Transport Support Scheme

Questions (223)

Anne Rabbitte

Question:

223. Deputy Anne Rabbitte asked the Minister for Health further to Parliamentary Question Nos. 278, 279 and 366 of 26 February 2019, the status of the revised proposals regarding the mobility allowance and motorised transport grant schemes; and if he will make a statement on the matter. [28738/19]

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 2013.

As outlined in my previous reply, my colleague, the Minister for Health and I, brought a Memorandum to Government 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 that 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. However, it is not possible for me at this stage to provide the Deputy with a precise time frame for when I will revert to Cabinet.

Hospital Services

Questions (224)

Michael Healy-Rae

Question:

224. Deputy Michael Healy-Rae asked the Minister for Health when a person (details supplied) will be called for an endoscopy; and if he will make a statement on the matter. [28739/19]

View answer

Written answers (Question to Health)

As this is a service matter, I have asked the Health Service Executive to respond to you directly as soon as possible

Medicinal Products Reimbursement

Questions (225)

Bobby Aylward

Question:

225. Deputy Bobby Aylward asked the Minister for Health if the possibility of extending access to a drug (details supplied) for all types of cancers including neuroendocrine of the larynx will be investigated; if he will request the National Centre for Pharmacoeconomics and the HSE Drugs Group to assess the matter as urgently as possible; and if he will make a statement on the matter. [28749/19]

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. As Minister I have no role in this statutory process. 

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 submit an application to the HSE to have the new medicine added to the reimbursement list.

Reimbursement is provided for licenced indications which have been granted a market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.

Pembrolizumab has been granted marketing authorisation for a number of indications and is included on the HSE reimbursement list for some of those indications. In addition, a number of other indications are currently being assessed for reimbursement.

Clinical trials for various immunotherapies, including pembrolizumab, are ongoing globally for a range of other possible indications which may receive marketing authorisation in the EU over the next number of years. Each of those indications will be considered for reimbursement as market authorisations are granted and applications received.

Hospital Appointments Status

Questions (226)

Michael Healy-Rae

Question:

226. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [28750/19]

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.

Disabilities Assessments

Questions (227)

Margaret Murphy O'Mahony

Question:

227. Deputy Margaret Murphy O'Mahony asked the Minister for Health if a family (details supplied) will have to go without an assessment of need for their child in view of the fact that the €1,000 fee for a private assessment is not within their financial means; and if he will make a statement on the matter. [28752/19]

View answer

Written answers (Question to Health)

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Hospital Waiting Lists Data

Questions (228)

Peadar Tóibín

Question:

228. Deputy Peadar Tóibín asked the Minister for Health the most recent outpatient and inpatient waiting list figures for the Midland Regional Hospital, Mullingar; the equivalent set of figures from the previous 12 months; the length of time these patients have been waiting on a 3, 6, 12 and 24 month basis; and if he will make a statement on the matter. [28776/19]

View answer

Written answers (Question to Health)

I am conscious that waiting times are often unacceptably long and of the burden that this places on patients and their families. In this regard, the Government is committed to improving waiting times for hospital appointments and procedures.  

Budget 2019 announced that the Government has further increased investment in tackling waiting lists, with funding to the National Treatment Purchase Fund (NTPF) increasing from €55 million in 2018 to €75 million in 2019. The joint Department of Health/HSE/National Treatment Purchase Fund (NTPF) Scheduled Care Access Plan 2019 was published in March and sets out measures to improve care for patients waiting for scheduled care in 2019 by reducing waiting times for inpatient/day case treatment and outpatient appointments. The plan places a strong focus on ten high-volume Inpatient/Day Case procedures. When combined with HSE activity, it is projected that the NTPF will be in a position to offer treatment to all clinically suitable patients waiting more than 6 months for one of these high-volume procedures.  

A key element of the Plan is the stabilisation of the Outpatient Waiting List. Under the Plan the HSE, in line with the National Service Plan, will aim to deliver 3.3 million outpatient appointments, of which approximately 1 million will be first appointments. For its part the NTPF will aim to deliver 40,000 first Outpatient appointments.  

