Tuesday, 13 Feb 2018

Written Answers Nos. 429-450

Drug and Alcohol Task Forces

Questions (429)

Micheál Martin

Question:

429. Deputy Micheál Martin asked the Minister for Health the status of the regional drug task forces; the involvement of the HSE on same; and if he will make a statement on the matter. [7239/18]

Written answers

Minister of State at the Department of Health

There are 10 Regional Drug & Alcohol Task Forces in Ireland. They were set up in 2003 on foot of recommendations from the first National Drugs Strategy (2001-2008), to facilitate a more effective response to the drugs problems in areas experiencing the highest levels of substance misuse.

Task Forces are partnerships between local statutory, voluntary and community sectors. Their current role is to prepare and oversee the implementation of Reducing Harm, Supporting Recovery 'A health-led response to drug and alcohol use in Ireland 2017 - 2025' at a local level by encouraging co-ordination and co-operation between services and by consulting with local communities to design and deliver services. The Task Force membership comprises elected representatives, representatives from the community and voluntary sector and relevant local statutory agencies including the Health Service Executive (HSE), Department of Social Protection, An Garda Síochána, Probation services, Education and Training Boards and the Local Authorities. Members meet on a regular basis.

The overall allocation to Regional Drug and Alcohol Task Forces for community-based drugs initiatives this year is €8.7 million. The HSE is responsible for the allocation and oversight of €7.6 million of this funding and the Department of Health is responsible for the remaining €1.1 million. It is a matter for each Task Force to ensure that the budget is effectively deployed to address current priorities and locally identified needs, taking into account the changing nature of the drugs phenomenon.

Drug and Alcohol Task Force Coordinators are, in the main, employed by the HSE. The HSE allocates funding to the Regional Drug and Alcohol Task Forces for various support workers, such as posts of development worker and administrator.

I am committed to working with Local and Regional Drug and Alcohol Task Forces in implementing the actions under Reducing Harm, Supporting Recovery.

Medical Aids and Appliances Provision

Questions (430)

Bernard Durkan

Question:

430. Deputy Bernard J. Durkan asked the Minister for Health the reason momentum wheelchairs are available at a cost to persons in County Kildare but appear to be available free of charge to those who require them in counties Wexford and Galway; his plans to rectify this; and if he will make a statement on the matter. [7240/18]

Written answers

Minister for Health

As this is a service matter it has been referred to the HSE for direct reply to the Deputy.

Nursing Homes Support Scheme Applications

Questions (431)

Kevin O'Keeffe

Question:

431. Deputy Kevin O'Keeffe asked the Minister for Health the position regarding an application under the nursing homes support scheme by a person (details supplied). [7284/18]

Written answers

Minister of State at the Department of Health

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Hospital Waiting Lists Data

Questions (432)

Brendan Smith

Question:

432. Deputy Brendan Smith asked the Minister for Health the number of persons on outpatient waiting lists awaiting eye care procedures at the end of 2016 and 2017, respectively; his plans to reduce such waiting lists; and if he will make a statement on the matter. [7290/18]

Written answers

Minister for Health

The NTPF publishes the Inpatient/Daycase and Outpatient waiting list figures by specialty for each hospital on its website each month. This information is available at www.NTPF.ie.

Data from the NTPF indicate that there was a total of 32,823 people awaiting an Ophthalmology Outpatient appointment at the end of December 2016 and 39,803 people awaiting an appointment at the end of December 2017.

The Outpatient Waiting List remains a significant challenge to be addressed in 2018. Outpatient activity has increased year-on-year, while the gap between referrals and appointment activity continues to widen, with 2017 data from the HSE indicating a gap of over 1,200 patients per week. A number of steps, including the commencement of a national waiting list validation project by the HSE, are being taken to ensure the lists are accurate. These efforts are to intensify in the coming months.

My Department has also requested the HSE to develop an Outpatient Waiting List Action Plan for 2018.

Health Services Provision

Questions (433)

Brendan Smith

Question:

433. Deputy Brendan Smith asked the Minister for Health his plans to reduce the reliance on hospital ophthalmology departments through appropriate additional community services delivered by optometrists in view of the need to reduce waiting lists; and if he will make a statement on the matter. [7291/18]

Written answers

Minister for Health

As this is a service matter it has been referred to the HSE for direct reply to the Deputy.

Ambulance Service

Questions (434)

Fergus O'Dowd

Question:

434. Deputy Fergus O'Dowd asked the Minister for Health the cost of private ambulance cover incurred by each acute hospital for the past 12 months; the number of such individual private ambulance journeys; the method of charging agreed (details supplied); the name of the companies involved; the amount received by each such ambulance company; the reason such private ambulances were used; the number of HSE or hospital owned ambulances attached or available to each such acute hospital; the number of such HSE ambulances normally available to each such acute hospital that were not available by acute hospital and a private ambulance had to be used; the cost of the national ambulance budget for 2016 to date; and if he will make a statement on the matter. [7303/18]

Written answers

Minister for Health

As the queries raised by the Deputy relate to a service issue, I have asked the HSE to respond to him directly.

