Written Answers Nos. 519-542
519. Deputy Michael McGrath asked the Minister for Health to outline the reason medical card holders are charged by their general practitioner each time they receive Faslodex 250 mg injections; and if he will make a statement on the matter. [44726/18]
View answerUnder the terms of the current GMS contract, GPs are required to provide eligible patients with ''all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess."
The HSE has advised that the GMS contract would comprehend the administration of Faslodex and other similar injections.
If a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for services provided by his or her GP, then that patient should report the matter to their HSE Local Health Office.
520. Deputy Michael McGrath asked the Minister for Health to outline his plans to ensure that the completion of the driver licence eyesight report form by a medical practitioner is a free service for medical card holders; and if he will make a statement on the matter. [44727/18]
View answerThe GMS contract stipulates that fees for medical and visit card holders are not paid to GPs in respect of certain medical certificates which may be required, for example, "under the Social Welfare Acts or for the purposes of insurance or assurance policies or for the issue of driving licences".
Any fees charged by GPs for services provided outside the terms of the GMS contract are a matter of private contract between the GP and their patients.
There are no plans at present to include the completion of forms required for driving licence applications as a service to be provided to GMS patients under the GMS or GP Visit Card scheme.
521. Deputy Mary Butler asked the Minister for Health when persons with type 1 diabetes over 21 years of age can expect to be given access to the FreeStyle Libre device under the long-term illness scheme; the reason some persons with type 1 diabetes over 21 years of age have access to the device on the reimbursement scheme while others do not; and if he will make a statement on the matter. [44739/18]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes. Therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
522. Deputy Peadar Tóibín asked the Minister for Health to outline his plans to introduce a system similar to the Spanish model in which organ donation is based on an opt-out system. [44740/18]
View answer686. Deputy Robert Troy asked the Minister for Health to outline the status of the general scheme of the human tissue Bill; and when he expects to be in a position to introduce a soft opt-out organ donation option. [45493/18]
View answerI propose to take Questions Nos. 522 and 686 together.
The General Scheme of a Human Tissue Bill is being finalised at present and will be submitted to Government shortly. The proposed legislation will include provisions for a soft opt-out organ donation system.
523. Deputy Peter Fitzpatrick asked the Minister for Health to outline the reason a person (details supplied) is being refused Versatis patches; and if he will make a statement on the matter. [44741/18]
View answerMedicines play a vital role in improving the health of Irish patients. Securing access to existing and new and innovative medicines is a key health service objective. However, the challenge is to do this in a safe and sustainable manner. Treatment must be appropriate and proportionate and clinical decision-making, such as prescribing, should be based on both patient needs and sound medical evidence.
Lidocaine 5% medicated plasters are licensed for localised relief of post-shingles pain in adults. This is the patch's only licensed use in Ireland. It has been reimbursed in the community drug schemes since 2010.
Clinical concern arose when, from 2012 on, usage increased significantly, to the point where more plasters were being used in Ireland than in the entire UK National Health Service. In such situations, it is important and appropriate for clinicians to review usage and, in 2016, the HSE Medicines Management Programme (MMP) reviewed the use of the plasters. The review estimated that only 5-10% of prescribing was for the licensed indication.
From September 2017, following the clinical review, the HSE introduced a new reimbursement approval system for the patches, to support appropriate use and patient care. Under these arrangements, the patient's GP or consultant applies to the MMP for reimbursement approval on behalf of the patient. If an application is refused, the clinician may submit an appeal to the MMP, making a clear clinical case for the patient. Information for patients and practitioners is on the HSE MMP website at: hse.ie/yourmedicines.
The outcome of an application or an appeal for reimbursement of lidocaine patches is a matter between the MMP and the treating clinician. The Deputy will appreciate that, as Minister for Health, I cannot intervene in individual cases.
The decision to introduce a new reimbursement approval process is a matter for the HSE. However, I fully support the objectives of the HSE Medicines Management Programme.
524. Deputy Clare Daly asked the Minister for Health to outline his plans to allow the sale of 5-hydroxytryptophan here; and the reason it has not been permitted for sale over the counter or on prescription to date. [44746/18]
View answerProducts containing 5-hydroxytryptophan (5-HTP) are considered to be medicines in Ireland. 5-HTP is reported to have actions in the body that could potentially be used to treat some medical conditions such as depression. Under national and European legislation, products for which medicinal claims are made, or which contain substances that could have medicinal effects on the body, are considered to be medicines.
All medicines must have a marketing authorisation prior to being placed on the Irish market. At present no medicine containing 5-HTP is authorised for use in Ireland. An application for a marketing authorisation for a medicine containing 5-HTP could be submitted by any company that has compiled data demonstrating the quality, safety and efficacy of the product and any such application would be reviewed in line with the standard requirements for medicines.
