Written Answers Nos. 216-230
216. Deputy Louise O'Reilly asked the Minister for Health the amount spent by the HSE and his Department on external public relations companies to date in 2019, in tabular form; the name of each company; the service provided; and if he will make a statement on the matter. [51963/19]
View answerThe amount spent on external public relations companies to date in 2019 by the Department of Health is as follows:
|
Company |
Service |
Cost |
|
Q4PR |
Communications support and strategic advice for Sláintecare |
3,078.08 |
As amount spent by the HSE is a service matter this has been referred to the HSE to respond directly to the Deputy.
218. Deputy Michael Fitzmaurice asked the Minister for Health if the pharmacy cuts set to be imposed, which will see the service of phased medication for vulnerable persons significantly reduced or wiped out, will be overturned; and if he will make a statement on the matter. [51967/19]
View answerI recognise the significant role community pharmacists play in the delivery of patient care and the potential for this role to be developed further in the context of health service reform and modernisation. Community pharmacy is recognised as the most accessible element of our health service with an unequalled reach in terms of patient contact and access.
Regulations governing the current pharmacy fee structure were made under section 9 of the FEMPI Act 2009 and are set to expire at the end of 2019. Under the Public Service Pay and Pensions Act 2017, these regulations must be replaced on 1st January 2020 to maintain a statutory basis for contractor payments and to prescribe the fees payable from that date.
In keeping with my obligations under Section 43 of the 2017 Act, my officials have undertaken a process of consultation with the Irish Pharmacy Union (IPU), as the representative body for the profession. My officials have met with an IPU delegation on two occasions where proposed fee restructuring was discussed. A detailed submission was received from the IPU. This consultation process has now concluded.
I met with the IPU on the 5th December, where I reiterated my intention to move beyond the arrangements underpinned by the FEMPI regulations and to commence a comprehensive review of the pharmacy contract. In this context I also communicated my intention to maintain the current fee structure from 1 January 2020.
The comprehensive review of the pharmacy contract in 2020 will address the role to be played by community pharmacy in the context of Sláintecare. It will consider all aspects of pharmacy service provision including delivery of a multi-disciplinary model of service delivery for patients, ensuring clarity of roles and achieving optimum value for money.
However, any publicly funded pharmacy service expansion should address unmet public healthcare needs, improve access to existing public health services or provide better value for money or patient outcomes. Accordingly, any measures to be considered must be evidence based.
New secondary legislation is currently being drafted in order to give effect to the prescribed fee structure, as required under the Public Service Pay and Pensions Act 2017.
219. Deputy Brendan Griffin asked the Minister for Health his views on a matter (details supplied) regarding access to medicines; and if he will make a statement on the matter. [51969/19]
View answer236. Deputy Fiona O'Loughlin asked the Minister for Health the progress made to ensure the swift provision of new medicines to persons with multiple sclerosis. [52035/19]
View answer237. Deputy Fiona O'Loughlin asked the Minister for Health the reason for the continued delay in access to medication for persons with multiple sclerosis in view of the fact drugs have recently become available and accessible in other EU countries, for example, siponimod; the steps he will take to expedite access of such drugs for patients; and the timeframe for same. [52036/19]
View answerI propose to take Questions Nos. 219, 236 and 237 together.
The HSE has statutory responsibility for medicine pricing and reimbursement decisions, under the Health (Pricing and Supply of Medical Goods) Act 2013. The Act specifies criteria for decisions on the reimbursement of medicines.
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 a drug's clinical and cost effectiveness as a health intervention.
As a country, we invest heavily in medicines, to the tune of almost €2 billion annually. In 2019 to date, the HSE has approved 31 new medicines and 5 new indications for existing medicines for reimbursement in the public healthcare system. The approvals to date represent an additional investment by the HSE over five years of approximately €220m in providing access to new and innovative treatment for Irish patients. It is expected that over 3,000 patients will benefit from access to these new medicines over the next 5 years.
