Written Answers Nos. 317-329
317. Deputy Brendan Smith asked the Minister for Health if additional funding will be provided in 2018 for home help, home support and home care packages; if his attention has been drawn to the difficulties caused to persons and families when delays occur in providing such support; and if he will make a statement on the matter. [53946/17]
View answerThe demand for the home help service, and for additional supports through the Home Care Package Scheme, continues to grow in parallel with the increasing numbers of older people. Many more of our older people with complex care needs are now being maintained at home, leading to increased demand for additional levels of service, and for services outside of core hours of Monday to Friday.
In Budget 2018 a further €41 million has been made available for older people services, comprising €9m once-off funding in 2017 and €32 million next year, to further strengthen supports for older people, particularly to facilitate speedier discharge from acute hospitals over the winter period. A significant proportion of this additional funding will go towards home care services.
Home care is monitored on an on-going basis, to ensure that activity is maximised relative to individual clients’ assessed care needs and within the overall available resources for home care and having regard to demand throughout the year.
The resources available for home care services while significant, are finite. Accordingly the services, and allocation of resources to individual clients, require prudent management on an on-going basis as demands for services increase. In this context, those clients who are assessed and approved for home care and who are not being provided immediately with a service are risk assessed and placed on a waiting list for a resource as it becomes available.
318. Deputy Aindrias Moynihan asked the Minister for Health if a discretionary medical card will be provided to a person (details supplied); and if he will make a statement on the matter. [53513/17]
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.
319. Deputy Tom Neville asked the Minister for Health his views on a matter in relation to a person (details supplied); and if he will make a statement on the matter. [53521/17]
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.
320. Deputy Fergus O'Dowd asked the Minister for Health if a reply will issue to a request from a group (details supplied) in relation to outreach services; the funds available to the group in relation to the outreach plans; and if he will make a statement on the matter. [53522/17]
View answerIn response to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
321. Deputy Fergus O'Dowd asked the Minister for Health if a reply will issue to concerns raised in correspondence (details supplied); if a commitment will be made to secure funds for the Louth-Meath branch of an organisation (details supplied); and if he will make a statement on the matter. [53527/17]
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.
The particular issue raised by the Deputy is a service matter for the HSE. Accordingly I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
322. Deputy Paul Kehoe asked the Minister for Health the status of the reforms of the fair deal scheme relating to small businesses and farmers; and if he will make a statement on the matter. [53528/17]
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.
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 I.F.A and the Irish Creamery Milk Suppliers Association to discuss various strategies that may assist with addressing their members concerns and have apprised them of the current progress. I remain hopeful to be in receipt of this legal advice before year end and 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. Any proposed changes will require primary legislation and I hope to be in a position to progress this in early 2018.
323. Deputy Kevin O'Keeffe asked the Minister for Health if he will arrange for the public health nurse to call to reassess a person (details supplied) in County Cork who requires additional home help hours [53535/17]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
324. Deputy Niamh Smyth 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. [53539/17]
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.
325. Deputy Timmy Dooley asked the Minister for Health when a person (details supplied) in County Clare will receive cataract surgery; and if he will make a statement on the matter. [53542/17]
View answerAs this is a service matter, I have asked the HSE to respond to you directly.
326. Deputy Niamh Smyth asked the Minister for Health his plans to increase funding for respite care across the country in an attempt to eliminate the pressures families are under, particularly in view of the postcode lottery system that currently exists with supports and services for family carers; and if he will make a statement on the matter. [53546/17]
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.
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.
327. Deputy Richard Boyd Barrett asked the Minister for Health the reason for the decision to remove lidocaine patches from the approved GMS list for chronic pain sufferers; if he will review the case of a person (details supplied); and if he will make a statement on the matter. [53556/17]
View answerMedicines play a vital role in improving the health of Irish patients. Securing access to existing and new and innovative medicines is a key objective of the health service. However, the challenge is to do this in an affordable and sustainable manner. The medicines bill for the community drugs schemes – primarily the GMS, Long Term Illness and Drugs Payment schemes and the High Tech Arrangement – is forecast at just over €1.7 billion in 2017.
