Question No. 727 answered with Question No. 716.

Diabetes Strategy

Questions (728)

Mattie McGrath

Question:

728. Deputy Mattie McGrath asked the Minister for Health his plans to establish a national diabetes register; and if he will make a statement on the matter. [18849/19]

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.

Health Services Staff Data

Questions (729)

Mattie McGrath

Question:

729. Deputy Mattie McGrath asked the Minister for Health the number of staff that have been recruited to operate the 40-bed modular unit proposed for South Tipperary General Hospital; and if he will make a statement on the matter. [18850/19]

View answer

Written answers (Question to Health)

As Minister for Health, I recognise that hospitals are increasingly operating at or above capacity, with year-round demand pressures that are further challenged over the winter months. It is against this background that the Health Service Capacity Review 2018 recommended an increase in acute hospitals beds of over 2,600 by 2031 to support the projected increase in demand for services in the years ahead.

Increasing capacity is therefore a priority for the Government.

The Capacity Programme for 2019 provides for the following increases to capacity, as set out in the National Service Plan 2019:

- 78 additional beds are planned for Quarter 1 of 2019, including the 40-bed modular build in South Tipperary General Hospital, the 30-bed ward in Our Lady of Lourdes Hospital Drogheda, 4 HDU beds in the Mater Hospital and 4 HDU beds in Cork University Hospital;

- 75 acute beds, of which 54 have opened to date, and 70 community beds to come on stream in 2019, as part of the Winter Plan 2018/19;

- preparation of 202 beds, by quarter 4 2019 with a view to bringing this extra capacity into operation in the first quarter of 2020.

Funding has been provided in the National Service Plan 2019 to facilitate the opening of the modular build at South Tipperary General Hospital and the HSE advise that the project is at an advanced stage. The HSE also advised that staff recruitment has commenced.

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

Health Services Staff Data

Questions (730)

Mattie McGrath

Question:

730. Deputy Mattie McGrath asked the Minister for Health the number of senior case workers for the protection of older persons employed on a local health office, LHO, area basis for each of the years 2011 to 2018 and to date in 2019; and if he will make a statement on the matter. [18851/19]

View answer

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.

Patient Data

Questions (731)

Mattie McGrath

Question:

731. Deputy Mattie McGrath asked the Minister for Health if records are kept on the number of patients who, after attending hospitals, subsequently went on to commit suicide while under the care of the hospital; if so, the details for same in each of the years 2011 to 2018 and to date in 2019; and if he will make a statement on the matter. [18852/19]

View answer

Written answers (Question to Health)

I have asked the Health Service Executive to respond to the Deputy directly.

Transport Support Scheme

Questions (732)

James Browne

Question:

732. Deputy James Browne asked the Minister for Health his plans to introduce a scheme to replace the motorised transport grant; and if he will make a statement on the matter. [18857/19]

View answer

Written answers (Question to 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. 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.

Addiction Treatment Services

Questions (733)

Carol Nolan

Question:

733. Deputy Carol Nolan asked the Minister for Health the status of funding and support being offered to the Midland Regional Drug and Alcohol Task Force; and if he will make a statement on the matter. [18865/19]

View answer

Written answers (Question to Health)

The Department of Health allocated funding of almost €100m to the HSE for addiction services in 2019. The HSE National Service Plan 2019 sets out the type and volume of addiction services to be provided, having regard to the funding allocated.

Implementing the health-led national drugs strategy continues to be a Government priority. Task forces have an important role in delivering the strategy at the local level. The Department provides €28m to Drug and Alcohol Task Forces through various channels of funding, including the HSE.

The Midland Regional Drug and Alcohol Task Force receives almost €800k of this funding each year.

On 06 March 2019, I announced additional funding of €1 million for implementation of the National Drugs Strategy; "Reducing Harm, Supporting Recovery".

This funding, which will be provided on a recurring, multi-annual basis, will address the priorities set down in the Strategy including early harm reduction responses to emerging trends in substance misuse, and improving services for groups with complex needs.

