Written Answers Nos. 346-359
346. Deputy Tony McLoughlin asked the Minister for Health the way in which agency staff nurses in the HSE hospitals are encompassed into the overall governance of the nursing wards; if it is similar to HSE nurses; and if he will make a statement on the matter. [20739/19]
View answerAs this is a service matter, I have asked the HSE to reply to you directly.
347. Deputy Brendan Griffin asked the Minister for Health if concerns relating to RehabCare's service in County Kerry will be addressed (details supplied); and if he will make a statement on the matter. [20740/19]
View answerThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives.
I want to acknowledge the important services provided by Rehab and the commitment of staff to people with disabilities and their families.
Minister Harris and I held a joint meeting on Tuesday 07 May last, with Rehab and the HSE. Rehab and the HSE committed to working together intensively with a view to making substantive progress in reaching a solution to the issues.
A further meeting is scheduled to take place tomorrow, 15 May.
Our collective aim is to ensure service continuity for service users and their families.
As the details supplied in Deputy's question relate to an individual case and service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
348. Deputy Niamh Smyth asked the Minister for Health the status of the RehabCare crisis; if his attention has been drawn to the fears and anxieties of service users and their families following the announcement on 7 May 2019 of a possible cessation of services locally in 12 months; if an urgent resolution to this matter will be found; and if he will make a statement on the matter. [20741/19]
View answerThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives.
I want to acknowledge the important services provided by Rehab and the commitment of staff to people with disabilities and their families.
Minister Harris and I held a joint meeting on Tuesday 7th May last, with Rehab and the HSE. Rehab and the HSE committed to working together intensively with a view to making substantive progress in reaching a solution to the issues.
A further meeting is scheduled to take place tomorrow, 15th May.
Our collective aim is to ensure service continuity for service users and their families.
349. Deputy John Curran asked the Minister for Health the action he is taking to fast track the publication of the national biosimilar policy in order to increase the use of biosimilar drugs in order that better value for money is achieved in the purchase of medicines; and if he will make a statement on the matter. [20753/19]
View answerMy Department and the HSE are engaging in a number of initiatives which will endeavour to lead to better access to medicines for patients, value for the taxpayer and the cost- effective provision of medicines in Ireland.
A public consultation on a national biosimilar medicines policy was undertaken by my Department in 2017. The responses to that consultation and other possible policy levers are being considered by my Department with a view to developing a national biosimilar medicines policy statement which will be published later this year.
At an operational level, the HSE's Acute Hospitals Drugs Management Programme has a biosimilar strategy in place since 2017 which is making considerable progress using a collaborative approach with hospital pharmacists and clinical teams to bring about changes in prescribing practice. In that respect, hospitals are working towards a targeted minimum prescribing rate for biosimilars of 50%.
The HSE is also working on identifying barriers to the prescribing of biosimilars with a specific focus on education and support. It is seeking to increase understanding of biosimilars through targeted presentations to clinicians and hospitals.
The culmination of these initiatives is a greater uptake in the usage of biosimilars and this is evident by hospital dispensing data. For example, the prescribing rate for the biosimilar drug Infliximab has increased from 5% in 2017 to 40% in 2018. The biosimilar drug Rituximab became available in July 2017 and the dispensing rate has already increased to 25%.
My Department proposes to build on these positive developments and to bring forward a policy statement that would support and complement the many initiatives which are already underway.
350. Deputy John Curran asked the Minister for Health the action he is taking to develop a national supply and pricing agreement for pharmaceutical products that creates a level playing field for all pharmaceutical companies; and if he will make a statement on the matter. [20754/19]
View answerThe Framework Agreement on the Supply and Pricing of Medicines between the Irish Pharmaceutical Healthcare Association and the Department of Health, the Department of Public Expenditure and Reform and the Health Service Executive commenced on 01 August 2016 and shall continue in force until 31 July 2020. The Framework Agreement provides a process for reference pricing on the introduction of interchangeable medicines.
Access to reimbursement for all drugs is determined by the Health (Pricing and Supply of Medical Goods) Act 2013 Act which provided for the introduction of a system of generic substitution and reference pricing, allowing the HSE to determine the price for generic medicines.
I am advised that preparatory work for negotiations on the next Framework Agreement will commence in the coming months in my Department and in that regard relevant stakeholders will be consulted.
351. Deputy John Curran asked the Minister for Health if he is satisfied that the pricing and reimbursement system of the HSE prioritises use of the most cost-effective medicines; and if he will make a statement on the matter. [20755/19]
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.
Reimbursement is for licensed indications which have been granted market authorisation by the European Medicines Agency (EMA) or the Health Products Regulatory Authority (HPRA).
In line with the 2013 Act and the national framework agreed with industry, if a company would like a medicine to be reimbursed by the HSE, it must apply to have the new medicine added to the reimbursement list.
In considering an application, the HSE must have regard to Part 1 and Part 3 of Schedule 3 of the 2013 Health Act. Part 3 requires the HSE to have regard to the following criteria:
1. The health needs of the public.
2. The cost-effectiveness of meeting health needs by supplying the item concerned rather than providing other health services.
