Treatment Abroad Scheme

Questions (320)

James Browne

Question:

320. Deputy James Browne asked the Minister for Health the number of persons who received mental health services under the treatment abroad scheme in each of the past five years. [51609/18]

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Written answers (Question to Health)

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

Mental Health Services Staff

Questions (321)

James Browne

Question:

321. Deputy James Browne asked the Minister for Health the status of the allocation of the posts from the 2015 €35 million funding for mental health; the number of posts this allocation supports; the number filled; and if he will make a statement on the matter. [51610/18]

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Written answers (Question to Health)

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

Mental Health Services Staff

Questions (322)

James Browne

Question:

322. Deputy James Browne asked the Minister for Health the status of the allocation of the posts from the 2016 €35 million funding for mental health; the number of posts this allocation supports; the number filled; and if he will make a statement on the matter. [51611/18]

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Written answers (Question to Health)

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

Mental Health Services Staff

Questions (323)

James Browne

Question:

323. Deputy James Browne asked the Minister for Health the status of the allocation of the posts from the 2017 €15 million funding for mental health; the number of posts this allocation supports; the number filled; and if he will make a statement on the matter. [51612/18]

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Written answers (Question to Health)

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

Hospitals Discharges

Questions (324)

John Brassil

Question:

324. Deputy John Brassil asked the Minister for Health the steps he will take to address the issue of delayed discharge recordings; if an updated definition of delayed discharge has been provided to allow for a standardised means of reporting delayed discharges across all hospitals; and if he will make a statement on the matter. [51618/18]

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Written answers (Question to Health)

As the Deputy will be aware, in June 2018, I appointed Graham Knowles, Chairperson of the University of Limerick Hospital Group, to chair a Working Group to carry out an independent expert review of delayed discharges. Delayed discharges result in longer lengths of stay for patients, impact on patient flow and contribute to congestion within the hospital system, including in our Emergency Departments. The purpose of the review was to identify the factors which result in delayed discharges and to identify short to medium term changes to reduce the overall number of delayed discharges in the acute hospital system. I received the Working Group's report in November.

The report made nine recommendations, including the development of a national policy to provide for a more consistent approach to recording delayed discharges, strengthening data collection, standardising definitions and ensuring consistent discharge guidelines. It also recommended a more integrated care approach between hospitals and community services, early discharge pathways to prevent admissions and enable assessment of care needs in the patient’s home or alternative care settings and a public health campaign to raise awareness that patients who are discharged without delay have better outcomes.

It is my intention to advance the recommendations of the review in 2019.

Hospitals Discharges

Questions (325)

John Brassil

Question:

325. Deputy John Brassil asked the Minister for Health the steps he will take to address the shortfall of appropriate step-down care for persons being discharged from acute hospitals; and if he will make a statement on the matter. [51619/18]

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Written answers (Question to Health)

Transitional Care Beds provide step-down care for people who have completed the acute phase of their treatment. Together with Home Supports, respite services and rehab services they allow people to continue to live in their own homes and communities. It is important that these services are provided in an integrated way.

The Government has committed significant resources to assist health services across the winter period as detailed in the HSE’s Winter Plan 2018-2019 which was published last week. While acknowledging the challenges of the winter period, the plan represents a system wide response across the health service. €10m additional funding has been released to the HSE to put in place a range of measures before the end of the year.

Support for community operations over the winter period includes the provision of an additional 550 home support packages, investment in aids and appliances and additional Transitional Care Beds which provide step-down care for people who have completed the acute phase of their treatment.

In terms of additional capacity, the plan envisages further provision of up to 70 Community and Rehab beds coming on stream on a phased basis. The plan includes a four-week period of focused action from 17 December until 13 January. During this period 9 key hospital sites and their associated Community Healthcare Organisations will be targeted with a suite of enhanced actions.

Hospital Staff

Questions (326)

John Brassil

Question:

326. Deputy John Brassil asked the Minister for Health if a full-time security person at the Sliabh Mish unit, University Hospital Kerry, will be provided in view of the ongoing security issues; and if he will make a statement on the matter. [51622/18]

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Written answers (Question to Health)

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

Healthcare Policy

Questions (327, 357)

Willie O'Dea

Question:

327. Deputy Willie O'Dea asked the Minister for Health his plans to reopen the health services of the Askeaton protocol (details supplied); if the Askeaton protocol is still used for investigations of potential emissions from industrial facilities that can cause damage to human health; and if he will make a statement on the matter. [51626/18]

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Willie O'Dea

Question:

357. Deputy Willie O'Dea asked the Minister for Health his plans to reopen the health services of the Askeaton protocol, which was a major part of the Askeaton investigation in the late 1990s, following the dossier he received from a person, which was complied by a person (details supplied) into their family in Askeaton; if the Askeaton protocol is still being used for investigations of potential emissions from industrial facilities that can cause damage to human health; and if he will make a statement on the matter. [51769/18]

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Written answers (Question to Health)

I propose to take Questions Nos. 327 and 357 together.

