Wednesday, 23 Jan 2019

Written Answers Nos. 131-150

Orthodontic Services Waiting Lists

Questions (131)

Seán Fleming

Question:

131. Deputy Sean Fleming asked the Minister for Health when an appointment for urgent orthodontic treatment will be allocated to a person (details supplied); and if he will make a statement on the matter. [3135/19]

Written answers

Minister for Health

As this is a service matter it has been referred to the HSE for direct reply to the Deputy.

Medical Card Eligibility

Questions (132)

Michael Moynihan

Question:

132. Deputy Michael Moynihan asked the Minister for Health his plans to ensure that persons who are given a cancer diagnosis receive a medical card without delay; if his attention has been drawn to the long waiting times that cancer patients are waiting for a medical card and the high medical expenses they incur as a result of these waiting times; and if he will make a statement on the matter. [3138/19]

Written answers

Minister for Health

The HSE's Expert Group on Medical Need and Medical Card Eligibility examined the issue of awarding medical cards on the basis of illness and concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility.   The Expert Group also concluded that a person’s means should remain the main qualifier for a medical card.  This position remains unchanged.

Nevertheless, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines.  The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness.

Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE affords applicants the opportunity to furnish supporting information documentation to fully take account of all the relevant circumstances that may benefit them in the assessment including medical evidence of cost and necessary expenses. 

With regard to persons suffering from cancer and other serious medical conditions the HSE also has a system in place for the provision of medical cards in response to emergency situations i.e. in circumstances where persons are in need of urgent or on-going medical care that they cannot afford and also for persons in palliative care who are terminally ill. These medical cards are issued within 24 hours of receipt of the required patient details and a letter which confirms the medical condition from a doctor or consultant. With the exception of terminally ill patients, all medical cards, granted on an emergency basis, are followed up with a full application within a number of weeks.

I would also like to note that since 1 July 2015, the HSE adopted the position that all children under 18 years of age with a diagnosis of cancer are awarded a medical card.  This card is valid for a period of 5 years.

Hospital Appointments Status

Questions (133)

Barry Cowen

Question:

133. Deputy Barry Cowen asked the Minister for Health the status of the case of a person (details supplied); and when the person can expect a hospital appointment. [3153/19]

Written answers

Minister for 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.

Medical Products

Questions (134)

Denis Naughten

Question:

134. Deputy Denis Naughten asked the Minister for Health his views on introducing a scheme to make epipens available in schools, workplaces and other public places similar to the provision of defibrillators; and if he will introduce a scheme to train volunteers as first responders. [3154/19]

Written answers

Minister for Health

In 2015 the then Minister for Health introduced the 'Emergency Medicines' legislation. An adrenaline auto-injector (Epipen) is a prescription-only medicine that ordinarily can only be supplied on foot of a prescription. There is nothing to prevent a person with a diagnosis of anaphylaxis who has been prescribed an Epipen from carrying their prescribed medication with then at all times. This is particularly important for persons at risk of an acute anaphylactic attack.

Medicines legislation, permits any person to administer any medicine to another person in accordance with the directions of a registered medical practitioner. Therefore, if a person has been prescribed a medicine, but is unable to administer it to themselves, such as in the case of an overdose, there is no legal impediment to another person administering that medicine to the patient. {Regulation 4A(1)(c) of the Medicinal Products (Prescription and Control of Supply) Regulations 2003, as amended) (S.I. No. 540 of 2003)]

Notwithstanding these provisions, S. I. No.  449 of 2015 amended the Prescription Regulations to allow certain prescription-only medicines, including adrenaline for known or suspected anaphylaxis, to be administered by trained members of the public in emergency situations. In order for an organisation, which can include schools, workplaces and other public places, to avail of an emergency medicine without the need for a prescription, members of that organisation must complete an approved course of training regarding the administration of such medicines and the management of any adverse reaction. The Pre Hospital Emergency Care Council (PHECC) has established a framework for the education and training of persons to safely and competently administer this medicine to those urgently requiring care.

General Medical Services Scheme Data

Questions (135)

Denis Naughten

Question:

135. Deputy Denis Naughten asked the Minister for Health the number of claims made to the primary care reimbursement service of the Health Service Executive under the general medical card scheme for children between 0 and 15 years of age for adrenalin auto-injectors in each of the years 2010 to 2018; and if he will make a statement on the matter. [3155/19]

Written answers

Minister for Health

Under 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.

