Nursing Staff Data

Questions (219)

Louise O'Reilly

Question:

219. Deputy Louise O'Reilly asked the Minister for Health the number of nurses employed in Cavan General Hospital in each of the years 2013 to 2017 and to date in 2018 in tabular form. [40607/18]

View answer

Written answers (Question to Health)

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

Medicinal Products Reimbursement

Questions (220)

Michael McGrath

Question:

220. Deputy Michael McGrath asked the Minister for Health the steps he is taking to ensure that the drug Spinraza is made available to persons of spinal muscular atrophy; and if he will make a statement on the matter. [40610/18]

View answer

Written answers (Question to Health)

The 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 reimbursement of medicines.

For a medicine to be considered for reimbursement by the HSE, it must first have a marketing authorisation from the European Medicines Agency (EMA) or the Health Products Regulatory Authority (HPRA), before being assessed under the 2013 Act.

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. This process ensures that only treatments that are clinical and cost effective are reimbursed.

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.

Nusinersen (Spinraza) is indicated for the treatment of 5q spinal muscular atrophy (SMA), a disorder characterised by progressive muscle atrophy and weakness.

In May 2017, the EMA granted market authorisation for nusinersen and in October 2017, the HSE received a reimbursement application for nusinersen.

In December 2017, the NCPE completed a HTA of nusinersen and did not recommend reimbursement at the price submitted. No decision has been arrived as yet on the application for the reimbursement of nusinersen as the statutory process is still on-going.

Pharmacy Regulations

Questions (221)

Brendan Griffin

Question:

221. Deputy Brendan Griffin asked the Minister for Health his views on a matter (details supplied); and if he will make a statement on the matter. [40614/18]

View answer

Written answers (Question to Health)

The Pharmacy Act 2007 established the Pharmaceutical Society of Ireland (PSI) and the functions of the Society are set out in the Act. The functions of the PSI are carried out on its behalf by the Council of the Society.

Section 30 of the Act provides for an exception to the general provision in the Act which requires the sale and supply of medicines at a pharmacy to be conducted under the personal supervision of a registered pharmacist, and specifies that no offence is committed where a registered pharmaceutical assistant “acts on behalf of a registered pharmacist during the temporary absence of the registered pharmacist”.

Section 30 also permits the Council to make rules as to:

1. What may or may not be done by a registered pharmaceutical assistant when acting on behalf of a registered pharmacist; and

2. What constitutes the temporary absence of a registered pharmacist.

On June 21, the Council of the Society approved for issuance for public consultation the proposed draft Pharmaceutical Society of Ireland (Temporary Absence of Pharmacist from Pharmacy) Rules 2018. This public consultation commenced on 17 July and ran until 14 August and afforded any interested party the opportunity to make representations on the matter directly to the PSI.

Following completion of the public consultation phase, the Council of the PSI considered the proposed draft Pharmaceutical Society of Ireland (Temporary Absence of Pharmacist from Pharmacy) Rules 2018 at its meeting on the 20th September 2018 where Council approved the draft rules without amendment.

Correspondence outlining the concerns of registered pharmaceutical assistants has been received by my Department. My role in relation to this process is limited to the consideration of any such Rules once submitted for my approval. I must consider any Rules presented to me from a fair and impartial perspective, without prejudice or prejudgement. This includes consideration of concerns raised by, or on behalf of, registered pharmaceutical assistants.

I await the receipt of the Rules for my consideration from the PSI and until that time, I am unfortunately not in a position to comment any further on the matter raised.

Medical Qualifications

Questions (222)

James Browne

Question:

222. Deputy James Browne asked the Minister for Health the position regarding the need for locum consultant post applicants, particularly within psychiatry, to hold specialist registration in the general division; and if he will make a statement on the matter. [40617/18]

View answer

Written answers (Question to Health)

The HSE Policy in respect of consultant appointments including psychiatry, both permanent and temporary, has a requirement that they are on the relevant Specialist Register. In March 2008, the HSE amended the qualifications specified for consultant posts to require registration in the relevant specialist division of the Register of Medical Practitioners at the Medical Council. The rationale for the change was the imperative to ensure that consultants employed in the public health system have the appropriate training, skills, competences and qualifications to deliver care as assessed by the Medical Council which has the statutory role of protecting the public by promoting the highest professional standards amongst doctors practising in the State. The Consultants’ Contract 2008 reflects this requirement.

HSE HR Circular 021/2017 addressed in detail the qualifications required for consultant posts. The effect of this is that applicants who are not registered in the relevant specialist division cannot be appointed to a permanent consultant post in a HSE hospital or service or in a Section 38 agency funded by the HSE.

The HSE has advised however that there are circumstances where it has been required to continue to appoint doctors who were not on the Specialist Register to fill consultant posts that were vacant so that essential services could be delivered. A process is in place where the Hospital Groups provide an assurance to the appropriate National Service Director that the required relevant supervisory supports are in place for Consultants not on the Specialist Register.

