Written Answers Nos. 1105-1129
1105. Deputy Louise O'Reilly asked the Minister for Health the emergency department waiting times greater than 24 hours for persons over 75 years of age to date in 2019; if the targets were met; if not, the number of persons over 75 years of age that had a wait of more than 24 hours in an emergency department to date in 2019, by month and hospital in tabular form; and if he will make a statement on the matter. [31727/19]
View answerThe hospital system is currently operating at close to full capacity. The number of patients attending Emergency Departments continues to increase year on year, with approximately 1.3 million attendances in 2018, up 3.5% on 2017. For the first six months of 2019, the number of patients over the age of 75 attending hospital EDs increased by 2.6% compared to the same period last year. This reflects increasing demand for unscheduled care, especially by patients in the 75 years and over age group.
However, the National Service Plan 2019 includes an expected activity target that 99% of patients aged 75 and over attending at an Emergency Department are discharged or admitted within 24 hours and any breach of this target in respect of patients in this age cohort is unacceptable.
With regard to the Deputy's specific question, I have asked the HSE to respond to the Deputy directly with the requested information.
1106. Deputy Louise O'Reilly asked the Minister for Health the number of persons in each local health office, LHO, area waiting for an ophthalmology appointment in primary care at the end of June 2019 or the latest date available; and the number waiting zero to 12 weeks, 12 to 26 weeks, 26 to 52 weeks, and more than 52 weeks, respectively. [31728/19]
View answerAs this is a service matter it has been referred to the HSE for reply to the Deputy.
1107. Deputy Louise O'Reilly asked the Minister for Health the number of persons in each local health office, LHO, area waiting for an audiology appointment in primary care at the end of June 2019 or the latest date available; and the number waiting zero to 12 weeks, 12 to 26 weeks, 26 to 52 weeks, and more than 52 weeks, respectively. [31729/19]
View answerAs this is a service matter it has been referred to the HSE for reply to the Deputy.
1108. Deputy Louise O'Reilly asked the Minister for Health the number of persons in each local health office, LHO, area waiting for a dietetics appointment in primary care at the end of June 2019 or the latest date available; and the number waiting zero to 12 weeks, 12 to 26 weeks, 26 to 52 weeks, and more than 52 weeks, respectively. [31730/19]
View answerAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
1109. Deputy Louise O'Reilly asked the Minister for Health the number of persons in each local health office, LHO, area waiting for an oral health appointment in primary care at the end of June 2019 or the latest date available; and the number waiting zero to 12 weeks, 12 to 26 weeks, 26 to 52 weeks, and more than 52 weeks, respectively. [31731/19]
View answerAs this is a service matter it has been referred to the HSE for reply to the Deputy.
1110. Deputy Louise O'Reilly asked the Minister for Health the number of children and adults, respectively, waiting for initial speech and language therapy assessment at 28 June 2019, by community healthcare organisation, CHO, and local health office, LHO, area, in tabular form; the comparative figure as at 28 June 2019; and if he will make a statement on the matter. [31732/19]
View answer1111. Deputy Louise O'Reilly asked the Minister for Health the number of children and adults, respectively, waiting for initial speech and language therapy assessment at 28 June 2019 by community healthcare organisation, CHO, and local health office, LHO, area, in tabular form; and the number waiting zero to 12 weeks, 12 to 26 weeks, 26 to 52 weeks, and more than 52 weeks, respectively. [31733/19]
View answerI propose to take Questions Nos. 1110 and 1111 together.
As these questions relate to service matters, I have arranged for them to be referred to the Health Service Executive (HSE) for direct reply.
1112. Deputy Peter Burke asked the Minister for Health if there are weight loss clinics run by the HSE in County Longford; and if the case of a person (details supplied) will be addressed further to their circumstances. [31734/19]
View answerAs the question relates to service matters, it has been referred to the HSE for direct reply to the Deputy.
