Tuesday, 6 Nov 2018

Written Answers Nos. 591-614

Hospital Waiting Lists Data

Questions (591, 592, 593, 594, 595, 596, 597)

Stephen Donnelly

Question:

591. Deputy Stephen S. Donnelly asked the Minister for Health the number of persons waiting as of 1 October 2018 or the nearest available date for an MRI scan (details supplied). [45071/18]

Stephen Donnelly

Question:

592. Deputy Stephen S. Donnelly asked the Minister for Health the number of persons waiting as of 1 October 2018 or the nearest available date for a CT scan (details supplied). [45072/18]

Stephen Donnelly

Question:

593. Deputy Stephen S. Donnelly asked the Minister for Health the number of persons waiting as of 1 October 2018 or the nearest available date for a bone scan (details supplied). [45073/18]

Stephen Donnelly

Question:

594. Deputy Stephen S. Donnelly asked the Minister for Health the number of persons waiting as of 1 October 2018 or the nearest available date for an angiogram (details supplied). [45074/18]

Stephen Donnelly

Question:

595. Deputy Stephen S. Donnelly asked the Minister for Health the number of persons waiting as of 1 October 2018 or the nearest available date for an electroencephalogram (details supplied). [45075/18]

Stephen Donnelly

Question:

596. Deputy Stephen S. Donnelly asked the Minister for Health the number of persons waiting as of 1 October 2018 or the nearest available date for cholangiopancreatography (details supplied). [45076/18]

Stephen Donnelly

Question:

597. Deputy Stephen S. Donnelly asked the Minister for Health the number of persons waiting as of 1 October 2018 or the nearest available date for an ultrasound scan (details supplied). [45077/18]

Written answers

Minister for Health

I propose to take Questions Nos. 591 to 597, inclusive, together.

Historically, radiology waiting list data has not been collected nationally.

The HSE advises that a pilot project commenced in 2016 by the HSE Acute Hospitals Division to progress the collection of national radiology waiting list data. The project has been supported by the Radiology Clinical Care Programme and has involved key stakeholders across the system including the National NIMIS Team, Hospital Groups, and the support of the National Treatment Purchase Fund (NTPF) for data collection and data management expertise.

The NTPF advise that they have received the most recent quarterly national radiology data from the HSE. The data is currently being audited by the NTPF and is due to be supplied to my Department in the coming weeks after which I will provide the information sought directly to the Deputy.

Psychological Assessments Waiting Times

Questions (598)

Frank O'Rourke

Question:

598. Deputy Frank O'Rourke asked the Minister for Health the number of children in CHO area 7 on the waiting list for an appointment with a child psychologist; the length of time each has been waiting; the measures in place to ease the appointments backlog; and if he will make a statement on the matter. [45078/18]

Written answers

Minister for 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.

Psychological Services

Questions (599)

Frank O'Rourke

Question:

599. Deputy Frank O'Rourke asked the Minister for Health if an interim child psychologist has been appointed to the north Kildare disability network team to replace the senior child psychologist who went on maternity leave on 1 September 2018; and if he will make a statement on the matter. [45079/18]

Written answers

Minister of State at the Department of Health

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.

General Practitioner Services Provision

Questions (600)

Frank O'Rourke

Question:

600. Deputy Frank O'Rourke asked the Minister for Health the measures and plans in place for extra general practitioner services in primary care at Kilcock, County Kildare, in view of the fact patients are being turned away from these services as they are all at capacity; and if he will make a statement on the matter. [45081/18]

Written answers

Minister for Health

As this question relates to a service matter, I have arranged for it to be referred to the Health Service Executive for direct reply to the Deputy.

Cancer Screening Programmes

Questions (601)

Joe Carey

Question:

601. Deputy Joe Carey asked the Minister for Health the waiting time for CervicalCheck screening participants; and if he will make a statement on the matter. [45084/18]

Written answers

Minister for Health

The Deputy's question relates to service delivery matters, and accordingly I have asked the HSE to reply directly to him 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.

Ambulance Service Staff

Questions (602)

Gino Kenny

Question:

602. Deputy Gino Kenny asked the Minister for Health if he will direct the HSE to engage with the ambulance personnel branch of a union (details supplied) that is asserting its fundamental employee rights to representation by their union of choice and to facilitate the payroll deduction of union subscriptions from members of a union in order to prevent an escalation in industrial action and to ultimately resolve this dispute; and if he will make a statement on the matter. [45090/18]

Written answers

Minister for Health

SIPTU is recognised by the HSE and has negotiating rights for ambulance grades employed by the Executive. As a result, the HSE deducts subscriptions at source for those ambulance staff that are members of that union.

