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Wednesday, 21 Mar 2018

Written Answers Nos 247-256

Mental Health Services Staff

Questions (247, 248, 249)

James Browne

Question:

247. Deputy James Browne asked the Minister for Health the number of nurses waiting on panels for a CAMHS position. [13064/18]

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James Browne

Question:

248. Deputy James Browne asked the Minister for Health the number of community CAMHS nursing positions advertised in 2017, and to date in 2018; the number of applications received for same; and the number of positions filled. [13065/18]

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James Browne

Question:

249. Deputy James Browne asked the Minister for Health the number of community CAMHS nursing positions filled; and the number of community CAMHS nursing positions required to reach the level recommended in A Vision for Change by CHO in tabular form. [13066/18]

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Written answers

I propose to take Questions Nos. 247 to 249, inclusive, together.

As these are service matters, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Hospital Appointments Status

Questions (250)

John Curran

Question:

250. Deputy John Curran asked the Minister for Health when an outpatient appointment will be made for a person (details supplied); and if the case will be examined. [13068/18]

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Written answers

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 inpatient, 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.

Hospital Appointments Status

Questions (251)

Seán Sherlock

Question:

251. Deputy Sean Sherlock asked the Minister for Health when a person (details supplied) in County Kildare will receive an appointment for a medical procedure. [13072/18]

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Written answers

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 inpatient, 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.

Hospital Appointments Status

Questions (252)

Robert Troy

Question:

252. Deputy Robert Troy asked the Minister for Health if a hospital appointment for a person (details supplied) will be expedited; and if he will make a statement on the matter. [13083/18]

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Written answers

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.

Motorised Transport Grant

Questions (253)

Maurice Quinlivan

Question:

253. Deputy Maurice Quinlivan asked the Minister for Health the number of persons in County Clare who received the motorised transport grant and the mobility allowance in 2013; when the motorised transport grant will be replaced; and if he will make a statement on the matter. [13084/18]

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Written answers

The Deputy will be familiar with the background to the closure of both the Mobility Allowance and Motorised Transport Grant schemes in February 2013. Since the closure of the Mobility Allowance, the Government has directed that the Health Service Executive should continue to pay an equivalent monthly payment of up to €208.50 per month to the 4,133 people in receipt of the Mobility Allowance, on an interim basis, pending the establishment of a new Transport Support 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.

It is hoped to bring a General Scheme and Heads of Bill to Government shortly, seeking Government approval to the drafting of the Bill for the new Transport Support Payment.

With regard to the Motorised Transport Grant, this scheme 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. The maximum Motorised Transport Grant, which was payable once in any three-year period, was €5,020.  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.

With regard to the Deputy's question seeking information on numbers of recipients in County Clare in respect of both the Motorised Transport Grant and the Mobility Allowance in 2013, I have referred this out to the Health Service Executive for a direct reply to the Deputy.

Hospital Facilities

Questions (254)

Donnchadh Ó Laoghaire

Question:

254. Deputy Donnchadh Ó Laoghaire asked the Minister for Health if funding has been allocated for a helipad at Cork University Hospital; and when the project will be completed and operational. [13087/18]

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Written answers

As the HSE is responsible for the delivery of health care infrastructure projects, the Executive has been requested to reply directly to you in relation to this matter.

Medicinal Products Reimbursement

Questions (255)

Michael Healy-Rae

Question:

255. Deputy Michael Healy-Rae asked the Minister for Health if he will reinstate the funding for the Versatis patches in view of cases similar to that of a person (details supplied); and if he will make a statement on the matter. [13131/18]

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Written answers

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 a safe and sustainable manner. Treatment must be appropriate and proportionate and clinical decision-making, such as prescribing, should be based on both patient needs and sound medical evidence.

Lidocaine 5% medicated plasters are licensed for the localised relief of post-shingles pain in adults. This is the only licensed use for the patch in Ireland. It has been reimbursed in the community drugs schemes since 2010.

When the plasters were first introduced, the budget impact was low, because of the specific indication for which they are licensed. It was therefore a cause of clinical concern that, from 2012 on, usage increased significantly, to the point where, as a nation, we were using more plasters than the entire UK National Health Service, with ten times our population.

When a treatment is intended for a small group of patients, and evidence suggests that it is being used for many times that number, it is important and appropriate for clinicians to review its use. In 2016, the HSE Medicines Management Programme, MMP, reviewed the use of the plasters. The review estimated that only 5-10% of prescribing had been for the licensed indication.

Following the clinical review, and in the interest of ensuring appropriate patient care, the HSE introduced a new reimbursement approval system for the patches from 1 September 2017. This process supports their appropriate use, ensuring that post-shingles patients continue to receive this treatment.

Under the new arrangements, all patients receiving lidocaine plasters for the licensed indication, shingles, were automatically approved on the HSE system. All of these patients continue to receive the treatment under the community schemes.

Non-shingles patients were given a three-month grace period, in which their GP could move them to other treatments or apply for continued reimbursement. However, from 1 December 2017, non-shingles patients were no longer automatically reimbursed under the community drugs schemes.

In order for non-shingles patients to receive the patch through the community schemes, their GP must apply online for continued reimbursement approval.  If an application is refused, the GP may appeal, making a clinical case for the patient.  The HSE advises that the turnaround time for applications is three working days and for appeals it is five days.

As of 16 March 2018, there have been 5,504 online applications from GPs requesting the reimbursement of Versatis. Of these applications, over 19%, or 1,059 patients, have been approved.

In addition, 526 online appeals have been made, and over 69% of these patients have been approved. The MMP has sought further information on 38 appeals before a recommendation on reimbursement can be made.

Since 1 September 2017, some 1,421 patients have been approved for the reimbursement of lidocaine plasters, based on the clinical case made by the GP.

It is clear that this new process supports appropriate use and prescribing and both post-shingles patients and other appropriate cases can continue to be treated with lidocaine plasters.

The introduction of the new approval system was flagged in August 2017, when details of the proposed changes were circulated by the HSE to prescribers and pharmacies. This advice has been re-issued in the last week, and information for patients and practitioners is on the HSE Medicines Management Programme website. https://www.hse.ie/eng/about/who/cspd/ncps/medicines-management/lidocaine-plaster/.

This decision is a matter for the HSE. However, I fully support the objectives of the HSE Medicines Management Programme.

Health Services

Questions (256)

Róisín Shortall

Question:

256. Deputy Róisín Shortall asked the Minister for Health the status of an issue raised in correspondence (details supplied); and if he will make a statement on the matter. [13133/18]

View answer

Written answers

As the Deputy is aware, I do not consider that the situation referred to was intended in the relevant legislation. To this end, officials in my Department are currently examining potential options to address the issue raised by the Deputy, including the possibility of legislative amendment. 

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