Written Answers Nos. 237-254
237. Deputy Robert Troy asked the Minister for Health if a review will be carried out into the dental care provided to long-stay patients at nursing home facilities (details supplied); his plans to amend legislation in this area in order to provide a greater level of service by allowing dental hygienists to visit nursing homes independently; and if he will make a statement on the matter. [40698/18]
View answerA new National Oral Health Policy is currently being finalised by my Department and I expect it will be published later this year. The Policy will replace the Dental Health Action Plan, published in 1994, and on which the provision of dental services in Ireland is currently based.
The aim of the policy is to develop a model of care that will enable preventative approaches to be prioritised, improve access, and support interventions appropriate to current and future oral health needs including those of long stay patients in nursing home facilities.
My Department is also currently developing new legislation to replace the Dentists Act 1985. The regulation and role 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.
238. Deputy Louise O'Reilly asked the Minister for Health if zygotes stored in Irish or international clinics that are formed prior to the full commencement of the Children and Family Relationships Act 2015 but are still yet to be implanted will be covered in order that both the biological mother and their spouse will be recognised as legal parents; if not, his plans to include such scenarios in the assisted human reproduction Bill; and if he will make a statement on the matter. [40700/18]
View answerAfter commencement of Parts 2 & 3 of the Children and Family Relationships Act 2015 the provisions of the Act are confined to procedures carried out in the State and where the child is born in the State. Transitional provisions relating to the use of embryos created prior to the commencement of Parts 2 & 3 of the Act are provided for in sub-section 26 (6) and sub-section 26 (8) of the Act. Sub-section 26 (8) allows for the use of an embryo in a donor-assisted human reproduction procedure that was formed before the date on which Part 3 of the Act comes into operation, subject to certain conditions. These conditions are that: the embryo was formed for the purpose of the donor-assisted human reproduction procedure; the donor of the gamete, used in the formation of the embryo, consented to the use of the gamete in a donor-assisted human reproduction procedure; and that each person who, at the time of the formation of the embryo, was an intending parent, has consented under section 9 or section 11 of the Act to be the parent of any child born as a result of the procedure in accordance with section 5 of the Act.
However, the transitional provisions only apply to a donor-assisted human reproduction procedure where the procedure is carried out in the State and where the child is born in the State.
239. Deputy James Browne asked the Minister for Health if a helipad will be provided at Wexford General Hospital in view of the establishment of a service (details supplied) based in Mallow and covering an area including County Wexford; and if he will make a statement on the matter. [40704/18]
View answerEngagement is ongoing between the National Ambulance Service and the Irish Community Rapid Response in relation to a proposed air ambulance service for the South and I await the submission of an agreed proposal.
I have asked the HSE to respond to you directly in relation to any plans to develop a helipad at Wexford General Hospital. I should however explain that a process is in place for the agreement and prioritisation of projects that are proposed for inclusion in the Capital Plan. Proposals must be considered in the context of the capital funding available and priority must be based on verified service needs. The HSE will continue to apply the available funding for capital developments in the most effective way possible to meet current and future needs.
240. Deputy Thomas P. Broughan asked the Minister for Health the measures being taken to address the rise in use of crack cocaine in view of the reported increase of this substance in recent years; and if he will make a statement on the matter. [40707/18]
View answer301. Deputy Maureen O'Sullivan asked the Minister for Health his views on the impact of crack cocaine in Dublin; and the measures being put in place to help persons seek treatment. [40956/18]
View answerI propose to take Questions Nos. 240 and 301 together.
The most recently published data on drug prevalence show that current use of cocaine (including crack) has remained stable at 0.5 per cent for the past three national surveys (2006/2007, 2010/2011 and 2014/2015).
The HSE is responsible for the provision of addiction services, including treatment. The Health Research Board bulletin ‘Drug Treatment in Ireland 2010 – 2016’, reports that cocaine is the third most common main problem drug. Since 2014, there has been a steady increase in the proportion of new cases for treatment reporting cocaine as a main problem drug in Ireland, rising from a low of 297 cases in 2013 to 568 cases in 2016. In 2016, 11.3% (112) of cocaine cases reported crack as their main problem drug an increase from 9.1% (81) in 2010.
Strengthening early harm reduction responses to current and emerging trends of drug use, including cocaine and crack cocaine, is a key theme in the national drugs strategy, ‘Reducing Harm, Supporting Recovery’. In July 2018, I launched the national cocaine harm reduction campaign, which is a collaboration between the HSE and the Ana Liffey Drugs Project.
The aim of the campaign is to raise awareness of the dangers of taking cocaine (both powder and crack). This campaign will communicate the risks and dangers of cocaine use to dependent users and at-risk groups, as well as to those who engage in ‘recreational use’. It is important to get the message out to the public about the risks associated with drugs like crack cocaine and highlight how these risks are hugely increased when combined with alcohol.
