Rehabilitative Training Allowance Payments

Questions (206, 207)

Pearse Doherty

Question:

206. Deputy Pearse Doherty asked the Minister for Health if the rehabilitative training allowance for new entrants will be reinstated; and if he will make a statement on the matter. [48158/19]

View answer

Pearse Doherty

Question:

207. Deputy Pearse Doherty asked the Minister for Health if his attention has been drawn to the inequality new entrants are encountering caused by the decision to cease the rehabilitative training allowance for new entrants; and if he will make a statement on the matter. [48159/19]

View answer

Written answers (Question to Health)

I propose to take Questions Nos. 206 and 207 together.

This 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. The 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 payment of the Rehabilitative Training (RT) Bonus came into place on the transition of Rehabilitative/Training Programmes to the HSE following the dissolution of the National Rehabilitation Board in June 2000.

The decision to phase out the Rehabilitative Training (RT) Bonus payment is designed to bring equity and consistency between people with a disability attending HSE funded rehabilitative training programmes who receive the payment, and those attending similar HSE funded Day Services or in other State schemes such as further education and training, who do not.

This action will ensure all HSE funded Day Services are provided on an equitable basis and will also ensure that the use of finite resources is maximised.

The Rehabilitative Training (RT) Bonus Payment is a historical payment, introduced in July 2001, aligned with a similar FÁS Training Bonus. However, during 2011 the FÁS Training Bonus was reduced to €20.00 and then eliminated the following year while to date the RT Bonus Payment has continued to be paid in the Health Sector

It is worth remembering that:

- There is no cut in the number of RT places available

- There is no cut in payment of the bonus - those who have it will continue to receive it for the remainder of their RT Placement

- The majority of attendees of HSE Disability Services, including Rehabilitative Training programmes, qualify for Disability Allowance, paid at the rate of €203 per week, which also qualifies them for a Free Travel Pass.

- No expectation of an additional RT bonus payment has been created by HSE for 2019 participants

The redirected funding (€3.7 m over 4 years), which will be ring-fenced, will facilitate either 148 new full day placements or 370 enhanced day places nationally based on priority need (a mixture of both is likely).

Each CHO will have the flexibility to redirect its own savings to address local service requirements. The HSE will put in place a monitoring system and regularly report the additional placements realised to the Department of Health.

Departmental Expenditure

Questions (208)

Jack Chambers

Question:

208. Deputy Jack Chambers asked the Minister for Health the amount spent on bottled water and disposable coffee cups by his Department to date in 2019; and if he will make a statement on the matter. [48192/19]

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Written answers (Question to Health)

My Department is working closely with the Department of Communications, Climate Action and Environment identifying specific actions aimed at promoting public sector behaviours which are consistent with the Government’s environmental policy. 

As a Department, we are well advanced in these areas and have initiated multiple internal initiatives including the elimination of the purchase of single-use bottled water and single-use plastic cups in Q3 2018. 

We do provide water using refillable water dispensers within the Department.  All our water dispenser bottles are collected and subsequently reused.  The following table outlines the costs involved to date in 2019.

Disposable coffee cups were provided for staff up until August 2019, the cups supplied were all compostable cups.

2019

Water Bottles

Disposable Coffee cups

Water Cooler Bottles

 

 €                     -  

 €                                                                         147.49

 €                                            15,571.41

Freedom of Information Data

Questions (209)

Barry Cowen

Question:

209. Deputy Barry Cowen asked the Minister for Health the date of each review and revision of the material published under the publication scheme of his Department as outlined in section 8 of the Freedom of Information Act 2014; and if he will make a statement on the matter. [48209/19]

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Written answers (Question to Health)

The requirement, under section 8 of the Freedom of Information legislation, to publish a Publication Scheme was completed, by my Department, within the legislative timeframe.

Our Publication Scheme is primarily made up of links to the relevant pages on our website.  Therefore, the Scheme is continually being updated in accordance with updates made by all Units within my Department. 

Other information (e.g. log of Freedom of Information requests received etc.) is updated quarterly in arrears.  The latest update was in March of this year and the second and third quarter information is currently being worked on and it is hoped to have it published shortly.

