Written Answers Nos. 646-667
646. Deputy Fergus O'Dowd asked the Minister for Health the national protocols in place for the administration of psychotropic drugs to patients in nursing homes and other institutions in which persons are in care; the system of monitoring and inspection in place to ensure that persons are not administered these drugs improperly or illegally; and if he will make a statement on the matter. [24505/18]
View answerThe Health Information and Quality Authority (HIQA) is the independent authority established under the Health Act 2007 to monitor safety and quality and drive continuous improvement in Ireland’s health and personal social care services. Since 2009 all nursing homes - public, voluntary and private, have been registered and inspected by HIQA. This responsibility is underpinned by a comprehensive quality framework comprising Regulations and National Standards.
The Health Act 2007 (Care & Welfare of Residents in Designated Centres for Older People) Regulations, 2013 contain provisions relating to 'Medicines and pharmaceutical services' and 'Managing behaviour that is challenging' including a requirement that where restraint is used, it is used only in accordance with national policy. All nursing homes are required to have written policies on the ordering, receipt, prescribing, storing and administration of medicines and on restraint. Providers must keep detailed records of all occasions on which restraint is used. These records must be available for examination by HIQA. The regulations require providers to notify the Chief Inspector on a quarterly basis of any occasion when restraint was used. Revised National Quality Standards for Residential care settings for Older People (2016) place a stronger focus on quality of life and a person-centred approach to the care of all residents. Standard 3.4 provides that “Each resident is protected through the residential service’s policies and procedures for medicines management” and Standard 3.5 requires providers to have in place “Arrangements to protect residents from harm, promote bodily integrity, personal liberty and a restraint-free environment in accordance with national policy”.
National policy on restraint, including chemical, physical and environmental restraint is set out in Towards a Restraint Free Environment in Nursing Homes, (2011) and is available on the Department of Health website.
The National Dementia Strategy (2014) acknowledges that in some cases the use of psychotropic medications is appropriate in conjunction with environmental interventions for the management of behavioural and psychological symptoms of dementia (BPSD). However, anti-psychotic drugs should only be used when all other non-pharmacological interventions have first been tried and exhausted. The National Dementia Strategy recommends that the HSE develop guidance material on the appropriate management of medication for people with dementia, and in particular on psychotropic medication management, with material to be made available in all relevant settings, including nursing homes. To address this action, the HSE’s National Dementia Office has convened a national interdisciplinary steering group to develop evidence-based clinical guidelines for healthcare professionals on the use of psychotropic medications in people with dementia, with a particular focus on antipsychotics. The guidelines will be submitted to the National Clinical Effectiveness Committee to be implemented as national clinical guidelines. The steering group will also develop an associated psychotropic medication audit tool and education and training materials in parallel with the clinical guidelines.
647. Deputy John Brassil asked the Minister for Health the amount of funding provided to each of the community healthcare organisations, CHOs, for implementation of recommendations in the primary care eye services review group report in 2017 and 2018; and if he will make a statement on the matter. [24507/18]
View answerAs this is a service matter it has been referred to the HSE for direct reply to the Deputy.
648. Deputy Mick Barry asked the Minister for Health if a group has been established in his Department to examine the provision of free contraception; if the group has formulated a comprehensive response to the development of a free contraception service; the funding to be allocated to the development of this service for 2018, 2019 and 2020; and if he will make a statement on the matter. [24508/18]
View answerI established a group, under the chairmanship of the Chief Medical Officer, to consider the issues raised by the Joint Committee on the Eighth Amendment of the Constitution in their ancillary recommendations.
Work is ongoing to explore all of the issues associated with enhancing access to contraception.
649. Deputy Noel Rock asked the Minister for Health his plans to add myalgic encephalomyelitis, ME, to the medical conditions listed as part of the long-term illness, LTI, scheme; and if he will make a statement on the matter. [24512/18]
View answerThe LTI Scheme was established under Section 59(3) of the Health Act 1970 (as amended). The conditions covered by the LTI are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide. Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
There are no plans to extend the list of conditions covered by the Scheme.
650. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the budget for provision of respite services in the State; the number of families accessing respite services; the average spend on respite services by the Health Service Executive, HSE, per family; and the waiting lists for respite services across the State. [24516/18]
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.
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.
651. Deputy Sean Sherlock asked the Minister for Health when a person (details supplied) in County Laois will receive a medical procedure. [24523/18]
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.
652. Deputy Sean Sherlock asked the Minister for Health when a person (details supplied) in County Kildare will receive a medical procedure. [24526/18]
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.
653. Deputy Lisa Chambers asked the Minister for Health the number of residential care places in County Mayo; the number of persons on the waiting list for residential care in the county; the estimated wait time and cost per place for residential care in the county; the way in which these figures compare to other counties; and if he will make a statement on the matter. [24528/18]
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.
