Written Answers Nos. 902-926
902. Deputy Brendan Howlin asked the Minister for Health his views on the difficulties in accessing home care packages in County Wexford; when additional funding will be allocated to the HSE to reduce the waiting lists and waiting times for home support services in County Wexford; if a home care package will be approved in the case of a person (details supplied); and if he will make a statement on the matter. [19482/19]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
903. Deputy Barry Cowen asked the Minister for Health the number of persons living with dementia who are availing of the fair deal scheme; and if he will make a statement on the matter. [19484/19]
View answerThe Nursing Homes Support Scheme (NHSS), commonly referred to as Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.
As outlined in the HSE's National Service Plan for 2019, the NHSS is expected to support on average 23,042 people in 2019.
The Department of Health does not have specific data relating to the exact number of NHSS participants that have dementia; however, An Irish National Survey of Dementia in Long Term Residential Care, which was launched in January 2015, states that in middle and high-income countries it is estimated that over 60% of the residents living in long-term care facilities have a diagnosis of dementia. Dementia is characterised by multiple cognitive deficits that include memory impairment, impairment in orientation, expression, understanding, planning and execution of some or any activities of daily living.
904. Deputy Kevin O'Keeffe asked the Minister for Health if a child (details supplied) will be called for specific treatment at the earliest date possible. [19487/19]
View answerAs this is a service matter it has been referred to the HSE for reply to the Deputy.
905. Deputy Richard Boyd Barrett asked the Minister for Health when ocrelizumab will be available to persons with multiple sclerosis who were promised access to the drug in January 2019; and if he will make a statement on the matter. [19511/19]
View answerThe 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.
The NCPE completed a health technology assessment on 29 August 2018 for Ocrelizumab (Ocrevus) for the treatment of adult patients with relapsing forms of multiple sclerosis (RMS). They recommended that Ocrelizumab (Ocrevus) not be considered for reimbursement unless cost-effectiveness can be improved relative to existing treatments.
On 4 October 2018 the NCPE completed their assessment for Ocrelizumab (Ocrevus) indicated for the treatment of adult patients with early primary progressive multiple sclerosis (PPMS). They did not recommend that Ocrelizumab (Ocrevus) be reimbursed for this indication.
The HSE is the statutory decision-making body for medicine reimbursement. It will make the final decision on whether Ocrelizumab (Ocrevus) will be reimbursed for each of these indications, taking into consideration the statutory criteria contained in the 2013 Health Act.
I am advised by the HSE that there has been considerable engagement between the HSE and the manufacturer over the past number of months and that commercial discussions are ongoing.
906. Deputy Richard Boyd Barrett asked the Minister for Health his plans to reduce or abolish the per-item prescription charges in budget 2020; and if he will make a statement on the matter. [19512/19]
View answerThe Programme for Partnership Government contains a commitment to reduce the cost of medicines by reducing the prescription charge for medical card holders.
In line with this commitment, in budget 2019 I announced a reduction in the prescription charge to €1.50, subject to a monthly cap of €15, for all medical card holders over the age of 70. This reduction came into effect on 1 April 2019.
This announcement follows on from my commitment in last year's budget, where I reduced the prescription charge to €2 for all medical card holders aged under 70.
I intend to consider any proposals for further reductions in the prescription charge in the context of the implementation of the health commitments in the Programme for Government and with regard to the funding available.
907. Deputy Richard Boyd Barrett asked the Minister for Health if hospitals will receive sufficient funding in budget 2020 to ensure they do not charge for parking for patients or visitors to the hospital; and if he will make a statement on the matter. [19513/19]
View answerHospitals which charge parking fees are cognisant of the financial implications parking costs can have on patients and their families, particularly those with long-term illnesses. Some hospitals have introduced a maximum daily fixed parking charge, thus capping this expense. I understand that some hospitals also provide reduced rate parking for long-term patients and visitors for whom the payment of the full rate would cause hardship.
In March 2018, I requested the HSE to carry out a review of hospital car parking charges, with the aim of establishing clear national guidelines in this area.
The HSE report on Hospital Car Parking Charges has been submitted to the Department of Health and is currently under consideration in collaboration with the HSE. The report will be published in due course.
Any consideration of funding for the provision of car parking will have to be considered in the context of service prioritisation and with regard to competing priorities for resources available as part of the 2020 Estimates process.
908. Deputy Richard Boyd Barrett asked the Minister for Health if his attention has been drawn to the fact that some doctors are charging medical card holders for reports such as those needed to apply for a driving licence for persons over 70 years of age; his views on whether the practice is acceptable; and if he will make a statement on the matter. [19514/19]
View answerThe GMS contract stipulates that fees for medical and GP visit card holders are not paid to GPs in respect of certain medical certificates which may be required, for example, "under the Social Welfare Acts or for the purposes of insurance or assurance policies or for the issue of driving licences". Any fees charged by GPs for services provided outside the terms of the GMS contract are a matter of private contract between the GP and their patients.
