Tuesday, 5 Feb 2019

Written Answers Nos. 444-462

Child and Adolescent Mental Health Services Data

Questions (444)

James Browne

Question:

444. Deputy James Browne asked the Minister for Health the number of children admitted to adult mental health units in 2018. [5601/19]

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.

Medicinal Products Reimbursement

Questions (445)

Niamh Smyth

Question:

445. Deputy Niamh Smyth asked the Minister for Health if a medical product will be supplied to a person (details supplied); and if he will make a statement on the matter. [5603/19]

Written answers

Minister for Health

Medicines 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 as 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 for a particular treatment is a matter for the HSE. However, I fully support the objectives of the HSE Medicines Management Programme.

Occupational Therapy Provision

Questions (446)

Michael McGrath

Question:

446. Deputy Michael McGrath asked the Minister for Health when a child (details supplied) in County Cork will be assessed for occupational therapy and receive appropriate therapy; and if he will make a statement on the matter. [5613/19]

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.

Disabilities Assessments

Questions (447)

Michael McGrath

Question:

447. Deputy Michael McGrath asked the Minister for Health when a child (details supplied) in County Cork will have an assessment of need under the Disability Act 2005; and if he will make a statement on the matter. [5618/19]

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.

Question No. 448 answered with Question No. 310.

Health Services Provision

Questions (449)

Anne Rabbitte

Question:

449. Deputy Anne Rabbitte asked the Minister for Health when a person (details supplied) will receive a bed; and if he will make a statement on the matter. [5639/19]

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

National Children's Hospital Expenditure

Questions (450)

Alan Kelly

Question:

450. Deputy Alan Kelly asked the Minister for Health the date in October 2018 his Department drew the attention of the Department of Public Expenditure and Reform, either formally or informally, to the overspends in the costs of the national children’s hospital; and if he will make a statement on the matter. [5640/19]

Written answers

Minister for Health

On 17 October 2018 my Department made a formal request for a meeting with the Department of Public Expenditure and Reform to discuss the position in relation to the project and potential cost issues emerging. The cost escalation was highlighted at a meeting in my Department on 9 November which included officials from that Department. Subsequently, my Department submitted a report from the National Paediatric Hospital Development Board on the cost overrun and the reasons for it to the Department of Public Expenditure and Reform on 19 November and met with officials of that Department to discuss it on 23 November.

National Children's Hospital

Questions (451, 453)

Alan Kelly

Question:

451. Deputy Alan Kelly asked the Minister for Health the date and times of meetings he and-or his officials had with the national children’s hospital project and programme board since its inception; the persons who attended each meeting; if the minutes of each meeting will be published; if he will publish the correspondence between the board and his Department; if he will publish the minutes of the meetings of the board; and if he will make a statement on the matter. [5641/19]

Alan Kelly

Question:

453. Deputy Alan Kelly asked the Minister for Health if he will publish the communications with the national paediatric hospital development board; the date and times of all meetings he and-or his officials had with the board; the purpose of these meetings; if he will publish the minutes of each meeting; and if he will make a statement on the matter. [5643/19]

Written answers

Minister for Health

I propose to take Questions Nos. 451 and 453 together.

On foot of my response to the Deputy's earlier Parliamentary Question my Department provided further details of the governance arrangements in place in relation to the Children’s Hospital Project and Programme (CHP&P). As outlined previously, the Children’s Hospital Project and Programme (CHP&P) Board is chaired by the Secretary General of the Department of Health and membership is comprised of officials from my Department and the HSE as follows: Assistant Secretary of the Acute Hospital Policy Division in the Department of Health, the Director General of the HSE and the HSE Deputy Director General Strategy (DDG). The Project Director of the National Paediatric Hospital Development Board(NPHDB) also attends CHP&P Board meetings. The CHP&P Board held it's first meeting in September 2017 and monitors the progress of the CHP&P against the agreed parameters of the programme in relation to timeline, scope and funding. The CHP&P Board has met at least every quarter since its establishment 9 Meetings have taken place as follows:

14th September 2017

12th December 2017

17th January 2018

14th March 2018

20th June 2018

19th September 2018

16th November 2018

11th December 2018

18th December 2018

As already requested, the Department has provided the minutes of the meetings to the Deputy; the minutes include attendance details.