To ensure patients receive the highest quality care, resources invested in medicines must be used efficiently and effectively. This requires an integrated approach to secure best value for money for all treatments, greater efficiencies in the supply chain and the use of the most cost-effective treatments.
Lidocaine 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. It was reimbursed in the community drugs schemes from 2010. The projected budget impact was low due to the specific licensed indication but total expenditure has increased significantly, from €9.4 million in 2012 to over €30 million in 2016, mainly from off-license use for pain not associated with shingles. Currently, over 25,000 patients receive this item.
An HSE Medicines Management Programme (MMP) review of this product highlighted that the clinical evidence for its use in PHN is limited due to lack of comparative data and its value is uncertain for all other types of pain. The National Centre for Pharmacoeconomics estimated that, in Ireland, between 5-10% of prescribing of this product is for the licensed indication of PHN.
Following the MMP review, the HSE introduced a new reimbursement system for the product from 1 September 2017. This process supports the appropriate use of Versatis, ensuring that PHN patients continue to receive this treatment. The HSE estimates that this protocol will reduce expenditure on this product by approximately 90%.
Under the protocol, all patients who were receiving antivirals for shingles were automatically approved for the lidocaine medicated plaster for three months. No action was required by GPs and the patient’s pharmacy was notified of his or her approval status.
These patients were identified and automatically registered on the HSE-PCRS system for three months and continued to receive the treatment from their pharmacy until 30 November 2017. However, from 1 December 2017, non-shingles patients will no longer get this item under the community drugs schemes. The HSE has produced information leaflets for patients and advised GPs on treatment alternatives.
In exceptional circumstances, the product may be approved for supply through the community schemes for unlicensed indications. GPs apply for reimbursement for unlicensed indications through the online system. The MMP reviews applications before a decision is made and communicated to the GP.
Full details of the review are available on the HSE website at http://hse.ie/eng/about/Who/clinical/natclinprog/medicinemanagementprogramme/yourmedicines/lidocaine-plaster/lidocaine-medicated-plaster.html.
This decision is a matter for the HSE. However, I fully support the objectives of the HSE Medicines Management Programme.
328. Deputy Brendan Howlin asked the Minister for Health the Acts, or parts of Acts, awaiting commencement within his area of statutory responsibility; the reason for the delay in the commencement of each; and if he will make a statement on the matter. [53570/17]
View answerInformation is shown in the table in relation to legislation within my area of statutory responsibility which has been enacted since 2011 and not yet commenced. The Deputy might let me know if he would like information in regard to any specific Act enacted prior to 2011.
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Acts passed since 2011 |
Sections not in force |
Current position |
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Health and Social Care Professionals (Amendment) Act 2017 |
Whole Act. This Act was enacted on 9 December 2017. |
It is envisaged that the commencement order to commence all sections will be made in December 2017. |
|
Civil Liability (Amendment) Act 2017 - Part 4 |
This Act was enacted in November 2017. |
The Minister for Health is responsible for Part 4 of the Civil Liability (Amendment) Act 2017. Part 4 of the Act provides for the voluntary open disclosure of patient safety incidents. It is intended to commence Part 4 of the Act in Spring 2018. |
|
Misuse of Drugs (Amendment) Act 2016 |
Sections 4, 5 and 7(a) and (b). |
Sections 4 and 5 facilitate the commencement of provisions of the Irish Medicines (Miscellaneous) Provisions Act 2006, transferring responsibility for the issuing of controlled drug licences from the Minister for Health to the Health Products Regulatory Authority (HPRA). Sections 7(a) and (b) revoke certain statutory instruments which were confirmed under the Misuse of Drugs (Amendment) Act 2015. These sections will be commenced when new regulations are made. |
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Children and Family Relationships Act 2015 |
Parts 2 and 3 |
Regulations to facilitate the commencement of Parts 2 & 3 of the Children and Family Relationships Act 2015 are being prepared. My Department is also working to resolve a small number of technical issues in order to ensure that the processes associated with Parts 2 and 3 of the Act can be commenced. |
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Health (General Practitioner Service) Act 2015 |
Section 2 - Amendment of section 58 of Health Act 1970. |
Consultations are ongoing with the Office of the Attorney General (AGO). A decision will be made on commencement on the conclusion of the consultation process. |