241. Deputy Thomas P. Broughan asked the Minister for Health the number of detox beds available by county; the average length of time a person is waiting to access such a bed; and if he will make a statement on the matter. [40708/18]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
242. Deputy Thomas P. Broughan asked the Minister for Health when the diet supplement Kuvan will be available to late treated adults with PKU; and if he will make a statement on the matter. [40711/18]
View answerThe Health Service Executive (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. The 2013 Act does not give the Minister for Health any powers in this regard. The HSE does not require approval or consent from the Minister or Government when making a reimbursement decision.
This process ensures that treatments that are clinical and cost effective are reimbursed. In circumstances where a company has failed to demonstrate the clinical benefit to support the price that they are seeking for their treatment, the HSE reaches a decision not to reimburse the medicine.
Kuvan (sapropterin) is a medicinal product for the treatment of phenylketonuria (PKU) and treatment once initiated would be expected to be lifelong.
The National Centre for Pharmacoeconomics completed a health technology assessment of sapropterin on the 15th September 2017 and they did not recommend reimbursement as it was not deemed cost effective.
The application was considered in detail by the HSE Drugs Group in January 2018 and referred to the Rare Diseases Technology Review Committee for more detailed consideration and consultation with expert clinicians and patients’ groups.
The Rare Diseases Technology Review Committee is responsible for:
1. Reviewing proposals received from industry or expert groups in Ireland for funding of new products for rare diseases, or expanded indications for existing products for rare diseases and making recommendations as to the implementation of the relevant recommendations from the National Rare Diseases Plan 2011-2018; and
2. Providing contributions to the development of clinical guidelines for relevant Orphan Medicinal Products (OMPs) and supporting the implementation of guidelines in conjunction with the National Drugs Management Programme Office where applicable.
The Committee’s recommendations for reimbursement of OMPs are not intended to replace any part of the existing medicines appraisal or reimbursement process.
The HSE Leadership are scheduled to meet in October and will deliberate on the recommendations received from the Rare Diseases Technology Review Committee in relation to sapropterin.
Reimbursement of sapropterin will be considered in line with the 2013 Act.
243. Deputy Thomas P. Broughan asked the Minister for Health if he will report on the lack of trained psychiatrists in the Mater Misericordiae University Hospital metabolic unit and the HSE mental health services for late treated adults with PKU; and if he will make a statement on the matter. [40712/18]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to you directly, as soon as possible.
244. Deputy Eamon Scanlon asked the Minister for Health his plans for an increase in funding for a community based podiatrist for persons with diabetes in County Sligo (details supplied); and if he will make a statement on the matter. [40716/18]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
245. Deputy Maurice Quinlivan asked the Minister for Health the reason for the delay in a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [40719/18]
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.
246. Deputy Brian Stanley asked the Minister for Health his plans to upgrade the HSE facilities at Erkina House, Rathdowney, County Laois. [40720/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
247. Deputy Brian Stanley asked the Minister for Health if his attention has been drawn to plans to transfer the patients of Erkina House, Rathdowney, County Laois to other facilities; and the consultation that has taken place with the patients or their families. [40721/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
248. Deputy Catherine Murphy asked the Minister for Health the community supports for persons with dementia here; his plans to expand the support levels for persons with dementia; his further plans to meet dementia advocacy groups to discuss increases in funding in the context of budget 2019; and if he will make a statement on the matter. [40722/18]
View answerThe National Dementia Strategy was launched in December 2014 to meet the challenges faced by the 55,000 people living with dementia in Ireland and to provide services to meet growing demand in future years. The Strategy contains 35 priority and additional actions and its implementation is being led by the National Dementia Office in the HSE. The office has made substantial progress towards developing evidence-based care pathways for people with dementia and progress to date, as well as future plans, is recorded in the mid-term review of the Strategy's implementation, which was published in May this year. The Strategy emphasises the need for a "whole community response" to dementia, as the majority of people with dementia live in their own communities and wish to avail of services in their local area.
In 2016 and 2017, the National Dementia Office partnered with the Alzheimer Society of Ireland on a project to map dementia-specific community-based services and supports. The project showed that the average number of community-based services in each Community Health Organisation was 35. Services provided in the community include dementia day care centres, a large proportion of which operate five days a week; dementia-specific homecare delivered by fully trained staff who are familiar with and understand the different symptoms and stages of dementia; dementia-friendly activities such as choirs and art gallery visits; dementia social clubs and Alzheimer Cafés; carer support groups; and dementia advisers. These services are provided by voluntary organisations and the HSE and partner organisations.
It is acknowledged that there are gaps in access to services and a large variance in what services are provided across the country. The National Dementia Office has met with senior HSE officials in each Community Healthcare Organisation region to highlight gaps in each area and to develop local action plans to improve service provision.