Where a medicine is not authorised in Ireland, a licensed wholesaler may import it if it has been prescribed by a doctor for a patient under his/her care, on his/her direct responsibility and to meet the special needs of a patient. The process for this is described in the ‘Guide to the Notification System for Exempt Medicinal Products’ which is available on the website of the Health Products Regulatory Authority.
The decision to prescribe or not prescribe any treatment, including 5-HTP, for an individual patient is a decision for the treating clinician, in consultation with their patient.
525. Deputy Eoin Ó Broin asked the Minister for Health if he will provide statistical and other information (details supplied) relating to persons with an acquired brain injury; and if he will make a statement on the matter. [44749/18]
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 a service issue, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
526. Deputy Róisín Shortall asked the Minister for Health when he will put in place a financial support scheme for women seeking assisted human reproduction or in vitro fertilisation, IVF, treatment; and if he will make a statement on the matter. [44753/18]
View answerAs you will be aware, the Government approved the drafting of a Bill on assisted human reproduction (AHR) and associated areas of research in October last year. The introduction of legislation in relation to AHR and associated research is a priority for me and the process of drafting this Bill will be completed in conjunction with the Office of the Attorney General. The General Scheme is published on my Department’s website. 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 review is on-going and the Committee intends to publish its report early in 2019.
In order to support the commencement of the legislation, officials in my Department are working with the HSE to develop a model of care for infertility to ensure the provision of safe, effective and accessible services through the public health system as part of the full range of services available in obstetrics and gynaecology.
Part of this work includes identifying policy options for a public funding model for AHR treatment. Once I have had the opportunity to consider these policy options I will bring a Memorandum to Government in relation to a model of care for infertility, including public funding for AHR treatment, for the Government's consideration.
It should be noted that any funding model that may ultimately be introduced would need to operate within the broader regulatory framework set out in the AHR Bill and a model of care for infertility.
It should also be noted that patients who access IVF treatment privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme. In addition, a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Scheme administered by the HSE. Medicines covered by the High Tech Scheme must be prescribed by a consultant/specialist and approved by the HSE ‘High Tech Liaison Officers’. The cost of the medicines is then covered, as appropriate, under the Medical Card or Drugs Payment Scheme. There is also a limited specialist AHR service available through the HSE, which provides funding for fertility preservation for cancer patients whose treatment is likely to impact on their future fertility.
527. Deputy Róisín Shortall asked the Minister for Health to set out the average waiting time for women to be informed of their smear test results after having had the test; if his attention has been drawn to the fact that some women are still waiting for their test results after 18 weeks; and if he will make a statement on the matter. [44754/18]
View answerThe Deputy's question relates to service delivery matters, and accordingly I have asked the HSE to reply directly to her on the specific issues raised.
The HSE advises that CervicalCheck laboratory activity remains significantly above normal levels. This is a result both of out-of-cycle smears, and also increased uptake generally. This has impacted turnaround times for results of smear tests. The HSE also advises that every effort is being made to ensure that tests are processed as quickly as possible, having regard to the high standards required for testing. This is a priority concern for my Department and the HSE.
528. Deputy Michael McGrath asked the Minister for Health to outline his views on the campaign of an organisation (details supplied) to abolish inpatient and inpatient day case charges for cancer patients; the policy on this issue; the steps he plans to take in this regard; and if he will make a statement on the matter. [44755/18]
View answerSignificant progress has been made over a number of years in dealing with cancer treatment with significantly improving survival rates in Ireland. The National Cancer Strategy 2017-2026 aims to build on the progress already made, with improved cancer prevention, diagnostics, treatment and aftercare support. The Irish Cancer Society made a significant input into the drawing up of the Strategy and plays a very positive role in supporting people affected by cancer.
Whilst the sentiment behind the Society's campaign in relation to hospital charges is appreciated, making exemptions to these charges on the basis of illness or treatments risks creating inequity within the system.
The statutory co-payment which is capped at a level that is not large relative to the true cost of providing hospital services, represents an important contribution towards hospitals' operating costs. While the overall charges are subject to ongoing review their abolition would have significant financial implications.
In Budget 2019 the Government prioritised the extension of the GP Visit Card income thresholds, reduction in the Drug Payment Scheme monthly threshold and reduction in the prescription charges for those with a medical card over 70 years. The Sláintecare Implementation Strategy commits to consider all existing charges in the context of the annual budgetary process and this will allow for priorities to be determined in reviewing and considering the scope for reduction in charges.
529. Deputy John Brassil asked the Minister for Health to set out the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [44760/18]
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.