3. The availability and suitability of items for supply or reimbursement.
4. The proposed costs, benefits and risks of the item or listed item relative to therapeutically similar items or listed items provided in other health service settings and the level of certainty in relation to the evidence of those costs, benefits and risks.
5. The potential or actual budget impact of the item or listed item.
6. The clinical need for the item or listed item.
7. The appropriate level of clinical supervision required in relation to the item to ensure patient safety.
8. The efficacy (performance in trial), effectiveness (performance in real situations) and added therapeutic benefit against existing standards of treatment (how much better it eats a condition than existing therapies).
9. The resources available to the HSE.
It will take into account such expert opinions and recommendations which it may have sought at its sole discretion, for example from the National Centre for Pharmacoeconomics (NCPE).
The NCPE conducts health technology assessments (HTAs) for the HSE, and makes recommendations on reimbursement to assist HSE decisions. The NCPE uses a decision framework to systematically assess whether a drug is cost-effective as a health intervention. It is through this assessment process that the HSE also seeks to reduce the price of medicines to more affordable prices. There is also an increased level of engagement (commercial negotiations) between the HSE and manufacturers in an effort to reduce the price to affordable levels.
I am satisfied that the 2013 Health Act provides for a fair, transparent and rigorous process for the assessment of all drugs which has delivered tangible results for Irish patients. To date in 2019, 23 new medicines and five new uses of existing medicines have been approved by the HSE, an investment of in excess of €175 million over five years.
352. Deputy John Curran asked the Minister for Health his plans to expand and overhaul the high-tech medicines scheme of the HSE in order to allow for more medicines to be on the list; and if he will make a statement on the matter. [20756/19]
View answerThe High Tech Arrangement, which is in place since 1996, provides for the supply and dispensing of high tech medicines through community pharmacies. The medicines are purchased by the HSE and supplied through community pharmacies for which pharmacies are paid a patient care fee by the HSE Primary Care Reimbursement Service each month.
These arrangements are designed to provide a quality community based service to patients, by ensuring the active involvement of community pharmacists in the dispensing of high tech medicines, that were previously supplied in the main through hospitals or Community Health Offices.
The High Tech Drug and Management System, which went live in March 2018, is kept under constant review by the HSE. It is a centralised ordering system which provides greatly improved governance and probity in the purchase and supply of these very expensive medicines.
353. Deputy Martin Kenny asked the Minister for Health further to Topical Issue No. 4 of 28 March 2019, the cost of the new diabetic day unit at Sligo University Hospital; the amount allocated from the capital budget; and the amount allocated in 2019 for this unit which is to be operational by 2020. [20761/19]
View answerAs 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.
354. Deputy Frank O'Rourke asked the Minister for Health when an assessment of need will be expedited for a person (details supplied); and if he will make a statement on the matter. [20762/19]
View answerThe 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.
355. Deputy Bernard J. Durkan asked the Minister for Health when an appointment for surgery will be accommodated in the case of a person (details supplied); and if he will make a statement on the matter. [20764/19]
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.
356. Deputy Bernard J. Durkan asked the Minister for Health if and when results awaited for a smear test will be issued in the case of a person (details supplied); and if he will make a statement on the matter. [20768/19]
View answerIn April 2018, following issues which had emerged in relation to the CervicalCheck screening programme, I made the decision to offer free out of cycle smears to any woman who was concerned about her health, where her GP felt she should have a further test as part of her reassurance.
Approximately 112,000 consultations were provided by GPs, and 57,810 early repeat smear tests were provided between the 1 May and 31 December – in other words, about half of the consultations resulted in a smear test.
Laboratory turnaround times have increased since that time as a consequence both of the 57,000 or so out of cycle smears and the increased uptake generally. The CervicalCheck programme has agreed with laboratories to prioritise those slides which originate from women who attended colposcopy, as this cohort of women are considered to have the most serious need. In addition, agreement has been reached with the laboratory with the largest backlog to process tests based on a HPV initial testing model; i.e. HPV testing will be carried out on samples prior to cytology. I am advised that this approach was chosen as the most effective way to process all outstanding tests based on prioritising women most at risk.
However, the HSE has advised that the natural history of cervical cancer would indicate that the disease would normally develop over a period of 10 to 15 years. It has said that in this context, a delay in the return of cervical screening results, whilst undesirable, is not necessarily dangerous and poses a very low risk to women.
In relation to the specific case referred to by the Deputy, I have asked the HSE to respond directly to him.
357. Deputy John McGuinness asked the Minister for Health the progress being made to arrange an early assessment and operation at University Hospital Waterford for a person (details supplied); if an immediate assessment will be arranged; and if he will make a statement on the matter. [20771/19]
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.
358. Deputy Niamh Smyth asked the Minister for Health the status of a hospital appointment for a person (details supplied); if an urgent appointment will be scheduled; and if he will make a statement on the matter. [20773/19]
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.
359. Deputy Gino Kenny asked the Minister for Health the number of the ministerial licences for medicinal cannabis granted that have been reimbursed for the cost of the medication; and if he will make a statement on the matter. [20846/19]
View answerI wish to advise the Deputy that, of the twenty licences which have been issued by my Department, three patients have been approved by the HSE for their product and travel costs to the Netherlands.