There are no plans at present to include the completion of forms required for driving licence applications as a service to be provided to GMS patients under the GMS or GP Visit Card scheme.
909. Deputy Eoin Ó Broin asked the Minister for Health if funding is available from the HSE for the refurbishment of the new premises for the Clondalkin adult mental health service; when work at the new location will commence in view of the fact that planning permission has been secured; when the works will be completed; and if the current service provision will remain at a location (details supplied) until the new premises is complete. [19516/19]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
910. Deputy Sean Fleming asked the Minister for Health when an appointment will be approved for a person (details supplied); and if he will make a statement on the matter. [19517/19]
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.
911. Deputy Michael McGrath asked the Minister for Health if consideration has been given from a public health perspective and to support lifelong healthy eating to funding a programme in which children are taught in school at second level the way to cook by qualified chefs; and if he will make a statement on the matter. [19521/19]
View answerThe Obesity Policy and Action Plan (OPAP), ‘A Healthy Weight for Ireland’, was launched in September 2016 under the auspices of the Healthy Ireland agenda, as a Government policy response to increasing obesity rates in Ireland. This Policy, which takes a ‘whole system’ approach, and covers a ten-year period up to 2025, was developed with a high degree of consultation, including with children and young people.
The Department of Health established an Obesity Policy Implementation Oversight Group in 2017, which is comprised of representatives from a range of Government Departments and Agencies, including the Department of Education and Skills.
Childhood obesity is a key priority under the Policy. New Healthy Eating Guidelines, Food Pyramid and supporting resources have already been published, disseminated and communicated in 2017, including to all primary and post-primary schools.
In the HSE the Healthy Eating Active Living programme is supporting work in the education sector, as well as with parents, families and communities in delivering a more co-ordinated approach to prevention and early intervention in child obesity. This includes a five-year communications campaign, called START, which is being delivered in collaboration with the HSE and safefood, with a focus on supporting parents to make healthy choices around food and activity.
In addition, new Nutrition Standards for schools, with an initial focus on school meal programmes funded by the Department of Employment Affairs and Social Protection, were published in September 2017. They were developed by the Department of Health with the assistance of safefood and the Health Service Executive, in cooperation with the members of the School Meals Programme in the Department of Employment Affairs and Social Protection and the Department of Education and Skills.
Further, Healthy Food Made Easy is a HSE-led nutrition and cooking programme that is delivered to a variety of groups in the community by trained leaders. The programme covers basic healthy eating messages as well as shopping skills and preparing for dietary change.
In the 2018/19 academic year the Department of Education facilitated the training of post-primary school teachers to deliver Healthy Food Made Easy in schools in all parts of the country. To date, 130 teachers have attended training with HSE Community Dietitians and Health Promotion Officers. This delivery of this programme in the post-primary school setting provides an opportunity to engage young people in a conversation about nutrition and to get some hands-on experience at cooking.
The programme also links well to several Statements of Learning in the new Junior Cycle and schools have integrated into their Junior Cycle Wellbeing Programmes.
Food education is taught as part of SPHE (Social and Personal Health Education) at both primary and secondary level and hands-on cooking experience is a core part of Home Economics, an optional subject at post-primary level. Any changes to the curricula for either of these subjects would be a matter for the Department of Education and Skills.
912. Deputy Kevin O'Keeffe asked the Minister for Health if a person (details supplied) will be assessed in respect of the provision of home help. [19523/19]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
913. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied) in University Hospital Kerry; and if he will make a statement on the matter. [19525/19]
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.
914. Deputy Thomas P. Broughan asked the Minister for Health if he will report on the availability of the latest cancer drugs that are available through a company (details supplied) that are not available to citizens accessing the public health service; and if he will make a statement on the matter. [19531/19]
View answerThe 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 an 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 provide 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.
915. Deputy Thomas P. Broughan asked the Minister for Health the steps he is taking to ensure that requests for the improvement of pay and conditions of all healthcare support staff are urgently addressed; and if he will make a statement on the matter. [19532/19]
View answerI expect that the Deputy is referring to the Job Evaluation scheme for support staff grades.
As part of the talks which took place under the Lansdowne Road Agreement, a chairman’s note was agreed by all parties on the reintroduction of a Job Evaluation Scheme in the Health Sector. This scheme had been discontinued in 2008. The note provided that all parties would agree on the scope and conduct of the scheme. SIPTU sought the introduction of the Job Evaluation scheme for the support grades along the same principles which operated in 2008.