In addition to these community supports, in 2014 the HSE introduced Dementia-Specific Intensive Homecare Packages (Dementia-IHCPs) to test the feasibility of providing a high level of support to people with dementia with complex needs to facilitate them to remain living at home. These were initially co-funded by the HSE and the Atlantic Philanthropies and now fully funded by the HSE, which has committed to continue to provide approximately 120 packages at any one time. In addition to the IHCPs, people with dementia are also able to avail of standard home care services on the basis of need and within the resources available
The Department of Health secured €6.26 million through the 2016, 2017 and 2018 Dormant Accounts Fund Action Plans for a number of projects to improve care and supports for people with dementia. Projects receiving funding include the delivery of post-diagnostic supports; a dementia diagnostic service for people with intellectual disability; a national network of memory technology resource rooms; the development of a national dementia registry; the national rollout of a dementia training programme for HSE homecare staff; the development of dementia resource centres; funding for a dementia community activation coordinator; and community support projects for people with dementia.
In terms of plans to expand support levels for people with dementia, the level of funding available for the Department of Health in 2019 and the quantum of services to be provided by the HSE will be considered as part of the national Estimates and budgetary process and National Service Planning.
In July and September, I met with the Alzheimer Society of Ireland to discuss dementia priorities. I have also met with Senator Colette Kelleher, a former CEO of the ASI and advocate for people with dementia, to specifically discuss the needs of people with dementia. I remain willing to engage with advocacy groups on dementia issues as we continue to work towards improved care pathways and services for people with dementia, their carers and families.
249. Deputy Catherine Murphy asked the Minister for Health if he has met with a group (details supplied) to discuss funding arrangements for a centre in order for it to open on more weeks per year; if the granting of funds has been considered in the context of budget 2019; if the attention of the group has been drawn to other funding avenues; and if he will make a statement on the matter. [40725/18]
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.
250. Deputy Brian Stanley asked the Minister for Health the position regarding the case of a person (details supplied) to whom medicinal cannabis has been recommended here and in another EU state as being beneficial but which practitioners here are refusing to prescribe due to potential liability; and if, in such cases it is possible to have the drug prescribed in another EU state. [40741/18]
View answerThe Department is not in a position to advise or comment on individual cases.
Medical practitioners and patients may consult the Department of Health website which contains information on medical cannabis, including clinical guidance on the use of medical cannabis and details on how a medical practitioner may apply for a Ministerial licence for medical cannabis. This information can be found at the following website: health.gov.ie/blog/publications/cannabis-for-medical-use/ It is important to note that the decision to prescribe or not prescribe any treatment, including cannabis treatment, for an individual patient is strictly a decision for the treating clinician, in consultation with their patient. The Minister for Health has no role in this clinical decision-making process.
Under the Misuse of Drugs Acts 1977 to 2016, and the Regulations made thereunder, it is an offence to cultivate, import, export, produce, supply and possess cannabis except in accordance with a licence issued by the Minister for Health.
251. Deputy Brian Stanley asked the Minister for Health the progress being made to deal with the difficulties in having medicinal cannabis prescribed for patients in cases in which this is recommended; if the matter will be discussed with the Medical Council; and his plans to introduce legislation in order to resolve the matter. [40742/18]
View answerThe Deputy may already be aware already that under the Misuse of Drugs legal framework, it is open to a medical practitioner to apply for a Ministerial licence for medical cannabis for the treatment of a patient under his or her care.
I would strongly advise that the Deputy and any persons interested in the use of cannabis for medical purposes to consult the Department of Health website which contains detailed information on the matter, including information on the types of cannabis products and the specified medical conditions for which they may be used to treat, as well as clinical guidance on its use. This information can be found at the following website address:
health.gov.ie/blog/publications/cannabis-for-medical-use.
Details of who may apply for a Ministerial licence and how to apply can also be found on this section of the Department's website at: health.gov.ie.
Having consulted the website, patients, healthcare professionals or others who require further details or clarifications are invited to contact my Department directly for further assistance.
252. Deputy Catherine Murphy asked the Minister for Health if his attention has been drawn to a recent survey regarding whether funding for extra community based podiatrists in County Kildare to support the diabetes community will be made available in the context of budget 2019; if his attention has been further drawn to the year on year increase in the number of persons with diabetes that underwent a lower limb amputation in 2017 in County Kildare; his plans to address this matter; and if he will make a statement on the matter. [40750/18]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
253. Deputy Stephen S. Donnelly asked the Minister for Health the reason he has been unable to meet with the family of a person (details supplied). [40754/18]
View answerI would wish to assure the Deputy that my office has been in regular correspondence with the person concerned in order to attempt to arrange a meeting. Unfortunately, it has not yet proved possible to set a date, however I can confirm that I remain committed to doing so at the earliest possible opportunity.
254. Deputy Stephen S. Donnelly asked the Minister for Health the progress being made on implementing the recommendations of the HSE report 51449 (details supplied). [40755/18]
View answerAs this is a service matter I have referred the Deputy's question to the HSE and asked them to respond directly to the Deputy.