On 26 March, I held a consultation with the Local and Regional Drug and Alcohol Task Forces and the HSE, to hear their views on how best to target the additional funding. The outcome of this consultation process will inform proposals, currently being developed, for the allocation of the funding. Further information on the criteria and proposed allocation of this new funding will be circulated to the Drug & Alcohol Task Forces and the HSE in due course.

Medical Card Eligibility

Questions (734)

Carol Nolan

Question:

734. Deputy Carol Nolan asked the Minister for Health if discretionary medical cards can be assessed on the basis of need rather than income; and if he will make a statement on the matter. [18869/19]

View answer

Written answers (Question to Health)

Under the provisions of the Health Act 1970 (as amended), eligibility for health services in Ireland is based primarily on residency and means. The Act obliges the HSE to assess whether a person is unable, without due hardship, to arrange general practitioner services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure. The HSE can only award medical cards in accordance with the Health Act and, therefore, it must assess applicants on the overall financial situation of the applicant and his or her spouse or partner.

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.

In responding to patients needs, the HSE has implemented revised processes to provide a more compassionate and more efficient process in the assessment of medical card applications. Such measures include the development of a Burden of Illness questionnaire which is used in selective circumstances where the assessing doctor in the HSE's national medical card unit requires a more comprehensive assessment of an applicant's medical and social circumstances and any resulting undue financial hardship.

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.

Long-Term Illness Scheme Coverage

Questions (735, 736)

Carol Nolan

Question:

735. Deputy Carol Nolan asked the Minister for Health the way in which the criteria for long-term illnesses was decided; and if he will make a statement on the matter. [18870/19]

View answer

Carol Nolan

Question:

736. Deputy Carol Nolan asked the Minister for Health if the long-term illnesses list will be reviewed or amended; and if he will make a statement on the matter. [18871/19]

View answer

Written answers (Question to Health)

I propose to take Questions Nos. 735 and 736 together.

The 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 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.

Fibromyalgia Support Services

Questions (737)

Carol Nolan

Question:

737. Deputy Carol Nolan asked the Minister for Health the reason persons with fibromyalgia can no longer access protocol 6 on the online Department of Employment Affairs and Social Protection list; and if he will make a statement on the matter. [18872/19]

View answer

Written answers (Question to Health)

I would like to advise the Deputy that this is a matter for my colleague, the Minister for Employment Affairs and Social Protection, Regina Doherty T.D.

Health Services Funding

Questions (738)

Brendan Griffin

Question:

738. Deputy Brendan Griffin asked the Minister for Health if an application for funding for a service (details supplied) will be examined; the options available in order to retain same; and if he will make a statement on the matter. [18873/19]

View answer

Written answers (Question to Health)

I can confirm that the application referred to in the question has been received by the relevant unit in my Department, and that this application will be examined under the same criteria as all the qualifying applications using the scoring mechanism detailed in the application form.

Hospital Appointments Status

Questions (739)

Pearse Doherty

Question:

739. Deputy Pearse Doherty asked the Minister for Health the reason an appointment for a person (details supplied) in Letterkenny University Hospital, County Donegal, was rescheduled on two occasions; if it is anticipated the latest appointment will be facilitated; and if he will make a statement on the matter. [18878/19]

View answer

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.

Hospital Appointments Status

Questions (740)

Pearse Doherty

Question:

740. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) will be called for a procedure in Letterkenny University Hospital; and if he will make a statement on the matter. [18879/19]

View answer

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.

Healthcare Policy

Questions (741)

Alan Kelly

Question:

741. Deputy Alan Kelly asked the Minister for Health if free sanitary products are being provided in all public hospitals; if not, his plans to do so; when they will be available; and if he will make a statement on the matter. [18886/19]

View answer

Written answers (Question to Health)

Period poverty is defined as the inability to afford female sanitary products and is a significant equality and equity concern.

A motion on period poverty, proposed by the cross-party Women’s Parliamentary Caucus, was passed in the Dáil on Wednesday, March 13th, 2019, and in the Seanad on Wednesday March 27th, 2019. Amongst other things, the motion called on the Government to provide a range of free, adequate, safe and suitable sanitary products and accompanying information, to be distributed throughout all public buildings.