Hospital Appointments Status

Questions (435)

Mary Butler

Question:

435. Deputy Mary Butler asked the Minister for Health when a person (details supplied) will be called for an operation at University Hospital Waterford; and if he will make a statement on the matter. [7308/18]

Written answers

Minister for Health

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The 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 the Deputy directly.

Services for People with Disabilities

Questions (436)

Seamus Healy

Question:

436. Deputy Seamus Healy asked the Minister for Health the position regarding an application for an assessment of needs for a person (details supplied) at HSE south Tipperary; and if he will make a statement on the matter. [7311/18]

Written answers

Minister of State at the Department of Health

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 an individual case, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Infectious Diseases

Questions (437)

Seán Fleming

Question:

437. Deputy Sean Fleming asked the Minister for Health the support that will be given to persons who have Lyme disease in view of the substantial additional cost persons who have this condition must incur on an ongoing basis; and if he will make a statement on the matter. [7317/18]

Written answers

Minister for Health

Lyme disease (also known as Lyme borelliosis) is an infection caused by a spiral-shaped bacterium called Borrelia burgdorferi. It is transmitted to humans by bites from ticks infected with the bacteria. The infection is generally mild affecting only the skin but can occasionally be more severe and highly debilitating. Lyme disease is diagnosed by medical history and physical examination. The infection is confirmed by blood tests which look for antibodies produced by an infected person's body in response to the infection. These normally take several weeks to develop and may not be present in the early stages of the disease. The standard laboratory approach to Lyme diagnostics is a two-stage approach and has been agreed by experts from the Scientific Advisory Committee of the Health Protection Surveillance Centre and other Irish and international experts. This testing is available in Ireland.

Lyme disease can be very successfully treated using common antibiotics by General Practitioners. These antibiotics are effective at clearing the rash and helping to prevent the development of complications. Antibiotics are generally given for up to three weeks. If complications develop, intravenous antibiotics may be considered.

The HSE Health Protection Surveillance Centre website (www.hpsc.ie) gives extensive information on Lyme Disease diagnosis, treatment and how to avoid tick bites. A Lyme Disease Subcommittee of the Scientific Advisory Committee of HPSC with professional clinical, entomological, scientific and environmental health expert representation (including a representative of the Lyme Support Group, Tick-Talk Ireland) has been established to explore all possible ways of raising awareness about Lyme disease. This Subcommittee is expected to meet shortly with a view to finalising its report. This report will cover a number of areas, including initiatives undertaken to date, summary advice relating to awareness, preventive advice for the general public, preventive advice and material for those responsible for sites or locations known to have or suspected as having higher densities of ticks, and summary advice relating to GP management of the condition. Any person who is suffering ill-health is eligible to seek medical attention, and to access appropriate health and social care services, irrespective of the cause of their symptoms.

Hospital Appointments Delays

Questions (438)

Michael Healy-Rae

Question:

438. Deputy Michael Healy-Rae asked the Minister for Health if he will address a matter regarding the case of a person (details supplied); and if he will make a statement on the matter. [7318/18]

Written answers

Minister for Health

In response to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly

Health Services Staff Remuneration

Questions (439)

Tom Neville

Question:

439. Deputy Tom Neville asked the Minister for Health his views on a matter (details supplied); and if he will make a statement on the matter. [7323/18]

Written answers

Minister for Health

I have asked the HSE to respond to the Deputy directly on this matter.

Medical Aids and Appliances Provision

Questions (440)

Tom Neville

Question:

440. Deputy Tom Neville asked the Minister for Health his views on a matter (details supplied) raised in correspondence; and if he will make a statement on the matter. [7325/18]

Written answers

Minister for Health

As this is a service matter it has been referred to the HSE for direct reply to the Deputy.

HSE Reviews

Questions (441)

Thomas Byrne

Question:

441. Deputy Thomas Byrne asked the Minister for Health if his attention has been drawn to a water ban in place in Kilcloon, County Meath; and the sequence of events in the way in which the HSE discovered that there were high levels of chlorine in the local water supply. [7332/18]

Written answers

Minister for Health

This is a matter for the HSE therefore I have referred the question to the HSE for attention and direct reply.

Medical Aids and Appliances Provision

Questions (442)

Michael Moynihan

Question:

442. Deputy Michael Moynihan asked the Minister for Health if his attention has been drawn to the long waiting times for funding for orthotics to be approved by the HSE for persons with disabilities in County Cork; the waiting period for this type of funding in the county in 2017; and if he will make a statement on the matter. [7348/18]

Written answers

Minister for Health

As this is a service matter it has been referred to the HSE for direct reply to the Deputy.