However, the National Ambulance Service Representative Association (NASRA) is not recognised by the HSE and, therefore, does not have negotiating rights. Whilst individuals have a right to membership of any trade union, if they choose to join an association which is not recognised by their employer, such membership is not facilitated by their employer. This means that the HSE does not facilitate deduction of union subscriptions for this particular Association. In light of all of the above, I do not intend directing the HSE to engage with this branch of the Psychiatric Nurses Association.

Pharmacy Regulations

Questions (603)

Robert Troy

Question:

603. Deputy Robert Troy asked the Minister for Health if the status of pharmaceutical assistants following recent recommendations made by an organisation (details supplied) will be protected; and if he will make a statement on the matter. [45092/18]

Written answers

Minister for Health

Pharmaceutical Assistants are a grade of pharmacy professionals who are permitted, under section 30(1) of the Pharmacy Act 2007, to act on behalf of a registered pharmacist during the “temporary absence” of the registered pharmacist.

Section 30(2) of the Pharmacy Act 2007 permits the Council of the Pharmaceutical Society of Ireland (PSI) 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.

These Rules are made by way of Statutory Instrument requiring the formal consent of the Minister for Health.

Following a public consultation process, which ran from 17 July until 14 August 2018, the Council of the PSI approved the draft Pharmaceutical Society of Ireland (Temporary Absence of Pharmacist from Pharmacy) Rules 2018 at its meeting on 20 September 2018.

I understand that since that date the PSI has undertaken to redraft the Rules in relation to what may or not be done by a registered pharmaceutical assistant when acting on behalf of a registered pharmacist. The redrafted Rules will require approval of the Council of the PSI before a public consultation phase. Subsequent to any public consultation phase the draft Rules must again be approved by the Council before submission for my consent. This Council approval is not anticipated until early in the New Year.

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.

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.

Services for People with Disabilities

Questions (604)

Stephen Donnelly

Question:

604. Deputy Stephen S. Donnelly asked the Minister for Health if emergency funding will be provided to an organisation (details supplied) to cover the costs of continuity of service provision; and if he will make a statement on the matter. [45108/18]

Written answers

Minister of State at the Department of Health

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.

Assisted Human Reproduction Legislation

Questions (605)

Paul Murphy

Question:

605. Deputy Paul Murphy asked the Minister for Health if he will report on the progress of the assisted human reproduction Bill, in particular in relation to areas (details supplied); when he plans to come before Dáil Éireann to report on this progress in line with the commitment made in Dáil Éireann on 11 July 2018; and if he will make a statement on the matter. [45110/18]

Written answers

Minister for Health

As 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 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. 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. However, it is not possible at this time to give a definitive timeline for the completion of the draft Bill and its subsequent passage through the Houses of the Oireachtas.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). Under the AHR Bill AHR services will be made available to people irrespective of gender, marital status or sexual orientation on the basis of equality and non-discrimination. 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 surrogate mothers) 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.The Children and Family Relationships (Amendment) Bill 2018 was enacted on 24 July 2018. This Act was introduced to correct typographical and technical errors in the Children and Family Relationships Act 2015, which will facilitate the subsequent commencement of Parts 2 and 3 of the Act. Parts 2 and 3 of the Children and Family Relationships Act deal with the regulation of donor-assisted human reproduction (DAHR) procedures carried out in the State, and with the rights of children born as a result of those procedures. Parts 2 & 3 of the Act will also provide for the granting of a retrospective declaration of parentage in relation to a child born as a result of a DAHR procedure prior to the commencement of Parts 2& 3, subject to certain conditions.A number of issues relating to areas that fall outside of provisions of Parts 2 and 3 of the Children and Family Relationships Act 2015 were raised during the debate on the Children and Family Relationships (Amendment) Act 2018. Officials from my Department are engaging with their colleagues in the Departments of Justice and Equality, Foreign Affairs and Trade, Employment Affairs and Social Protection, and Children and Youth Affairs, in relation to these issues and it is my intention to give a substantial update on these issues once this process of engagement has been concluded.

Hospital Staff

Questions (606)

Martin Ferris

Question:

606. Deputy Martin Ferris asked the Minister for Health the status of the rheumatologist and the staffing level at the rheumatology department of University Hospital Kerry; and if he will make a statement on the matter. [45112/18]

Written answers

Minister for Health

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

Hospital Beds Data

Questions (607)

Fiona O'Loughlin

Question:

607. Deputy Fiona O'Loughlin asked the Minister for Health the average annual operational cost of a filled bed in a public hospital; and if he will make a statement on the matter. [45116/18]

Written answers

Minister for Health

As the Health Service Executive is responsible for the delivery of health services, I have asked the HSE to respond directly to you.

