Written Answers Nos 378-396
378. Deputy Bernard J. Durkan asked the Minister for Health if a medical card application will be reopened for persons (details supplied) to facilitate the provision of a letter in the format requested; and if he will make a statement on the matter. [17593/18]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
379. Deputy Louise O'Reilly asked the Minister for Health the reason the minor ailments scheme piloted in Kells, Roscommon, Macroom and Edenderry will not be extended and rolled out to other areas; when the report on the pilot will be made public; and if he will make a statement on the matter. [17598/18]
View answerIn 2016, the HSE ran a three month feasibility study on a pharmacy-delivered minor ailment service in an Irish healthcare context. The HSE submitted the report to my Department for consideration and it is expected that this examination will be concluded shortly.
380. Deputy Michael Harty asked the Minister for Health when a person (details supplied) in County Clare will receive an appointment for orthopaedic surgery at University Hospital Limerick; and if he will make a statement on the matter. [17604/18]
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 the Deputy directly.
381. Deputy Lisa Chambers asked the Minister for Health the reason a person (details supplied) cannot qualify under the HSE criteria for the provision of Pembrolizumab to be covered by private health insurance; his plans to afford a discretion in the HSE criteria of 50% tumour expression of PD-L1 in instances in which an oncologist is of the opinion that the treatment is appropriate; if the criterion of 50% tumour expression of PD-L1 will be reconsidered; if an opportunity for a person to qualify under the scheme once a person has started treatment with Pembrolizumab and is shown to be responding to the treatment will be afforded; and if he will make a statement on the matter. [17618/18]
View answerThe HSE has statutory responsibility for medicine pricing and reimbursement decisions, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. As Minister for Health, I do not have any statutory power or function in relation to the reimbursement of medicines. The Act specifies the criteria for decisions on the reimbursement of medicines.
In line with the 2013 Act, if a company would like a medicine to be reimbursed by the HSE pursuant to the community drugs scheme, the company must first submit an application to the HSE to have the new medicine added to the reimbursement list.
As outlined in the Framework Agreement with industry, and in line with the 2013 Act, the HSE will decide, within 180 days of receiving the application (or a longer period if further information is sought from the company), to either add the medicine to the reimbursement list or agree to reimburse it as a hospital medicine, or refuse to reimburse the medicine.
HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).
The NCPE conducts health technology assessments (HTAs) for the HSE, and makes recommendations on reimbursement to assist HSE decisions. The NCPE uses a decision framework to systematically assess whether a drug is cost-effective as a health intervention.
The HSE strives to reach a decision in as timely a manner as possible. However, because of the significant monies involved, it must ensure that the best price is achieved, as these commitments are often multi-million euro investments on an on-going basis. This can lead to a protracted deliberation process.
Pembrolizumab is currently reimbursed for the following indications:
- KEYTRUDA as monotherapy is indicated for the treatment of advanced (unresectable or metastatic) melanoma in adults.
- KEYTRUDA as monotherapy is indicated for the first-line treatment of metastatic non-small cell lung carcinoma (NSCLC) in adults whose tumours express PD-L1 with a 50% tumour proportion score (TPS) with no EGFR or ALK positive tumour mutations.
I have been informed by the HSE that they are currently assessing the following indication for reimbursement:
- KEYTRUDA as monotherapy is indicated for the treatment of locally advanced or metastatic NSCLC in adults whose tumours express PD-L1 with a 1% TPS and who have received at least one prior chemotherapy regimen. Patients with EGFR or ALK positive tumour mutations should also have received targeted therapy before receiving KEYTRUDA.
Once the NCPE assessment has been completed, the HSE will evaluate this application for reimbursement in line with the criteria which has been laid out within the 2013 Act.
382. Deputy Michael Harty asked the Minister for Health if University Hospital Limerick is running out of trolleys to cater for waiting patients; and if he will make a statement on the matter. [17623/18]
View answerAgainst a background of growing demand for unscheduled care and high acute hospital occupancy rates, Government provided €30 million in 2017 and a further €40 million in 2018 for measures to increase acute hospital capacity and alleviate overcrowding in Emergency Departments. Almost 50% of this funding was used to deliver home support packages and transitional care beds to reduce the incidence of delayed discharges. Furthermore, over 200 beds have been opened this winter and more beds are due to come on stream later in the year.