The NTPF advise that over recent months they have placed a particular focus on engaging with hospital groups and individual hospitals to identify outpatient waiting list proposals. While the NTPF have already approved over 38,000 outpatient appointments, they advise that the impact of these initiatives may not be seen until the end of the year. Approximately 75% of outpatient appointments approved to date relate to 4 high-volume specialities, specifically Ophthalmology, ENT, Orthopaedics, and Dermatology.  

In addition, my Department is working with the HSE and NTPF, under the Access Plan, with the objective of developing medium-long term improvement initiatives for patient access to hospital procedures. This will include moving care to more appropriate settings and providing care at the lowest level of complexity such as providing ophthalmology in the community; maximising the use of Advanced Nurse Practitioner led clinics; and physiotherapists to manage orthopaedic clinics.  

The data requested by the deputy is outlined in the documents in the following link.

Outpatient WL

MRH Mullingar WL

Mental Health Services Funding

Questions (229)

Anne Rabbitte

Question:

229. Deputy Anne Rabbitte asked the Minister for Health the level of funding provided for mental health services in each county in each of the years 2014 to 2018 and to date in 2019, in tabular form; and if he will make a statement on the matter. [28780/19]

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.

Mental Health Services Data

Questions (230)

Anne Rabbitte

Question:

230. Deputy Anne Rabbitte asked the Minister for Health the number of children that ended up having to access adult mental health services in each county in each of the years 2014 to 2018 and to date in 2019, in tabular form; and if he will make a statement on the matter. [28781/19]

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.

State Claims Agency Data

Questions (231)

Michael McGrath

Question:

231. Deputy Michael McGrath asked the Minister for Health if the information requested in Parliamentary Question No. 244 of 2 April 2019 will be forwarded; and if he will make a statement on the matter. [28797/19]

View answer

Written answers (Question to Health)

I refer to the Parliamentary Question No. 244 for written answer on 2nd April 2019. A holding reply had issued to the PQ at the time and I had undertaken to obtain the outstanding information for the Deputy from the State Claims Agency (SCA), which manages claims in relation to clinical negligence. Due to an administrative oversight, my Department had not issued the information which had been received from the State Claims Agency. I apologise to the Deputy for this oversight. The response to the Deputy's question is now set out below.

In relation to the Deputy's reference in his question concerning missed diagnosis, it is important to note that a screening test is not a diagnostic test. Cervical screening aims to prevent cervical cancer through the early detection and treatment of pre-cancerous changes on the cervix. Earlier detection can often increase treatment options, as well as reduce the invasiveness of that treatment. It is estimated that regular cervical screening can prevent 75% (or 3 out of 4) of cervical cancer cases. Since 2008, 1,200 invasive cancers have been detected by CervicalCheck. More than 50,000 women with high grade abnormalities (CIN 2 & 3) have been diagnosed and treated, considerably reducing their risk of developing cervical cancer. CervicalCheck has been successful in reducing cervical cancer rates in Ireland - these dropped from around 14 per 100,000 in the period 2009-2011 to 10 per 100,000 in the period 2013-2015. Cervical screening will not prevent all cases of cervical cancer, and some women will still develop cervical cancer despite regular screening.

Also, I would like to clarify matters regarding the Deputy's reference to alleged failings in the cervical cancer screening programme. It should be noted that the Report of the Scoping Inquiry into the CervicalCheck Screening Programme, conducted by Dr Gabriel Scally, is unequivocal in stating that the widespread non-disclosure of the results of historical screening audits was a substantial breach of trust for the women and families concerned. It caused significant distress and additional suffering to those affected.

However, Dr Scally was clear in his Final Report, published in September 2018, that the Inquiry was satisfied with the quality management processes in the laboratories contracted by CervicalCheck. His report presented no evidence that either the rates of discordant smear reporting or the performance of the programme fell below what is expected in a cervical screening programme. Dr Scally also confirmed that he found no reason why the existing contracts for laboratory services should not continue until the new HPV regime is introduced.

