Written Answers Nos. 530-546
530. Deputy Louise O'Reilly asked the Minister for Health the amount paid by the HSE to a company (details supplied) since 2011 for services, infrastructure or projects by year in tabular form; and if he will make a statement on the matter. [30272/18]
View answerAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
531. Deputy Robert Troy asked the Minister for Health the timeframe for the implementation of a new home care scheme; and when it will be put on a statutory basis. [30274/18]
View answerIn advancement of the Government’s commitment to promote community-care so that people can continue to live independently in their own homes for as long as possible, the Department of Health is currently engaged in the development of a new, stand-alone statutory scheme and system of regulation for home-care services.
The new home-care scheme will introduce clear rules in relation to the services for which individuals are eligible and in relation to service-allocation. It will therefore be an important step in ensuring that the system operates in a consistent and fair manner and will help to improve access to home-care services on an affordable and sustainable basis. The introduction of a system of regulation for home-care will help to ensure public confidence in the services provided. The new scheme will also be designed to support family/unpaid carers and will complement and integrate effectively with other health and social-care services such as long-term residential care (including the Nursing Homes Support Scheme), primary and community services and hospital services.
As an initial step in the development of the new scheme, the Department of Health commissioned the Health Research Board to undertake a review of the home-care systems in place in four European countries. The review, which was published last April, will help to ensure that Ireland’s new home-care scheme and system of regulation is informed by international experience. In addition a public consultation on the financing and regulation of home-care was undertaken last year. The purpose of this consultation, to which approximately 2,600 submissions were received, was to enable the Department to find out about the views of service-users, their families and healthcare workers on current and future home-care provision. A report on the findings of the consultation was published on 26 June and will inform the development of the new scheme. Further consultation with service-users will take place later this year, in addition to which the Department is actively engaging with the key NGOs and representative groups.
The development of a statutory scheme and system of regulation for home-care services is a complex undertaking. While the publication of the HRB review and of the report on the findings of the public consultation represent important milestones in the process of developing the new scheme, a significant amount of additional work remains to be carried out before final decisions are taken on the form of the home-care scheme and system of regulation. This is required if the reforms are to be successful, affordable and sustainable. The Department will continue to prioritise its work in developing the new scheme and every effort will be made to progress this matter as quickly as possible. However a realistic timeframe for the establishment of the new scheme on a statutory basis is 2–3 years.
While the new home-care scheme is under development, the Department of Health and Health Service Executive are continuing efforts to improve existing home-care services. In 2018 the HSE brought the funding for home help and Home Care Packages together into a single home support service for older people. As well as simplifying the application-process for home-care, the new service will be more responsive to service-users' changing needs. More broadly the HSE will continue to encourage local integration of services and to build appropriate care-pathways, in particular for people with complex needs. A consumer-directed approach to home-support provision will be introduced, giving service-users greater choice in relation to when they receive services and their selection of a service-provider. This enhancement of current service-provision is being supported by increased investment in home-care services. In line with the commitment in A Programme for a Partnership Government (2016) to increase funding for home-care annually, funding for Older Persons’ Services rose from €763m in 2017 to €811m in 2018, including approximately €417m for the provision of home-support services.
532. Deputy Alan Farrell asked the Minister for Health if he will report on the availability of ambulances in the greater Dublin area; the average response times for ambulances following receipt of a 999 call; the number of instances in which an ambulance has not been immediately dispatched following receipt of an emergency call; the action he is taking to ensure adequate ambulance resources are in place and to ensure emergency calls can be responded to in a fast and efficient manner; and if he will make a statement on the matter. [30278/18]
View answerAs this is a service issue, I have asked the HSE to reply to you directly.
533. Deputy James Browne asked the Minister for Health the mental health supports available for children awaiting scoliosis surgery here; and if he will make a statement on the matter. [30283/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible
534. Deputy James Browne asked the Minister for Health the mental health supports available for young persons that have a physical disability; and if he will make a statement on the matter. [30284/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible
535. Deputy Louise O'Reilly asked the Minister for Health the next national steps to be taken with respect to the WHO protocol to eliminate illicit trade in tobacco products in view of the fact that the conditions for the entry into force of the instrument adopted under the WHO Framework Convention on Tobacco Control were met on 27 June 2018; and if he will make a statement on the matter. [30286/18]
View answerIreland is applying the standard approach to the ratification of international agreements to the Protocol on the Illicit Trade of Tobacco in that it is seeking to ensure that all the necessary domestic legislation and amendments to legislation have been identified and effected before it proceeds to ratification. This approach is to ensure that Ireland can fulfil all of its obligations under the agreement upon its entry into force for Ireland.
536. Deputy Thomas P. Broughan asked the Minister for Health if his attention has been drawn to the fact that there is no dietician in the Dublin 3, 5, 9, 13 and 17 areas; if funding will be made available for same; and if he will make a statement on the matter. [30290/18]
View answerAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
537. Deputy Richard Boyd Barrett asked the Minister for Health if the approval of the drugs Nivolumab and Pembrolizumab will be expedited in order to prolong the life of certain cancer patients and in particular in the case of a person (details supplied); if they will be made VAT exempt and tax allowable in the circumstances in which a patient has no option but to self fund these drugs; and if he will make a statement on the matter. [30314/18]
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. In addition, Section 6 of the HSE Governance Act 2013 precludes me from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual. It would be inappropriate to comment on the cases of individual patients.
In Ireland the majority of patients’ access medicines through the publicly funded Community Drug Schemes.
In line with the Health (Pricing and Supply of Medical Goods) Act 2013, if a company would like a medicine to be reimbursed by the HSE and available through the community drugs schemes, the company must first submit an application to the HSE to have the new medicine added to the reimbursement list.