Medicinal Products Availability

Questions (223)

John McGuinness

Question:

223. Deputy John McGuinness asked the Minister for Health if the drug niraparib will be made available to a person (details supplied) in view of the fact that they are platinum resistant and due to this were refused access to the drug by the compassionate access programme; if his attention has been drawn to the fact that the drug is available in the UK and Europe for both sets of patients; and if the matter will be expedited. [40620/18]

View answer

Written answers (Question to Health)

The 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 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.

In line with the 2013 Act, if a company would like a medicine to be reimbursed by the HSE pursuant to the community drugs schemes, 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 on the Supply and Pricing of Medicines, 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.

I have been informed that the NCPE completed a rapid review on Niraparib (Zejula) on 21 June 2018. They recommended that a full HTA be conducted to assess the clinical effectiveness and cost effectiveness of niraparib compared with the current standard of care. The HSE commissioned the HTA on 27 June 2018.

Hospital Appointments Status

Questions (224)

Robert Troy

Question:

224. Deputy Robert Troy asked the Minister for Health if an appointment for a person (details supplied) will be expedited; and if he will make a statement on the matter. [40629/18]

View answer

Written answers (Question to Health)

Under 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.

Bullying in the Workplace

Questions (225)

Clare Daly

Question:

225. Deputy Clare Daly asked the Minister for Health the number of complaints in regard to bullying that have been submitted by nurses and midwives via the HSE's new complaints notification process created as part of the organisation's dignity at work policy since the notification system launched. [40630/18]

View answer

Written answers (Question to Health)

I have asked the HSE to respond to you directly on this matter.

Medical Aids and Appliances Provision

Questions (226)

Darragh O'Brien

Question:

226. Deputy Darragh O'Brien asked the Minister for Health the plans in place in order to address the shortage of anaphylactic pens here; and if he will make a statement on the matter. [40634/18]

View answer

Written answers (Question to Health)

The Health Products Regulatory Authority (HPRA) has advised that it is aware of the global intermittent supply of certain adrenaline auto-injectors (AAIs) that has subsequently impacted the Irish market. The shortage of these products has caused increased demand for the other AAI ranges marketed in Ireland resulting in further supply disruptions.

The Medicine Shortages Framework was launched in September. It is a collaborative initiative that brings together key players in the health sector with the aim of developing strategies to mitigate the effect of shortages in Ireland so that patient health is protected. This new framework will result in a co-ordinated national response to managing medicine shortages and provides mechanisms that can be swiftly activated if a shortage of a particular medicine does occur. The framework strengthens and improves procedures which provide enhanced protection for patients through forward planning and shortage identification. It was developed after extensive consultation with a wide range of stakeholders involved in the provision of medicines, including state agencies, healthcare professionals, patient groups, and industry.

The HPRA provides the platform for, and facilitates the coordination of, all stakeholders to share information in order to prevent or mitigate the impact of medicine shortages when they occur. A medicine shortages list is being maintained on the HPRA website as part of this framework and is updated frequently as new information arises in relation to shortages of individual medicines.

Under this framework, the HPRA has been working closely with all suppliers of AAIs in Ireland to reduce the impact of supply disruptions on patients and healthcare professionals. As a result, while there remain limited supplies of certain AAIs, alternative AAIs are available.

Due to the general increased demand for AAIs at this time of year individual pharmacies may still be experiencing supply issues, but there are supplies within the system and more are expected in the coming weeks.

While the supply situation for individual AAIs is subject to change the HPRA will be maintaining regular contact with all AAI suppliers and other relevant stakeholders, including wholesalers and healthcare professionals (including the Irish Food Allergy Network).

Patients and their carers should familiarise themselves with any AAI that has been supplied to them, especially if it is one they have not received previously. If a patient has any questions relating to administration of an AAI, they should speak to their pharmacist or doctor.

Hospital Staff Data

Questions (227)

Mary Butler

Question:

227. Deputy Mary Butler asked the Minister for Health the number of consultant radiologists attached to University Hospital Waterford; the respective speciality applicable to each radiologist, for example, mammography, MRI and so on of each; his plans to increase the number employed; and if he will make a statement on the matter. [40639/18]

View answer

Written answers (Question to Health)

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

Hospital Waiting Lists Action Plans

Questions (228)

Mary Butler

Question:

228. Deputy Mary Butler asked the Minister for Health his plans to reduce the outpatient waiting list for neurology at University Hospital Waterford; and if he will make a statement on the matter. [40640/18]

View answer

Written answers (Question to Health)

Improving waiting times for hospital procedures and outpatient appointments is a key commitment in the Programme for Government.

