Drugs in Sport

Questions (1256, 1364)

Tony McLoughlin

Question:

1256. Deputy Tony McLoughlin asked the Minister for Health his plans to address the issue of steroid abuse here particularly among young males; and if he will make a statement on the matter. [32375/19]

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Louise O'Reilly

Question:

1364. Deputy Louise O'Reilly asked the Minister for Health if he will work with sporting organisations to raise awareness of steroid and performance enhancing drug abuse in sport and run a steroid and performance enhancing drug abuse awareness campaign with sporting organisations. [32664/19]

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Written answers (Question to Health)

I propose to take Questions Nos. 1256 and 1364 together.

Anabolic steroids are synthetic versions of the male hormone testosterone. They are medicinal products and medicines containing anabolic steroids are subject to prescription control.  As authorised prescription-only medicines, they are only available on foot of a prescription from a doctor to treat specific medical conditions. The sale and supply of anabolic steroids to the public outside of a registered pharmacy is illegal.

The inappropriate use of prescription-only medicines can cause significant harm. In addition, prescription-only medicines that are supplied illegally, including anabolic steroids, have often been shown to be falsified and there can be no guarantee as to their safety, quality or efficacy.

The HSE reports that 30 cases were treated for steroids as a main problem drug between 2010 and 2016. The vast majority were male. Most cases were aged between 25 and 34 years of age. An additional 85 cases recorded steroids as an additional problem drug. Again almost all were male and most were aged between 20 and 39 years of age.

The Health Products Regulatory Authority (HPRA) is the competent authority for the implementation of EU and national legislation relating to medicines in Ireland. HPRA's role includes monitoring and inspecting medicinal products on the market to ensure their safety, efficacy and legality. HPRA works closely with the Revenue Commissioners, An Garda Síochána and international enforcement agencies to prevent the unauthorised flow of illegal medicinal products, including anabolic steroids.

Growing evidence ranging from the increasing levels of illegal products detained by the HPRA each year, as well as needle exchange figures and a number of tragic deaths highlighted in the media in recent times, point to a growth in non-medical use of anabolic steroids. The HPRA states that in 2017, working in conjunction with An Garda Síochána and the Revenue Commissioners, it detained 449,411 dosage units of illegal anabolic steroids, compared to 109,006 units in 2016 and 38,049 in 2015. HPRA research also revealed a significant proportion of Irish people are unaware of the many serious side effects caused by anabolic steroid use. 

It is also within the remit of HPRA to run campaigns in this area. They launched a targeted information and education campaign for young men in late 2018 entitled ‘Zero Gains’, to highlight to users of illegally supplied products the very significant health risks associated with taking anabolic steroids. The campaign was developed in light of growing evidence of an increased use of anabolic steroids for body enhancement, as well the research that showed a significant lack of awareness of the serious health complications posed by these products.

The campaign incorporates online search, social and digital media in addition to outdoor and in-gym adverts. A new website www.zerogains.ie was launched to provide reliable and trustworthy information on the real risks of anabolic steroid use. It also provided practical advice to help anyone who is suffering from issues with use and provides details on how members of the public can report concerns about the illegal sales and supply of steroids to the authorities.

The National Drugs Strategy Reducing Harm, Supporting Recovery- A health-led response to drug and alcohol use in Ireland 2017-2025 has an action to establish a working group to examine the evidence in relation to current and emerging trends of drug use, including the use of image and performance enhancing drugs (such as anabolic steroids). This working group will be established by the HSE in conjunction with other relevant stakeholders, including sports groups, during the lifespan of the strategy.

HIV-AIDS Programmes

Questions (1257)

Micheál Martin

Question:

1257. Deputy Micheál Martin asked the Minister for Health the timeline for the implementation of the pre-exposure prophylaxis, PrEP, HIV prevention programme. [32382/19]

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Written answers (Question to Health)

Sexual health is a priority for me and I was pleased to receive the Health Information and Quality Authority Health Technology Assessment report, which found that the introduction of a PrEP HIV prevention programme would be safe, effective and cost saving.

Considerable work is already underway in the HSE to introduce a PrEP programme, commencing in the autumn.  I have forwarded the Deputy's question to the Executive for additional information.

Disability Support Services

Questions (1258)

David Cullinane

Question:

1258. Deputy David Cullinane asked the Minister for Health if his attention has been drawn to the case of a person (details supplied) who is on a waiting list for a residential care home in County Wexford and has not been given a commencement date; and if he will make a statement on the matter. [32385/19]

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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.