National Children's Hospital

Questions (608)

Fiona O'Loughlin

Question:

608. Deputy Fiona O'Loughlin asked the Minister for Health the original planned completion date for the national children's hospital; the estimated completion date for the hospital; and if he will make a statement on the matter. [45120/18]

Written answers

Minister for Health

As announced in April 2017, the new children’s hospital was scheduled to be open by the end of 2021. The construction contract for the building of the new children’s hospital and associated Paediatric Outpatients and Urgent Care Centres contract were signed in August 2017. At that time, the agreed contract timeline was extended to ensure full alignment in construction timetables for the contractor and specialist sub-contractors. The projected practical completion date for the new hospital is March 2022, allowing for the opening of the main hospital in Q3 2022. The Paediatric Outpatients and Urgent Care Centre at Connolly is scheduled to open in 2019 followed by the Centre at Tallaght in 2020 in advance of the opening of the main hospital in 2022.

Home Help Service

Questions (609)

Thomas Pringle

Question:

609. Deputy Thomas Pringle asked the Minister for Health the number of persons awaiting approval for home help hours in the north west in each month in each of the past three years to date; and if he will make a statement on the matter. [45133/18]

Written answers

Minister of State at the Department of Health

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

Health Services Funding

Questions (610)

Thomas Pringle

Question:

610. Deputy Thomas Pringle asked the Minister for Health the amount of extra funding allocated from budget 2019 to address the trolley crisis in Letterkenny University Hospital not taking into account funds allocated to cover the existing overspend in the health budget; and if he will make a statement on the matter. [45134/18]

Written answers

Minister for Health

My Department is working with the HSE to ensure the most effective response to the winter challenges to unscheduled care provision.

As part of Budget 2019, an additional €10m in funding is being provided in 2018 to enable hospitals to get patients home or to an alternative care setting, as appropriate, before the end of the year, with a focus on supporting patients in the over 75 age group.

I have asked the HSE to ensure that activity in 2019 is planned to manage critical demand pressures, most particularly in respect of increased attendance at emergency departments. This planning will include activity in hospitals, primary care and community care.

€10 million in funding is being made available in 2019 to increase acute bed capacity in line with the recommendations of the Health Service Capacity Review. Increasing capacity is a priority of this Government.

My Department is currently in discussions with the HSE, in the context of the National Service Plan 2019, to identify the sites for investment and the associated number of beds, as part of an agreed capacity programme for 2019.

The selection and opening of beds on specific sites in 2019 and future years will be considered as part of the annual estimates and service planning process, and is subject to financial, operational, human resource and policy considerations and priorities.

Ambulance Service Provision

Questions (611)

Thomas Pringle

Question:

611. Deputy Thomas Pringle asked the Minister for Health his views on whether ambulance cover in County Donegal is sufficient for the needs of the county; the number of stations that exist; the criteria for deployment of ambulances at each station; and if he will make a statement on the matter. [45135/18]

Written answers

Minister for Health

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

Pharmacy Regulations

Questions (612)

Niamh Smyth

Question:

612. Deputy Niamh Smyth asked the Minister for Health if he will address a matter (details supplied) regarding pharmaceutical assistants; and if he will make a statement on the matter. [45150/18]

Written answers

Minister for 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 Pharmacy Act 2007 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 2018, the Council of the PSI 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 the Council approved the draft rules without amendment.

I understand that since that date the PSI has undertaken to redraft the Rules in relation to what may or not be done by a registered pharmaceutical assistant when acting on behalf of a registered pharmacist. The redrafted Rules will require approval of the Council of the PSI before a public consultation phase. Subsequent to any public consultation phase the draft Rules must again be approved by the Council before submission for my consent. This Council approval is not anticipated until early in the New Year.

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.

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.

Electronic Cigarettes

Questions (613, 713)

Noel Rock

Question:

613. Deputy Noel Rock asked the Minister for Health if the policy towards e-cigarettes will be updated in view of the Healthy Ireland 2018 finding that 41% of smokers who successfully quit in the past year used an e-cigarette to do so; if he will consider commissioning a second health technology assessment or other research into their effectiveness as a cessation tool; and if he will make a statement on the matter. [45154/18]

Charlie McConalogue

Question:

713. Deputy Charlie McConalogue asked the Minister for Health the status of the position regarding the use of e-cigarettes as a means of smoking cessation; if his attention has been drawn to recent reports in the UK which promote their use (details supplied); and if he will make a statement on the matter. [45591/18]

Written answers

Minister for Health

I propose to take Questions Nos. 613 and 713 together.

The recently published Healthy Ireland 2018 survey found that the prevalence of smoking in Ireland has declined from 22% in 2017 to 20% in 2018 which is to be welcomed.

The Tobacco Free Ireland (2013) policy document contains a number of recommendations to assist smokers in quitting tobacco use. One of those recommendations is to examine the evidence regarding the outcomes of the use of Nicotine Replacement Therapy ('NRT') and other approaches.