Medicinal Products Reimbursement

Questions (443, 451)

Frank O'Rourke

Question:

443. Deputy Frank O'Rourke asked the Minister for Health if the provision of Versatis patches on the general medical card scheme will be restored for a person (details supplied); and if he will make a statement on the matter. [7349/18]

Timmy Dooley

Question:

451. Deputy Timmy Dooley asked the Minister for Health the reason Versatis patches have been withdrawn from the medical card scheme for persons that are in pain; and if he will make a statement on the matter. [7432/18]

Written answers

Minister for Health

I propose to take Questions Nos. 443 and 451 together.

Medicines 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 – was approximately €1.8 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 has been reimbursed in the community drugs schemes since 2010. The projected budget impact on introduction was low due to the specific licensed indication but total expenditure trebled between 2012 and 2016, from €9.4 million to over €30 million, 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 other types of pain. The National Centre for Pharmacoeconomics estimated that, in Ireland, only 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 its appropriate use, 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. No action was required by GPs and the patient’s pharmacy was notified of his or her approval status.

However, since 1 December 2017, non-shingles patients no longer receive this item under the community drugs schemes. In August 2017 the HSE advised GPs of the changes and of treatment alternatives.

It is possible for non-shingles patients to be approved for the patch through the community drug schemes. The patient's GP should apply to the Medicines Management Programme through the online system, and the MMP will review the application and inform the GP of its decision.

I am advised that the MMP has received over 4,500 applications from GPs, of which some 10% have been approved. For many of the conditions applied for, prescribing of the patch was inappropriate, for example for conditions such as deep venous thrombosis, angina, gout and endometriosis.

Where a GP’s application is rejected, it may be appealed. Of some 200 appeals to date, the HSE advises that over 50% have been accepted on clinical grounds.

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.

Vaccination Programme

Questions (444)

John Curran

Question:

444. Deputy John Curran asked the Minister for Health his views on the fact that thousands of the 40,000 eligible schoolgirls are still not getting the HPV vaccine; his plans to increase the take up of the HPV vaccine among eligible schoolgirls; and if he will make a statement on the matter. [7356/18]

Written answers

Minister for Health

Cervical cancer is the fourth most common cancer in women worldwide. Each year in Ireland around 300 women are diagnosed with cervical cancer and 90 die from the disease. All cervical cancers are linked to high risk Human Papillomavirus (HPV) types. In 2009 the National Immunisation Advisory Committee (NIAC) recommended HPV vaccination for all 12 year old girls to reduce their risk of cervical cancer and in September 2010 the HPV vaccination programme was introduced for all girls in first year of second level schools.

I am aware of claims of an association between HPV vaccination and a number of conditions experienced by a group of young women. An illness that occurs around the time a vaccine is given and is already known to be common in adolescence does not imply the vaccine caused the problem. It appears that some girls first suffered symptoms around the time they received the HPV vaccine, and understandably some parents have connected the vaccine to their daughter’s condition. However, these claims have led to a significant drop in uptake rates of the HPV vaccine from 87% in 2014/15 to 72% in 2015/16 and 51% in 2016/17. Provisional figures from the HSE indicate that HPV vaccine uptake rates increased in September/October 2017 to 62% due to a comprehensive communications campaign for parents with support from a large number of key stakeholders.

One of the most important things we can do is to provide accurate and credible information to enable parents to take a fully informed decision concerning HPV vaccination. We know that HPV vaccine works and that many countries have seen significant decreases of pre-cancer of the cervix as a result of vaccination. The safety and effectiveness of the vaccine is endorsed by Irish and international scientific and medical institutions. The HSE launched their information campaign for HPV vaccination as part of the 2017/18 Schools Immunisation Programme on 30 August 2017. The Information campaign supports the HPV vaccination programme and provides information packs for parents which are scientifically accurate and endorsed by Irish and international bodies. In addition information is available for primary care facilities and pharmacies.

I would urge any parent who has doubts or questions about vaccination to engage with your family doctor, or alternatively to visit the HPV website – www.hpv.ie. These sources of information are clear and accurate and will answer any queries you may have. Parents of all eligible girls are strongly encouraged to access this information and ensure that their daughters receive this important cancer preventing vaccine.

As Minister for Health I fully support the HPV immunisation programme and its aim to increase uptake rates of this important lifesaving vaccine.

Vaccination Programme

Questions (445)

John Curran

Question:

445. Deputy John Curran asked the Minister for Health his plans to extend the HPV vaccine to boys; and if he will make a statement on the matter. [7357/18]

Written answers

Minister for Health

The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). NIAC is a committee of the Royal College of Physicians of Ireland comprising of experts in a number of specialties including infectious diseases, paediatrics and public health. The committee's recommendations are informed by public health advice and international best practice. All relevant and appropriate information is taken into account when deciding to make changes to the State's immunisation programmes.