654. Deputy Lisa Chambers asked the Minister for Health the funding allocated to residential care providers in County Mayo; his plans to provide extra funding to residential care providers in County Mayo; and if he will make a statement on the matter. [24529/18]
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.
655. Deputy Niamh Smyth asked the Minister for Health if a person (details supplied) is on the waiting list for a knee replacement at Our Lady's Hospital, Navan; the status of his or her appointment; and if he will make a statement on the matter. [24536/18]
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.
656. Deputy Clare Daly asked the Minister for Health the additional duty of care placed on a doctor prescribing an unlicensed medicine; and the additional steps the doctor must take to ensure patients' attention is being drawn to the various risks attached to prescribing of the medicine in view of the fact that the Health Products Regulatory Authority, HPRA, has no involvement in the safety of the medicine. [24542/18]
View answerUnder European and Irish legislation, before a medicine can be placed on the market the manufacturer must seek an authorisation from the Health Products Regulatory Authority (HPRA), or in the case of certain medicines, the European Medicines Agency.
Where a medicine is not authorised in Ireland, a licensed wholesaler may import it if it has been prescribed by a doctor for a patient under his/her care, on his/her direct responsibility and in order to meet the special needs of a patient. The process for this is described in the ‘Guide to the Notification System for Exempt Medicinal Products’ which is available on the website of the HPRA. For this notification scheme, there are a number of specialist wholesalers which deal with the importation of ‘exempt medicines’ into Ireland, via pharmacies and subject to a prescription.
The responsibility for the clinical use of unlicensed medicines lies with the prescriber. In accordance with the Medical Council’s Guide to Professional Conduct and Ethics, medical practitioners must ensure as far as possible that any treatment, medication or therapy prescribed for a patient is safe, evidence-based and in the patient’s best interests. This applies equally to licensed and unlicensed medicinal products.
657. Deputy Fergus O'Dowd asked the Minister for Health the status of the memorandum of understanding, co-operation and information sharing signed in June 2015 between Health Information and Quality Authority, HIQA, and the Office of the Ombudsman; the number of meetings that have taken place; the level at which they have taken place; the number of cases by HIQA and the Office of the Ombudsman in which information was shared; the number of cases in which HIQA has been informed of a complaint which had already been dealt with at local level since the memorandum was signed and transferred to the office of the Ombudsman by year; the outcome of all cases; and if he will make a statement on the matter. [24546/18]
View answerAs this is a service matter the question has been referred to the Health Information and Quality Authority (HIQA) for attention and direct reply to the Deputy.
If you have not received a reply from HIQA within 15 days, please contact my Private Office and my officials will follow the matter up.
658. Deputy Michael Healy-Rae asked the Minister for Health if he will examine a series of matters on BreastCheck (details supplied); and if he will make a statement on the matter. [24553/18]
View answerBreastCheck, the national breast screening programme, offers free screening mammograms every two years to women within the eligible population.
The screening process seeks to identify cancer at an early stage when it has a better outcome and may be treated less aggressively with less morbidity. The program has been running since 2000 and over that time has provided more than 1.7 million mammograms to women and detected over 11,500 breast cancers; more than half of which were diagnosed at an early stage.
Until recently, the eligible age range for screening was 50 to 64. The implementation of an age extension of BreastCheck to 65-69 year olds commenced in Quarter 4 of 2015. The age extension is being implemented on an incremental basis, and it is anticipated that the full age extension will be implemented by 2021.
BreastCheck is an important aspect of cancer control in Ireland and it is not envisaged that there will be any cut to the current funding levels of the programme.
659. Deputy Mick Barry asked the Minister for Health if he will meet with an organisation (details supplied) to discuss failings in the market access system for obtaining drugs for the condition. [24558/18]
View answer837. Deputy John Lahart asked the Minister for Health if he has had or plans to have meetings with pharmaceutical companies regarding the availability of new drugs for persons with multiple sclerosis; the outcome of meetings that may have taken place; and if he will make a statement on the matter. [25289/18]
View answer927. Deputy Eamon Scanlon asked the Minister for Health the efforts being made to ensure that new medicines are available to persons with multiple sclerosis as early as possible through a fair and sustainable system; if his Department is engaging with an organisation (details supplied) regarding accessing new and effective treatments; and if he will make a statement on the matter. [25580/18]
View answerI propose to take Questions Nos. 659, 837 and 927 together.
The 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 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.
660. Deputy Pearse Doherty asked the Minister for Health further to Parliamentary Question No. 1051 of 16 January 2018, the progress being made to introduce dialectical behaviour therapy services for adults in County Donegal; and if he will make a statement on the matter. [24559/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
661. Deputy Alan Kelly asked the Minister for Health if all electronic correspondence between him and either of his two special advisers regarding all aspects of the CervicalCheck crisis will be published; and if he will make a statement on the matter. [24560/18]
View answerIn order to provide a clear picture of the circumstances in relation to the CervicalCheck clinical audit process, it is essential to establish the facts in a comprehensive and precise manner. It is also important to restore the trust and confidence of women in CervicalCheck.