Nursing Homes Support Scheme Data

Questions (210)

Mary Butler

Question:

210. Deputy Mary Butler asked the Minister for Health the number of persons awaiting placement under the fair deal scheme as of 15 November 2019 or the latest date available; the average waiting time; the number of persons awaiting placement under the scheme by local health area in tabular form; and the length of time waiting. [48220/19]

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.

Home Help Service Data

Questions (211)

Mary Butler

Question:

211. Deputy Mary Butler asked the Minister for Health the number of home support hours being provided in each LHO area as of 15 November 2019 or the latest date available; the way in which this compares to target in each LHO for the same time period; the number of persons on the waiting list for home support hours in each LHO area; and the number waiting 0 to three, three to six, six to 12 and more than 12 months, respectively in tabular form. [48221/19]

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.

Services for People with Disabilities

Questions (212)

Niamh Smyth

Question:

212. Deputy Niamh Smyth asked the Minister for Health if correspondence (details supplied) will be reviewed; if his attention has been drawn to the gravity of this matter; if he will prevent the closure of the facility; and if he will make a statement on the matter. [48223/19]

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

HSE Reviews

Questions (213)

John Brassil

Question:

213. Deputy John Brassil asked the Minister for Health if the findings of the review of the HSE reimbursement and pricing decision-making process undertaken by a firm (details supplied) will be published; the date his Department received these findings; if his Department will be implementing recommendations received; and if he will make a statement on the matter. [48230/19]

View answer

Written answers (Question to Health)

Work on the review of the HSE reimbursement and pricing decision-making process is ongoing. The review, conducted by Mazars, is progressing and on completion my officials will consider its findings.

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.

Medicinal Products

Questions (214)

John Brassil

Question:

214. Deputy John Brassil asked the Minister for Health the status of the implementation of the HSE’s best-value biologics process; if the HSE has plans to review this process to drive greater adoption of the designated best-value biological drug; if the HSE will expand this programme to further therapy areas in which a biosimilar drug is available here; and if he will make a statement on the matter. [48231/19]

View answer

Written answers (Question to Health)

The Health Service Executive has operational responsibility for best-value biological medicines, thus the matter has been referred to the HSE for their attention and direct reply to the Deputy.

Medicinal Products

Questions (215)

John Brassil

Question:

215. Deputy John Brassil asked the Minister for Health the status of the planned development of a national biosimilar medicines policy statement; and if he will make a statement on the matter. [48232/19]

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Written answers (Question to Health)

Since 2017, my Department has been engaged in public consultation activities and in the exploration and implementation of a number of operational policy levers to both increase awareness and to facilitate the use of biosimilar medicines.

At an operational level, the HSE's Acute Hospitals Drugs Management Programme has a biosimilar strategy in place since 2017, which is making considerable progress using a collaborative approach with hospital pharmacists and clinical teams to bring about changes in prescribing practice. Hospitals are working towards a HSE targeted minimum prescribing rate for biosimilars of 50%.

The HSE is also working on identifying barriers to the prescribing of biosimilars, with a specific focus on education and support. It is seeking to increase understanding of biosimilars through targeted presentations to clinicians and hospitals.  This is proving promising, for example the prescribing rate for the biosimilar drug Infliximab increased from 5% in 2017 to 40% in 2018.

In May 2019, the HSE Medicines Management Programme completed the evaluation process for the identification of the best-value biological (BVB) medicines for TNF- inhibitors on the High-Tech Drug arrangements. In June 2019 the HSE introduced a system of gain-share to encourage the prescribing of the BVB medicines.

Drawing together all of these  initiatives  my Department, in collaboration with a number of agencies, is currently developing a National Biosimilar Medicines Policy Statement. The aim of the statement and supporting documentation is to highlight and endorse the many initiatives that are already underway in Ireland and thereby to promote confidence in biosimilar use among healthcare professionals.

Health Services Staff Recruitment

Questions (216)

Niamh Smyth

Question:

216. Deputy Niamh Smyth asked the Minister for Health if a case (details supplied) will be reviewed; if the matter will be investigated and referred to the HSE for reply; and if he will make a statement on the matter. [48233/19]

View answer

Written answers (Question to Health)

I have referred this matter to the HSE for direct reply to you.

Disability Services Funding

Questions (217)

John Curran

Question:

217. Deputy John Curran asked the Minister for Health if his Department and the HSE will review the funding being made available to an organisation (details supplied) who provide preschool for children with intellectual disabilities; and if he will make a statement on the matter. [48237/19]

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.

