Written Answers Nos. 401-419
401. Deputy Sean Fleming asked the Minister for Health the position regarding allowing the FreeStyle Libre system under the long-term illness scheme for persons with type 1 diabetes (details supplied); and if he will make a statement on the matter. [17731/19]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
402. Deputy Eugene Murphy asked the Minister for Health if a permanent clinical psychiatrist is now assigned to Roscommon mental health services; if the services will now be returning to a position of locum psychiatrists due to a recent transfer of senior staff within the services; and if he will make a statement on the matter. [17732/19]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
403. Deputy Sean Fleming asked the Minister for Health the position regarding the falsified medicines directive; and if he will make a statement on the matter. [17733/19]
View answerThe ‘Safety Features’ Delegated Regulation introduced new rules for the supply of medicines from 9 February 2019. These safety features include a form of an anti-tamper device and unique identifiers embedded in a 2D barcode on the pack. The purpose of the Regulation is to benefit patient safety and maintain confidence in the safety of medicines supplied to them.
S.I. No. 36 of 2019 provides that the Irish legislative system is consistent with the requirements of the Regulation. Nothing in the new national Regulations seeks to alter the existing legal and regulatory responsibilities of persons authorised to place medicinal products on the market or to supply them to the public. It will apply to manufacturers, wholesalers and pharmacy owners and pharmacists equally. These obligations of the Delegated Regulation and Statutory Instrument are legal requirements for legal persons authorised to supply medication. As such legal responsibility lies with the business owner and the individual authorised to supply the medication.
The Regulation provided a 3-year transition period, which commenced in 2016, to facilitate preparation for its introduction. Details of the requirements of the Delegated Regulation have been communicated to all sectors throughout this period by the Irish Medicines Verification Office, the Health Products Regulatory Authority, the Pharmaceutical Society of Ireland and the Irish Pharmaceutical Union.
Recognising the concerns raised by stakeholders, and to ensure that above all, the normal supply of medicines to patients is maintained, it was decided to implement the system in a pragmatic manner and defer operating the offences provisions in the legislation for an initial period. This was to allow everyone involved to develop familiarity with the new arrangements and overcome any teething issues before we proceed to commencement of the enforcement provisions that deal with offences. However, it should be noted that this approach will be reviewed three months post implementation to consider commencement of enforcement provisions at that time.
404. Deputy Stephen Donnelly asked the Minister for Health the status of the provision of new ambulance bases at Ardee, Mullingar, Limerick, Cork and Galway. [17734/19]
View answerAs the Health Service Executive is responsible for the delivery of healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
405. Deputy Stephen Donnelly asked the Minister for Health if he will report on the development of a structured replacement programme for equipment and ambulances and minor capital works as promised in the National Development Plan 2018-2027. [17735/19]
View answerAs the Health Service Executive is responsible for the management of healthcare equipment, ambulances and infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
406. Deputy Michael Moynihan asked the Minister for Health when the nursing home support scheme rules will be changed to cap the assessment of farm assets at three years; and if he will make a statement on the matter. [17742/19]
View answerThe proposed policy change to the Nursing Homes Support Scheme (NHSS), to cap contributions based on farm assets at 3 years where a family successor commits to working the productive asset, has been approved by Government. My Department is working on the development of draft Heads of Bill while considering a number of complex ancillary policy and operational matters which may need to be addressed in the proposed legislation.
It is intended that this proposed policy change, the 3 year cap, will be extended to eligible existing participants in long term residential care so that they are not disadvantaged, but that there would be no retrospective recoupment of contributions for those who have paid contributions over and above the 3 year period.
The General Scheme of a Bill has been drafted and we are currently working closely with legal advisers on advice and legal quality control. The focus on matters relating to Brexit, including planning and preparing in a legal and legislative context, has unfortunately had an impact on progressing the Heads of Bill. However, subject to legal advice, I expect to bring the Heads of Bill to Government in May. The changes to the Scheme will come into effect in 2019 subject to the legislative process.
407. Deputy Michael Lowry asked the Minister for Health if pulmonary fibrosis is covered by the long- term illness scheme; if not, his plans to address the matter; and if he will make a statement on the matter. [17746/19]
View answerThe LTI Scheme was established under Section 59(3) of the Health Act 1970 (as amended). The conditions covered by the LTI are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of thalidomide.
Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
There are no plans to extend the list of conditions covered by the Scheme at this time. However, I wish to inform the Deputy that the LTI Scheme will be included as part of a review of the current eligibility framework, including the basis for existing hospital and medication charges, to be carried out under commitments given in the Sláintecare Implementation Strategy.
For people who are not eligible for the LTI Scheme, there are other arrangements which protect them from excessive medicine costs.
Under the Drug Payment Scheme, no individual or family pays more than €124 a month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card. In the assessment process, the HSE can take into account medical costs incurred by an individual or a family.
People who are not eligible for a medical card may still be able to avail of a GP visit card, which covers the cost of GP consultations.
408. Deputy Louise O'Reilly asked the Minister for Health when a decision will be made regarding the availability of Spinraza in view of the fact a new application has been submitted by a company (details supplied). [17756/19]
View answerThe HSE has statutory responsibility for medicine pricing and reimbursement, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. The Act specifies the criteria for decisions on the reimbursement of medicines. The Minister for Health has no role or powers in relation to such matters.
Following detailed consideration of an application for the reimbursement of Spinraza and lengthy engagement with the company, the HSE recently decided that it was unable to reimburse Spinraza. The HSE concluded that the evidence for clinical effectiveness was still quite limited and that the price proposed by the manufacturer was not a cost-effective use of resources.
The HSE wrote to the manufacturer involved and informed them of the proposal to refuse reimbursement at the current price offering. Under the requirements of the Health (Pricing and Supply of Medical Goods) Act 2013 the company had 28 days to respond or make representations to the HSE’s proposed decision.
I am advised by the HSE that the manufacturer has submitted a revised submission, which will now be considered at the next HSE Drugs Group meeting, following which a recommendation will be made to the HSE Leadership Team for a final decision.
409. Deputy Louise O'Reilly asked the Minister for Health the expenditure for the Healthy Ireland office for each year since its establishment; the cost of information campaigns; and if he will make a statement on the matter. [17757/19]
View answerThe Health and Wellbeing Programme in my Department is responsible for coordinating the implementation of Healthy Ireland which is the National Framework for Improved Health and Wellbeing 2013-2025. Healthy Ireland is based on evidence and experience from around the world which clearly shows that to create positive changes in health and wellbeing takes the involvement of the whole of Government and all of society working in unison. Since Healthy Ireland was launched in March 2013, my Department has developed several policies and strategies to support population health and wellbeing, including obesity, physical activity, sexual health, tobacco and alcohol.
It is not possible to identify in totality how much funding is currently spent on improving health and wellbeing across all Government Departments and agencies and in wider society.
Since the launch of Healthy Ireland, expenditure on its implementation from within the budget of the Department of Health has amounted to the following:
2013 - €89,315;
2014 - €586,470;
2015 - €607,706.83;
2016 - €1,156,405;
2017 - €5,996,837 (incl. the Healthy Ireland Fund)
2018 - €5,586,906 (incl. the Healthy Ireland Fund)
2019 - €622,514 (to date)
The Healthy Ireland Fund was established in 2017, with an initial annual allocation of €5 million, and aims to stimulate and support cross-sectoral action to support implementation of Healthy Ireland.
In addition to the expenditure noted above, other expenditure arising within the Department could also be described as "Healthy Ireland" depending on classification.
In relation to the cost of information campaigns, expenditure relating to the Healthy Ireland Communication and Citizen Engagement Campaign activity for 2018 amounted to €758,585. The campaign, which is a Government priority campaign, focusses on three key themes, Healthy Eating, Physical Activity and Mental Wellbeing, and aims to encourage people to make positive choices to improve their physical and mental health, while also providing support and information to help people make those healthier choices. Campaign activity in 2018 included digital and social media activity, sponsored media articles and radio advertising, to increase awareness of Healthy Ireland, promote the gov.ie/healthyireland resource and link people with relevant information and supports provided by partner organisations. The campaign is continuing in 2019, and the latest phase was launched on the 8th of April.
In July 2018, the Government made a decision to establish a Healthy Ireland Office in the Department of Health to co-ordinate and oversee the delivery of the above actions and to support strengthened cross-Government collaboration on the implementation of Healthy Ireland. Work to progress the establishment of this Office is underway.
410. Deputy Louise O'Reilly asked the Minister for Health the funding that has been made available to the Healthy Ireland fund each year since its establishment; if the funding for each of those years was spent in its entirety; the eligibility criteria for availing of the funding; and if he will make a statement on the matter. [17758/19]
View answerIn July 2016, the Government approved the creation of a Healthy Ireland Fund and subsequently provided an initial allocation of €5 million in Budget 2017 to kick-start the establishment of the Fund.