In this regard, I have appointed Dr Gabriel Scally, President of the Epidemiology and Public Health section of the Royal Society of Medicine, to carry out an independent Scoping Inquiry and this is now well underway. My Department has established a dedicated team to oversee and progress the CervicalCheck records search, which is being informed by the broad Terms of Reference of the Inquiry. To that end, the Department has committed to a comprehensive trawl of records including as far back as 2006. This is a considerable undertaking covering paper, electronic and email records.
The trawl is being undertaken in as systematic a way as possible to ensure its thoroughness with a view to identifying with reasonable certainty all potentially relevant records held by the Department. Quality assurance processes and a system of checks are also being put in place to ensure the process’ overall validity and reliability. The format of any planned publication of the output of this process will be considered in due course but it of course includes correspondence between my advisers and me.
662. Deputy Micheál Martin asked the Minister for Health the status of the implementation of the Programme for Partnership Government as it applies to his Department; and if he will make a statement on the matter. [24577/18]
View answerDetails of the implementation status on the Health Commitments contained in the Programme for Partnership Government are available in the Annual Report as produced by the Programme for Government office of Department of an Taoiseach.
The role of the Programme for Government Office is to monitor the implementation of the commitments contained in the Programme for Government (PfG) across all Departments. An Annual Report is published setting out the progress across Government made towards meeting those commitments. The Office publishes shorter progress reports on a regular basis also. Please see further details at: taoiseach.gov.ie/eng/Work_Of_The_Department/Programme_for_Government/Programme_for_Government .
663. Deputy Mattie McGrath asked the Minister for Health the number of children on the national donor-conceived person register as per the provisions of the Children and Family Relationships Act 2015; and if he will make a statement on the matter. [24585/18]
View answer733. Deputy Róisín Shortall asked the Minister for Health the position regarding the sections of the Children and Family Relationships Act 2015 which have not yet been commenced further to concerns raised by an organisation (details supplied) on behalf of same-sex couples; the reason for the delay; and if he will make a statement on the matter. [24903/18]
View answerI propose to take Questions Nos. 663 and 733 together.
A number of technical drafting issues have come to light in relation to Parts 2 & 3 of the Children and Family Relationships Act 2015. The implications of these issues are being explored by officials in the Department of Health and the Office of the Attorney General, and as these discussions are ongoing, we do not wish to pre-empt the outcome by citing specific details. Clarification on whether primary legislation is required to resolve these issues is being sought. In the event that primary legislation is required the Minister for Health would seek to deal with it as a matter of urgency.
664. Deputy Michael Healy-Rae asked the Minister for Health the status of an application by a person (details supplied) for a wheelchair; and if he will make a statement on the matter. [24591/18]
View answerAs this is a service matter it has been referred to the HSE for direct reply to the Deputy.
665. Deputy Michael Harty asked the Minister for Health if exceptions to Health Service Executive, HSE, Circular 15/2017 (details supplied) will be considered; and if he will make a statement on the matter. [24601/18]
View answerI understand you are referring to the Department of Health Circular 15/2017 of 6 December 2017 which allows certain public servants in the health sector to remain in employment beyond their compulsory retirement age of 65 years until they reach the eligibility age for the Contributory State Pension, currently 66 years.
As you are aware, my colleague the Minister for Finance and Public Expenditure & Reform, Paschal Donohoe, T.D., secured Government approval in December 2017 for an increase in the compulsory retirement age to 70 years for public servants who are currently required to retire at 65 years.
Primary legislation is required for this change to be implemented. The Government has approved the General Scheme of a Bill to give effect to its decision and I understand that the drafting process is currently underway and that the Bill is on the list of priority legislation for publication in the current session. Indeed, I understand that the drafting of the legislation is significantly advanced with an expected publication date, subject to Government approval, of the end of June.
In advance of the legislation coming into effect, the Government agreed that interim arrangements would be introduced for serving public servants who reach the age of 65 years between the date of the Government Decision and the coming into effect of the necessary legislation. These arrangements enable such public servants to be retained until they reach the age of eligibility for the Contributory State Pension, 66 years.
These are strictly interim arrangements to be applied to public servants up to the date of their eligibility for the Contributory State Pension only. This reflects the Government Decision and therefore there are no provisions for any exceptions to the criteria for retention as set out in the Department of Health Circular 15/2017.
666. Deputy Sean Fleming asked the Minister for Health the status of home help and other support in the home available to a person (details supplied); and if he will make a statement on the matter. [24607/18]
View answerAs the Deputy's question relates to an individual case, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
667. Deputy Marcella Corcoran Kennedy asked the Minister for Health the reason funding has been withdrawn by the Health Service Executive that makes possible an annual one week holiday for medium-term and long-term patients living in community based Health Service Executive owned homes (details supplied) in counties Laois and Offaly. [24614/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