In relation to communications with the NPHDB, in addition to CHP&P Board a Children’s Hospital Project and Programme (CHP&P) Steering Group is in place to direct the overall programme of work. Department officials and the NPHDB Project Director are members of the CHP&P Steering Group. The Steering Group reports to the CHP&P Board and the Chair of the CHP&P Steering Group presents a report to the CHP&P Board meetings setting out any issues that need to be considered or decided at CHP&P Board level. The Steering Group was established in May 2017 and has met 15 times to date as follows:

26th May 2017

29th August 2017

20th October 2017

22nd November 2017

25th January 2018

26th February 2018

26th March 2018

23rd April 2018

31st May 2018

25th June 2018

27th August 2018

24th September 2018

22nd October 2018

10th December 2018

17th December 2018

I understand that the HSE has provided minutes of the CHP&P Steering Group meetings to the Deputy; the minutes include attendance details.

From 2014 to 2017 a Steering Group, chaired by the Assistant Secretary, Acute Hospitals Division, reporting to the Secretary General, was in place to oversee, monitor and support the project. The NPHDB Chair and Project Director were members of that Group. That Group met 22 times and minutes of the meetings can be provided to the Deputy if required.

In relation to communication with the NPHDB up to 2014, the Deputy will be aware that the NPHDB was established in 2007 and engagement between the Department and the then NPHDB over that period would have related to the project proposed for the Mater site up to February 2012 when planning permission for that project was refused. The focus in 2012 and 2013 was on progressing the decision of an alternative site and, once made, preparing for the initiation of the project on the St James’s campus. Material relating to meetings between the Department and the NPHDB over that period would be archived and would take some time to retrieve.

In addition to the formal meetings that Department officials and the NPHDB Project Director of the NPHDB attend as outlined above, Department officials engage with the NPHDB on an on-going basis in relation to any relevant issues arising including areas such as ICT, equipping, communication and milestone events organisation. Department officials also engage on an on-going basis with the NPHDB in relation to other NPHDB matters such as NPHDB membership, staffing and annual accounts.

National Children's Hospital

Questions (452)

Alan Kelly

Question:

452. Deputy Alan Kelly asked the Minister for Health the date in November 2018 he or his officials informed the Taoiseach of the cost overruns in the national children’s hospital; the format in which this information was given; the person or body that provided same; if he will publish documentation relating to same; and if he will make a statement on the matter. [5642/19]

Written answers

Minister for Health (Deputy Simon Harris)

On completion of the Guaranteed Maximum Price process, the National Paediatric Hospital Development Board informed my officials of the revised cost of €1.433bn on 8 November 2018, and I was subsequently briefed on 9 November on the emerging position.

On 9 November, the cost escalation was highlighted at a meeting with the Taoiseach. It was agreed that further details would be provided in a formal way to the Department of Public Expenditure and Reform and to the Department of the Taoiseach prior to Government consideration. Officials in the Department of the Taoiseach were briefed on 21 November, 26 November and 13 December. The information on cost increases presented at those meetings has already been provided to the Oireachtas Health Committee.

Question No. 453 answered with Question No. 451.

Health Services Expenditure

Questions (454)

Bernard Durkan

Question:

454. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he expects to be in a position to meet the capital programme for his Department as previously set out; and if he will make a statement on the matter. [5652/19]

Written answers

Minister for Health

The Health Service Executive is currently developing its Capital Plan for 2019. The HSE Capital Plan will determine the projects that can progress in 2019 and beyond having regard to the available capital funding, the number of large national capital projects currently underway and the relevant priority of each project. The requirements of the new children's hospital and other health capital projects, currently at various stages of development, are being considered as part of this process. Once the HSE has finalised its Capital Plan for 2019, it will then be submitted to me for consideration.