Departmental Expenditure

Questions (218)

Barry Cowen

Question:

218. Deputy Barry Cowen asked the Minister for Health the amount spent on public relations, promotion and advertising, including multimedia, in his Department in each of the years 2016 to 2018 and to date in 2019 (details supplied) in tabular form; and if he will make a statement on the matter. [48248/19]

View answer

Written answers (Question to Health)

I have provided below, in tabular form, the details of the amount spent on public relations, promotion and advertising including multimedia by the Department of Health for the years 2016 through 2018, and to date in 2019. I have also included a summary below.

2016: €32,746.17

2017: €25,354.70

2018: €433,677.74

2019: €898,902.46

Table 1

Table 2

Table 3

Table 4

Midwifery Services

Questions (219)

Thomas P. Broughan

Question:

219. Deputy Thomas P. Broughan asked the Minister for Health the staffing levels of midwives in HSE maternity units and hospitals; the number by which these staff numbers fall short or exceed the birthrate plus metric; and if he will make a statement on the matter. [48260/19]

View answer

Written answers (Question to Health)

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

Medicinal Products Availability

Questions (220)

Thomas P. Broughan

Question:

220. Deputy Thomas P. Broughan asked the Minister for Health if he will report on the availability of the new medicine trikafta for persons with cystic fibrosis; and if he will make a statement on the matter. [48261/19]

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.

Reimbursement is for licensed indications which have been granted a market authorisation by the European Medicines Agency or the Health Products Regulatory Authority. With respect to Trikafta, no such market authorisation has been granted by the European Medicines Agency.

In line with the 2013 Act and the Framework Agreement on the Supply and Pricing of Medicines agreed with industry, if a company would like a medicine to be reimbursed by the HSE, the company must submit an application to the HSE to have the new medicine added to the reimbursement list.

As outlined in the Framework Agreement, and in line with the 2013 Act, the HSE will decide, within 180 days of receiving the application (or a longer period if further information is sought from the company), to either add the medicine to the reimbursement list or agree to reimburse it as a hospital medicine, or refuse to reimburse the medicine.

HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on 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 is cost-effective as a health intervention.

Tobacco Control Measures

Questions (221)

Thomas P. Broughan

Question:

221. Deputy Thomas P. Broughan asked the Minister for Health his views on plans to regulate vaping; if he is considering an outright ban on the practice; and if he will make a statement on the matter. [48262/19]

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Written answers (Question to Health)

In October of this year I received Government approval to draft the Public Health (Tobacco Products and Nicotine Inhaling Products) Bill. The Bill will include provisions to prohibit the sale of nicotine inhaling products, including e-cigarettes, to and by persons under 18 years and will introduce a licensing system for the retail sale of nicotine inhaling products.

E-cigarettes are already regulated by the European Union (Manufacture, Presentation and Sale of Tobacco and Related Products) Regulations 2016 (S.I. No. 271 of 2016) which transpose EU Directive 2014/40/EU on Tobacco and Related Products.

The Regulations provide for mandatory safety and quality requirements for e-cigarettes and refill containers, including maximum nicotine concentrations for e-cigarettes containing nicotine, and maximum volumes for cartridges, tanks and nicotine liquid containers. In addition, the Regulations require e-cigarette manufacturers or importers to notify the Health Service Executive of all products that they place on the market and, if a manufacturer, importer or distributor has a reason to believe that a product is not safe, they are required to immediately notify the Health Service Executive and to explain what corrective action has been taken.

Under the Regulations there must be health warnings on packaging which advise consumers that e-cigarettes contain nicotine which is a highly addictive substance. Finally the Regulations prohibit advertisements for e-cigarettes on television and radio, online, and in printed publications, other than publications directed at persons in the e-cigarette industry or publications outside the EU.

The current position on e-cigarettes is based on advice from the Health Information and Quality Authority (HIQA) in its 2017 Health Technology Assessment of Smoking Cessation Products and Services. In relation to the safety of e-cigarettes the HIQA assessment concluded that this remains an evolving area of research and that while potentially safer than smoking, evidence on long-term safety has yet to be established.