1113. Deputy Niamh Smyth asked the Minister for Health the financial assistance available for families that need to undergo IVF treatment as in the case of a person (details supplied). [31735/19]
View answer1247. Deputy Catherine Murphy asked the Minister for Health when the fund in respect of publicly funded assisted human reproduction will be made available; the way in which prospective patients will apply; if he will make access to the fund available on a retrospective basis; if persons will have access to the fund at a later date in respect of the treatment should they opt for assisted human reproduction before the scheme is introduced; and if he will make a statement on the matter. [32343/19]
View answer1353. Deputy Frank O'Rourke asked the Minister for Health if the review of the assisted human reproduction Bill has been completed further to his announcement in December 2018 that funding was to be provided for fertility treatment under the public health system; if so, the details on the scheme; if the application process is now open; if funding applications will be means tested; if funding will be backdated to 2018 for applicants; and if he will make a statement on the matter. [32647/19]
View answer1422. Deputy Kathleen Funchion asked the Minister for Health the progress made regarding free fertility treatment for couples experiencing such difficulties; and if he will make a statement on the matter. [32833/19]
View answer1532. Deputy Éamon Ó Cuív asked the Minister for Health his plans to provide free IVF services to those that need such treatment; if this service will be means tested; and if he will make a statement on the matter. [33291/19]
View answer1630. Deputy Niamh Smyth asked the Minister for Health the financial assistance in place for families that need to undergo IVF treatment; and if he will make a statement on the matter. [33638/19]
View answerI propose to take Questions Nos. 1113, 1247, 1353, 1422, 1532 and 1630 together.
In October 2017, the Government approved the drafting of a bill on assisted human reproduction (AHR) and associated areas of research, based on the published General Scheme of the Assisted Human Reproduction Bill. The Joint Oireachtas Committee on Health published the report of its review of the General Scheme on 11 July 2019, as part of the pre-legislative scrutiny process, which began in January 2018. The Committee makes 11 main recommendations, which include proposals both related to broad policy objectives and more technical amendments. Given the comprehensive scope of the legislation and the ethical, legal and social issues which arise from AHR practices, it is anticipated that certain areas of the General Scheme will require further consideration and refinement during the ongoing process of drafting the bill. The Joint Committee’s Report and its recommendations will be considered as part of this process.
Interlinked with the legislation, officials in my Department, in conjunction with the HSE, are developing a model of care for infertility and an associated public fund for AHR. This work includes developing proposals on the allocation of the €1 million fund for use in relation to AHR which was announced in December 2018.
Accordingly, options in relation to the parameters of any potential public funding model, including what eligibility criteria may be included, are still under consideration, and an announcement will be forthcoming once the relevant decisions have been finalised.
It should be noted that while AHR treatment is not currently funded by the Irish Public Health Service, a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Arrangements administered by the HSE. Medicines covered by the High Tech Arrangements must be prescribed by a consultant/specialist and authorised for supply to the client’s nominated community pharmacy by the High Tech Hub managed by the Primary Care Reimbursement Service. The cost of the medicines is then covered, as appropriate, under the client’s eligibility, i.e., Medical Card or Drugs Payment Scheme. I understand that the impact on the total cost of AHR treatment for individuals who avail of these schemes is not insignificant.
In addition, there is other support available in that patients who access IVF treatment privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme.
Overall, the development of a model of care for infertility will help to ensure the provision of safe, effective and accessible services through the public health system as part of the full range of services available in obstetrics and gynaecology.
1114. Deputy Seán Crowe asked the Minister for Health the reason for the decision to grant Spinraza to 25 persons under 18 years of age while 18 other adults are denied access to the drug. [31736/19]
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 to be applied in the making of reimbursement decisions which include the clinical and cost effectiveness of the product, the opportunity cost and the impact on resources that are available to the HSE.
As Minister for Health, I do not have any statutory power or function in relation to the reimbursement of medicines.
However, I can advise that on 11 June 2019, the HSE Leadership Team approved access to the drug Nusinersen (Spinraza) for children with Spinal Muscular Atrophy (SMA) Type I, II or III on an exceptional and individualised basis.