Disability Support Services

Questions (136)

Thomas P. Broughan

Question:

136. Deputy Thomas P. Broughan asked the Minister for Health further to Parliamentary Question Nos. 707 and 708 of 15 January 2019, the way in which there will be an increase of 170,000 personal assistant hours over the 2018 target without an increase in funding; and if he will make a statement on the matter. [3158/19]

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.

Industrial Disputes

Questions (137, 138, 139, 140)

Peadar Tóibín

Question:

137. Deputy Peadar Tóibín asked the Minister for Health his plans for negotiation as a dispute resolution regarding the threatened paramedic dispute in relation to the withdrawal of labour on the 22 January 2019; and the steps he will take in relation to same. [3166/19]

Peadar Tóibín

Question:

138. Deputy Peadar Tóibín asked the Minister for Health his plans to intervene in the paramedic dispute to find an acceptable conclusion to both sides on the matter; and if he will make a statement on the matter. [3167/19]

Peadar Tóibín

Question:

139. Deputy Peadar Tóibín asked the Minister for Health if his attention has been drawn to the fact that the HSE has not responded to requests by an organisation (details supplied) to meet to discuss contingency plans in order to agree appropriate emergency ambulance cover for the day of the threatened dispute; and the action has he taken to ensure both sides meet to discuss such a plan. [3168/19]

Peadar Tóibín

Question:

140. Deputy Peadar Tóibín asked the Minister for Health his views on the impact the ambulance dispute will have on the existing significant pressures on the service particularly in the middle of the influenza season and the bed shortage within the health sector. [3169/19]

Written answers

Minister for Health

I propose to take Questions Nos. 137 to 140, inclusive, together.

SIPTU is recognised by the HSE and has negotiating rights for frontline 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 order to mitigate the risk of any potential disruption to service, I have been advised by the HSE that the National Ambulance Service had robust contingency arrangements in place to respond to the industrial action.  This involved ensuring the availability of the Irish Defence Forces to provide crewed ambulances on the day of the strike. 

It is regrettable that the Psychiatric Nurses Association has taken this action.  Whilst negotiation is usually a preferred course of action, in this instance it is not possible for the HSE to engage with the PNA as it is an organisation with no negotiating rights in respect of frontline ambulance personnel. 

Drug Treatment Programmes

Questions (141)

John Lahart

Question:

141. Deputy John Lahart asked the Minister for Health if methadone treatment facilities are included in the primary care centre promised for Ballyboden, Dublin 16; and if he will make a statement on the matter. [3198/19]

Written answers

Minister of State at the Department of Health

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

Transport Support Scheme

Questions (142)

Seamus Healy

Question:

142. Deputy Seamus Healy asked the Minister for Health the position regarding the reintroduction of the motorised transport grant and mobility allowance; and if he will make a statement on the matter. [3200/19]

Written answers

Minister of State at the Department of Health

The Deputy will be familiar with the background to the closure of both the Mobility Allowance and Motorised Transport Grant schemes in February 2013. 

My colleague, the Minister for Health and I brought a Memorandum to Government in May 2018 on proposals for a new Transport Support Payment Scheme in May 2018.  Following  consideration of the matter, it was decided to withdraw the Memorandum from the Cabinet Agenda at the time. I intend to revert to Government in due course with revised proposals to reflect the discussions at that Cabinet meeting and further discussions between myself and Minister Harris on the best way to progress the Transport Scheme.  

It is important to note that the Disabled Drivers and Disabled Passengers scheme operated by the Revenue Commissioners, remains in place. This scheme provides VRT and VAT relief, an exemption from road tax and a fuel grant to drivers and passengers with a disability, who qualify under the relevant criteria set out in governing regulations made by the Minister for Finance. Specifically adapted vehicles driven by persons with a disability are also exempt from payment of tolls on national roads and toll bridges. Transport Infrastructure Ireland has responsibility for this particular scheme.

There are improvements in access to a range of transport support schemes available to persons with disabilities in the State and on-going work is being carried out by Government Departments, agencies and transport providers to further improve access to public transport services. Under the National Disability Inclusion Strategy, the Department of Transport, Tourism and Sport has responsibility for the continued development of accessibility and availability of public transport for people with a disability.