Although the HIQA assessment was published only in 2017, in March of this year I asked the Health Research Board to undertake a review of the evidence on the health harms of e-cigarettes, their effectiveness as an aid to smoking cessation and whether they act as a gateway to smoking tobacco products. This review is expected to be completed in March 2020 and its findings will contribute to informing any additional regulation in this area.

Air Quality

Questions (222)

Thomas P. Broughan

Question:

222. Deputy Thomas P. Broughan asked the Minister for Health the response of his Department to a recent EPA study carried out for the HSE which highlights the relationship between poor air quality, breathing conditions such as asthma and hospital admissions; and if he will make a statement on the matter. [48263/19]

View answer

Written answers (Question to Health)

Policy responsibility for air quality is a matter for the Department of Communications, Climate Action and Environment.

Air quality is an important environmental determinant of health and in this regard the HSE has a priority to identify and advise the general public on strategies to reduce their risk of adverse effects during episodes of poor air quality.  To this end, the HSE and the EPA established a collaboration to look at the relationship between short-term changes in ambient air quality and hospital admissions due to cardiovascular and respiratory diseases in Dublin city and county between 2014 and 2018.  The Air Quality Index for Health (AQIH) was the measure used for ambient air quality (Available URL: http://www.epa.ie/air/quality/index/).

The preliminary findings from this work have highlighted that the ambient air quality in Dublin is predominantly good (i.e. Good: 96% ; Fair: 3% ; Poor: 1% ; and Very poor: < 1%).  Other findings are comparable to reports within the literature, but uniquely show the Irish experience.

The report is currently being finalised for publication.

Departmental Administrative Arrangements

Questions (223)

Eugene Murphy

Question:

223. Deputy Eugene Murphy asked the Minister for Agriculture, Food and the Marine his plans to deal with the current and ongoing information technology problems in the payments section of his Department which is leading to ongoing delays in relation to processing files which have already been inspected and awaiting payments; and if he will make a statement on the matter. [47884/19]

View answer

Written answers (Question to Agriculture)

EU regulations governing the administration of the Basic Payment Scheme, the Areas of Natural Constraints Scheme and other area-based schemes require that full and comprehensive administrative checks, including Ground or Remote Sensing (Satellite) inspections where applicable, are fully completed to ensure eligibility with the various schemes requirements before any payments issue. There are certain minimum numbers of inspections that must take place annually under the various schemes.

It is important to note that, in many cases, the existence of an inspection will not necessarily be delaying payment. In relation to the ANC Scheme, this scheme is subject to a range of eligibility and compliance criteria such as the requirement to meet a minimum stocking density in addition to maintaining minimum livestock units calculated over the twelve months of the scheme year. At this stage, a number of farmers are not eligible to receive payment as they have not met scheme-specific criteria. When an applicant meets these criteria, they will become eligible for payment, which will be processed promptly. Factors that may impact on payment issuing under BPS include, for example, applications to transfer entitlements, request for change in ownership etc., and officials in my Department are actively processing such cases.

Some 8,000 applicants have been selected for a Land Eligibility inspection in respect of the various 2019 area-based schemes. As of 19th November, inspections results have been received for over 90% of these inspections, of which 92% have been advanced to payment stage processing. The balance of these cases fall into a number of categories, namely, applicants have been notified of the inspection outcome where an area over-declaration has been identified and a response is awaited; applicants have chosen to submit comments on notified inspection outcomes - these are currently being examined and are subject to final processing. The balance of the outstanding inspection results are currently being finalised and will then be advanced through the final stages of processing promptly.

My Department continues to finalise the outcome of both Ground and Remote Sensing inspections on a daily basis to ensure that BPS and ANC Schemes payments due are issued as quickly as possible.

Forestry Sector

Questions (224)

Timmy Dooley

Question:

224. Deputy Timmy Dooley asked the Minister for Agriculture, Food and the Marine if the majority of forestry licences were taking 99 days plus prior to the introduction of the new appropriate assessment procedure (details supplied) when the licence process will be capable of delivering a sustainable work flow to the forest industry in view of the fact that the sector is facing significant redundancies in January 2020; and if he will make a statement on the matter. [47887/19]

View answer

Written answers (Question to Agriculture)

I acknowledge that changes made to internal Appropriate Assessment Procedures (AAP) has resulted in delays to many files.  These are beyond my Department’s control as we are obliged to implement changes to AAP that were required following important Court of Justice of the European Union (CJEU) decisions and their subsequent interpretation by the Forestry Appeals Committee and others.  All forestry licences issued by my Department undergo a legal consent process.  Since 2017, all  afforestation licence and forest road applications received have been subject to a statutory public notification system and all afforestation, forest roads and felling decisions issued are subject to a statutory appeal system operated by the Forestry Appeals Committee (FAC).