The HSE decision process in relation to Spinraza involved a full Health Technology Assessment followed by detailed consideration by the HSE expert groups on new drug therapies, including the Technology Review Group for Rare Diseases and the HSE Drugs Committee. Evidence of the clinical effectiveness of this new drug therapy was also reviewed.
After a thorough review of all of the data it was decided to approve access for children with genetically confirmed SMA Type I, II or III, in accordance with the controlled access criteria recommended by the Rare Diseases Technology Review Committee. The rare diseases committee recommendation was clearly targeted at the youngest and most severely affected SMA patients, and this group is the clear priority for the HSE. The actual patient assessment and approval process will be the means for determining access on an individual case by case basis.
1115. Deputy Robert Troy asked the Minister for Health if an appointment will be scheduled for a person (details supplied). [31743/19]
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.
1116. Deputy Robert Troy asked the Minister for Health if an appointment will be scheduled for a person (details supplied). [31744/19]
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.
1117. Deputy Kathleen Funchion asked the Minister for Health the reason for the delay in respect of agreed and promised overnight respite for a person (details supplied); the reason no commitment has been given for the transition to take place and agreement on the timeframe under which it should happen has been reached; the reason the recommendation and approval for increasing overnight respite care for the person from two to four nights have yet to be implemented; and if he will make a statement on the matter. [31751/19]
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.
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 an individual case, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
1118. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) in County Donegal will receive an appointment from Letterkenny University Hospital for a medical procedure; and if he will make a statement on the matter. [31752/19]
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.
1119. Deputy Sean Sherlock asked the Minister for Health the status of a medical card application review in respect of a person (details supplied) in County Cork. [31753/19]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
1120. Deputy Seán Haughey asked the Minister for Health when a person (details supplied) will be invited for a full assessment of needs at a centre; and if he will make a statement on the matter. [31756/19]
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 a 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.
1121. Deputy Seán Haughey asked the Minister for Health when a person (details supplied) will receive occupational therapy at the primary care centre in Blanchardstown, Dublin 15; and if he will make a statement on the matter. [31757/19]
View answerAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
1122. Deputy Seán Haughey asked the Minister for Health when a person (details supplied) will receive an appointment for a hip replacement at Temple Street Children’s University Hospital; and if he will make a statement on the matter. [31759/19]
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.
1124. Deputy Mary Butler asked the Minister for Health when the new residential care centre at St. Patrick’s Hospital, Waterford will be operational; when the facility will take in its first patients; if staff will be utilised from existing staffing levels; if funding will be allocated for additional staff being recruited; and if he will make a statement on the matter. [31782/19]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1125. Deputy Margaret Murphy O'Mahony asked the Minister for Health the status of the national clinical programme for rheumatology; the status including timelines, locations and so on, on the proposed roll-out of pilot treatment programmes; the budgets in place for the programmes for 2019, 2020 and 2021; and if he will make a statement on the matter. [31790/19]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
1126. Deputy Stephen Donnelly asked the Minister for Health the capital projects in health infrastructure underway by county or local health office area in tabular form; the date of the commencement of each project; the timeframe for completion of same; the estimated cost of each at commencement of the project; and if he will make a statement on the matter. [31791/19]
View answerAs the Health Service Executive is responsible for the delivery of healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
1127. Deputy James Lawless asked the Minister for Health if the recruitment embargo in the HSE has been lifted as planned; and if he will make a statement on the matter. [31794/19]
View answerThere 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.
1128. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) in County Donegal can expect to be reimbursed from the HSE for a procedure carried out in Belfast through the cross-border healthcare directive; and if he will make a statement on the matter. [31801/19]
View answerAs this is a service matter I have asked the HSE to reply directly to the Deputy.
1129. Deputy Louise O'Reilly asked the Minister for Health further to Parliamentary Question No. 623 of 8 May 2019, if the organisation (details supplied) that is collecting samples and data from patients attending clinics in order to build a database of genetic information on Irish persons have done this on the basis of informed consent; if those whose data were collected were informed of the body or bodies which would have access to the samples; if they were informed of what samples and related personal data would be used for; if not, his plans regarding same; and the consequences, legal and other, in this regard. [31808/19]
View answerGMI is a commercial R&D genomics company and as such the Minister cannot speak definitively on specific matters pertaining to GMI.