In response to the Deputy's question relating to the number of claims on hand in this regard, I have been informed by the State Claims Agency that the information set out below has been extracted from the National Incident Management System (NIMS) and is correct as at 30th March 2019:

1. Number of Claims on hand: There are currently 98 claims relating to allegations of misinterpretation of slides by the National Screening Service under active management by the State Claims Agency.

2. Number of Claims Settled: To date the SCA has settled 4 of these claims.

3. Amount paid out in claims to date: Due to the low volume of claims paid out to date, the SCA is unable to provide this figure as it could lead to the identification of an individual.

4. Legal costs of the cases: In respect of all associated National Screening Services cases, legal costs amounting to €590,583 have been paid. These legal costs include fees paid to mediation services, which is consistent with the SCA’s policy of using mediation wherever possible to resolve these claims in a non-adversarial manner that does not add to the considerable pain and trauma of the people affected and their families. These legal fees also include matters not relating to the areas in which the State has already accepted liability. It is anticipated that much of the work carried out in respect of these initial cases, and by extension the fees incurred, will be applied in resolving future cases that have been notified to the SCA and that this work will not need to be repeated in managing these future cases.

For clarity, I would ask the Deputy to note that the settlements outlined above were agreed with the laboratories, and the amounts were paid by the laboratories.

Disabilities Assessments

Questions (232)

Noel Rock

Question:

232. Deputy Noel Rock asked the Minister for Health if the case of a person (details supplied) will be investigated regarding an assessment of needs application; and if he will make a statement on the matter. [28803/19]

View answer

Written answers (Question to Health)

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Cannabis for Medicinal Use

Questions (233)

Louise O'Reilly

Question:

233. Deputy Louise O'Reilly asked the Minister for Health the arrangements in place to facilitate access to the compassionate access programme for medicinal cannabis for persons in Northern Ireland; if a protocol exists for access; if not, if one is being devised; if, in the interim, access can be arranged; and if he will make a statement on the matter. [28818/19]

View answer

Written answers (Question to Health)

My understanding is that the Deputy is referring to access to healthcare in Ireland for a person from Northern Ireland, under the terms of the Cross Border Directive (CBD).

The Directive provides that patients who are entitled to a particular health service in the public healthcare system of their home Member State are also entitled to be reimbursed by their home State if they choose to receive such treatment in another Member State.  In this context the person should contact the UK National Contact Point (NCP) to check their eligibility for healthcare under the Directive in any particular circumstance and the particular pathway they should take to avail of such healthcare.

In addition, the Directive provides that the NCP in the Member State in which treatment is being sought must ensure that information about accessing healthcare services in that State under the Directive, including detail of the healthcare providers in the State, is available or accessible to persons from other EU / EEA States.  In this context the person may contact the Irish NCP in writing at HSE National Contact Point (NCP), St Canices, Laken, Dublin Road, Kilkenny, R95 P231 or by phone on 00 353 (0)56 7784546.

Medical Card Eligibility

Questions (234)

Louise O'Reilly

Question:

234. Deputy Louise O'Reilly asked the Minister for Health the reason persons living with fibromyalgia are not covered under the medical card and the GMS. [28819/19]

View answer

Written answers (Question to Health)

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 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.

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. These medical cards are issued within 24 hours of receipt of the required patient details and a letter which confirms the medical condition from a doctor or consultant. With the exception of terminally ill patients, all medical cards, granted on an emergency basis, are followed up with a full application within a number of weeks.

Respite Care Services Funding

Questions (235)

Louise O'Reilly

Question:

235. Deputy Louise O'Reilly asked the Minister for Health if the HSE has cut funding for a respite services summer camp for children with special needs at a location (details supplied). [28820/19]

View answer

Written answers (Question to Health)

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities. The Programme for Partnership Government states that the Government wishes to provide more accessible respite care to facilitate full support for people with a disability.

