Tuesday, 10 Jul 2018

Written Answers Nos. 394-410

Health Services Provision

Questions (394)

Eugene Murphy

Question:

394. Deputy Eugene Murphy asked the Minister for Health if all health services provided in a practice (details supplied) in County Roscommon will be maintained. [30059/18]

Written answers

Minister for Health

As this question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.

Maternity Services

Questions (395, 396)

Jack Chambers

Question:

395. Deputy Jack Chambers asked the Minister for Health the status of the recommendations that have been made in internal and external reviews of maternity services in each maternity hospital for the past ten years; and if he will make a statement on the matter. [30062/18]

Jack Chambers

Question:

396. Deputy Jack Chambers asked the Minister for Health if the HSE has a process in place to collate the recommendations made by internal and external reviews of maternity services in hospitals for the past ten years; the implementation of each of those recommendations; and if he will make a statement on the matter. [30063/18]

Written answers

Minister for Health

I propose to take Questions Nos. 395 and 396 together.

While I have asked the HSE to reply directly to the Deputy's questions concerning recommendations made following previous reviews of maternity services, I welcome the opportunity to reiterate the Government's commitment to the progressive development of those services and to outline some of the progress which has been made in this regard.

Ireland’s first National Maternity Strategy, ‘Creating A Better Future Together, 2016 – 2026’ was published in January 2016. In addition to population needs, international trends and the findings of a public consultation process, the development of the Strategy was informed by previous reports and experiences of our maternity services, both positive and negative. Indeed, the development of the Strategy delivered on a recommendation from the report, Investigation into the safety, quality and standards of services provided by the Health Service Executive to patients, including pregnant women, at risk of clinical deterioration, including those provided in University Hospital Galway, and as reflected in the care and treatment provided to Savita Halappanavar. Consequently, many recommendations made in past reports are addressed in the Strategy.

The Strategy aims to ensure that appropriate care pathways - Supported, Assisted and Specialised - are in place in order that mothers, babies and families get the right care, at the right time, by the right team and in the right place. It recognises that, while all pregnant women need a certain level of support, some will require more specialised care. Accordingly, it proposes an integrated model that delivers care at the lowest level of complexity and encompasses all the necessary safety nets in line with patient safety principles.

The phased implementation of the Strategy is being led by the National Women & Infants Health Programme, which has been established in the HSE to lead the management, organisation and delivery of maternity, gynaecology and neonatal services across primary, community and acute care. One of the Programme's objectives is to ensure, where relevant, that learning from individual sites is disseminated to all maternity hospitals/units nationwide.

Additional development funding of €4.15 million is being allocated to maternity services this year. The Programme has prioritised improving quality and safety, establishing community midwifery teams and increasing access to anomaly scans. Such initiatives represent essential building blocks to provide a consistently safe and high quality maternity service and will continue to deliver tangible benefits for the 80,000 families who access maternity care each year.

General Practitioner Services Provision

Questions (397)

John McGuinness

Question:

397. Deputy John McGuinness asked the Minister for Health if general practitioner cards will be extended to all carers in receipt of the respite care support grant. [30066/18]

Written answers

Minister for Health

In December 2017, the Government announced that additional funding would be provided to enable all carers in receipt of Carer's Allowance to qualify for a GP visit card. Government approval was given on the 11 April to provide GP services without fees to persons in receipt of either full or half rate Carer's Allowance or Carer's Benefit and to draft the Heads of Bill to legislate for this provision. It is intended that this measure will be implemented this year, subject to the enactment of the necessary legislation which is currently passing through the Houses of the Oireachtas.

There are currently no plans to extend GP visit Cards to persons specifically in receipt of a Carer's Support Grant (formerly known as the Respite Care Grant), however it is noted that many persons in receipt of this Grant will qualify for a GP visit card as the Carer's Support Grant is paid automatically to persons in receipt of Carer's Allowance or Carer's Benefit.

Health Services Provision

Questions (398)

John McGuinness

Question:

398. Deputy John McGuinness asked the Minister for Health if panic buttons and personal alarms will be made available to persons under 65 years of age who are vulnerable and require 24/7 care. [30067/18]

Written answers

Minister of State at the Department of Health

The provision of panic buttons or personal alarms is not a matter for my Department. I understand that Pobal, funded by the Department of Rural and Community Development, provides personal alarms for people over 65 years and older through the Seniors Alert Scheme. No such scheme is in operation for the under 65's.