HSE Staff Recruitment

Questions (1259)

Jim O'Callaghan

Question:

1259. Deputy Jim O'Callaghan asked the Minister for Health the status of the HSE recruitment embargo; and if he will make a statement on the matter. [32386/19]

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Written answers (Question to Health)

There is no recruitment embargo or moratorium in the health service at present. 

The HSE are required to operate within their allocated budget in line with the National Service Plan approved for 2019, but will proceed with the filling of posts associated with new developments while ensuring the safe delivery of services.  

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

Hospital Appointments Status

Questions (1260)

Kevin O'Keeffe

Question:

1260. Deputy Kevin O'Keeffe asked the Minister for Health if an outpatient appointment will be expedited for a person (details supplied) in County Cork. [32389/19]

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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.

Protected Disclosures Data

Questions (1261)

Catherine Murphy

Question:

1261. Deputy Catherine Murphy asked the Minister for Health the number of protected disclosures for which he has engaged an external consultancy and or legal firm since 2014 to date; the name of the firms engaged; the year and the costs associated with engaging the consultancy and or legal firms in respect of protected disclosures; the way in which persons are protected in cases in which an external consultancy firm is engaged in respect of protected disclosures; and if he will make a statement on the matter. [32401/19]

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Written answers (Question to Health)

My Department engaged three external consultancy firms to assist with five protected disclosures received during this period, as set out in the following table.

All external consultancy firms engaged by my Department must comply with the requirement to protect the identity of the discloser under section 16 of the Protected Disclosures Act 2014. Furthermore, when awarding a contract to an external consultancy firm for the provision of services under the Protected Disclosures Act 2014, a strong confidentiality agreement between my Department and the contractor is made. This is to ensure that contractor is aware of the obligations under the Act; the information provided to the contractor is only used for the purposes of the contract and the information remains confidential.

Year

Company

Number of Protected Disclosures

Total Cost (inclusive of VAT)

2018

Mazars

2

€23,264.90 

€22,140.00*

2017

Resolve Ireland

1

€9,225.00

2017

John Healy B.L.

2

€54,000.00**

* Payment of €2,398.50 (inc. VAT) made to date.

**No payment made to date.

Disease Management

Questions (1262)

Peadar Tóibín

Question:

1262. Deputy Peadar Tóibín asked the Minister for Health if he will address matters in relation to the treatment of Huntington's disease (details supplied). [32413/19]

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Written answers (Question to Health)

Huntington's Disease is an inherited disease that causes the progressive breakdown (degeneration) of nerve cells in the brain and can cause a range of symptoms. This disease has a broad impact on a person's functional abilities and usually results in movement, thinking (cognitive) and psychiatric disorders. Diagnosis is based on clinical symptoms and signs in an individual with a parent with proven Huntington's Disease and is confirmed by confirmation of the presence of the Huntington's Disease gene. There is no cure. Management is multi-disciplinary and is based on treating symptoms with a view to improving quality of life.

Any patient is eligible to apply to the Drugs Payment Scheme or to apply for a Medical Card. In addition, under the Drug Payment Scheme, no individual or family pays more than €124 a month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines. People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card or other state financial supports. In the assessment process, the HSE can take into account medical costs incurred by an individual or a family.  People who are not eligible for a medical card may still be able to avail of a GP visit card, which covers the cost of GP consultations. The Department of Employment Affairs and Social Protection can provide further information on the supports and services they can provide including Illness Benefit, Disability Allowance, Carer’s Allowance, Carer’s Benefit and Carer’s Support Grant.

General medical services are provided by GPs. If the patients clinical condition warrants a referral to a Consultant then their GP will organise that for them. A patient's Local Health Office is the entry point to access wider community health and personal social services. In addition to GP services these also include public health nursing, community welfare, speech therapy, social work, physiotherapy, occupational therapy, chiropody, psychiatric services and home help. The Department of Health also supports a non-condition specific approach to the delivery of health and personal social services to people with a disability. The overarching principle governing the planning and delivery of health services and supports for adults and children with disabilities, is that they should be integrated as much as possible with services and supports for the rest of the population. The Government’s policy in this regard is set out in the National Disability Inclusion Strategy (NDIS) which was published by the Department of Justice and Equality in July 2017

There are no plans to add this condition to the list of conditions currently listed under the Long-Term illness scheme. Instead, Sláintecare is focused on the need to expand entitlement and eligibility as part of a transition towards universal health and social care access. In 2019-2020 various entitlement and eligibility scenarios will be modelled and costs and benefits will be examined. Sláintecare proposes providing universal services at no or low cost to the patient / service user. Sláintecare will report on how, when, and in what order of priority this could be done and make proposals to government for consideration.

