Written Answers Nos. 431-448
431. Deputy Gino Kenny asked the Minister for Health his plans to use a drug approval and reimbursement system for MS drugs similar to that in Germany (details supplied); and if he will make a statement on the matter. [39943/18]
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. The Act specifies the criteria for decisions on the reimbursement of medicines. As Minister for Health, I do not have any statutory power or function in relation to the reimbursement of medicines.
In line with the 2013 Act, if a company would like a medicine to be reimbursed by the HSE through the community drugs schemes, it must first submit an application to the HSE to have the new medicine added to the reimbursement list.
As outlined in the 2016 Framework Agreement with the Irish Pharmaceutical Healthcare Association (IPHA), 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), whether to add the medicine to the reimbursement list, agree to reimburse it as a hospital medicine, or refuse to reimburse it.
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.
432. Deputy Joe Carey asked the Minister for Health the position in respect of the annual planning process regarding the report of the working group on the development of lymphoedema and lipoedema, in particular in terms of County Clare; and if funds will be included in budget 2019 for the delivery of the service. [39947/18]
View answerI am advised that the report of the Working Group on a Model of Care for Lymphoedema and Lipoedema Treatment in Ireland is under consideration by the HSE.
The recommendations arising from the report will be considered by my Department once they become available, with a view to progressing implementation by the HSE through the annual service planning process.
433. Deputy Michael Healy-Rae asked the Minister for Health the status of a cataract operation in Cork University Hospital for a person (details supplied); and if he will make a statement on the matter. [39951/18]
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.
434. Deputy Michael Healy-Rae asked the Minister for Health the status of a cataract operation for a person (details supplied); and if he will make a statement on the matter. [39952/18]
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.
435. Deputy Niamh Smyth asked the Minister for Health if the case of a person (details supplied) will be reviewed; the status of the case; and if he will make a statement on the matter. [39953/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
436. Deputy James Browne asked the Minister for Health the reason an application by a person (details supplied) for the treatment abroad scheme was not approved; and if he will make a statement on the matter. [39954/18]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
437. Deputy James Browne asked the Minister for Health the reason a multidisciplinary approach was not adopted in respect of the treatment for a person (details supplied); and if he will make a statement on the matter. [39955/18]
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.
438. Deputy Kevin O'Keeffe asked the Minister for Health if a person (details supplied) will be assessed for home help; and if he will make a statement on the matter. [39956/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
439. Deputy Brian Stanley asked the Minister for Health if funding will be provided for a charity (details supplied) in County Offaly; and if he will make a statement on the matter. [39971/18]
View answerApplications for funding are processed by the Health Service Executive, therefore I have asked them to respond directly to the Deputy as soon as possible.
440. Deputy Joan Collins asked the Minister for Health if he will address a matter regarding the case of a person (details supplied); and if he will make a statement on the matter. [39979/18]
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.
441. Deputy Jack Chambers asked the Minister for Health if a person (details supplied) in a public hospital will not be improperly charged following admission to same; and if he will make a statement on the matter. [39982/18]
View answerAll persons ordinarily resident in Ireland are entitled to receive public in-patient services in public hospitals, subject to applicable statutory public in-patient charges. This is irrespective of whether a person has private health insurance cover. However, for a specified episode of in-patient services, where a person does not avail of, or waives his/her right to public in-patient services, but instead avails of private in-patient services for example private consultant services, he/she shall not have eligibility for public in-patient services for that episode of in-patient care.
Patients opting to be treated privately have chosen to pay the consultant and the hospital in respect of the services that each provides. Under the Health Act 1970 (as amended), the HSE is required to levy statutory private in-patient charges on all patients opting to receive private in-patient services, irrespective of the type of accommodation provided. There is no provision in the legislation to waive these charges.
I have asked the HSE to investigate the circumstance of this individual case and respond directly to the Deputy.
442. Deputy Michael Healy-Rae asked the Minister for Health if he will address a matter (details supplied) regarding procedures under the cross-border healthcare directive; and if he will make a statement on the matter. [39984/18]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
443. Deputy Lisa Chambers asked the Minister for Health if the stockpiling of medicines has commenced in preparation for a no-deal Brexit; if not, when he plans to commence same; and if he will make a statement on the matter. [39990/18]
View answerThe Department of Health and its agencies, including the HSE and the Health Products Regulatory Authority, are engaging in intensive Brexit preparedness and contingency planning in the area of health. This includes planning for a no-deal Brexit scenario.
Priorities include ensuring continuity in the supply of medicines and medical devices, ensuring access to services, recognition of qualifications, continuation of existing cross border health co-operation and public health arrangements.
It is important to note that all Member States will potentially face issues regarding the supply of medicines after Brexit. The European Medicines Agency (EMA) and the European Commission are providing guidance to help pharmaceutical companies prepare for Brexit, and this guidance is based on the assumption that the UK will become a third country as of 30 March 2019. The HPRA’s guidance to pharmaceutical companies and other stakeholders is also based on this assumption.
