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Tuesday, 9 Oct 2018

Written Answers Nos. 310-327

General Practitioner Contracts

Questions (310)

Brendan Griffin

Question:

310. Deputy Brendan Griffin asked the Minister for Health if an organisation (details supplied) will be recognised in negotiations on the new GMS contract; the status of the new GMS contract negotiations; and if he will make a statement on the matter. [40977/18]

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Written answers

The Government is committed to engaging with the representatives of general practitioners on the development of a package of measures and reforms to modernise the 1989 GMS Contract.

Officials from my Department and the HSE met with the Irish Medical Organisation at the beginning of May to set out the State's position in relation to reform of the GMS contract.

Agreement on the delivery of service improvements and contractual reform has the potential to facilitate a substantial increase in the resourcing of general practice on a multi-annual basis. Engagement with GP representatives on contractual issues is expected to recommence in the coming weeks.

I have acknowledged that the National Association of General Practitioners is anxious to be involved in discussions about reform and I have indicated my willingness to consult with them on issues facing general practice.

General Practitioner Contracts

Questions (311)

Brendan Griffin

Question:

311. Deputy Brendan Griffin asked the Minister for Health the status of the review of free general practitioner care contract for children under six years of age; when this review will be completed; and if he will make a statement on the matter. [40982/18]

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Written answers

A review of the GP Contract governing the provision of care to children under six years of age has not commenced. My first priority is the development of a package of measures and reforms to modernise the 1989 GMS Contract.

The goal is to develop a contractual framework that has a population health focus, providing in particular for health promotion, disease prevention and for the structured care of chronic conditions.

Agreement on the delivery of these much needed service improvements and contractual reforms has the potential to facilitate a substantial increase in the resourcing of general practice on a multi-annual basis as well as enabling GPs to better meet the needs of patients. Engagement with GP representatives on contractual issues is expected to recommence shortly.

Health Services Funding

Questions (312)

Brendan Griffin

Question:

312. Deputy Brendan Griffin asked the Minister for Health if the general practitioner capital fund will be reinstated; and if he will make a statement on the matter. [40983/18]

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Written answers

I assume the Deputy is referring to the General Practice Development Fund which was in operation between 1993 and 2010. There are no plans to reinstate this fund. However, the Government is committed to engaging with GP representatives on the development of a package of measures and reforms to modernise the 1989 GMS contract.

The goal is to develop a contractual framework that has a population health focus, providing in particular for health promotion, disease prevention and for the structured care of chronic conditions. This will enable general practitioners to better meet the needs of patients and will also promote general practice as a viable and rewarding career for both existing doctors and future medical graduates.

There is potential for State expenditure on General Practitioner services to increase significantly in coming years if the talks are successful. Engagement with GP representatives on contractual issues is expected to recommence in the coming weeks.

Health Services Provision

Questions (313)

Michael Healy-Rae

Question:

313. Deputy Michael Healy-Rae asked the Minister for Health if the case of a person (details supplied) will be examined; and if he will make a statement on the matter. [40986/18]

View answer

Written answers

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.

Question No. 314 answered with Question No. 270.
Question No. 315 answered with Question No. 271.

Services for People with Disabilities

Questions (316)

Anne Rabbitte

Question:

316. Deputy Anne Rabbitte asked the Minister for Health the number of initial assessments of need of children with disabilities that are carried out per community healthcare organisation annually. [40999/18]

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Written answers

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 service matters, 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 (317)

Anne Rabbitte

Question:

317. Deputy Anne Rabbitte asked the Minister for Health the qualifications that must be held by assessment-of-needs officers; the number of officer positions nationally; his views on whether this number is adequate in meeting assessment demands; and if he will make a statement on the matter. [41000/18]

View answer

Written answers

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

Dental Services Expenditure

Questions (318)

Anne Rabbitte

Question:

318. Deputy Anne Rabbitte asked the Minister for Health when the pre-economic crisis budget for the dental treatment services scheme will be reinstated; and if he will make a statement on the matter. [41001/18]

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Written answers

The Dental Treatment Services Scheme (DTSS) provides dental treatments to medical card holders. In 2010 the range of treatments provided under the Scheme was reduced in order to cap expenditure at the 2008 level of €63 million. Expenditure on the DTSS in 2017 was €63.3 million. The HSE continues to monitor the operation of the DTSS to ensure the most beneficial, effective and efficient use of available resources.

A new National Oral Health Policy is currently being developed and I expect it will be published later this year. 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. It is proposed that any future budgetary changes will be considered in the context of achieving these aims.

