Written Answers Nos. 204-217
204. Deputy Joan Collins asked the Minister for Health if the HSE will publish the findings of an audit of staffing levels in cystic fibrosis hospital centres that was undertaken in 2016; and the reason this information has not been published. [2566/18]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to you directly.
205. Deputy Éamon Ó Cuív asked the Minister for Health the extra resources being provided to the National Ambulance Service in 2018 for service improvement; the improvements to the service envisaged in 2018 in the agreed plan with his Department; and if he will make a statement on the matter. [2570/18]
View answerAs this is a service matter, I have asked the HSE to respond to you directly.
206. Deputy Clare Daly asked the Minister for Health the reason for the decision to discontinue supplying of Versatis medicated plasters with lidocaine to medical card holders; the alternative that will be made available to persons that rely on these items; and if he will make a statement on the matter. [2577/18]
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.
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 has been 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 annual 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 no longer received 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.
207. Deputy Martin Ferris asked the Minister for Health the number of radiologists that were on duty at University Hospital Kerry from 8 to 14 January 2018; and the number of hours worked by each. [2586/18]
View answerIn relation to the specific issue raised, I have asked the HSE to respond to you directly.
208. Deputy Ruth Coppinger asked the Minister for Health his views on removing the requirement for a psychiatric evaluation for a transgender person seeking hormone treatment. [2588/18]
View answerA proposed model of care for transgender children, adolescents and adults was submitted by the HSE Quality Improvement Division to the HSE Divisions of Primary Care, Mental Health and Acute Hospital for consideration in January 2017. The model was developed in consultation with key treating clinicians, planners, policy makers, advocates and service users and outlines key services required to ensure the needs of the transgender population are addressed.
In line with evidence-based international best practice, a thorough assessment is a pre-requisite to commencing hormone suppressants in Ireland. This is to ensure that the correct path is being taken for the individual and to ensure co-morbid issues are identified and addressed.
209. Deputy Ruth Coppinger asked the Minister for Health his plans to reduce the waiting times for transgender persons to access hormone treatment. [2589/18]
View answerI am aware that the waiting times are often unacceptably long and this places a significant burden on patients and their families. Reducing waiting times for the longest waiting patients is one of this Government's key priorities. Consequently, Budget 2018 allocated €55 million for the National Treatment Purchase Fund in 2018. This significant increase in funding more than doubles their 2017 total allocation which was €20m.
The HSE and NTPF are working together to develop coherent and synergistic Waiting List Action Plans in 2018 with the objective of arranging the provision of treatment for patients across a range of inpatient/daycase and outpatient specialties and procedures. These initiatives will continue to focus on long-waiting patients and overall waiting list numbers.
The NTPF publishes the Inpatient and Outpatient waiting list figures by specialty and hospital each month. This information is available on NTPF.ie. The most recent figures published by the NTPF for December 2017 indicates that there is a total of 41 people on the Inpatient/Daycase waiting list for Endocrinology and a total of 9,043 people on the Outpatient waiting list for Endocrinology. The Deputy may wish to note that this data is extracted from the overall waiting list figures which do not differentiate transgender patients from other patients on the waiting list.
With respect to transgender persons seeking to access hormone treatment, the existing care pathway in Ireland generally begins with an approach by an individual to their GP. The GP may refer the person to the local Community Mental Health Team for support and a diagnosis of Gender Dysphoria by psychiatrist or a clinical psychologist. A thorough assessment is a pre-requisite to commencing hormone suppressants in Ireland, in line with international best practice. This is to ensure that the correct path is being taken for the individual and to ensure co-morbid issues are identified and addressed.
More broadly, 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.
210. Deputy Eugene Murphy asked the Minister for Health the reason a person (details supplied) has not been transferred from Sligo hospital to Tallaght hospital for treatment; and if he will make a statement on the matter. [2612/18]
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.
211. Deputy Billy Kelleher asked the Minister for Health the number of audiologists for adult services by county; his views on whether there is a sufficient number employed; the number on the panel for 2017; and if he will make a statement on the matter. [2616/18]
View answerAs this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.
212. Deputy Billy Kelleher asked the Minister for Health if consideration has been given to the outsourcing of audiologist services by way of voucher or similar system; and if he will make a statement on the matter. [2620/18]
View answerAs this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.
213. Deputy Louise O'Reilly asked the Minister for Health the amount spent by his Department and the HSE on specifically combatting obesity in each of the past five years, in tabular form; and if he will make a statement on the matter. [2621/18]
View answer214. Deputy Louise O'Reilly asked the Minister for Health the amount spent by his Department and the HSE on combating obesity in respect of expenditure on each programme (details supplied), in tabular form; and if he will make a statement on the matter. [2622/18]
View answer215. Deputy Louise O'Reilly asked the Minister for Health the amount spent by his Department and the HSE on combating obesity through Healthy Ireland in each of the past five years, in tabular form; and if he will make a statement on the matter. [2623/18]
View answer216. Deputy Louise O'Reilly asked the Minister for Health the amount spent by his Department and the HSE on advertising and awareness campaigns relating to obesity in each of the past five years, in tabular form; and if he will make a statement on the matter. [2624/18]
View answer217. Deputy Louise O'Reilly asked the Minister for Health the amount spent by his Department and the HSE on the treatment of obesity in each of the past five years, in tabular form; and if he will make a statement on the matter. [2625/18]
View answerI propose to take Questions Nos. 213 to 217, inclusive, together.
Since the launch of Healthy Ireland, expenditure on its implementation from within the budget of the Department of Health has been the following:
|
Year |
Expenditure |
|
2013 |
€89,315 |
|
2014 |
€586,470 |
|
2015 |
€607,707 |
|
2016 |
€1,156,405 |
|
2017 |
€996,837 |
In addition to the expenditure noted above, other expenditure arising within the Department could also be described as "Healthy Ireland" depending on classification. It is not possible to disaggregate this expenditure with respect to obesity alone. The approximate costs associated with both development and publication of the new Health Eating Guidelines & Food Pyramid and the national Obesity Policy & Action Plan were €55,719 and €19,186 respectively.
Separate to the expenditure detailed above, the Government, in July 2016, approved the creation of a Healthy Ireland Fund and subsequently provided an initial allocation of €5 million in Budget 2017 to kick-start its establishment. The Fund was announced by An Taoiseach on Monday the 2 October 2017. €5 million was allocated in Budget 2018.
The Healthy Ireland Fund will help drive the cross-governmental approach as set out in the Healthy Ireland Framework to improve the mental and physical health and wellbeing of the population. The main aim of the Fund is to support innovative, cross-sectoral, evidence based projects, programmes and initiatives that support the implementation of the key national policies in various areas including Obesity and Physical Activity. In particular the Fund will be for projects and programmes aimed at children and young people and their families, and supporting communities and vulnerable groups who are at most risk of experiencing health inequalities.
Finally, as some of the issues raised in the deputy’s questions are service matters, they have been referred to the HSE for direct reply.