The aim of the Healthy Ireland Fund is to stimulate and support innovative, cross-sectoral, evidence-based projects, programmes and initiatives that support the implementation of the key national policies in areas such as Obesity, Smoking, Alcohol, Physical Activity and Sexual Health. Additionally, the Fund aims to support projects and programmes aimed at children and young people and their families and supporting communities and vulnerable groups who are at most risk of experiencing health inequalities.
The Fund, which is primarily administered by Pobal on behalf of the Department, is currently arranged into two strands, strand 1 is for actions that are locally based and therefore targets funding at Local Community Development Committees (LCDC) and Children and Young Persons Services Committees (CYPSC). Strand 2 is targeted at national level programmes through statutory organisations. In round 1 and 2 of the Fund, the LCDC and CYPSC applicants were eligible to apply for the development of local area plans for the implementation of Healthy Ireland, membership of the Healthy Cities and Counties Network and the implementation of local priorities for health and wellbeing that were identified in existing Local Economic and Community Plans or Children and Children and Young People’s Plan.
The results of the first year of the Healthy Ireland have been very encouraging, especially in relation to the targeting of socially disadvantaged communities. Of the 382 actions delivered under strand 1, a total of 2,456 organisations were reported to be involved in the implementation of local priority actions and aan estimated 770,000 people were reported to have benefitted. These actions generally targeted health inequality, especially people living in areas of social disadvantage (71% of actions), people with disabilities (45%), people from new communities including refugees and asylum seekers (39%) and members of the Traveller community (36%). Similarly, the total number of people reported as benefitting from national actions under Strand 2 was 130,735. The number of organisations benefitting was reported as 1,785, and almost two thirds of actions (63%) reported a focus on people with disabilities and/or chronic illnesses (including mental health issues) and over half of actions (54%) were focused on people living in areas of social disadvantage.
In relation to the funding that has been made available by my Department annually since the inception of the Healthy Ireland Fund, and the outturn of these funds. In 2017, €5 million was provided in the Budget and was fully expended, in 2018, a further €5 million was provided in the Budget and €4,995,000 was expended. The fund received a €5 million allocation in Budget 2019.
Funding from the Department of Children and Youth Affairs and the Department of Rural and Community Development has also been allocated towards the Healthy Ireland Fund in 2017 and 2018, demonstrating the commitment to the Healthy Ireland Framework across Government.
An additional €1 million is being made available, from within the additional development funding allocation made to the Department in revised estimates 2019 to the Healthy Ireland Fund to boost community engagement on health and wellbeing locally in each local authority area.
411. Deputy Louise O'Reilly asked the Minister for Health the situation regarding the recognition of professional qualifications in a post-Brexit scenario specifically regarding the recognition of nursing qualifications from British universities here and Irish universities in Britain; and if qualifications will be respected and equivalence accepted. [17759/19]
View answerCurrently, there is EU legislation, Directive 2005/36/EC, which provides an EEA-wide system for the recognition of professional qualifications and under which Irish and UK citizens have professional qualifications, including those in nursing recognised, should they wish to work in another member state. The continued recognition of professional qualifications is an issue of critical importance for the health system given the number of health care professionals who received their professional training in Ireland and work in the United Kingdom ( UK) or vice versa.
This issue has been considered in the context of the negotiations on the Withdrawal Agreement and on the Framework for the Future Relationship. An EU/UK agreement on the recognition of qualifications, were that to be achieved, would be expected to address the issue in the most comprehensive way possible.
Should the UK leave on the basis of an agreed Withdrawal Agreement, including a transition period, the current EU Directive will continue to apply to the UK during that time. The EU and the UK indicated in the Political Declaration setting out the framework of the Future Relationship between the EU and the UK that during negotiations they should develop appropriate arrangements for the recognition of those professional qualifications which are in the Parties' mutual interest.
Should the UK leave the EU on the basis of a No Deal scenario, Directive 2005/36/EC will no longer apply in the UK, or to UK qualifications, with effect from the withdrawal date.