It has been agreed that the best way to progress this matter is through the National Strategy for Women and Girls (NSWG) Strategy Committee, which is led by the Department of Justice and Equality and includes representation from across Government, the HSE, the National Women’s Council of Ireland and a number of NGOs.

It is envisaged that the issues raised will be discussed at the next meeting of the NSWG Strategy Committee, which is scheduled for June 11th, 2019.

As the provision of services in hospitals is an operational matter, I have referred the Deputy’s question to the HSE for direct response to him/her.

Hospitals Discharges

Questions (742)

Alan Kelly

Question:

742. Deputy Alan Kelly asked the Minister for Health his plans to deal with delayed discharges in hospitals; the volume of delayed discharges across all hospitals in each of the years 2016 to 2018 and to date in 2019; and if he will make a statement on the matter. [18887/19]

View answer

Written answers (Question to Health)

The Independent Expert Review of Delayed Discharges review recognised that delayed discharges or transfers of care are caused by a multitude of factors and it made nine recommendations which include 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.

Following the publication of the Report of the Review Group, I requested that the HSE establish an appropriate multi-disciplinary structure to progress implementation of its recommendations.

On foot of that request, the HSE has established an Implementation Group, co-chaired by officials representing the National Directors of Acute and Community Operations. I attended the Group’s first meeting last month. This Group will identify changes that can be made within the next six months and those that can be implemented over eighteen months. Shortly, I will also be establishing a Departmental oversight group to provide appropriate oversight of the HSE's implementation of the recommendations of the Review.

In relation to the statistical information sought, I have requested the Health Service Executive to respond directly to the Deputy as soon as possible.

Assisted Human Reproduction

Questions (743)

Mattie McGrath

Question:

743. Deputy Mattie McGrath asked the Minister for Health if a moratorium on all clinical uses of human germline editing, that is, changing heritable DNA in sperm, eggs or embryos to make genetically modified children will be supported; and if he will make a statement on the matter. [18895/19]

View answer

Written answers (Question to Health)

In October 2017, the Government approved the drafting of a Bill on assisted human reproduction (AHR) and associated areas of research, based on the published General Scheme of the Assisted Human Reproduction Bill. The Joint Oireachtas Committee on Health is currently conducting a review of the General Scheme as part of the pre-legislative scrutiny process, which began in January of last year. The Joint Committee intends to report thereon before the summer recess and the recommendations in its report will be considered during the ongoing process of drafting this Bill in conjunction with the Office of the Attorney General.

Part 7 of the General Scheme outlines specific conditions and restrictions relating to research and activities involving the editing of the human genome. Under the General Scheme, where the genome of a human gamete or embryo has been edited such that the genetic change could be passed on to children and future generations, then it is prohibited to use that gamete or embryo in providing AHR treatment.

Part 9 of the General Scheme clarifies that contravening this provision would constitute an offence.

Assisted Human Reproduction Services Provision

Questions (744)

Mattie McGrath

Question:

744. Deputy Mattie McGrath asked the Minister for Health if the use of CRISPR gene editing technology is available or licensed here; and if he will make a statement on the matter. [18896/19]

View answer

Written answers (Question to Health)

As this question relates to CRISPR availability and use in the health delivery setting, this question has been referred to the HSE for direct response to the Deputy.

Medicinal Products Reimbursement

Questions (745)

Róisín Shortall

Question:

745. Deputy Róisín Shortall asked the Minister for Health the position regarding a new anti-calcitonin gene-related peptide, CGRP, medication for the preventative treatment of chronic migraine; if the National Centre for Pharmacoeconomics, NCPE, has completed its full health technology assessment; and if he will make a statement on the matter. [18900/19]

View answer

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. The Act specifies the criteria for decisions on the reimbursement of medicines. The Minister for Health has no role in this statutory process.

I am advised by the HSE that there are currently two products undergoing assessment by the National Centre for Pharmacoeconomics (NCPE) for the treatment of chronic migraine.

On 17 April 2019 the NCPE published a rapid review report on fremanezumab which is indicated for prophylaxis of migraine in adults who have at least four migraine days per month.