Medicinal Products Expenditure

Questions (399, 400, 401)

John Brassil

Question:

399. Deputy John Brassil asked the Minister for Health the level of drugs expenditure in the health budget in each of the years 2015 to 2017 and to date in 2018; and the percentage of the health budget spent on drugs in each of those years, in tabular form. [30071/18]

John Brassil

Question:

400. Deputy John Brassil asked the Minister for Health the levels of high-tech and orphan drugs expenditure in each of the years 2015 to 2017 and to date in 2018; and the percentage of the drugs budget spent on high-tech and orphan drugs in each of the years, in tabular form. [30072/18]

John Brassil

Question:

401. Deputy John Brassil asked the Minister for Health the way in which Ireland's expenditure on high-tech and orphan drugs in each of the years 2015 to 2017 and to date in 2018 compares with the EU average on a per capita basis and in terms of a proportion of both health expenditure and drugs expenditure. [30073/18]

Written answers

Minister for Health

I propose to take Questions Nos. 399 to 401, inclusive, together.

Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

Emergency Departments Staff

Questions (402)

John Brassil

Question:

402. Deputy John Brassil asked the Minister for Health the provisions being made to address the staff shortages in the emergency department at University Hospital Kerry; and if he will make a statement on the matter. [30074/18]

Written answers

Minister for Health

The Government is fully aware of the difficulties and challenges that are currently faced by all hospital staff, including nurses and midwives, in delivering care in the hospital setting. I am aware that nursing staff working in University Hospital Kerry Emergency Department engaged in a lunchtime protest last week. I understand that this was to highlight their concerns in relation to overcrowding in the Emergency Department and its impact on patient care.

At a national level, there is an agreement in place in relation to Emergency Departments, which was brokered through the Workplace Relations Commission. HSE management and officials from my Department recently (27th June) engaged in a conciliation session with the INMO on implementation of this agreement. The outcome of this conciliation was that HSE and the INMO re-affirmed its commitment to fully comply with all aspects of the Agreement.

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

Nursing Homes Support Scheme

Questions (403)

Peter Burke

Question:

403. Deputy Peter Burke asked the Minister for Health the way in which the transitional care funding works, which funding is in place to bridge the gap in the interim for fair deal applicants who are occupying a bed in an acute facility but can be admitted to a nursing home; the definition of acute facility in this context; the person who pays for the bridging loan; the way in which it is recouped; if there are proposed changes to this practice being considered as part of the review of the fair deal scheme; and if he will make a statement on the matter. [30075/18]

Written answers

Minister of State at the Department of Health

There has been a sustained focus in recent years on reducing delayed discharges and enabling patients to be discharged from hospital sooner. Additional measures, including Home Support Packages and transitional care approvals to private nursing homes are funded through Services for Older People and not through the Nursing Homes Support Scheme (NHSS). There is no cost to the patient or resident and therefore no bridging loan or recoupment is necessary. There are no plans to make changes to the NHSS in this regard.

Health Screening Programmes

Questions (404)

Eoin Ó Broin

Question:

404. Deputy Eoin Ó Broin asked the Minister for Health his policy in regard to sickle cell disease; his plans to fund a national screening programme to detect children affected by the disease; his plans to found cross-border access to bone marrow transplants within the EU for those suffering from sickle cell disease; if his Department and the HSE are seeking to learn from the experience of their counterparts in the UK who have more experience on the matter; and if he will meet representatives of organisations (details supplied) to discuss the way in which to progress the matter. [30082/18]

Written answers

Minister for Health

There are over 600 people with sickle cell disease in Ireland and over two thirds of those with the disease are under 18 years of age. Majority of those with the disease are seen in the two centres of expertise - Our Lady's Children Hospital in Crumlin and St. James's Hospital. To ensure an early diagnosis and prevent early deaths, the team at Crumlin, over many years, organised a neo-natal screening in the majority of maternity hospitals.

Sickle cell disease, among many other rare diseases, is addressed as part of the generic policy framework in the National Rare disease plan which was published in 2014. The scope of the plan is broad given that there are 8,000 rare diseases approximately affecting millions of EU citizens; and consequently, there can be a dearth of expertise and knowledge about some rare diseases, simply because they are so rare.

One of the achievements of the Rare Disease Plan was to encourage designated centres of expertise to participate in European Reference Networks (ERNs) for Rare Diseases. ERNs are European networks connecting health care providers and centres of expertise so that international expertise on specific rare diseases may be pooled together for the benefit of patients. Any centre applying for membership of an ERN must have strategies in place to ensure that care is patient-centred; that patient' rights and preferences are respected; and must show a research component to their work.

The recommendations in the national plan related to empowering and protecting patients and carers, and research on rare diseases will be fulfilled in part through this process. It is expected that ERNs will have a major structuring effect by linking thematic expert centres across the EU.

With the encouragement of the National Clinical Programme for Rare Diseases and the Department of Health, five centres of expertise were designated in June 2016 during the first round of calls from the European Commission for participation in European Reference Networks. Three of these designated centres applied for membership of ERNs and two were approved.