Most appeals have been in connection with our Appropriate Assessment (AA) procedure.  The Habitat Directive (Article 6.3) requires that where a plan or project is likely to have a significant effect on a Natura site, either individually or in-combination with other plans or projects, it must undergo an appropriate assessment of its implications for that Natura site.  In this regard, the introduction of the 15km assessment buffer around potential forestry sites is necessary and is an industry norm.

Currently, we are amending the AA procedure in order to introduce a robust and workable system which will address the issues now faced.  Introducing this system involves the recruitment of additional ecological expertise and changes in procedures for the forestry inspectorate.  My Department recently advertised for additional ecologists and we also have access to external ecological support, which will be supplemented in due course.  Inspectors have already undergone training and will receive appropriate support in delivering these new procedures.  A categorisation of files affected by these requirements is also underway in order to best assess further action needed and by whom.

Notwithstanding that this has led to a temporary disruption in issuing afforestation licences, we know that the sector has approximately 3,200 hectares of approvals issued this year which are shovel-ready and yet to be planted. 

I am fully aware of the concerns of the sector in relation to the AA process.  My officials are in regular communication with stakeholders and they have been fully apprised of the issues involved and of my Department’s efforts to address them.  They have also been advised of steps they can take to ensure that applications received are completed to an acceptable standard and to take account of any issues relating to sensitive habitats. 

Furthermore, for my part, I have commissioned a consultant to review my Department's processes and procedures on forestry applications and approvals similar to an exercise undertaken in Scotland.  I expect to receive this report by the end of November and that it will provide an opportunity to make our processes more effective and efficient going forward.

Harbours and Piers Funding

Questions (225)

Pearse Doherty

Question:

225. Deputy Pearse Doherty asked the Minister for Agriculture, Food and the Marine when the necessary funding will be provided to complete the breakwater at Greencastle Harbour, County Donegal, a project that his Department previously funded to its current stage. [47902/19]

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Written answers (Question to Agriculture)

Greencastle Harbour is owned by Donegal County Council and responsibility for its maintenance and development rests with that Local Authority in the first instance and its parent Department, the Department of Housing, Planning and Local Government thereafter.

My Department owns, operates and maintains six designated State-owned Fishery Harbour Centres, located at Castletownbere, Dingle, Dunmore East, Howth, Killybegs and Ros An Mhíl under statute. In addition, my Department also has responsibility for the upkeep and maintenance of North Harbour at Cape Clear, as well as the maintenance of a small number of specific piers, lights and beacons throughout Ireland, in accordance with the Marine Works (Ireland) Act 1902, and piers, lights and beacons constructed under the auspices of the Congested Districts Board.

My legislative remit does not extend to Greencastle Harbour, and given that the ownership of, and overall responsibility for Greencastle Harbour rests with the County Council, it is the Council who will decide on any further development, repair or maintenance of Greencastle Harbour.

Any further programme of works, the costings and timescales for those works, would have to be considered further in the context of Government priorities and Project Ireland 2040.

My Department does provide limited funding to assist coastal Local Authorities in carrying out small scale projects for the development and repair of Local Authority owned piers, harbours and slipways under the annual Fishery Harbour and Coastal Infrastructure Development Programme, subject to available Exchequer funding and overall national priorities.  Since 2010, Donegal County Council has received funding of € 2.9m under this programme.

I have approved funding of €2.2m for the Local Authority element of my Department’s 2019 Fishery Harbour and Coastal Infrastructure Development Programme. Donegal County Council has secured €172,500 of funding for six projects under this year’s programme. A key element in the determination of the projects to be funded is the priority placed on them by the Local Authority, and while an application was received in relation to Greencastle, the approved projects received a higher prioritisation by Donegal County Council.

Should any application be submitted by Donegal County Council in relation to Greencastle under any future programme, it will be given due consideration, taking into account the terms and conditions of the scheme, the priority attached by the Council and available funds.