Notwithstanding the increased level of resources provided, this winter has been particularly difficult for our health services with ED attendances up 3.7% and admissions up 3.3% during the first quarter of the year, as compared to the same period in 2017. In relation to University Hospital Limerick, in the first quarter of 2018, attendances rose by 11.6% and admissions rose by 10.8%, with a steep rise of 16.4% in attendances and 21% in admissions by those in the over 75 age group.
The situation was further exacerbated by Storm Emma and the severe weather that followed. In response to this, I approved a further €5m in emergency funding to provide additional home support packages and transitional care beds to assist the safe discharge of patients who required support to return home following the adverse weather.
In relation to the specific question asked regarding trolleys in University Hospital Limerick, as this is a service matter I have referred it to the HSE for a direct response to the Deputy.
383. Deputy Michael Moynihan asked the Minister for Health if he will engage with an organisation (details supplied) to ensure new medicines are available to persons with MS as soon as possible; his views on the fact that it can take over four years for a new medicine to be reimbursed here; and if he will make a statement on the matter. [17629/18]
View answerThe HSE has statutory responsibility for medicine pricing and reimbursement decisions, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. As Minister for Health, I do not have any statutory power or function in relation to the reimbursement of medicines. The Act specifies the criteria for decisions on the reimbursement of medicines.
In line with the 2013 Act, if a company would like a medicine to be reimbursed by the HSE pursuant to the Community Drugs scheme, the company must first submit an application to the HSE to have the new medicine added to the Reimbursement List.
As outlined in the IPHA agreement, and in line with the 2013 Act, the HSE will decide, within 180 days of receiving the application (or a longer period if further information is sought from the company), to either add the medicine to the reimbursement list or agree to reimburse it as a hospital medicine, or refuse to reimburse the medicine.
HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).
The NCPE conducts health technology assessments (HTAs) for the HSE, and makes recommendations on reimbursement to assist HSE decisions. The NCPE uses a decision framework to systematically assess whether a drug is cost-effective as a health intervention.
The HSE strives to reach a decision in as timely a manner as possible. However, because of the significant monies involved, it must ensure that the best price is achieved, as these commitments are often multi-million euro investments on an on-going basis. This can lead to a protracted deliberation process.
I am keen to engage with Industry and to explore ways in which new medicines might be more easily introduced in Ireland. However, any innovative approaches that may be tabled must be compatible with the statutory provisions which are in place and must also recognise the fundamental pricing/funding issues in the context of finite Exchequer resources.
I have indicated willingness to meet with MS Ireland and my office is in contact with the organisation to arrange a mutually convenient date.
384. Deputy Fiona O'Loughlin asked the Minister for Health if the situation of a person (details supplied) will be investigated; and if he will make a statement on the matter. [17635/18]
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.
As the Deputy's question relates to a service issue, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
385. Deputy Fiona O'Loughlin asked the Minister for Health if the case of a person (details supplied) will be examined. [17637/18]
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.
As the Deputy's question relates to a service issue, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
386. Deputy David Cullinane asked the Minister for Health his plans to provide a modular laboratory at UHW; and if he will make a statement on the matter. [17649/18]
View answerFollowing an independent review of the need for a second cath lab in University Hospital Waterford (UHW), the Herity report concluded that the needs of the effective catchment population for Waterford University Hospital could be accommodated within a single cath lab. Funding has been provided to support extension of the existing cath lab operating hours to 12 weekly sessions per week, or by 20%, as recommended in the Herity Report. Recruitment efforts to support this service extension are ongoing.
In the interim, a mobile cath lab service has also been provided. The mobile cath lab was deployed in October 2017 for an initial period of 20 weeks and this was extended in February for another 10 weeks to allow further time for the recruitment effort. As requested by the Minister, the Department has now requested proposals from the HSE on the continued deployment of the mobile cath lab. A modular cath lab has also been proposed, as an interim solution pending the outcome of the National Review of Specialist Cardiac Services, and the Department of Health is currently examining this proposal at the Minister’s request.
A national review of specialist cardiac services is underway, which aims to achieve optimal patient outcomes at population level with particular emphasis on the safety, quality and sustainability of the services that patients receive by establishing the need for an optimal configuration of a national adult cardiac service. In terms of scope, the National Review will cover scheduled and unscheduled hospital-based services for the diagnosis and treatment of cardiac disease in adults. The Steering Group for the review held its first meeting on 31 January last. As set out in the National Development Plan 2018-2027, investment in cardiac catheterisation laboratories and other cardiac services infrastructure nationally will be informed by the outcome of the National Review.