Autism Support Services

Questions (319)

Anne Rabbitte

Question:

319. Deputy Anne Rabbitte asked the Minister for Health the level of funding being provided to an autism support organisation in each CHO area in each of the years 2011 to 2017, in tabular form; and if he will make a statement on the matter. [41002/18]

View answer

Written answers

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

Autism Support Services

Questions (320)

Anne Rabbitte

Question:

320. Deputy Anne Rabbitte asked the Minister for Health the provision in 2018 in each CHO area for autism assistance dogs for persons who may require one; the provision made in each of the years 2011 to 2017, in tabular form; and if he will make a statement on the matter. [41003/18]

View answer

Written answers

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

HSE Reviews

Questions (321)

Anne Rabbitte

Question:

321. Deputy Anne Rabbitte asked the Minister for Health when the 2017 review of the HSE National Review of Autism Services - Past, Present and Way Forward 2012 will be published; and if he will make a statement on the matter. [41004/18]

View answer

Written answers

In September 2017, the Minister for Health requested that the HSE conduct a review of Autism services with a view to identify existing models of best practice.

The Department of Health also completed an epidemiological/research study into the prevalence and future projections for Autism Spectrum disorder.

Both reports were completed and submitted to the Minister earlier this year.

While there are no current plans to publish the HSE review, the findings and recommendations serve to inform the development of current and future Autism policy and services.

Assisted Human Reproduction Legislation

Questions (322)

John Curran

Question:

322. Deputy John Curran asked the Minister for Health the progress made regarding the establishment of a regulatory body for assisted human reproduction, including surrogacy further to the report of the Commission on Assisted Human Reproduction; his plans to introduce surrogacy legislation; and if he will make a statement on the matter. [41007/18]

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Written answers

As you will be aware, the Government approved the drafting of a Bill on assisted human reproduction (AHR) and associated areas of research, which will be based on the published General Scheme, in October last year. This comprehensive piece of legislation encompasses the regulation of a range of practices, including: gamete (sperm or egg) and embryo donation for AHR and research; surrogacy; pre-implantation genetic diagnosis (PGD) of embryos; posthumous assisted reproduction; and embryo and stem cell research. The General Scheme also provides for an independent regulatory authority for AHR.

Officials in my Department are engaging with the Office of the Attorney General in relation to the process of drafting this Bill. The General Scheme is published on my Department’s website and the Joint Committee on Health is currently conducting a review of the General Scheme of the Assisted Human Reproduction Bill 2017 as part of the pre-legislative scrutiny process, which began in January of this year.

The specific provisions relating to surrogacy are outlined in Part 6 of the General Scheme. These provisions outline the specific conditions under which surrogacy in Ireland will be permitted, including a requirement for all surrogacy agreements to be pre-authorised by the AHR Regulatory Authority. The Scheme also sets out a court-based mechanism through which the parentage of a child born through surrogacy may be transferred from the surrogate (and her husband, if applicable) to the intending parent(s).

Commercial surrogacy raises a number of concerns relating to the welfare and commodification of the children involved as well as the potential risks of coercion and exploitation of financially vulnerable women to act as surrogates. In light of this the General Scheme explicitly prohibits commercial surrogacy being conducted in Ireland.

The aim of the AHR legislation is to promote and ensure the health and safety of parents, others involved in the process (such as donors and surrogates) and, most importantly, the children who will be born as a result of AHR. Consideration of the welfare and best interests of children born through AHR is a key principle underpinning the Scheme.

Hospital Appointments Status

Questions (323)

Brendan Griffin

Question:

323. Deputy Brendan Griffin asked the Minister for Health if a person (details supplied) will receive a hospital appointment; and if he will make a statement on the matter. [41014/18]

View answer

Written answers

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.

Midwifery Services Provision

Questions (324)

Seán Fleming

Question:

324. Deputy Sean Fleming asked the Minister for Health the estimated amount it would cost in a full year if 350 extra midwives were recruited; and if he will make a statement on the matter. [41023/18]

View answer

Written answers

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

Medicinal Products Prices

Questions (325)

Brendan Griffin

Question:

325. 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. [41028/18]

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Written answers

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 protracted deliberative processes which are usually bound by strict confidentially clauses at the insistence of companies.

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.

Two members of the Beneluxa Initiative (Belgium and the Netherlands) completed a joint negotiation for the reimbursement of nusinersen in July 2018. This process began before Ireland joined the collaboration and Ireland was not party to these negotiations.

In February I received the Report on Evaluating Orphan Drugs from the Joint Committee on Health. Currently my Department is examining the Committee's Report and its recommendations. The report raises some significant policy issues which require careful consideration by my Department, the HSE and the National Centre for Pharmacoeconomics.

Hospital Appointments Status

Questions (326)

Timmy Dooley

Question:

326. Deputy Timmy Dooley asked the Minister for Health when a person (details supplied) in County Clare will have knee surgery; and if he will make a statement on the matter. [41031/18]

View answer

Written answers

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.

Hospital Staff Data

Questions (327)

Lisa Chambers

Question:

327. Deputy Lisa Chambers asked the Minister for Health if there are vacant posts at the maternity ward in Mayo University Hospital; if so, the length of time the posts have been vacant; the reason for the vacancies; when the posts are due to be filled; and if he will make a statement on the matter. [41044/18]

View answer

Written answers

As this is a service issue, I have asked the HSE to reply to you directly.

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