditure to Health in Budget 2018, including funds for an additional 1,800 front line staff. The overall Health budget for 2018 is almost €15.3 billion. The HSE is currently finalising the 2018 Service Plan and will allocate the additional posts in accordance with service demands.
The HSE has been focused on increasing the number of frontline staff over the past three years as the budgetary position has improved and progress has been made in growing the consultant, NCHD and nursing workforce. At the end of September 2017 there were 2,951 whole time equivalent consultants in the public health services. This is 126 more than the end September 2016 figure and an increase of 666 in the past decade. The number of NCHDs has also increased significantly. At the end of September 2017 there were 6,286 whole time equivalent NCHDs, an increase of 311 compared with the end of September 2016 number and an increase of over 1,394 in the past decade. The HSE has been focused on addressing issues associated with the creation and approval of consultant posts and successful recruitment. It is now giving effect to the report 'Towards Successful Consultant Recruitment, Appointment and Retention', completed in December 2016. It is also focused on implementing the recommendations of the 'MacCraith Group' to support the recruitment and retention of NCHDs.
Recruitment of nurses and midwives is a key priority this year. Nursing and midwifery numbers at the end of September 2017 stood at 36,170 whole time equivalents. The number of nursing posts has increased by 632 in the 12 months from end September 2016 and by over 2,000 in the four years from end September 2013 to end September 2017. The Nursing Recruitment and Retention Agreement concluded with the INMO and SIPTU Nursing earlier this year committed to increasing the number of nurses and midwives by 1,224 additional permanent posts in 2017. The recent quarterly progress report on the Agreement from the HSE (30th Sept 2017) states that the HSE has filled 20% of the target posts. The HSE is currently concluding the process of offering all graduating nurses and midwives permanent contracts. This is expected to deliver a significant increase in staff nurse numbers between now and year-end, given that most students who complete their training at the end of August are recruited in the 4th quarter, following registration.
The Report of the Public Service Pay Commission identified problems in recruitment and retention in specific and specialist groups that are internationally in demand particularly in the health sector Following the ratification of the Public Service Stability Agreement, the Commission will now carry out a more comprehensive examination of underlying difficulties in recruitment and retention in those sectors and employment streams where difficulties are clearly evident. The Commission is committed to reporting on medical and nursing grades in 2018. The outcome of its assessment will be subject to discussions between the relevant parties.
Ministerial Functions
Questions (62)
James Browne
Question:62. Deputy James Browne asked the Minister for Health if he will report on the recent attendance of the Minister for State at the annual conference of a society (details supplied); and if he will make a statement on the matter. [48233/17]
View answerWritten answers
The Minister of State, Deputy Jim Daly, was invited to, and addressed, the Annual Conference of the Psychological Society of Ireland in Limerick on 8th November 2017. The theme of the Conference was "Living with Uncertainty".
In this context, the Minister covered various relevant issues in his address, including the need to develop responses to this specific issue and to wider evolving mental health challenges, the continued priority of the Government to develop all aspects of relevant policies and services, and promoting partnerships with the non-statutory sector to promote high quality standards across mental health care, including Prevention and Early Intervention measures.
The Minister issued a Press Release relating to this event, which is available on my Department's website.
Minister Daly adopts a pro-active and comprehensive approach to promoting this key healthcare programme, and he will continue to do so at every opportunity.