The issue of rare diseases and of the creation of an all-island patient register has been raised in the context of on-going discussions at North-South meetings. It is also anticipated that the Model of Care for Rare Diseases will set out recommendations for rare disease registries. This model of care is in development by the National Clinical Programme for Rare Diseases. At the EU level, the Joint Research Centre is developing a joint European Platform on Rare Disease Registration which will promote EU level standards for data collection and contribute to the development of rare disease registries across the EU.

As Minister I consider meeting any organisation that requests to do so. However due to busy parliamentary and other business it is not always possible to meet all representative groups that contact my office.

In respect of the other issues raised, I have asked the HSE to respond directly to the Deputy.

Mental Health Services Funding

Questions (405)

James Browne

Question:

405. Deputy James Browne asked the Minister for Health if the proceeds of the sale of a site (details supplied) will be invested in mental health services; and if he will make a statement on the matter. [30109/18]

Written answers

Minister for Health

The Government's commitment to delivering a new Central Mental Hospital is clearly articulated in the Programme for Government, and funding has been earmarked for this purpose in the Capital Plan. The construction of the National Forensic Mental Health Services Hospital in Portrane is not dependent on the sale of the Dundrum site. That said, there is a Government decision and policy as set out in "A Vision for Change" that proceeds from the sale of older mental health assets, such as the Dundrum site, will be reinvested in new developments within mental health.

The disposal or otherwise of the site of the Central Mental Hospital in Dundrum cannot proceed until such time as the hospital is vacated, following the completion of the new National Forensic Mental Health Hospital in Portrane.

Mental Health Services Provision

Questions (406)

James Browne

Question:

406. Deputy James Browne asked the Minister for Health his plans to increase the capacity and or number of beds for forensic patients beyond the 3.5 per 100,000 envisioned for the new forensic mental health facility at Portrane, County Dublin; and if he will make a statement on the matter. [30110/18]

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

Child and Adolescent Mental Health Services Provision

Questions (407)

James Browne

Question:

407. Deputy James Browne asked the Minister for Health the way in which CAMHS patients will be treated within the new forensic mental health hospital to replace the Central Mental Hospital; if these patients will be housed separately from the new unit; if there will be specific CAMH services on site; and if he will make a statement on the matter. [30111/18]

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

Services for People with Disabilities

Questions (408)

Mattie McGrath

Question:

408. Deputy Mattie McGrath asked the Minister for Health if transport services will be provided for a person (details supplied) to attend a facility; and if he will make a statement on the matter. [30114/18]

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.

Services for People with Disabilities

Questions (409)

Timmy Dooley

Question:

409. Deputy Timmy Dooley asked the Minister for Health if a blind person can receive a direct payment in lieu of personal assistant hours in order that they can purchase a flexible personal assistant service to meet their specific needs; and if he will make a statement on the matter. [30115/18]

Written answers

Minister of State at the Department of Health

There are currently no means by which a person can receive a direct payment to purchase a personal assistant service. However, as the Deputy may be aware, in line with a commitment in the Programme for Government I established a Task Force on Personalised Budgets for People with Disabilities on 20 September 2016. The Task Force consisted of a Strategy Group and an Advisory & Consultative Group. It included officials from the relevant Government Departments and agencies, HSE, academic and policy experts, stakeholder organisations and a wide range of people with lived experience of disability and disability services (both intellectual and physical).

Its remit was to consider people whose primary disability was physical or sensory, intellectual, autism, neurological or any combination of these and to make recommendations on personalised budgets models which will give people with disabilities more control in accessing health funded personal social services, giving them greater independence and choice in accessing services which best meet their individual needs. The Report, which I intend to publish in the near future, will outline the next steps for the development of personalised budgets in Ireland.

Cross-Border Health Services Provision

Questions (410)

Noel Grealish

Question:

410. Deputy Noel Grealish asked the Minister for Health if an issue of cross-Corder healthcare for a person (details supplied) will be addressed and clarified; if they have a right to equality of treatment which would be given to a citizen resident in Northern Ireland; and if he will make a statement on the matter. [30124/18]

Written answers

Minister for Health

EU Regulation 883/2004 enables an Irish Citizen to receive emergency healthcare when on a temporary visit to another EU/EEA Member State. The Member State providing the emergency care will provide necessary healthcare to ensure that a patient is in a stable condition to allow them to enable return to their home Member State.

In relation to this particular case, the HSE has advised that contact should be made on behalf of the patient seeking to avail of healthcare in Ireland with Letterkenny University Hospital in the first instance to make arrangements for an assessment of the patient's medical needs.