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

Health Services Staff Data

Questions (236)

Louise O'Reilly

Question:

236. Deputy Louise O'Reilly asked the Minister for Health further to Parliamentary Question No. 163 of 12 June 2019, the action he will be taking to protect health service staff from assaults [28822/19]

View answer

Written answers (Question to Health)

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

Hospital Services

Questions (237)

Mary Lou McDonald

Question:

237. Deputy Mary Lou McDonald asked the Minister for Health when a person (details supplied) will receive an appointment at Cappagh Hospital for surgery. [28857/19]

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.

Medicinal Products Reimbursement

Questions (238)

Jonathan O'Brien

Question:

238. Deputy Jonathan O'Brien asked the Minister for Health if the HSE will fund Ocrevus for persons with primary progressive multiple sclerosis (details supplied); and if he will make a statement on the matter. [28858/19]

View answer

Written answers (Question to Health)

The HSE has statutory responsibility for medicine pricing and reimbursement decisions, under the Health (Pricing and Supply of Medical Goods) Act 2013. The Act specifies criteria for decisions on the reimbursement of medicines. As Minister, I have no role in this statutory process.

HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, including the advice of 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's clinical and cost effectiveness as a health intervention.

The HSE strives to reach a decision in as timely a manner as possible. However, because of the significant monies involved, it must ensure that the best price is achieved, as these commitments are often multi-million euro, ongoing investments. This can lead to a protracted deliberation process.

I wish to advise you that the NCPE completed a health technology assessment in October 2018 on ocrelizumab for adult patients with early primary progressive multiple sclerosis. The NCPE did not recommend that it be reimbursed for this indication. However, the HSE has advised that there has since been considerable commercial engagement with the applicant.

The HSE's final decsion on reimbursement will take into consideration the statutory criteria contained in the 2013 Health Act.

Nursing Homes Support Scheme Data

Questions (239)

Stephen Donnelly

Question:

239. Deputy Stephen Donnelly asked the Minister for Health the number of persons awaiting placement under the fair deal scheme at the end of June 2019 or the latest date available; the average waiting time; and the length of time waiting by local health area in tabular form [28871/19]

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.

Hospital Beds Data

Questions (240)

Stephen Donnelly

Question:

240. Deputy Stephen Donnelly asked the Minister for Health the number of beds and wards in all public and voluntary acute hospitals that were closed on 28 June 2019 or the latest date on which data for validated bed closures at hospital and ward level are available, in tabular form. [28872/19]

View answer

Written answers (Question to Health)

The Open Beds Report, published by my Department monthly, provides a summary of the average numbers of open inpatient beds and day beds/places in the acute hospital system based on data provided by the HSE. It can be found here: https://health.gov.ie/blog/publications/department-of-health-open-beds-report/

According to provisional data received from the HSE Acute Business Information Unit, there were on average 10,984 inpatient beds and 2,223 day case beds/places available nationally in April 2019.

Information relating to closed beds is collated at a particular date in time. The number of beds closed can fluctuate greatly from day to day for a variety of reasons, including on-going refurbishment, maintenance work, and infection control measures.

In relation to the particular data requested, I have asked the HSE to respond to the Deputy directly.

Hospitals Discharges

Questions (241)

Stephen Donnelly

Question:

241. Deputy Stephen Donnelly asked the Minister for Health the number of delayed discharges in each public and voluntary hospital at the end of June 2019, in tabular form. [28873/19]

View answer

Written answers (Question to Health)

Delayed discharge data in the manner requested by the Deputy is published by the HSE in the Management Data Report (MDR). The latest MDR to end March is available at: 

https://www.hse.ie/eng/services/publications/performancereports/management-data-report-march-2019.pdf

With regard to data to end June, as this is a service matter, I have asked the HSE to respond to the Deputy directly.

Hospitals Discharges

Questions (242)

Stephen Donnelly

Question:

242. Deputy Stephen Donnelly asked the Minister for Health the number of bed days lost through delayed discharges in June 2019 in each public and voluntary hospital, in tabular form. [28874/19]

View answer

Written answers (Question to Health)

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