It is understood that the Askeaton Protocol to which the Deputy refers is the 'Disease Cluster Investigation Protocol'. I am informed by the HSE that the protocol is still in use in relation to investigations of potential emissions from industrial facilities that can cause damage to human health.

The correspondence to which the Deputy refers in relation to this matter is being examined by my Department.

Cancer Screening Programmes

Questions (328, 329)

Micheál Martin

Question:

328. Deputy Micheál Martin asked the Minister for Health the status of the assessment of the capacity of laboratories here to perform cervical screening; when this assessment will be completed; and if he will make a statement on the matter. [51641/18]

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Micheál Martin

Question:

329. Deputy Micheál Martin asked the Minister for Health the additional funding to be allocated to laboratories here; and if he will make a statement on the matter. [51642/18]

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Written answers (Question to Health)

I propose to take Questions Nos. 328 and 329 together.

I take it that the Deputy is referring to the on-going preparation for the move to HPV testing as the primary screening mechanism for CervicalCheck.

As the Deputy will be aware, switching to HPV testing as the primary screening mechanism will require a reconfiguration of laboratory services. While it is likely that a tendering process will be needed to meet at least some of the HPV testing requirement, the potential to use public laboratories in Ireland to carry out testing for the programme is being carefully assessed as part of the planning of this major project.

Funding to implement the switch to HPV screening has been allocated in Budget 2019, along with funding to implement the recommendations of Dr Gabriel Scally’s inquiry in to the CervicalCheck Screening Programme, illustrating the Government’s commitment to these essential projects.

I want to be clear, however, that the Report of the Scoping Inquiry into CervicalCheck, published on 12 September on the website of my Department, provides welcome reassurance on the quality management processes of all laboratories currently contracted to provide services for CervicalCheck, including the private laboratories contracted both in Ireland and America (Medlab Pathology and Quest Diagnostics, respectively) and the Coombe Women and Infants University Hospital in Dublin.

Legislative Measures

Questions (330)

Micheál Martin

Question:

330. Deputy Micheál Martin asked the Minister for Health the status of the legislation requiring mandatory disclosure; and if he will make a statement on the matter. [51643/18]

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Written answers (Question to Health)

The Government approved the general scheme of the Patient Safety Bill on 5 July 2018. The Bill provides the legislative framework for a number of important patient safety issues, including providing in legislation for mandatory open disclosure of “serious patient safety incidents” and the notification of such incidents to the appropriate regulatory body and the State Claims Agency. The Bill also empowers the Minister for Health to issue guidance with respect to the undertaking of clinical audit against explicit clinical standards on a national basis, as well as the extension of the Health Information and Quality Authority’s remit to private hospitals.

With respect to the mandatory open disclosure of “serious patient safety incidents”, it is intended that the Bill will provide assurance with regard to transparency of reporting to patients and/or their families, and act as a platform for the dissemination of learning across the whole health system through the requirement for mandatory external reporting by health service providers to the appropriate authority.

The Oireachtas Joint Committee on Health undertook pre-legislative scrutiny of the Patient Safety Bill on 26 September 2018, while the Office of the Parliamentary Counsel to Government is working with my officials in drafting of the Patient Safety Bill. In parallel to the drafting process, my officials also continue to engage in wide consultation with key stakeholders. It is expected that the final draft of the Bill will be brought to Government for approval early next year.

Medical Products

Questions (331)

Micheál Martin

Question:

331. Deputy Micheál Martin asked the Minister for Health his plans and implementation times for the introduction of a managed access programme for the provision of Pembro; the number of women who will receive it in year one, two and so on; if there is a specific line of funding for same; and if he will make a statement on the matter. [51644/18]

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Written answers (Question to Health)

The HSE has statutory responsibility for medicine pricing and reimbursement decisions in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013 which specifies the criteria for decisions on the reimbursement of medicines.

Before any medicinal product can be assessed for reimbursement by the HSE, it is required to have been granted a marketing authorisation by either the European Medicines Agency (EMA) or the Health Products Regulatory Authority (HPRA) in accordance with the criteria under the 2013 Act.

In that respect, Pembrolizumab has been granted marketing authorisation in Ireland and the EU for a number of indications and is included on the HSE reimbursement list for some of those indications. Furthermore, Pembrolizumab is being assessed by the HSE using the criteria in the 2013 Act for a number of other indications for which it has received marketing authorisation.

However, Pembrolizumab has not been granted a marketing authorisation by either the EMA or by HPRA for the treatment of cervical cancer and accordingly, in accordance with the 2013 Act, it cannot be assessed by HSE for reimbursement for cervical cancer, using the standard criteria.