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Assisted Decision-Making (Capacity) Act 2015 |
Section 82, except insofar as it relates to the definition of “Minister”, Sections 83 – 90, Section 91(1), except insofar as it relates to definitions of “Code of Practice” and “Working Group”, Sections 91(3) – 91(14), Sections 92 and 93. |
The Assisted Decision-Making (Capacity) Act was signed into law on 30 December 2015. The Minister for Justice and Equality is responsible for commencement of the Assisted Decision-Making (Capacity) Act 2015, except for Part 8, which the Minister for Health is responsible for commencing. Part 8 of the Act provides a legislative framework for advance healthcare directives (AHDs). Section 91(2) of the Act was commenced on 17 October 2016 and a multidisciplinary Working Group was subsequently established by the Minister for Health to assist in the development of the Code of Practice on the AHD provisions. The Working Group will submit its recommendations for the Code of Practice on the AHD provisions to the Director of the Decision Support Service. The Director shall, with the consent of the Minister for Health, publish a Code of Practice, based (whether in whole or in part) on those recommendations. The preparation of this Code of Practice will facilitate the subsequent commencement of Part 8 of the Act, pertaining to AHDs, in its entirety. |
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Health Identifiers Act 2014 |
Sections 7(2)-(6), 10(3), 11(1)-(5), (7), 12-20, 24, 35-39. |
The 2014 Act provides the legal basis for the introduction of a system of unique health identifiers for (a) individuals and (b) health services providers. It was always the intention that implementation of the health identifier project would be on a phased basis. Accordingly, the commencement of the Act's provisions, in a timely and relevant way, is structured to support the planned phased implementation. The initial implementation focus is on the identifier for individuals and, necessary provisions in the Act, in that area, have been commenced. |
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Health (General Practitioner Service) Act 2014 |
Sections 2, 3(a) and 9 - Amendments to Health Act 1970 and other issues. |
Following the conclusion of consultations with the Office of the Attorney General (AGO) and discussions with the HSE, a decision will be made on commencement on these sections. |
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Health (Miscellaneous Provisions) Act 2014 |
Sections 6(a)(iii), 12(b), insofar as it relates to the insertion of subsection (1B) of section 26 of the Health and Social Care Professionals Act 2005, sections 21 and 23. |
Section 6(a)(iii), part of section 12(b) and section 21 relate to the proposed division of the profession of radiographer into the two professions of radiographer and radiation therapist. The sections can be commenced when CORU (the statutory regulator for health and social care professionals) has made the necessary bye laws. Section 23 provides for conditions to be attached to the registration of a person with a relevant medical disability. CORU’s registration system is being updated to allow this section to be commenced. It is envisaged that commencement of these sections (6(a)(iii), part of 12(b), 21 and 23) will take place during 2018. |
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Public Health (Sunbeds) Act 2014 |
Section 14. |
Section 14 relates to training in the use of sunbeds by sunbed business operators or their employees. This matter is still under consideration. |
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Health (Alteration of Criteria for Eligibility) Act 2013 |
Section 4 - Amendment of section 47 of Health Act 1970. |
Consultations have taken place with the Office of the Attorney General (AGO). As commencement of this section is now bound up with the commencement of sections 2, 3(a) and 9 of the Health (General Practitioners Services) Act 2014, a decision will be made on commencement on the conclusion of the commencement process for those sections. |
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Health (Amendment) Act 2013 |
Section 4. |
This section provides that the HSE may outsource the operation and administration of the Nursing Homes Support Scheme. However there are no plans at present to change the existing arrangements in this regard. |
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Nurses and Midwives Act 2011 |
Sections 4(2), 9(2)(g)(ii), 37(2)(a), 39, 40, 41, 44, 45, 59(1)(b) regarding professional competence, 59(2)(d), 65(1)(b), 84, 87 – 91, 102(2), (3) (5) and 103. |
This is a comprehensive piece of legislation which is being commenced on a gradual basis. |
329. Deputy Thomas P. Broughan asked the Minister for Health the additional resources which are being provided in 2018 for homecare and respite services in view of deficiencies revealed by a recent RTÉ investigation; and if he will make a statement on the matter. [53576/17]
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.
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.