This question also concerns service matters and as such it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Hospital Appointments Status

Questions (1263)

Michael Healy-Rae

Question:

1263. Deputy Michael Healy-Rae asked the Minister for Health if surgery will be expedited for a person (details supplied); and if he will make a statement on the matter. [32414/19]

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.

Nursing and Midwifery Board of Ireland

Questions (1264, 1265)

Catherine Connolly

Question:

1264. Deputy Catherine Connolly asked the Minister for Health his views on the delays in the NMBI in relation to the processing of applications from overseas applicants; the number of persons waiting to have their applications processed by length of time waiting in months in tabular form; the plans in place to address the backlog at the NMBI; the anticipated timeframe to clear the backlog; and if he will make a statement on the matter. [32415/19]

View answer

Catherine Connolly

Question:

1265. Deputy Catherine Connolly asked the Minister for Health the number and grade including permanent, temporary and contract of staff at the NMBI involved in the administrative process in relation to the processing of applications from overseas applicants; the number of files per day per person that can be processed; and if he will make a statement on the matter. [32416/19]

View answer

Written answers (Question to Health)

I propose to take Questions Nos. 1264 and 1265 together.

As this is an operational matter, I have referred the Deputy's questions to the NMBI for attention and direct reply.

Nursing and Midwifery Board of Ireland

Questions (1266, 1267)

Catherine Connolly

Question:

1266. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Question No. 674 of 11 June 2019, if a copy of the response issued by the Nursing and Midwifery Board of Ireland, NMBI, will be provided; and if he will make a statement on the matter. [32417/19]

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Catherine Connolly

Question:

1267. Deputy Catherine Connolly asked the Minister for Health the reason it took from September 2014 to 11 June 2019 to raise with the board of the Nursing and Midwifery Board of Ireland, NMBI, the matter of inappropriate expenditure of midwives and nurses fees on legal expenses for a person (details supplied) named in a protected disclosure; if he is satisfied that the matter is now resolved; and if he will make a statement on the matter. [32418/19]

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Written answers (Question to Health)

I propose to take Questions Nos. 1266 and 1267 together.

Parliamentary Question No 674 of 11 June 2019 raised a query about a contribution made by the Nursing and Midwifery Board of Ireland (NMBI) towards the legal costs of a person. On foot of that question, my Department requested the NMBI to provide details to the Deputy who raised the question. In its response, the NMBI stated that "the protected disclosure process took place over a period of almost two years. Persons who are subject to protected disclosures are entitled to due process. NMBI did pay towards the legal costs of a person whose actions were the subject of a protected disclosure".

As I have stated previously, a protected disclosure was submitted to my Department in September 2014. That matter was subject to external review and, on foot of that review, two reports were commissioned. In view of the reports commissioned, the findings of same, and the steps taken by the NMBI to implement the recommendations of the reports, I am satisfied that significant action has been taken on foot of the complaints made. These complaints were an important input to the enhancement of governance in the NMBI.

Cross-Border Health Services Provision

Questions (1268)

Robert Troy

Question:

1268. Deputy Robert Troy asked the Minister for Health if an application for a cross-Border refund will be expedited for a person (details supplied). [32421/19]

View answer

Written answers (Question to Health)

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

Medical Aids and Appliances Provision

Questions (1269)

Róisín Shortall

Question:

1269. Deputy Róisín Shortall asked the Minister for Health the steps he will take to make the FreeStyle Libre device available to persons with type 1 diabetes; the reason for the delay; and if he will make a statement on the matter. [32454/19]

View answer

Written answers (Question to Health)

Under 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.

Hospitals Data

Questions (1270)

Louise O'Reilly

Question:

1270. Deputy Louise O'Reilly asked the Minister for Health the number of medical facilities including maternity theatres, hospital wards, surgical theatres and so on which are not operational or have been closed due to staff shortages or funding issues; the location of same; the cost of maintenance, security, cleaning and so on; the length of time they have been closed or non-operational; the reason they are not in operation in tabular form (details supplied); and if he will make a statement on the matter. [32456/19]

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.

Mental Health Services Data

Questions (1271)

Louise O'Reilly

Question:

1271. Deputy Louise O'Reilly asked the Minister for Health the waiting lists for adults for mental health services by LHO and CHO in tabular form. [32457/19]

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 (1272)

Louise O'Reilly

Question:

1272. Deputy Louise O'Reilly asked the Minister for Health the number of persons in each LHO area waiting for a counselling appointment in primary care at the end of June 2019 or the latest date available; and the number waiting zero to 12, 12 to 26, 26 to 52 and more than 52 weeks, respectively. [32458/19]

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.

