Family Support Services

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<h3>Questions (296)</h3>
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<div class="question" id="pq_296">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/en/members/member/Jack-Chambers.D.2016-10-03/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Jack-Chambers.D.2016-10-03/image/thumb" alt="Jack Chambers"/>
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<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Jack-Chambers.D.2016-10-03/">Jack Chambers</a>
</h4>
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<div class="content"><h4 class="from">Jack Chambers</h4><span class="question-start">Question:</span>
<p id="para_4334" class="">296. <strong>Deputy Jack Chambers</strong> asked the <strong>Minister for Health</strong> the progress made to provide family supports for those with sickle cell disease; and if he will make a statement on the matter. [30364/19]</p>
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<div class="sub-header" id="pq-answers-296">
<h3>Written answers (Question to Health)</h3>
</div><div class="speech brief" id="spk_910">
<div class="c-avatar -debate -short">
<a class="c-avatar__img-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Simon-Harris.D.2011-03-09/image/thumb" alt="Simon Harris"/>
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<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">Minister for Health</a>
</h4>
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<p id="para_4335" class="">As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.</p>
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Disease Management

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<h3>Questions (297)</h3>
</div>

<div class="question" id="pq_297">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/en/members/member/Jack-Chambers.D.2016-10-03/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Jack-Chambers.D.2016-10-03/image/thumb" alt="Jack Chambers"/>
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<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Jack-Chambers.D.2016-10-03/">Jack Chambers</a>
</h4>
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<div class="content"><h4 class="from">Jack Chambers</h4><span class="question-start">Question:</span>
<p id="para_4336" class="">297. <strong>Deputy Jack Chambers</strong> asked the <strong>Minister for Health</strong> the way in which the health system is adapting to assist the growing numbers of persons with sickle cell disease; and if he will make a statement on the matter. [30365/19]</p>
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<div class="sub-header" id="pq-answers-297">
<h3>Written answers (Question to Health)</h3>
</div><div class="speech brief" id="spk_911">
<div class="c-avatar -debate -short">
<a class="c-avatar__img-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Simon-Harris.D.2011-03-09/image/thumb" alt="Simon Harris"/>
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<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">Minister for Health</a>
</h4>
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<p id="para_4337" class="">As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.</p>
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Health Services Provision

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<h3>Questions (298)</h3>
</div>

<div class="question" id="pq_298">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/en/members/member/Seán-Fleming.D.1997-06-26/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Seán-Fleming.D.1997-06-26/image/thumb" alt="Seán Fleming"/>
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<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Seán-Fleming.D.1997-06-26/">Seán Fleming</a>
</h4>
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<div class="content"><h4 class="from">Seán Fleming</h4><span class="question-start">Question:</span>
<p id="para_4338" class="">298. <strong>Deputy Sean Fleming</strong> asked the <strong>Minister for Health</strong> when medical treatment will be made available to a person (details supplied); and if he will make a statement on the matter. [30369/19]</p>
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<div class="sub-header" id="pq-answers-298">
<h3>Written answers (Question to Health)</h3>
</div><div class="speech brief" id="spk_912">
<div class="c-avatar -debate -short">
<a class="c-avatar__img-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Simon-Harris.D.2011-03-09/image/thumb" alt="Simon Harris"/>
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<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">Minister for Health</a>
</h4>
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<p id="para_4339" class="">As the Deputy's question relates to an operational issue, I have referred the matter to the HSE for direct reply. </p>
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Medicinal Products Reimbursement

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<h3>Questions (299)</h3>
</div>