NIAC has made a recommendation that the HPV vaccine should be given to boys. My Department asked the Health Information and Quality Authority (HIQA) to carry out a health technology assessment (HTA). Work has commenced on the HTA and is expected to be completed in 2018. Any decision to extend the current programme which offers HPV vaccination to all girls in their first year of second-level education to a programme that also offers vaccination to boys will be informed by the evidence contained in the HTA.

Defibrillators in Schools Provision

Questions (446)

John Curran

Question:

446. Deputy John Curran asked the Minister for Health his plans to liaise with the Minister for Education and Skills on the findings, due in 2018, of the national steering group on out-of-hospital cardiac arrest in order to make defibrillators more easily accessible in public places and schools; and if he will make a statement on the matter. [7358/18]

Written answers

Minister for Health

A national Out of Hospital Cardiac Arrest Steering group was established in 2017. The purpose of this project is to improve survival rates for those who suffer an out of hospital cardiac arrest through the development and implementation of an out of hospital cardiac arrest strategy up to 2020. This work will support the National Ambulance Service (NAS) and Community First Responder Ireland (CFR Ireland) in their commitment to improve clinical outcomes for Out-of-Hospital Cardiac Arrest (OHCA). It is also considering how to improve Out of Hospital Cardiac Arrest survival by strengthening the ‘Chain of Survival’ across Ireland. National and international evidence and experience will be assessed to see if it can be applied in Ireland. It is anticipated that the report of the OHCA Steering group will provide advice to the HSE and the Department on the most effective ways of improving survival including the use of defibrillators in community settings and schools and on increasing CPR training. Once the findings of the Steering group have been published any relevant recommendations will be carefully considered by both Departments. The position in relation to schools is that under the provisions of the Education Act 1998, the Board of Management is the body charged with the direct governance of a school. The decision to install a defibrillator is made at local school level and is a matter for the Board of Management of each individual school.

Hospital Appointments Status

Questions (447)

Niamh Smyth

Question:

447. Deputy Niamh Smyth asked the Minister for Health if an appointment can be scheduled for a person (detail supplied); and if he will make a statement on the matter. [7366/18]

Written answers

Minister for Health

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The 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 the Deputy directly.

Disabled Drivers Grant

Questions (448)

Robert Troy

Question:

448. Deputy Robert Troy asked the Minister for Health when the motorised transport grant, which was suspended in 2013 for new applications, will be reopened. [7385/18]

Written answers

Minister of State at the Department of Health

The Deputy will be familiar with the background to the closure of both the Mobility Allowance and Motorised Transport Grant schemes in February 2013.

The Motorised Transport Grant operated as a means-tested grant to assist persons with severe disabilities with the purchase or adaptation of a car, where that car was essential to retain employment. Following closure of the scheme in February 2013, no further Motorised Transport Grants have been payable.

It is important to note that the Disabled Drivers and Disabled Passengers scheme operated by the Revenue Commissioners, remains in place. This scheme provides VRT and VAT relief, an exemption from road tax and a fuel grant to drivers and passengers with a disability, who qualify under the relevant criteria set out in governing regulations made by the Minister for Finance. Specifically adapted vehicles driven by disabled persons are also exempt from payment of tolls on national toll roads and toll bridges. Transport Infrastructure Ireland has responsibility for this particular Scheme.

The Government decided that the detailed preparatory work required for a new Transport Support Scheme and associated statutory provisions should be progressed by the Minister for Health. The Programme for a Partnership Government acknowledges the ongoing drafting of primary legislation for a new Transport Support Scheme to assist those with a disability to meet their mobility costs. The Health (Transport Support) Bill is on the list of priority legislation for publication in the Spring/Summer session 2018. I can confirm that work on the policy proposals for the new Scheme is at an advanced stage.

The proposals seek to ensure that:

- There is a firm statutory basis to the Scheme's operation;

- There is transparency and equity in the eligibility criteria attaching to the Scheme;

- Resources are targeted at those with greatest needs; and

- The Scheme is capable of being costed and is affordable on its introduction and on an ongoing basis.

Question No. 449 answered with Question No. 406.

Orthodontic Services Waiting Lists

Questions (450)

Robert Troy

Question:

450. Deputy Robert Troy asked the Minister for Health his views on the current waiting times for orthodontic treatment in CHO area 8; if solutions to the staffing shortage in this area can be investigated; and his further views on a number of possible short-term solutions (details supplied) to ease this waiting list and provide essential treatment for the most severe cases within the region. [7390/18]

Written answers

Minister for Health

As this is a service matter it has been referred to the HSE for direct reply to the Deputy.