EU Directives

Questions (143, 151)

Catherine Murphy

Question:

143. Deputy Catherine Murphy asked the Minister for Health the consultation he has had with pharmacy representative groups in advance of the implementation of the falsified medicines EU directive; if his attention has been drawn to the fact the directive may impact on the day-to-day work of the dispensing pharmacist; if he has consulted with all points of the supply chain of pharmaceutical drugs on same; and if he will make a statement on the matter. [3202/19]

John Brassil

Question:

151. Deputy John Brassil asked the Minister for Health the liability arising for hospital pharmacists in the implementation of the European Union falsified medicines directive; and if he will make a statement on the matter. [3246/19]

Written answers

Minister for Health

I propose to take Questions Nos. 143 and 151 together.

The Safety Features Delegated Regulation (EU 2016/16) provides that from February 2019, most prescription medicines and a very small number of non-prescription medicines will have to carry ‘safety features’ on their outer packaging. These safety features take the form of an anti-tamper device (e.g. foil seal, breakable cap) and a set of unique identifiers embedded in a 2D barcode on the pack.

The Delegated Regulation was finalised and published in 2016. The intervening 3 year transition period allowed time for all concerned parties to prepare well in advance of the legislation coming into full effect on 9th February 2019.  Details of the requirements of the Delegated Regulation have been widely communicated to all sectors throughout this 3 year transition period.

The Delegated Regulation is directly applicable across all EU Member States. However, a Statutory Instrument is being prepared to ensure that the Irish legislative system is consistent with the requirements of the new Regulation. 

A copy of the draft Instrument was recently circulated as part of a targeted consultation process. The consultation process provides a mechanism for stakeholders and interested parties to express concerns and to make submissions. The Department is considering all points submitted in the consultation, prior to finalising the Statutory Instrument. 

National Children's Hospital

Questions (144)

Fiona O'Loughlin

Question:

144. Deputy Fiona O'Loughlin asked the Minister for Health the number of nurses that will be needed at 25%, 50%, and 100% capacity, respectively for the new children’s hospital; and if he will make a statement on the matter. [3211/19]

Written answers

Minister for Health

As this is a service matter, I have asked Children's Health Ireland to respond to you directly, as soon as possible.

National Children's Hospital

Questions (145)

Fiona O'Loughlin

Question:

145. Deputy Fiona O'Loughlin asked the Minister for Health the number of nurses that indicated that they would be interested in moving to the new children's hospital when asked in late 2018. [3212/19]

Written answers

Minister for Health

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

Healthcare Infrastructure Provision

Questions (146)

Fiona O'Loughlin

Question:

146. Deputy Fiona O'Loughlin asked the Minister for Health the details of extensions to a facility (details supplied) in the past eight years; the details of announcements of extensions to the facility; and if he will make a statement on the matter. [3213/19]

Written answers

Minister for Health

As the Health Service Executive is responsible for the management of healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.

Mental Health Services Data

Questions (147)

Fiona O'Loughlin

Question:

147. Deputy Fiona O'Loughlin asked the Minister for Health the number of beds in a facility (details supplied); the number of persons that occupied the beds in each of the years 2009 to 2018 and to date in 2019, in tabular form. [3214/19]

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.

Primary Care Centres Provision

Questions (148, 149)

Fiona O'Loughlin

Question:

148. Deputy Fiona O'Loughlin asked the Minister for Health the timescale for a project (details supplied); the treatments and therapies that will be available; and if he will make a statement on the matter. [3215/19]

Fiona O'Loughlin

Question:

149. Deputy Fiona O'Loughlin asked the Minister for Health if there will be a pharmacy near a new building (details supplied). [3216/19]

Written answers

Minister for Health

I propose to take Questions Nos. 148 and 149 together.

As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.

HSE Planning

Questions (150)

John Brassil

Question:

150. Deputy John Brassil asked the Minister for Health the plans the HSE has to install robotic dispensing systems to facilitate the implementation of the European Union falsified medicines directive; and if he will make a statement on the matter. [3245/19]

Written answers

Minister for Health

As this is an operational/procurement matter, I have asked the HSE to respond directly to the Deputy on this issue.