This scheme for support grades was agreed in 2017; however, as recommended by the Health Sector Oversight body, the question of implementing the outcome of the scheme was to be considered by the parties at the conclusion of the exercise.
In October 2018, a report on the outcome of Phase 1 and 2 of the scheme was submitted to HSE management. The report has advised that all the grades examined, with the exception of the Multi Task Attendant, are due an upgrade. This would have significant cost implications. The Department of Public Expenditure and Reform has advised that the implementation of the outcome of the scheme will need to be considered in the context of the pay talks in relation to the successor to the current Public Service Stability Agreement.
916. Deputy Thomas P. Broughan asked the Minister for Health the action he is taking to address the incidence of carbapenemase-producing enterobacteriaceae infections; the number of cases of this infection that occurred here in 2017, 2018 and to date in 2019; and if he will make a statement on the matter. [19533/19]
View answerOn 25 October 2017, I convened the National Public Health Emergency Team (NPHET) as a result of the activation of the Public Health Emergency Plan, as a public health response to CPE in Ireland.
Over the last eighteen months, a number of measures have been put in place including strong governance arrangements for healthcare-associated infections (HCAIs) and antimicrobial resistance (AMR) within the HSE. The NPHET has also driven enhanced surveillance of HCAIs and built capacity within the system for the challenges associated with these threats. Guidance documents have been developed by the Expert Group convened by the NPHET which provide expert advice to hospitals and the community health care services regarding actions that should be taken regarding CPE screening and control of spread of CPE.
My Department has allocated significant targeted funding of €7 million to increase our public health system’s capacity to tackle antimicrobial resistance (AMR) and healthcare-associated infections, including the superbug CPE. This includes €2 million allocated in 2018 and a further €5 million for 2019. This funding will help to ensure a sustainable response by building infection prevention and control teams both in hospitals and in the community to reduce the spread of infection and disease, enhance surveillance and optimise the use of antimicrobials such as antibiotics.
The next phase of work will focus on the HSE's further implementation of measures to address CPE and other HCAIs to ensure a coherent operational response. My Department and the HSE will continue to work closely together on this important issue. This is also in line with the priorities identified under Ireland's National Action Plan on Antimicrobial Resistance 2017-2020.
CPE means a type of bacteria that lives in the gut and is resistant to almost all antibiotics. If CPE stay in the gut they are mostly harmless and this is called colonisation. Only a small number of people who are colonised with (carry) CPE will go on to develop an invasive CPE infection.
Under Infectious Diseases Regulations, invasive CPE infection has been a notifiable disease since September 2011 and cases are reported through the Computerised Infectious Disease Reporting (CIDR) system. The Health Protection Surveillance Centre (HPSC) publishes national data on invasive CPE infections since 2012. In 2017 there were 14 notifications of invasive CPE infections and in 2018 there were 16 notifications. Published data for 2019 reports that there were two notifications of invasive CPE infection up to the end of February.
As part of the enhanced surveillance of CPE established via the NPHET, the HPSC now publishes a monthly CPE surveillance report. This surveillance report includes national data on rates of CPE infection and colonisation as well as data on outbreaks, screening and other related information. Data are available from December 2017 and all reports are available on the HPSC’s website hpsc.ie.
917. Deputy Lisa Chambers asked the Minister for Health the status of persons who are offered positions in the HSE but are affected by the recruitment ban; and if he will make a statement on the matter. [19535/19]
View answer918. Deputy Lisa Chambers asked the Minister for Health when the HSE recruitment ban will be lifted; and if he will make a statement on the matter. [19536/19]
View answerI propose to take Questions Nos. 917 and 918 together.
Officials from my Department have been engaging intensively with the HSE in reaching agreement on a Pay and Numbers Strategy for 2019.
The key focus in developing the strategy is to ensure that affordable and appropriate recruitment decisions are made by the HSE as they need to operate within their allocated budget considering the National Service Plan approved for 2019. Where individual Hospital Groups or CHOs have not demonstrated their ability to do this, the HSE has decided to introduce interim control measures in these locations, for a consolidation period of three months to the end of June, until it receives clarity on their plans and financial performance for Quarter 1 of 2019. On receipt and acceptance of balanced plans, these additional controls can be reviewed and removed where appropriate.
I have asked the HSE to respond directly to the Deputy on these matters.
919. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the number of approved home care packages including home help hours applications for which no funding has been released by county across each county of CHO 1; the length of time the longest of these is awaiting the release of funds to allow the packages commence; and if he will make a statement on the matter. [19541/19]
View answer920. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the number of approved home care packages including home help hours applications for which no funding has been released by each CHO area; the length of time the longest of these is awaiting the release of funds to allow the packages commence; and if he will make a statement on the matter. [19542/19]
View answerI propose to take Questions Nos. 919 and 920 together.