Brexit Preparations

Questions (455)

Bernard Durkan

Question:

455. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he is satisfied he has made the provisions necessary in the context of Brexit; and if he will make a statement on the matter. [5653/19]

Written answers

Minister for Health

Any Brexit scenario will mean considerable change and impact for Ireland. The Government remains firmly of the view that ratifying the Withdrawal Agreement that has been agreed between the EU and the UK remains the best way to ensure an orderly UK exit. At its meeting on 11 December 2018, the Government decided to give greater immediate priority to the preparations for a no deal Brexit. This is being co-ordinated by the Department of the Taoiseach in collaboration with the Department of Foreign Affairs and Trade, and involves all Government Departments and agencies.

The Department of Health, the HSE and other Health Agencies have been taking forward detailed Brexit preparedness and contingency work related to the impacts in the area of health of the United Kingdom leaving the European Union, with or without a deal, including proposed legislative provisions. A number of issues are being examined and contingency planning for a range of eventualities is underway. A key issue will be to ensure that there is minimum disruption to health services and that essential existing services are maintained on a cross-Border, all-island and Ireland-UK basis. Protecting and maintaining the Common Travel Area and the associated rights and privileges is a key part of this process.

The Department and its Agencies particularly the Health Products Regulatory Authority (HPRA), the Food Safety Authority of Ireland (FSAI) and the HSE have been in regular contact with stakeholders to assess the level of preparedness for a no deal Brexit. It is important to state that while the Department continues to monitor and seek assurances in a number of areas, our current analysis is that there are no immediate risks to the health of the population because of Brexit.

The Department of Health has strengthened its internal capacity to plan for Brexit. The Secretary General meets with the heads of the HSE, the HPRA and the FSAI weekly to review progress on Brexit preparedness and to consider any new challenges identified. A Brexit Operations Team has also been established in my Department, chaired by a Deputy Secretary General and comprised of senior officials from the Department, HSE, HPRA and the FSAI. This group works to resolve issues and to escalate them to the Heads of Agency group, chaired by the Secretary General, if necessary. An inter-agency communications group, chaired by my Department, has been established to plan for all aspects of a communications strategy to ensure that the public is fully informed of the health implications of either a central case Brexit or a no deal Brexit. A further working group is working to identify and monitor medicines that may be vulnerable to supply disruption as a result of Brexit.

The Irish and British Governments have committed to maintaining the Common Travel Area and its associated rights and privileges. These arrangements facilitate access to health services in the UK and Ireland, including access to emergency, routine and planned healthcare. My Department, as part of the cross-government approach to contingency planning, has prepared heads of a bill which is consistent with our commitment to provide for the rights and privileges of the Common Travel Area. The proposed legislation would allow the Minister for Health and the HSE, as appropriate, to cover the cost of healthcare provided in the UK under the same conditions as currently e.g. where treatments are not provided under our own healthcare system or for an Irish person who becomes ill while on a visit to the UK and needs immediate health care there.

I am satisfied that all necessary contingency arrangements are being made to mitigate, in so far as possible, the risks to the health sector of a no deal Brexit.

Question No. 456 answered with Question No. 332.

Ministerial Meetings

Questions (457)

Bernard Durkan

Question:

457. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he remains in contact with victims of the cervical smear test issue; and if he will make a statement on the matter. [5655/19]

Written answers

Minister for Health

Since I became aware of the issues surrounding CervicalCheck, my primary concern has been ensuring that the needs of the women and families affected have been met, and I have been in ongoing contact with those affected through a variety of channels.