387. Deputy Kevin O'Keeffe asked the Minister for Health if an item of equipment will be provided to a child (details supplied) in County Cork. [17651/18]
View answerAs this is a service matter it has been referred to the HSE for direct reply to the Deputy.
388. Deputy Thomas P. Broughan asked the Minister for Health the number of inpatients and outpatients who did not attend at Beaumont Hospital in 2016, 2017, and to date in 2018, in tabular form; and if he will make a statement on the matter. [17657/18]
View answerIn relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
389. Deputy Gino Kenny asked the Minister for Health if his Department will consider replicating the FDA black box warning regarding cautionary use by persons under 18 years of age on antidepressants such as Prozac in the USA on the packaging of similar drugs here (details supplied); and if he will make a statement on the matter. [17660/18]
View answerThe legal framework for provision of detailed warnings for medicines across the EU is through the product information, which specifically provides for the format and content of these documents. The summary of product characteristics (SmPC) for the healthcare professional and the package leaflet (PL) for patients are reviewed and approved as an intrinsic part of the licensing of a medicine, and continuously updated to reflect the current state of knowledge of the medicine and the risks associated with its use. As such, it is considered important for healthcare professionals and patients/carers to regularly read and review these documents to support safe and appropriate use.
With regard specifically to Prozac, which is one of a group of antidepressant medicines known as SSRIs, it should be noted that the information included in the US ‘black box’ is entirely consistent with that provided in the approved product information for these medicines in the EU.
390. Deputy Robert Troy asked the Minister for Health if funding and resources will be allocated to child psychological services to reduce the waiting lists for access to these services; and his views on the fact that there are over 7,000 children on waiting lists for these services. [17671/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
391. Deputy Mary Butler 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. [17672/18]
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 the Deputy directly.
392. Deputy Louise O'Reilly asked the Minister for Health the amount paid to a group (details supplied) for producing the health service capacity review report. [17699/18]
View answerThe amount paid to the company referred to in the details supplied was €324,700 (exclusive of VAT) for the provision of technical, analytical, and engagement expertise, along with the design and printing of the 2018 Health Service Capacity Review.
393. Deputy Hildegarde Naughton asked the Minister for Health the number of patient transport taskings being provided to private operators and the HSE's intermediate care service to and from each of the Saolta hospital group hospitals in each of the years 2015 to 2017, including patient transport taskings for the purposes of dialysis and for outpatient appointments from community nursing homes; and if he will make a statement on the matter. [17701/18]
View answerAs this is a service issue, I have asked the HSE to reply to you directly.
394. Deputy John Brassil asked the Minister for Health if the process for children with intellectual disabilities transitioning out of second level education will be reassessed; his views on new measures to implement an earlier programme of transition; and if he will make a statement on the matter. [17702/18]
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.
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.
395. Deputy Michael Healy-Rae asked the Minister for Health if he will address a matter in respect of a person (details supplied) regarding funding; and if he will make a statement on the matter. [17729/18]
View answerSince August 2014 Brentuximab vedotin has been approved and funded by the HSE for use in relapsed or refractory CD30+ Hodgkin Lymphoma following Autologous Stem Cell Transplantation (ASCT) or following at least two prior therapies when ASCT or multi-agent chemotherapy is not a treatment option as well as for use in relapsed or refractory systemic anaplastic large cell lymphoma (sALCL).
A pricing application is ongoing in relation to the use of Brentuximab vedotin for CD30+ cutaneous T-cell lymphoma (CTCL). This application is being considered in line with the criteria set out in the Health (Pricing and Supply of Medical Goods) Act 2013.
The European Medicines Agency to date has not approved any other indication (use) in Europe. The treatment of Angioimmunoblastic T-cell lymphoma is not included in the currently reimbursed indications.
396. Deputy John Curran asked the Minister for Health the number of persons who received treatment in the first quarter of 2018 under the National Treatment Purchase Fund; and if he will make a statement on the matter. [17745/18]
View answerIn the first quarter of 2018, the number of persons that have received treatment under the National Treatment Purchase Fund is 3,801. The number of persons treated on the GI Scopes waiting list is 541.