The rapid review offered the following recommendation to the HSE “a full health technology assessment is recommended to assess the clinical effectiveness and cost effectiveness of fremanezumab compared with the current standard of care, on the basis of the proposed price relative to currently available therapies. This recommendation should be considered while also having regard to the criteria specified in the Health (Pricing and Supply of Medical Goods Act) 2013.”

The HSE is formally considering the NCPE recommendation.

The NCPE is in the process of carrying out a full health technology assessment on a second agent Erenumab (Aimovig) which is indicated for the treatment of migraine in adults who have at least 4 migraine days per month.

The applicant company submitted a dossier on 22 January 2019 and the NCPE has completed a preliminary review and is awaiting a response from the applicant company.

Medicinal Products Reimbursement

Questions (746)

Robert Troy

Question:

746. Deputy Robert Troy asked the Minister for Health if the same treatments will be put in place via the public service that are available to customers of a company (details supplied). [18908/19]

View answer

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. The Act specifies the criteria for decisions on the reimbursement of medicines. The Minister for Health has no role in this statutory process.

In line with the 2013 Act, if a company would like a medicine to be reimbursed by the HSE pursuant to the community drugs schemes, the company must first submit an application to the HSE to have the new medicine added to the reimbursement list.

As outlined in the Framework Agreement on the Supply and Pricing of Medicines, and in line with the 2013 Act, the HSE will decide, within 180 days of receiving the application (or a longer period if further information is sought from the company), to either add the medicine to the reimbursement list or agree to reimburse it as a hospital medicine, or refuse to reimburse the medicine.

The HSE at all times ensures that the systems that it has in place are designed to ensure equitable access to all medicines across all therapeutic areas, cancer and non-cancer, from the resources provided to it.

In March 2019, the Vhi sent a circular to Oncologists advising them that it was extending cover to a number of new cancer medicines. The decision by the Vhi applies only to private care to private Vhi patients in private hospitals. It will have no impact on the availability and use of medicines in public hospitals, where there is no distinction between public and private patients.

The effect of the VHI decision will be that Vhi private patients in private hospitals may have access to a medicine that is not yet available in the public hospital system. However, a number of the medicines, or indications, which the VHI has now decided to cover, are at various stages of the HSE assessment and reimbursement process with a view to making them available in the public hospital system.

Gambling Legislation

Questions (747, 748)

Jim O'Callaghan

Question:

747. Deputy Jim O'Callaghan asked the Minister for Health his responsibilities with regard to addressing gambling addiction; and if he will make a statement on the matter. [18910/19]

View answer

Jim O'Callaghan

Question:

748. Deputy Jim O'Callaghan asked the Minister for Health his plans to put forward legislation to address gambling addiction; and if he will make a statement on the matter. [18912/19]

View answer

Written answers (Question to Health)

I propose to take Questions Nos. 747 and 748 together.

The Health Service Executive has responsibility for the provision of addiction treatment services.

People who present to the HSE for addiction treatment for gambling are offered the same range of interventions as those who present with a drug and alcohol addiction, or a mental health concern, including an initial assessment, a comprehensive assessment, and individual counselling.

Counselling and rehabilitation services provide care to those with a gambling addiction through one to one counselling, financial advice and onward referral to other services and supports where appropriate, such as Gamblers Anonymous.

The HSE provides funding to a number of voluntary sector providers who treat gambling addiction, along with drug and alcohol addictions.

The Department of Justice and Equality has responsibility for gambling regulation.

Nursing Home Accommodation Provision

Questions (749)

Alan Kelly

Question:

749. Deputy Alan Kelly asked the Minister for Health the status of the development of a new nursing home (details supplied); and if he will make a statement on the matter. [18914/19]

View answer

Written answers (Question to Health)

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

Health Services Provision

Questions (750)

Clare Daly

Question:

750. Deputy Clare Daly asked the Minister for Health if it will be ensured that a person (details supplied) is not left without a hoist, enabling the person to leave bed and access various appointments. [18923/19]

View answer

Written answers (Question to Health)

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

Home Care Packages Data

Questions (751)

Michael Healy-Rae

Question:

751. Deputy Michael Healy-Rae asked the Minister for Health the status of an application for home care by a person (details supplied); and if he will make a statement on the matter. [18925/19]

View answer

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.