Notwithstanding the significant progress on drug costs achieved from price reductions under the pricing framework agreed with industry and commercial negotiations conducted by the HSE, the Health Service is still facing very significant challenges in relation to the affordability of medicines. The industry continues to develop very expensive products, particularly in the high-tech medicines area and the costs involved are a challenge for health systems even in countries with much greater resources than Ireland.
The HSE has received 2 applications for pricing and reimbursement of ocrelizumab (Ocrevus). Application 1 is for use of Ocrelizumab for the treatment of adult patients with relapsing forms of Multiple Sclerosis (RMS) with active disease defined by clinical or imaging features. Following a number of rounds of commercial negotiations, an agreement was reached in relation to the commercial terms which will apply to this indication. The HSE intends to progress ocrelizumab for the RMS indication, which has been approved for funding from October 2019, on a patient-specific basis for this indication.
Application 2 is for the use of ocrelizumab for the treatment of adult patients with early primary progressive multiple sclerosis (PPMS) in terms of disease duration and level of disability, and with imaging features characteristic of inflammatory activity. On 4 October 2018 the NCPE completed its assessment for this indication. They did not recommend that ocrelizumab be reimbursed for this indication.
The HSE and the manufacturer have had a number of rounds of commercial negotiations in relation to this indication. Commercial discussions have concluded and the medicine has been reviewed by the HSE Drugs Group. The HSE Senior Leadership Team have received the Drugs Group recommendation. The HSE's final decision on reimbursement will take into consideration the criteria contained in the 2013 Health Act.
The HSE has also received an application for reimbursement of Delta-9-tetrahydrocannabinol/Cannabidiol, THC/CBD (Sativex) which is indicated as treatment for symptom improvement in adult patients with moderate to severe spasticity due to multiple sclerosis who have not responded adequately to other anti-spasticity medication and who demonstrate clinically significant improvement in spasticity related symptoms during an initial trial of therapy.
The HSE commissioned a full HTA with respect to this indication in April 2018. On 12 August 2019, the NCPE received the applicant's submission and the HTA is currently underway.
On 14 November 2019, the EMA's Committee for Medicinal Products for Human Use (CHMP) recommended the granting of a marketing authorisation for the medicinal product siponimod (Mayzent), intended for the treatment of adult patients with secondary progressive multiple sclerosis (SPMS) with active disease. The EMA's decision on whether to grant marketing authorisation for siponimod will take into account CHMP's recommendation.
The Government wants new and innovative medicines to be available to our citizens as quickly as possible but this can only be achieved if medicines are priced by the pharmaceutical industry in a viable and sustainable manner.
My Department and the HSE are working on making greater efficiencies in medicines usage through a range of initiatives both domestically and internationally to ensure the greatest possible access to new treatments for patients in Ireland.
The HSE’s Medicines Management Programme (MMP), incorporating the Preferred Drugs initiative, is overseeing the implementation of a number of actions to bring about greater value for the taxpayer through cost-effective provision of medicines. These measures include the designation of preferred products with a focus on high-cost prescribing areas, in particular optimising the use of biosimilars.
I and officials have also been engaging over the past number of years with a number of voluntary EU forums. In June 2018, I signed the Beneluxa Initiative on Pharmaceutical Policy. This Agreement is in line with my objective to work with other European countries to identify workable solutions, in an increasingly challenging environment, to secure timely access for patients to new medicines in an affordable and sustainable way. In June 2019, Ireland became a Founding Member of the International Horizon Scanning Initiative which is being established as part of the work programme of Beneluxa.
220. Deputy Robert Troy asked the Minister for Health if an application by a person (details supplied) for inclusion on the fair deal scheme will be expedited. [51974/19]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
222. Deputy Denis Naughten asked the Minister for Health when a person (details supplied) will be called for a procedure; the reason for the delay in same; and if he will make a statement on the matter. [51977/19]
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.
223. Deputy Niamh Smyth asked the Minister for Health the status of the provision of a nurse (details supplied) at Cavan General Hospital; and if he will make a statement on the matter. [51978/19]
View answerAs this is a service matter, I have asked the HSE to respond to you directly.