<div class="question" id="pq_299">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/en/members/member/Marc-MacSharry.S.2002-09-12/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Marc-MacSharry.S.2002-09-12/image/thumb" alt="Marc MacSharry"/>
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<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Marc-MacSharry.S.2002-09-12/">Marc MacSharry</a>
</h4>
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<div class="content"><h4 class="from">Marc MacSharry</h4><span class="question-start">Question:</span>
<p id="para_4340" class="">299. <strong>Deputy Marc MacSharry</strong> asked the <strong>Minister for Health</strong> if the approval of the reimbursement of the drug Tagrisso as a second line therapy for non-small cell lung cancer will be expedited, in view of the need of a very small patient cohort and relatively small budget impact; and if he will make a statement on the matter. [30370/19]</p>
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<div class="sub-header" id="pq-answers-299">
<h3>Written answers (Question to Health)</h3>
</div><div class="speech" id="spk_913">
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<a class="c-avatar__img-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">
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<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">Minister for Health</a>
</h4>
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<p id="para_4341" class="">The HSE has statutory responsibility for medicine pricing and reimbursement under the Health (Pricing and Supply of Medical Goods) Act 2013. The Act specifies the criteria for decisions on the reimbursement of medicines. As Minister for Health, I have no role or powers in relation to such matters. </p>
<p id="para_4342" class=""> Decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds by the HSE, including advice from the National Centre for Pharmacoeconomics (NCPE). </p>
<p id="para_4343" class=""> The HSE has a robust assessment and commercial negotiation process for new medicines. This process challenges inappropriate costings from applicant companies and delivers improved value for money on new medicines, allowing more treatments to be provided within a finite budget. </p>
<p id="para_4344" class=""> 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 can be ongoing multi-million euro investments. </p>
<p id="para_4345" class=""> I am advised by the HSE that it has assessed osimertinib for the following indication:</p>
<p id="para_4346" class="">- The treatment of adult patients with locally advanced or metastatic EGFR T790M mutation-positive NSCLC. </p>
<p id="para_4347" class=""> In respect of this indication, the NCPE completed its Health Technology Assessment (HTA) in May 2018. Following the assessment and after a number of rounds of commercial negotiations and HSE reviews, the HSE notified the applicant in February 2019 that it was minded to not approve osimertinib for the 2nd line treatment of EGFR T790M mutation-positive non-small-cell lung cancers. </p>
<p id="para_4348" class=""> The Health (Pricing and Supply of Medical Goods) Act 2013 requires a period of representations after such notifications, before the HSE makes any formal final decision. The HSE reviewed representations received at its May 2019 meeting and they are currently under consideration .</p>
<p id="para_4349" class=""> In addition, the HSE have commissioned a HTA on osimertinib for:</p>
<p id="para_4350" class="">- the first-line treatment of adult patients with locally advanced or metastatic non-small cell lung cancer with activating epidermal growth factor receptor (EGFR) mutations. </p>
<p id="para_4351" class=""> I am informed that this assessment is ongoing and will be assessed in line with the 2013 Act.</p>
</div>
</div>
</div>

HSE Expenditure

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<h3>Questions (300)</h3>
</div>

<div class="question" id="pq_300">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/en/members/member/Marc-MacSharry.S.2002-09-12/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Marc-MacSharry.S.2002-09-12/image/thumb" alt="Marc MacSharry"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Marc-MacSharry.S.2002-09-12/">Marc MacSharry</a>
</h4>
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<div class="content"><h4 class="from">Marc MacSharry</h4><span class="question-start">Question:</span>
<p id="para_4352" class="">300. <strong>Deputy Marc MacSharry</strong> asked the <strong>Minister for Health</strong> the anticipated savings the HSE will generate through the best value biological medicines initiative recently launched by the medicines management programme in 2019 and 2020; the proportion of these savings that will be reinvested into new medicines; and if he will make a statement on the matter. [30371/19]</p>
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<div class="sub-header" id="pq-answers-300">
<h3>Written answers (Question to Health)</h3>
</div><div class="speech brief" id="spk_914">
<div class="c-avatar -debate -short">
<a class="c-avatar__img-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Simon-Harris.D.2011-03-09/image/thumb" alt="Simon Harris"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">Minister for Health</a>
</h4>
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<p id="para_4353" class="">The Health Service Executive has responsibility for medicines expenditure, thus the matter has been referred to the HSE for their attention and direct reply to the Deputy.</p>
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Medicinal Products Expenditure

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<h3>Questions (301)</h3>
</div>

<div class="question" id="pq_301">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/en/members/member/Marc-MacSharry.S.2002-09-12/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Marc-MacSharry.S.2002-09-12/image/thumb" alt="Marc MacSharry"/>
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<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Marc-MacSharry.S.2002-09-12/">Marc MacSharry</a>
</h4>
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<div class="content"><h4 class="from">Marc MacSharry</h4><span class="question-start">Question:</span>
<p id="para_4354" class="">301. <strong>Deputy Marc MacSharry</strong> asked the <strong>Minister for Health</strong> the oncology medicines that had a health technology assessment completed by the National Centre for Pharmacoeconomics, NCPE, since 2016 and are not reimbursed by the HSE, in tabular form; and if he will make a statement on the matter. [30372/19]</p>
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<div class="sub-header" id="pq-answers-301">
<h3>Written answers (Question to Health)</h3>
</div><div class="speech brief" id="spk_915">
<div class="c-avatar -debate -short">
<a class="c-avatar__img-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Simon-Harris.D.2011-03-09/image/thumb" alt="Simon Harris"/>
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<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">Minister for Health</a>
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<p id="para_4355" class="">The Health Service Executive has responsibility for medicines expenditure, thus the matter has been referred to the HSE for their attention and direct reply to the Deputy.</p>
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Medicinal Products Expenditure