The Deputy will be aware that a Government decision of 11 May 2018 put in place a package of support measures for the women and families affected by the issues related to CervicalCheck. As part of this package, all out of pocket medical costs incurred by the women affected will be met to the extent that they are not already covered either under existing public schemes or any private health insurance policy that an individual might hold. This commitment included medicines which might not be approved for reimbursement, once they are prescribed by the treating clinician. Although not specifically referenced, Pembrolizumab would be encompassed under this aspect of the support package.

I am aware of the concerns raised by the Deputy and other public representatives regarding the question of providing Pembrolizumab to other cervical cancer patients on the same basis as encompassed by the Government decision of 11 May 2018. In the light of these concerns, I have requested the HSE to examine ways in which other women with cervical cancer could be afforded access to Pembrolizumab if prescribed by their treating clinician.

This is not a straightforward matter and there is a range of issues to be addressed in pursing such an approach. These include the question of supply of the product and any terms (including financial ones) under which it might be supplied, the cooperation of the clinical community and the development of appropriate governance and management arrangements, the method of selection of patients suitable to commence treatment and the criteria that would govern clinical decisions in respect of continuation or discontinuation of treatment. Any proposals must place patient safety as a priority, given that this is not a licensed medicine for the treatment of cervical cancer.

I too am anxious to see early progress in this matter and I have asked the HSE to revert to me as a matter of urgency.

Departmental Funding

Questions (332)

John Brassil

Question:

332. Deputy John Brassil asked the Minister for Health if funding for a centre (details supplied) is still available; and if he will make a statement on the matter. [51651/18]

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Written answers (Question to Health)

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

HSE Funding

Questions (333)

John Brassil

Question:

333. Deputy John Brassil asked the Minister for Health if the HSE will continue to fund the running of a centre (details supplied); and if he will make a statement on the matter. [51652/18]

View answer

Written answers (Question to Health)

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

Services for People with Disabilities

Questions (334)

Mary Butler

Question:

334. Deputy Mary Butler asked the Minister for Health when a person (details supplied) can expect to receive confirmation of admission to National Rehabilitation Hospital in Dún Laoghaire; and if he will make a statement on the matter. [51653/18]

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Written answers (Question to 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 a service issue, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Medical Aids and Appliances Provision

Questions (335)

Willie O'Dea

Question:

335. Deputy Willie O'Dea asked the Minister for Health if the pause in the use of transvaginal mesh (details supplied) will be conditional upon the science proving the device is safe for use. [51656/18]

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Written answers (Question to Health)

On 24 July 2018, the HSE was requested by the Chief Medical Officer to pause all uro-gynaecological mesh procedures, in cases where it is clinically appropriate and safe to do so, pending confirmation by the HSE of the implementation of recommendations relating to (i) professional training requirements, (ii) patient information and consent and (iii) the development and maintenance of a national data set for all mesh procedures carried out in HSE funded hospitals. The request to institute a pause in vaginal mesh procedures was considered proportionate and necessary to address public and patient concern about the ongoing safety of mesh devices as comprehensively as possible.

In addition, a Synthetic Mesh Devices Advisory Group has been convened by the National Women and Infant Health Programme which includes three patient representatives, and representatives of stakeholder organisations to advise on and progress all the recommendations. The work being progressed by the HSE will include identifying best practice and the appropriate specialist clinical expertise. The HSE will also work to identify the facilities required at hospital group and national level to provide comprehensive aftercare services.

As requested by the CMO in July 2018, the pause in the use of mesh procedures for the management of stress urinary incontinence and pelvic organ prolapse in HSE-funded hospitals is ongoing. In cases where it is clinically appropriate and safe to do so, it may be resumed pending confirmation by the HSE of the implementation of recommendations.

Home Care Packages Data

Questions (336)

Peadar Tóibín

Question:

336. Deputy Peadar Tóibín asked the Minister for Health the expenditure on home support packages in County Meath in 2018; the projected expenditure for 2019; the number of persons this will benefit; the waiting list for those wishing to access home support packages in County Meath; and if he will make a statement on the matter. [51657/18]

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Written answers (Question to Health)

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

Home Care Packages Data

Questions (337)

Peadar Tóibín

Question:

337. Deputy Peadar Tóibín asked the Minister for Health the number of home care packages provided by local health office area; the number of persons on the waiting list by area; the length of time persons have been on the waiting list; and if he will make a statement on the matter. [51658/18]

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Written answers (Question to Health)

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

Hospital Appointments Status

Questions (338)

Niamh Smyth

Question:

338. Deputy Niamh Smyth asked the Minister for Health the status of an appointment for a person (details supplied); if an appointment will be expedited; and if he will make a statement on the matter. [51659/18]

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Written answers (Question to Health)

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.

In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.