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:
- Pembrolizumab (Keytruda) as monotherapy is indicated for the treatment of advanced (unresectable or metastatic) melanoma in adults.
- Pembrolizumab (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 deliberating on the following indications for reimbursement:
- Pembrolizumab (Keytruda) as a monotherapy for the treatment of adult patients with relapsed or refractory classical Hodgkin lymphoma who have failed autologous stem cell transplant and brentuximab vedotin (BV), or who are transplant-ineligible and have failed BV.
- Pembrolizumab (Keytruda) as a monotherapy 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.
The National Centre for Pharmacoeconomics (NCPE) completed a health technology assessment on 28 May 2018 for the latter indication. They recommended that pembrolizumab (Keytruda) be considered for reimbursement if cost-effectiveness can be improved relative to existing treatments. The HSE will now evaluate this application for reimbursement in line with criteria laid out within the 2013 Act before making a final reimbursement decision.
In addition to this, the HSE have commissioned HTAs on the following indications:
- Pembrolizumab (Keytruda) for the first-line treatment of patients with locally advanced or metastatic urothelial carcinoma who are not eligible for cisplatin-containing chemotherapy.
- Pembrolizumab (Keytruda) as monotherapy for the treatment of locally advanced or metastatic urothelial carcinoma in adults who have received prior platinum-containing chemotherapy.
There are no other indications for Pembrolizumab approved in the European Union at this time. Clinical trials are ongoing globally in relation to a range of other possible indications which may receive marketing authorisation in the EU over the next number of years. Each of those indications will be considered for reimbursement as market authorisations are received.
Nivolumab is currently reimbursed for the following indications:
- Nivolumab (Opdivo) for monotherapy treatment for patients diagnosed with unresectable metastatic melanoma.
- Nivolumab (Opdivo) for the treatment of relapsed or refractory classical Hodgkin lymphoma after autologous stem cell transplant and treatment with brentuximab vedotin.
- Nivolumab (Opdivo) for the treatment of advanced renal cell carcinoma after prior therapy in adults.
- Nivolumab (Opdivo) for the treatment of squamous cell carcinoma of the head and neck (SCCHN) in adults progressing on or after platinum-based therapy.
- Nivolumab (Opdivo) plus ipilimumab (Yervoy) for the treatment of advanced melanoma.
The Department has been informed by the HSE that the following indications are currently in process for reimbursement:
- 2nd line use in locally advanced non-small cell lung cancer (NSCLC) in adult
- 2nd line use in locally advanced unresectable or metastatic urothelial carcinoma
- Adjuvant melanoma indication
These applications for reimbursement will be processed in line with the 2013 Act.
In relation to the issue of VAT exemption for self-funding patients, as you will appreciate that is a matter for my colleague Mr Paschal Donohoe TD, Minister for Finance and Public Expenditure and Reform for his attention.
538. Deputy Michael Healy-Rae asked the Minister for Health the status of an application for funding by a person (details supplied); and if he will make a statement on the matter. [30315/18]
View answerAs this is a service matter it has been referred to the HSE for direct reply to the Deputy.
539. Deputy Róisín Shortall asked the Minister for Health when he plans to commence Part 9 of the Children and Family Relationships Act 2015; the resources that have been set aside to allow the commencement of this Part; and the reason for the delay. [30317/18]
View answerPart 9 of the Children and Family Relationships Act 2015 and the registration of births is the responsibility of the Minister for Employment Affairs and Social Protection. The current legislation governing registration of births provides only for the registration of a mother’s details and a father’s details. It is not possible, at present, to register the details of a birth using the term “parent”. This is provided for in Part 9 of the Children and Family Relationships Act 2015, which is yet to be commenced.
On 5 July 2018 the Government approved the publication of the Children and Family Relationships (Amendment) Bill 2018 and it is scheduled to be introduced into Dáil Éireann on Wednesday 11 July. It is envisaged that the passage of this Bill through the Oireachtas will facilitate the commencement of Parts 2 & 3 of the Act of 2015 in the autumn of 2018, which are the responsibility of my Department.
540. Deputy Thomas Byrne asked the Minister for Health the status of an appointment for a person (details supplied). [30318/18]
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, since 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.
541. Deputy James Lawless asked the Minister for Health if a hospital appointment for a person (details supplied) will be confirmed; and if he will make a statement on the matter. [30320/18]
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, since 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.
542. Deputy Niamh Smyth asked the Minister for Health further to Parliamentary Question No. 190 of 21 June 2018, if staff will be acquired to cover dental services in Virginia health centre; if his attention has been drawn to the fact that waiting lists are behind in County Cavan due to children from east County Cavan going to Cavan town for treatment (details supplied); and if he will make a statement on the matter. [30322/18]
View answerAs this is a service matter it has been referred to the HSE for direct reply to the Deputy.
543. Deputy Niamh Smyth asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [30325/18]
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, since 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.
544. Deputy Mary Butler asked the Minister for Health when a person (details supplied) will be assessed for a wheelchair; and if he will make a statement on the matter. [30326/18]
View answerAs this is a service matter it has been referred to the HSE for direct reply to the Deputy.
545. Deputy Jackie Cahill asked the Minister for Health if the benefits of acupuncture in the management of mental health will be investigated with an organisation (details supplied); the way in which the organisation's members can be incorporated with the HSE as an additional method in the management of mental health nationally; and if he will make a statement on the matter. [30327/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible
546. Deputy Pearse Doherty asked the Minister for Health further to Parliamentary Question No. 310 of 8 May 2018, if a detailed breakdown of patient entitlement to post-mastectomy products, including product types and product cost across each of the relevant HSE local area offices will be provided in tabular form; and if he will make a statement on the matter. [30328/18]
View answerAs this is a service matter it has been referred to the HSE for direct reply to the Deputy.