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<h3>Questions (302)</h3>
</div>

<div class="question" id="pq_302">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/en/members/member/Marc-MacSharry.S.2002-09-12/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Marc-MacSharry.S.2002-09-12/image/thumb" alt="Marc MacSharry"/>
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<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Marc-MacSharry.S.2002-09-12/">Marc MacSharry</a>
</h4>
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<div class="content"><h4 class="from">Marc MacSharry</h4><span class="question-start">Question:</span>
<p id="para_4356" class="">302. <strong>Deputy Marc MacSharry</strong> asked the <strong>Minister for Health</strong> the estimated budgetary impact for all medicines for rare cancers that are seeking reimbursement with the HSE; and if he will make a statement on the matter. [30373/19]</p>
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<div class="sub-header" id="pq-answers-302">
<h3>Written answers (Question to Health)</h3>
</div><div class="speech brief" id="spk_916">
<div class="c-avatar -debate -short">
<a class="c-avatar__img-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Simon-Harris.D.2011-03-09/image/thumb" alt="Simon Harris"/>
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<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">Minister for Health</a>
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<p id="para_4357" class="">The Health Service Executive has responsibility for medicines expenditure, thus the matter has been referred to the HSE for their attention and direct reply to the Deputy.</p>
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Cancer Screening Programmes

<div class="sub-header">
<h3>Questions (303)</h3>
</div>

<div class="question" id="pq_303">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/en/members/member/Micheál-Martin.D.1989-06-29/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Micheál-Martin.D.1989-06-29/image/thumb" alt="Micheál Martin"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Micheál-Martin.D.1989-06-29/">Micheál Martin</a>
</h4>
</div>
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<div class="content"><h4 class="from">Micheál Martin</h4><span class="question-start">Question:</span>
<p id="para_4358" class="">303. <strong>Deputy Micheál Martin</strong> asked the <strong>Minister for Health</strong> the inquiries made as to whether the entire cervical screening service should be re-established to ensure an entirely integrated service for HPV, cytology, colposcopy and histopathology; and if he will make a statement on the matter. [30374/19]</p>
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<div class="sub-header" id="pq-answers-303">
<h3>Written answers (Question to Health)</h3>
</div><div class="speech" id="spk_917">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Simon-Harris.D.2011-03-09/image/thumb" alt="Simon Harris"/>
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<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">Minister for Health</a>
</h4>
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<p id="para_4359" class="">Following the issues which emerged in relation to CervicalCheck in 2018, Government established a Scoping Inquiry led by Dr Gabriel Scally. The Scoping Inquiry submitted its Final Report in September 2018 and a Supplementary Report this June, and provided welcome assurance in relation to the quality management processes in the labs. Dr Scally has said he has found no evidence of deficiencies in screening quality in any of the labs. These are very welcome reassurances for women in Ireland, given the importance of screening for women’s health and the need for external laboratory capacity to support the programme. </p>
<p id="para_4360" class=""> At the same time, Dr Scally did as we know uncover significant issues across a range of areas within screening, and made 58 recommendations in total across his reports. My focus now is on the full implementation of all of those recommendations, which are fundamental to strengthening the programme and ensuring it delivers a service of the highest quality for Irish women. </p>
<p id="para_4361" class=""> I take it that, in referring to an integrated service, the Deputy is referring particularly to the laboratory element of the screening pathway which is currently provided primarily by external providers, with a small element provided by the Coombe Hospital. While Dr Scally made no recommendation regarding how laboratory services should be provided, the HSE has advised it is committed to the further development of laboratory services at the Coombe, and that work is ongoing in relation to development of costings and a business case, taking account of future need. </p>
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Hospital Beds Closures