In addition to working with the relevant agencies, the Department of Health will continue to support the Department of Foreign Affairs and Trade in its engagements with the European Commission’s Article 50 Taskforce and its Brexit Preparedness Group in the ongoing review and discussion of mitigating actions at national and EU level.
444. Deputy Willie Penrose asked the Minister for Health if, in the context of Lyme disease and the importance of promoting awareness of same at primary care level, the appointment of a general practitioner champion for Lyme disease will be examined in order that clinical diagnosis can be made early and effectively and ensure general practitioners and consultants recognise the results from tests that have been carried out by accredited laboratories abroad; and if he will make a statement on the matter. [39995/18]
View answer452. Deputy Louise O'Reilly asked the Minister for Health the reason the health authorities here refuse to accept the diagnosis of Lyme disease following blood tests from accredited laboratories in Germany; the progress the health authorities have made in facilitating the diagnosis of the disease here; and the necessary follow up supports for those living with the disease. [40043/18]
View answerI propose to take Questions Nos. 444 and 452 together.
Lyme disease (also known as Lyme borelliosis) is an infection caused by a spiral-shaped bacterium called Borrelia burgdorferi. It is the commonest cause of tick-borne infection in Europe. Lyme neuroborreliosis was made statutorily notifiable in Ireland by the Infectious Diseases (Amendment) Regulations 2011 (S.I. no 452 of 2011).
Infection with Lyme disease is generally mild and patients are generally treated by their family doctor. If there are more severe complications, the patient can be referred for specialist assessment and treatment. It is important that those suffering from the symptoms associated with Lyme disease seek the most appropriate medical attention available.
Testing and treatment for Lyme borreliosis is widely available in Ireland in all major hospitals. Lyme borelliosis is diagnosed by medical history and a physical examination. The infection is confirmed by blood tests which look for antibodies to Borrelia burgdorferi produced by an infected person's body in response to the infection. These normally take several weeks to develop and may not be present in the early stages of the disease.
Laboratories in Ireland generally follow the laboratory testing recommendations of the US Centres for Disease Control and Prevention, the Infectious Disease Society of America, the European Federation of Neurological Societies, and the British Infection Association. Whereas Irish laboratories have their own quality assurance methods to make sure the tests are working correctly and are also accredited by the Irish National Accreditation Body to perform the relevant tests correctly, testing which is performed abroad may be performed in laboratories which have not met National or International Accreditation (Quality Standards) to a similar degree, giving rise to a greater degree of risk of diagnosis of a “false positive” result or interpreting equivocal results in a manner that is more likely to give rise to verification bias.
Best practice dictates that if a patient presents for medical treatment with a report / test from another EU member state, the GP or consultant would examine the patient using both clinical and laboratory diagnostics before they would be in a position to prescribe a course of treatment for them. The same protocol would apply across most other EU member states as the GP or consultant would need to be totally satisfied that the patient is correctly diagnosed while getting the right course of treatment for their illness.
The Health Protection Surveillance Centre (HPSC) of the HSE is responsible for the surveillance of notifiable infectious diseases such as Lyme disease. The HPSC provides advice and information concerning developments regarding the testing and treatment of Lyme disease to my Department. The Scientific Advisory Committee (SAC) of the HPSC has established a Lyme Borreliosis Subcommittee, the aim of which is to develop strategies to undertake primary prevention with a view to minimising the harm caused by Lyme Borreliosis in Ireland. There is a GP representative on this committee.
The suggestion of an appointment of a general practitioner champion for Lyme disease may be considered by this committee. I have referred your question to the HSE for further clarification.
445. Deputy Jonathan O'Brien asked the Minister for Health the number of section 39 organisations employed by the Department of Health and-or the HSE to carry out services and functions. [40009/18]
View answer446. Deputy Jonathan O'Brien asked the Minister for Health the difference between section 38 and 39 organisations and their relationship with the public sector. [40013/18]
View answerI propose to take Questions Nos. 445 and 446 together.
My Department does not enter into contracts with section 38 or section 39 organisations.
A primary function of the HSE is to manage and deliver health and personal social services. It can either do this itself or it can enter an arrangement under section 38 or section 39 of the Health Act 2004 with a service provider to deliver the service. The legal framework available to the HSE for funding such service providers is set in sections 38 and 39 of the Health Act 2004.
Under section 38 the HSE may enter into an arrangement with a body or person for the provision of health and personal social services on behalf of the HSE; the employees of such a body are public servants. Under section 39 the HSE may give assistance to any person or body that provides services similar or ancillary to those provided by the HSE; the employees of such bodies are not public servants.
As section 38 and 39 organisations come under the remit of the HSE, I have referred these PQs to the HSE for direct reply.
447. Deputy Jonathan O'Brien asked the Minister for Health the level of public funding for section 39 workers in each of the years 2008 to 2017 and to date in 2018. [40015/18]
View answerI have asked the Health Service Executive to respond to you directly on this matter.