In 2018, the HSE expects to deal with a total 3.3m out-patient attendances at an overall ratio of new to return patients of 1:2.5. The HSE also advises that in 2017 almost half a million (479,000) outpatients did not attend their appointments. The establishment, earlier this year, of the central validation office in the National Treatment Purchase Fund is an important development in this regard.

My Department is engaging with the HSE and the NTPF to finalise an Outpatient Action Plan. This Plan will aim to reduce the growth in the number of patients waiting for outpatient services through improving the accuracy of the waiting list and trialling NTPF funded interventions, including weekend and out of hours clinics. NTPF has invited proposals from Hospital Groups and as of end of September had approved almost 12,700 outpatient appointments.

In relation to the specific query raised in relation to plans to reduce the neurology waiting list at University Hospital Waterford, as this is a service matter, I have asked the HSE to respond to the Deputy directly.

Hospital Appointments Status

Questions (229)

Mary Butler

Question:

229. Deputy Mary Butler asked the Minister for Health when a person (details supplied) will be called for a MRI scan at University Hospital Waterford; and if he will make a statement on the matter. [40641/18]

View answer

Written answers (Question to Health)

Under 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.

Medical Card Administration

Questions (230)

Jack Chambers

Question:

230. Deputy Jack Chambers asked the Minister for Health the way in which applications for medical cards from persons with severe rheumatoid arthritis are considered in the context of their condition; and if he will make a statement on the matter. [40647/18]

View answer

Written answers (Question to Health)

The HSE's Expert Group on Medical Need and Medical Card Eligibility examined the issue of awarding medical cards on the basis of illness and concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. The Expert Group also concluded that a person’s means should remain the main qualifier for a medical card. This position remains unchanged.

Medical card provision is based on financial assessment. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. The Act obliges the HSE to assess whether a person is unable, without due hardship, to arrange general practitioner services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure and every application must be assessed on that basis. Under the legislation, having a particular illness, in itself, does not establish eligibility for a medical card and therefore, the medical conditions of applicants for this scheme are not monitored on that basis. Where the applicant's income is within the income guidelines, a medical card or GP visit card will be awarded.

Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. It should be noted, in certain circumstances, the HSE may exercise discretion and grant a medical card, even though an applicant exceeds his or her income threshold, where he or she faces difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE affords applicants the opportunity to furnish supporting information documentation to fully take account of all the relevant circumstances that may benefit them in the assessment, including medical evidence of cost and necessary expenses.

Child and Adolescent Mental Health Services

Questions (231)

James Browne

Question:

231. Deputy James Browne asked the Minister for Health the reason for the delay of 34 months in County Wexford for an appointment with a child and adolescent primary care psychologist; the further reason the service is taking no urgent appointments; and if he will make a statement on the matter. [40659/18]

View answer

Written answers (Question to Health)

As this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.

Home Help Service Provision

Questions (232)

Bernard Durkan

Question:

232. Deputy Bernard J. Durkan asked the Minister for Health the progress to date in the determination of an application for additional home support in the case of a person (details supplied); and if he will make a statement on the matter. [40660/18]

View answer

Written answers (Question to Health)

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

Homeless Accommodation Provision

Questions (233)

Thomas P. Broughan

Question:

233. Deputy Thomas P. Broughan asked the Minister for Health the number of beds in homeless accommodation; if they are supported temporary accommodation, temporary emergency accommodation or other available specifically for homeless persons leaving hospital in each of the years 2015 to 2017 and to date in 2018; and if he will make a statement on the matter. [40667/18]

View answer

Written answers (Question to Health)

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Mental Health Services

Questions (234)

Thomas P. Broughan

Question:

234. Deputy Thomas P. Broughan asked the Minister for Health if his attention has been drawn to the fact that the waiting times for accessing mental health supports in Dublin 5 (details supplied) is 16 weeks; the steps he is taking in order to address the matter; and if he will make a statement on the matter. [40669/18]

View answer

Written answers (Question to Health)

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

Mental Health Services

Questions (235)

Thomas P. Broughan

Question:

235. Deputy Thomas P. Broughan asked the Minister for Health the waiting times for an appointment in each of the mental health services in Dublin 5 (details supplied); the average time a patient will wait for an appointment in each of these facilities; and if he will make a statement on the matter. [40670/18]

View answer

Written answers (Question to Health)

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

Dental Services

Questions (236)

Robert Troy

Question:

236. Deputy Robert Troy asked the Minister for Health if changes will be brought forward to the Dentists Act 1985 which would allow dental hygienists to treat patients without the need for supervision by a dentist; and if he will make a statement on the matter. [40697/18]

View answer

Written answers (Question to Health)

My Department is currently developing new legislation to replace the Dentists Act, 1985. The role and the regulation of dental hygienists is being examined in the context of this new legislation. The drafting of the scheme of the Bill has commenced, however it is at an early stage.