<div class="sub-header">
<h3>Questions (304)</h3>
</div>

<div class="question" id="pq_304">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/en/members/member/Róisín-Shortall.D.1992-12-14/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Róisín-Shortall.D.1992-12-14/image/thumb" alt="Róisín Shortall"/>
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<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Róisín-Shortall.D.1992-12-14/">Róisín Shortall</a>
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<div class="content"><h4 class="from">Róisín Shortall</h4><span class="question-start">Question:</span>
<p id="para_4362" class="">304. <strong>Deputy Róisín Shortall</strong> asked the <strong>Minister for Health</strong> his views on reports that the HSE plans to close the elms ward in St Mary’s Hospital, Phoenix Park; and his plans to ensure that the facility remains open. [30387/19]</p>
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<h3>Written answers (Question to Health)</h3>
</div><div class="speech" id="spk_918">
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<a class="c-avatar__img-link" href="/en/members/member/Jim-Daly.D.2011-03-09/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Jim-Daly.D.2011-03-09/image/thumb" alt="Jim Daly"/>
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<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Jim-Daly.D.2011-03-09/">Minister of State at the Department of Health</a>
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<p id="para_4363" class="">St Mary’s Hospital in the Phoenix Park provides 150 long term residential beds, located across two modern purpose-built units.  The hospital also provides 75 sub-acute or short stay beds, located separately in the main hospital building which dates back to the 18th century.</p>
<p id="para_4364" class=""> A recent Health and Safety Assessment identified significant patient and staff safety risk issues in the main building and in particular on Elms Ward. The risks identified relate to safety, fire safety management, layout, size, age, fixtures, fittings and lighting. Environmental risks were identified in relation to safe evacuation of patients. Elms Ward was found to have significant risk to patients and staff due to its uneven floor.</p>
<p id="para_4365" class=""> To comply with legislative requirements, and in the best interests of patients and staff, the HSE needs to close the ward on a phased basis with effect from 1st July 2019, to be completed by August. This decision was based solely on health and safety concerns, and not as a cost saving measure.  There will be some reduction in access to transitional care beds from acute settings, however, all patients will remain in the Hospital until their current care is completed. The Department has been assured that all commitments for booked respite care will be honoured and plans are being put in place to that effect. </p>
<p id="para_4366" class=""> Staff were advised of this decision through consultation with their line management and they will be reassigned within the Hospital. The HSE has advised the Department that significant capital is required to address the health and safety issues and part of the project development process will be to examine all options available to provide safe services.</p>
<p id="para_4367" class=""> The primary focus must be on patients.  Engagement with them, their families, staff, union representatives and any other relevant stakeholders is on-going to ensure minimal impact for all concerned during the closure of the ward.</p>
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Cross-Border Health Services Provision

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<h3>Questions (305)</h3>
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<div class="question" id="pq_305">
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<a class="c-avatar__img-link" href="/en/members/member/Róisín-Shortall.D.1992-12-14/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Róisín-Shortall.D.1992-12-14/image/thumb" alt="Róisín Shortall"/>
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<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Róisín-Shortall.D.1992-12-14/">Róisín Shortall</a>
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<div class="content"><h4 class="from">Róisín Shortall</h4><span class="question-start">Question:</span>
<p id="para_4368" class="">305. <strong>Deputy Róisín Shortall</strong> asked the <strong>Minister for Health</strong> the cost of implementing the cross-Border directive in each year since its inception; the estimated cost for 2019; and if he will make a statement on the matter. [30388/19]</p>
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<div class="sub-header" id="pq-answers-305">
<h3>Written answers (Question to Health)</h3>
</div><div class="speech brief" id="spk_919">
<div class="c-avatar -debate -short">
<a class="c-avatar__img-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Simon-Harris.D.2011-03-09/image/thumb" alt="Simon Harris"/>
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<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">Minister for Health</a>
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<p id="para_4369" class="">As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.</p>
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Treatment Abroad Scheme

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<h3>Questions (306)</h3>
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<div class="question" id="pq_306">
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<a class="c-avatar__img-link" href="/en/members/member/Róisín-Shortall.D.1992-12-14/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Róisín-Shortall.D.1992-12-14/image/thumb" alt="Róisín Shortall"/>
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<a class="c-avatar__name-link" href="/en/members/member/Róisín-Shortall.D.1992-12-14/">Róisín Shortall</a>
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<div class="content"><h4 class="from">Róisín Shortall</h4><span class="question-start">Question:</span>
<p id="para_4370" class="">306. <strong>Deputy Róisín Shortall</strong> asked the <strong>Minister for Health</strong> the cost of implementing the treatment abroad scheme in each year since its inception; the estimated cost for 2019; and if he will make a statement on the matter. [30389/19]</p>
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<div class="sub-header" id="pq-answers-306">
<h3>Written answers (Question to Health)</h3>
</div><div class="speech brief" id="spk_920">
<div class="c-avatar -debate -short">
<a class="c-avatar__img-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Simon-Harris.D.2011-03-09/image/thumb" alt="Simon Harris"/>
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<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/en/members/member/Simon-Harris.D.2011-03-09/">Minister for Health</a>
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<p id="para_4371" class="">As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.</p>
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