As these are service matters I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
921. Deputy Clare Daly asked the Minister for Health the level of liability of the pharmaceutical industry in respect of vaccine injury; and if it has been indemnified by the State with the Exchequer taking on liability such as in the Pandemrix vaccination programme. [19548/19]
View answerThe Health Products Regulatory Authority (HPRA) is responsible for monitoring the safety and quality of all medicines including vaccines that are licensed in Ireland. The HPRA and the European Medicines Agency (EMA) continually monitor adverse events to vaccination. The HPRA operates a national adverse reaction reporting system, which members of the public and healthcare professionals are encouraged to submit any suspected adverse reactions to. All Reports received by the HPRA are routinely transmitted to the EMA's adverse reaction database for inclusion in global signal detection and monitoring activities.
In Ireland the pharmaceutical industry does not seek indemnification as part of the normal tendering process in relation to providing vaccines. However, the contract for the supply of pandemic influenza vaccine during the 2009 pandemic included clauses concerning indemnification of the manufacturers at that time. The same indemnification clause applied to all other countries availing of the pandemic vaccine. As all vaccines used in Ireland’s immunisation programmes have been approved for use in the European Union by the EMA there is no requirement for indemnity.
922. Deputy Denise Mitchell asked the Minister for Health the number of retail outlets registered to sell tobacco with the National Register of Tobacco Retailers; and if he will make a statement on the matter. [19551/19]
View answerAs this matter is an operational issue I have sent the question to the Health Service Executive (HSE) for direct reply.
923. Deputy Denise Mitchell asked the Minister for Health the estimated cost of making nicotine replacement therapy free of charge to all those enrolled in smoking cessation programmes; and if he will make a statement on the matter. [19557/19]
View answerTobacco consumption is the largest avoidable health threat in Ireland and 1 in 2 smokers will die from a tobacco-related disease.
The Tobacco Free Ireland (2013) policy document contains a number of recommendations to assist smokers in quitting tobacco use. In relation to nicotine replacement therapy (‘NRT’) the recommendation is that NRT should be more widely available, including in outlets where tobacco products are sold. In 2014 the Health Products Regulatory Authority announced that they licensed some nicotine replacement therapies to be sold in non-pharmacy outlets.
NRT is one element of a range of tobacco cessation services provided by the Health Service Executive (‘HSE’) to those who wish to quit tobacco use. These services include quit clinics and courses, primary care supports provided by GPs, pharmacists and dentists, online and social media supports on Quit.ie and Facebook as well as medication and nicotine replacement therapies. Determining the number of people who access the wide range of cessation services is difficult as people choose to use the services differently. For example, the number of people who use either the online quit plan or the text service cannot be captured. On that basis it is not possible to provide an estimate of the costs involved in making NRT free of charge to all those engaging with the services.
NRT is available free of charge to medical card holders as the evidence shows that those in lower income groups have a higher prevalence of smoking and therefore carry a higher burden of tobacco-related disease than those in higher income groups.
924. Deputy Denise Mitchell asked the Minister for Health his plans to examine operational structures to provide nicotine replacement therapy without a prescription to GMS patients; and if he will make a statement on the matter. [19558/19]
View answerTobacco consumption is the largest avoidable health threat in Ireland and one in two smokers will die from a tobacco-related disease. The policy document "Tobacco Free Ireland" sets out over 60 recommendations, with the overall aims of denormalising smoking in our society, protecting children from the harms of tobacco, enforcing, regulating and legislating for tobacco activities and products, educating about the dangers of tobacco and assisting those who smoke to stop.
Making nicotine replacement therapy (NRT) more widely available, including in outlets where tobacco products are sold, is one of the recommendations in "Tobacco Free Ireland".
NRT is available to medical card holders, on prescription, on the General Medical Services (GMS) Scheme. There are no plans to remove this requirement. NRT products are also available as over-the-counter items in pharmacies, without the need for a prescription.
In 2014, the Health Products Regulatory Authority announced that it had licensed some NRT items for sale in non-pharmacy outlets. In addition, two non-nicotine prescription medicines are authorised in Ireland to assist in smoking cessation, and these are available in medical card and drug payment schemes.
925. Deputy Denise Mitchell asked the Minister for Health the estimated cost of abolishing the exclusion of nicotine replacement therapy from the drugs payment scheme in a full year; and if he will make a statement on the matter. [19559/19]
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.
926. Deputy Niamh Smyth asked the Minister for Health if an appointment will be scheduled for a person (details supplied); and if he will make a statement on the matter. [19563/19]
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.