My Department requested HIQA to undertake a Health Technology Assessment ('HTA') of the clinical and cost effectiveness of pharmaceutical and non-pharmaceutical smoking cessation products and services. The HTA was published in 2017 and found that all the pharmacological interventions were effective compared to no treatment and that a prescription only drug called varenicline was the most effective drug on its own. However, the HTA also found that using a combination of varenicline and NRT was the most effective pharmacological intervention and that people using this combination were over three and a half times more likely to quit than those who were in a control group and did not receive this treatment.

Group behavioural therapy, individual counselling, intensive advice and telephone support were all found to be effective behavioural interventions with group therapy found to be the most effective of these interventions. The addition of a behavioural intervention to a pharmacological intervention improved the effectiveness of the intervention.

The HTA recommended that smoking cessation services should seek to increase the uptake of varenicline, either alone or in combination with NRT, for smokers who want to use a pharmacological support.

In relation to e-cigarettes and vaping, although the HTA found that results for e-cigarettes are promising, there is currently a lack of evidence to recommend their use as a smoking cessation aid and at present no e-cigarette product is licensed as a medicinal product in Ireland. The safety of e-cigarettes is an evolving area of research; while potentially safer than smoking, evidence on its long-term safety has yet to be established. In the absence of additional evidence confirming the effectiveness of e-cigarettes, the HTA recommended that the HSE smoking cessation services should seek to increase the uptake of combination NRT treatment among those for whom varenicline is contraindicated, not tolerated or not preferred.

The results of the HTA are informing the development by the HSE, in conjunction with the National Clinical Effectiveness Committee, of national clinical guidelines.

The Department of Health is aware of, and actively monitoring, publications by authoritative bodies internationally on the use of e-cigarettes as a smoking cessation tool. Analysis of emerging research on all products, and the findings of Healthy Ireland 2018 in relation to e-cigarette usage in Ireland, will continue to inform decisions around any future additional regulation in this area.

Health Services Expenditure

Questions (614)

Stephen Donnelly

Question:

614. Deputy Stephen S. Donnelly asked the Minister for Health the reason health spending has overrun to a large extent since 2014; and if he will make a statement on the matter. [45155/18]

Written answers

Minister for Health

In any given year, the Government has a finite amount of money for allocation in the Budget, and has many competing priorities.

During the fiscal crisis, as with most areas of public spending, significant reductions in health funding were experienced. Including 2014, the budget provided for Health was less than that provided in the previous year, with significant targeted savings through pay reductions and efficiency.

2015 saw the first modest increase in the health vote for a number of years, and whilst welcome, proved insufficient, given the erosion of the base funding during the financial emergency. The supplementary estimate that year was required to meet ongoing running costs in the sector, new initiatives commenced during the year and some demand led services, and was provided on a once off basis. Thus, whilst 2016 saw a further budgetary increase, the majority of the funding merely met the existing costs within the system, along with pay rate increases. In recognition of the difficulties facing the system, the Minister for Public Expenditure and Reform approved a further €500m for health in the REV, this sum remaining in the base for 2017. This allowed for services for older people to be maintained at the previous year's levels (€30m), met shortfalls in the State Claims Agency (SCA) and PCRS (€200m) and provided for a Winter Initiative at €40m.

Additional funding of €450m was provided in the 2017 budget, along with a further supplementary estimate of €195m. Of the original funding, 39% was required for pay rate and pension costs with a further 6% supporting the SCA. In relation to the supplementary estimate that year, a 38% or €75m related to the acceleration of the restoration of pay under the Lansdowne Road Agreement, with a further 25% or €50m required for the SCA.

For 2018, 45% of the additional funding provided in the budget was required for pay restoration, resulting in very modest increase for services, and the consequent need for a further supplementary estimate. When account is taken of pay restoration, costs associated with the SCA and other demand led areas, there is a reason for the level of increased expenditure year on year. Further, the nature of the health services is such that the normal budget management levers available to other sectors, such as reduction of services, are simply not available to us and consequently, overruns can and do occur. External factors, such as the actions of the Private Health Insurers, can also drive the need for additional funding.

During the period 2014 to 2018 the reasons for the receipt of supplementary funding are as follows:

Government/DoH Policy Implementation	Demographics, Complexity, Capacity	Demand-Led	Other
Emergency Department Taskforce Action Plan	Acute Hospitals	State Claims Agency	Private insurer campaign
Waiting List Initiative	Disabilities - Emergency Placements and Regulation	Local Demand Led Schemes	Appropriation in Aid shortfalls
Winter Initiative	Home Supports	Pensions	First charge
Accelerated Pay Awards		Overseas Treatment