530. Deputy Brendan Griffin asked the Minister for Health to outline his views on a matter (details supplied); and if he will make a statement on the matter. [44763/18]
View answerAs previously advised, CervicalCheck laboratory activity remains significantly above normal levels. This is a result both of out-of-cycle smears, and also increased uptake generally. This has impacted turnaround times for results of smear tests. The HSE also advises that every effort is being made to ensure that tests are processed as quickly as possible, having regard to the high standards required for testing. This is a priority concern for my Department and the HSE.
A response has also been sent to Ms Coffey to advise her of this position.
531. Deputy Tom Neville asked the Minister for Health when new contracts will be offered to carers employed by the HSE in County Kerry in view of the fact that their hours are going to a private company; and if he will make a statement on the matter. [44765/18]
View answerI have asked the HSE to respond directly to the Deputy on this matter.
532. Deputy Robert Troy asked the Minister for Health if an appointment for surgery will be expedited for a person (details supplied); his views on whether persons in such a condition are being left too long on a waiting list which is resulting in ongoing illness and infection; and if he will make a statement on the matter. [44767/18]
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.
533. Deputy Catherine Murphy asked the Minister for Health if he, his departmental officials and or his ministerial predecessors have met companies and an organisation (details supplied) and or representatives of same in the past three years to date; if so, if a schedule of those meetings and the associated minutes will be published; and if he will make a statement on the matter. [44778/18]
View answerI have not held any meetings with the company in question. I have surveyed the Department and have not had any reports of officials who have had meetings with this company. Due to the limited timeframe available, not all units have responded as yet. Should any of them indicate that meetings were held with the company I will revert to the Deputy with details.
534. Deputy John Brassil asked the Minister for Health to set out the status of the recommencement of arthroplasty operations at University Hospital Kerry; and if he will make a statement on the matter. [44789/18]
View answer535. Deputy John Brassil asked the Minister for Health to set out the number of arthroplasty operations that have been undertaken at University Hospital Kerry since 15 October 2018; the number that have been for private and public patients, respectively; and if he will make a statement on the matter. [44790/18]
View answer536. Deputy John Brassil asked the Minister for Health to set out the number of public patients who were on the waiting list for a procedure prior to the suspension of arthroplasty operations at University Hospital Kerry; the number of public patients waiting for an arthroplasty operation; and if he will make a statement on the matter. [44791/18]
View answer537. Deputy John Brassil asked the Minister for Health to outline the reason arthroplasty procedures have not recommenced for public patients at University Hospital Kerry; and if he will make a statement on the matter. [44792/18]
View answer539. Deputy John Brassil asked the Minister for Health to outline his plans to address the need for patients to have arthroplasty operations whilst services are suspending at University Hospital Kerry; and if he will make a statement on the matter. [44794/18]
View answerI propose to take Questions Nos. 534 to 537, inclusive, and 539 together.
I acknowledge that waiting times are often unacceptably long and I am conscious of the burden that this places on patients and their families. However, the provision of a safe service for all of our patients is also paramount.
The HSE advise that the elective arthroplasty (joint replacement) service at University Hospital Kerry (UHK) was temporarily suspended in June following a spike in post-operative infections. During this time significant structural and process improvements/upgrades have been made including the physical relocation of the ward.
Patient pre-assessment restarted two weeks ago and elective arthroplasty surgery recommenced on the morning of the 5 November.
Prior to the suspension of the service there were 133 patients on the arthroplasty waiting list. No new patients were added to the list during the time of suspension of service, and as a consequence there were still 133 patients on the waiting list when the service was re-opened on the 5th of November. No public or private patients were seen during the time of suspension.
Management and the orthopaedic surgeons of UHK are confident that delayed patients will be seen quickly now that the service has re-started. UHK advise that with the re-organisation of theatre scheduling there may be additional capacity for elective arthroplasty operations going forward.
538. Deputy John Brassil asked the Minister for Health when arthroplasty procedures will recommence for public patients at University Hospital Kerry; if it is a matter of funding; if so, his plans to meet the funding shortfall; his views on whether the current situation regarding arthroplasty operations at the hospital is acceptable; and if he will make a statement on the matter. [44793/18]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to you directly as soon as possible.
540. Deputy John Brassil asked the Minister for Health to set out the status of an outpatient appointment for a person (details supplied); and if he will make a statement on the matter. [44808/18]
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 Brendan Griffin asked the Minister for Health to outline his views on a matter relating to a person (details supplied); and if he will make a statement on the matter. [44809/18]
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.
542. Deputy Mick Wallace asked the Minister for Health to outline the progress of the refurbishment of the new child and adolescent mental health services centre at Arden House, Wexford town; and the date on which it will open. [44814/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