Child and Adolescent Mental Health Services Data

Questions (1273)

Louise O'Reilly

Question:

1273. Deputy Louise O'Reilly asked the Minister for Health the number of persons in each LHO area waiting for a child and adolescent mental health services appointment at the end of June 2019 or the latest date available; and the number waiting zero to 12, 12 to 26, 26 to 52 and more than 52 weeks, respectively. [32459/19]

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 (1274)

Louise O'Reilly

Question:

1274. Deputy Louise O'Reilly asked the Minister for Health the number of persons in each LHO area waiting for a psychology appointment in primary care at the end of June 2019 or the latest date available; and the number waiting zero to 12, 12 to 26, 26 to 52 and more than 52 weeks, respectively. [32460/19]

View answer

Written answers (Question to Health)

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

Mental Health Services Data

Questions (1275)

Louise O'Reilly

Question:

1275. Deputy Louise O'Reilly asked the Minister for Health the number of children admitted to adult mental health units between 1 January and 30 June 2019. [32461/19]

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.

Nursing Staff Remuneration

Questions (1276)

Robert Troy

Question:

1276. Deputy Robert Troy asked the Minister for Health the steps he is taking in conjunction with the HSE to increase levels of pay in the nursing sector; the steps being taken to increase the pay scale for newly qualified nurses; and his views on whether pay scale rates are causing a large portion of graduates to seek employment overseas and denying hospitals here of highly trained personnel. [32463/19]

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Written answers (Question to Health)

The recent Labour Court recommendations in relation to the nurses dispute and the new Enhanced Practice Nurse/Midwife contract will see the financial position of nurses and midwives improve and should  help to both recruit and retain nurses in  the public health service.  I welcome the fact that the INMO membership voted 62% in favour of accepting these recommendations and the new contract.  

In relation to pay, the new Enhanced Practice Nurse and Midwife contract will deliver salary improvements for those that migrate to this new role range from between 2% - 11%.  The Enhanced Nurse / Midwife Practice salary scale ranges between €35,806 to €47,201.  The agreement will see improvements to a range of allowances, their extension to additional nurses and midwives, and a new allowance for those in medical surgical wards up to the maximum full year cost of €10m.  It also includes a commitment to increase the number of Advanced Nurse Practitioners to a minimum of 2% of the nursing workforce.

Implementation of the agreement should commence in the near future.

Chronic Disease Management Programme

Questions (1277)

John Brassil

Question:

1277. Deputy John Brassil asked the Minister for Health the status of the planned 2019 review for the models of care for chronic illnesses; and if he will make a statement on the matter. [32467/19]

View answer

Written answers (Question to Health)

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Medicinal Products Data

Questions (1278)

John Brassil

Question:

1278. Deputy John Brassil asked the Minister for Health the status of the governance review of the drugs approval and procurement process; and if he will make a statement on the matter. [32468/19]

View answer

Written answers (Question to Health)

The Department completed a tender process for a review of the HSE reimbursement and pricing decision-making process. Mazars has been appointed as the consultancy firm to complete this review. Work on the review is progressing.

The review will make recommendations, as considered appropriate, in respect of any required improvements to the HSE’s systems, structures, processes, governance arrangements or use of specialist resources in respect of the review.

In making its recommendations, the review will have regard to best practice regarding the procurement of medicines, the conduct of high-value commercial negotiations, governance, organisational structures, skill-mix and oversight.

Health Services Data

Questions (1279)

John Brassil

Question:

1279. Deputy John Brassil asked the Minister for Health the status of the development of proposals for multi-annual budgeting in the healthcare system; if consideration is being given to creating multi-annual budgets for the reimbursement of medicines; and if he will make a statement on the matter. [32469/19]

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Written answers (Question to Health)

The Sláintecare Implementation Strategy commits to reform the funding system to support new models of care and drive value to make better use of resources. In this regard the Department is examining the feasibility of implementing multi-annual budgeting in the healthcare system. Part of this work includes examining international best practice in this area.

Currently there is no separate budget for medicine reimbursement. The 2019 letter of determination sets out the funding levels for the HSE each year and this informs the NSP. 

The 2019 NSP set out a budget of €2,737.6 m which was allocated to the Primary Care Reimbursement Service. This budget is profiled over 12 months in order to reflect how expenditure is expected to be incurred each month. Funding for new medicines / treatments are built into this budget during the estimates process.