The Minister is, however, very clear on the regulatory, ethical and other prevailing best practice conditions necessary for the conduct of health research in Ireland (academic-led, hospital-led or commercially-led) - all of which place participant consent as the critical cornerstone.
Health research is important. It means enhanced care for patients. It also promotes the recruitment and retention of outstanding clinicians, ensures better returns on healthcare expenditure and supports broader Government goals of employment and economic gain. For all those reasons, the Government is committed to the continued development of a research-active health system in Ireland. That commitment has already seen significant public investment in physical infrastructure, personnel, new skills and technology. At the same time, the Government is equally determined to ensure good research governance as well as appropriate and streamlined regulatory processes. The trust of patients is seen as critical to ensuring a vibrant, innovative and well-regulated health research sector.
The Health Research Regulations were made, last August, by the Minister for Health under section 36 of the Data Protection Act 2018. The purpose of the Regulations is to support health research by helping to build greater public confidence in the way individuals’ health data are collected, used and disclosed for health research. Building that confidence is seen by the Minister as essential to the long term success of health research in Ireland.
The Regulations set out for the first time in Irish legislation sound information governance principles that are in line with law and international best practice in health research. They also ensure that there is certainty, consistency and clarity for all health researchers on what the rules are. From the data subject’s perspective, the Regulations place a heightened emphasis on transparency. Further, given the sensitivity of personal health data and the fact that genetic data is now expressly referenced as a special category of personal data in GDPR, the regulations have a requirement for explicit consent as an Article 9(2)(j) “suitable and specific safeguard” for the processing of personal data for health research.
The Minister for Health made such Regulations in the area of processing personal data for health research for two related reasons:
- to bring certainly, clarity and consistency to the relevant rules (something the health research sector had been seeking for a long time) and
- to ensure that data subjects could be confident that the processing of their sensitive personal data was subject to safeguards that would encourage them to provide their information for health research projects.
The processing of personal data for health research purposes has an applicable legal framework that goes beyond data protection.
At international level, the European Convention on Human Rights (ECHR) and the case law of the court both attach considerable importance to privacy and confidentiality when it comes to medical records. The ECHR reflects the longstanding Common Law duty of confidentiality between health professionals and patients. Breach of the common law duty confidentiality (without justifiable reasons) would leave the health professional open to a civil action and a complaint to his or her professional regulatory body.
At the level of Bunreacht na hEireann, the Courts have held that the Constitution includes an unenumerated right to privacy.
In the last five-six decades recognition of the moral right of research subjects to make their own choice or to self-determine or decide on the research participation has been one of the most important developments in the field of ethics related to research involving human subjects. As such, all research projects involving human participants in Ireland are required to undergo a robust review by a Research Ethics Committee and approval from a REC is required to advance any study. As an ethical principle, a REC must be satisfied that the law has been followed and that the consent of the individual data subject has been obtained where it is intended to access and use his or her medical records.
The Article 29 Guidance on the GDPR prepared by the EU Data Protection Board makes clear that consent should be given by a clear affirmative act establishing a freely given, specific, informed and unambiguous indication of the data subject’s agreement to the processing of personal data relating to him or her, such as by a written statement, including by electronic means, or an oral statement. It also makes clear that consent should cover all processing activities carried out for the same purpose or purposes and when the processing has multiple purposes, consent should be given for all of them. For consent to be informed, the data subject should be aware at least of the identity of the controller and the purposes of the processing for which the personal data are intended.
This and further detailed guidance for the research community has been provided repeatedly and at numerous events and fora by Department officials, and with the support of the Health Research Board.
As the regulator in this area, the only organisation who can categorically assess and confirm whether the research-related activities of GMI, or any research investigator, satisfy the GDPR requirements of transparency and consent is the Data Protection Commission.