The Irish health professional regulators each have “third country” recognition routes which apply to qualifications which are obtained in neither the EEA nor in Ireland. They have considered these “third country” recognition routes with the objective of ensuring efficient routes for recognition of UK qualifications, while ensuring that this is done in an objective, evidence-based and non-discriminatory way. The Irish regulators, including the nurse and midwife regulator, the Nursing and Midwifery Board of Ireland (NMBI), are satisfied that they can continue to recognise UK qualifications within approximately the same time frames and the same level of application fee, but under this different legal base.
These routes provide not only for the recognition of professional qualifications where education and training standards are equivalent in Ireland and in the country of training; but they also provide for the consideration of relevant post-qualification professional experience where, for example, training standards differ or where an applicant may possess an older, foreign qualification which does not meet the current Irish reference standards.
The NMBI has information on the implications of Brexit on its website at www.nmbi.ie/Registration/Brexit.
In relation to the post-Brexit recognition of Irish health professional qualifications in the UK, the UK has prepared its European Qualifications (Health and Social Care Profession) Regulations 2018 which it is intended to enact in the case of a no-deal Brexit. This legislation will enable Irish health professional qualifications, including those in nursing, to be recognised in the UK.
It is important to note that decisions on qualification recognition already made under the EU Directive remain valid and professionals can continue to practice in either jurisdiction subject, of course, to compliance with all regulations within that profession.
412. Deputy Louise O'Reilly asked the Minister for Health the children and adults with additional needs who are accessing professional services and supports in Kinnegad, County Westmeath, in tabular form; and the existing services and supports in the area that are available and accessible for children and adults with additional needs. [17760/19]
View answer413. Deputy Louise O'Reilly asked the Minister for Health the number of children and adults with additional needs from Kinnegad, County Westmeath, who in the past 12 months have been referred to services in Mullingar and the wider County Westmeath area when seeking professional medical and-or counselling support in tabular form [17761/19]
View answerI propose to take Questions Nos. 412 and 413 together.
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 questions relate to service matters, I have arranged for the questions to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
414. Deputy Louise O'Reilly asked the Minister for Health the number of older persons waiting for home support packages; and the waiting lists for home care packages by CHO and LHO in tabular form. [17762/19]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
415. Deputy Louise O'Reilly asked the Minister for Health his plans to roll out the newborn screening test pilot scheme for detecting metachromatic leukodystrophy which was developed and piloted recently in the Unites States of America. [17763/19]
View answerAll babies (between 3 and 5 days old) born in Ireland are currently screened for 8 rare but serious medical conditions as part of the National Newborn Bloodspot Screening Programme. Metachromatic leukodystrophy currently is not part of the newborn bloodspot screening.
As recommended in the Scally Review (2019), a National Screening Committee will be established and become operational before the end of 2019. Similar, to the UK National Screening Committee, their role will be to undertake an independent assessment of the evidence for screening for a particular condition against internationally accepted criteria. Any potential changes to the National Newborn Bloodspot Screening Programme will be incorporated as part of the Committee's work programme.
416. Deputy Louise O'Reilly asked the Minister for Health his plans to increase the number of rare disorders for which newborn babies are screened. [17764/19]
View answerCurrently all babies (between 3 and 5 days old) born in Ireland are screened for 8 rare but serious medical conditions as part of the National Newborn Bloodspot Screening Programme. These include:
- cystic fibrosis
- congenital hypothyroidism
- phenylketonuria
- classical galactosaemia
- MCADD (medium-chain acyl-CoA dehydrogenase deficiency)
- homocystinuria
- maple syrup urine disease
- glutaric aciduria type 1.
As recommended in the Scally Review (2019), a National Screening Committee will be established and become operational before the end of 2019. Similar, to the UK National Screening Committee, their role will be to undertake an independent assessment of the evidence for screening for a particular condition against internationally accepted criteria. Any potential changes to the National Newborn Bloodspot Screening Programme will be incorporated as part of the Committee's work programme.
417. Deputy Niamh Smyth asked the Minister for Health if an urgent appointment will be scheduled with the surgical team in the case of a person (details supplied); and if he will make a statement on the matter. [17770/19]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
418. Deputy Clare Daly asked the Minister for Health his views on the lack of support for young persons in terms of the waiting lists to gain assistance for serious eating disorders in north County Dublin in view of the strain on resources of organisations (details supplied); and if he will make a statement on the matter. [17786/19]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
419. Deputy Ruth Coppinger asked the Minister for Health if he will meet with a transgender group (details supplied). [17787/19]
View answerI can advise the Deputy that a meeting with the group to whom she refers, has been scheduled.