In recent days I held a meeting with the 221+ support group which was attended by a large number of members. This group comprises patients directly affected by the issues surrounding CervicalCheck and is supported by a number of patient groups (the Marie Keating Foundation, the Irish Cancer Society and the Irish Patient Association). Any women or family members of the group who wished to attend were welcome. I also met at that time with individual women who wished to speak to me privately

Patient representatives are members of the CervicalCheck Steering Committee which I established last June, chaired by my Department and which has held 15 meetings to date.

I also receive correspondences from affected women and families on a regular basis.

Cancer Screening Programmes

Questions (458)

Bernard Durkan

Question:

458. Deputy Bernard J. Durkan asked the Minister for Health the alternatives now in operation or proposed to improve the reliability of cancer screening for women in the aftermath of the cervical smear test issues; and if he will make a statement on the matter. [5656/19]

Written answers

Minister for Health

In September, Government accepted all 50 of the recommendations that were set out in Dr Scally’s report into CervicalCheck, which was published on the 12th of September. I then committed to returning to Government within three months as recommended by Dr Scally with a full plan for the implementation of these recommendations. That plan was published on the 11th of December on my Department’s website. Work is now underway in my Department, in the HSE and in the National Cancer Registry of Ireland on the range of actions within the Plan.

The Implementation Plan sets out 126 actions addressing Dr Scally’s recommendations, across the areas of women and women’s health, organisation and governance, laboratory services and procurement, open disclosure, cancer registration, other screening programmes and resolution.

As the Deputy will be aware, I have also asked the HSE to introduce HPV testing as the primary screening method for the prevention of cervical cancer. The HPV test is a more accurate testing mechanism than liquid-based cytology, which is the current primary testing mechanism. This is expected to reduce the number of false negatives, although false negatives will always be part of any cervical screening programme. Its introduction is in line with developments in cervical screening internationally.

In addition, following the announcement by the Health Information and Quality Authority that the proposed extension of the HPV vaccination programme to boys will be both clinically and cost effective, in December 2018 I confirmed the extension of vaccination to boys.

Funding to implement the switch to HPV screening, and extend HPV vaccination to boys, has been allocated in Budget 2019.

The Government’s goal is to bring about the near elimination of cervical cancer in Ireland. A well organised screening programme, when combined with HPV vaccination for boys and girls, will assist us in achieving that goal.

Cancer Incidence

Questions (459)

Bernard Durkan

Question:

459. Deputy Bernard J. Durkan asked the Minister for Health the extent to which his Department monitors the incidence of various forms of cancer throughout the regions in conjunction with the National Cancer Registry Ireland; and if he will make a statement on the matter. [5657/19]

Written answers

Minister for Health

The National Cancer Registry Ireland (NCRI) is charged with collecting and classifying information on all cancer cases that occur in Ireland.

The NCRI produces annual reports covering cancer incidence, mortality, treatment and survival. Each year approximately four further reports are produced focusing on specific cancer issues. An example is the NCRI Report on 'Cancer care and survival in relation to centralisation of Irish cancer services', which was published on Tuesday 29th January.

Overall, NCRI data is used widely in the development of cancer services, service planning and in monitoring progress being made under the National Cancer Strategy.

Health Services Data

Questions (460)

Bernard Durkan

Question:

460. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the normal school medical examinations have successfully identified particular health issues among children in the past five years; and if he will make a statement on the matter. [5658/19]

Written answers

Minister for Health

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

Health Services Staff Data

Questions (461)

Bernard Durkan

Question:

461. Deputy Bernard J. Durkan asked the Minister for Health the number of extra nurses, nurse assistants, doctors and consultants employed throughout the public health sector in the past three years; and if he will make a statement on the matter. [5659/19]

Written answers

Minister for Health

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

Health Services Staff Data

Questions (462)

Bernard Durkan

Question:

462. Deputy Bernard J. Durkan asked the Minister for Health the number of personnel at all levels involved in the delivery of the public health services; and if he will make a statement on the matter. [5660/19]

Written answers

Minister for Health

The HSE has been requested to reply directly to Deputy Durkan.