224. Deputy Michael McGrath asked the Minister for Health the number of medical cards in issue in which the entitlement arises under EU regulations in respect of persons in receipt of social security pensions from other countries in the EU, the EEA or Switzerland or that are working and paying social insurance in one of the countries; the relevant countries in this regard in tabular form; and if he will make a statement on the matter. [51985/19]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
225. Deputy Louise O'Reilly asked the Minister for Health the reason the new children's hospital has chosen to install a surveillance system (details supplied), including specialised facial recognition cameras; the further reason it was decided to use facial recognition cameras; and his views on whether it is necessary or acceptable. [51995/19]
View answerThe safety of patients, visitors and staff at the new children’s hospital is of paramount importance to everyone working on the new children’s hospital project.
Stanley Security Systems, who have been working in this area for more than 25 years, were successful in the competitive procurement process for the installation of the security systems at the new children’s hospital.
There continues to be significant technological developments and innovation in the area of security systems and, as would be expected, the procurement process undertaken sought to ensure that the equipment procured is fully future proofed.
Less than 3% of the cameras procured for the new children’s hospital have the potential for high definition facial recognition capabilities. These cameras have many capabilities, and can also be used in the same way as remaining 97% of the cameras, which do not have facial recognition capabilities.
It has not yet been decided which aspect of the security systems’ capabilities will be used. This decision will be taken nearer the opening of the hospital by Children’s Health Ireland and will be fully in line with Irish and European data protection and privacy legislation and guidelines, to ensure that the occupants of the hospital have the appropriate protections and security afforded to them, in line with their privacy rights.
226. Deputy Louise O'Reilly asked the Minister for Health his views on whether it is acceptable that the new national children's hospital will install a surveillance system manufactured by a company (details supplied), including specialised facial recognition cameras, in view of the recent human rights sanctions and alleged control of the company by the Chinese Government. [51996/19]
View answerThe safety of patients, visitors and staff at the new children’s hospital is of paramount importance to everyone working on the new children’s hospital project.
Stanley Security Systems, who have been working in this area for more than 25 years, were successful in the competitive procurement process for the installation of the security systems at the new children’s hospital.
There continues to be significant technological developments and innovation in the area of security systems and, as would be expected, the procurement process undertaken sought to ensure that the equipment procured is fully future proofed.
Less than 3% of the cameras procured for the new children’s hospital have the potential for high definition facial recognition capabilities. These cameras have many capabilities, and can also be used in the same way as remaining 97% of the cameras, which do not have facial recognition capabilities.
It has not yet been decided which aspect of the security systems’ capabilities will be used. This decision will be taken nearer the opening of the hospital by Children’s Health Ireland and will be fully in line with Irish and European data protection and privacy legislation and guidelines, to ensure that the occupants of the hospital have the appropriate protections and security afforded to them, in line with their privacy rights.
227. Deputy Michael Harty asked the Minister for Health if he has secured funding for an organisation (details supplied), which is the first disabled persons organisation here and the only one to be composed of and directed solely by persons with intellectual disabilities; and if he will make a statement on the matter. [52005/19]
View answerThe National Platform of Self-Advocates is an advocacy service for people with intellectual disabilities which was established and is run by people with intellectual disabilities.
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. The Department of Health does not fund organisations directly while the HSE can only fund organisations for the purpose of providing health services on its behalf.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the HSE for direct reply to the Deputy.
228. Deputy John Curran asked the Minister for Health the number of persons waiting one week, one, three, six and 12 months, respectively, to be discharged from each hospital; and if he will make a statement on the matter. [52006/19]
View answerDelayed transfers of care (previously referred to as delayed discharges) occur when patients have been deemed clinically fit for discharge from an acute bed but their discharge is delayed because they are waiting for some form of ongoing support or care following their discharge. There are many reasons for this, such as a patient undertaking the application process for NHSS, awaiting assessment for a home support package, homelessness, ward of court application, and the availability of resources.
When possible, the HSE will use transitional care to accommodate the patient during the period between discharge and the finalisation of new care arrangements, but there can often be a delay, especially in cases where the patient and family are coming to terms with the new circumstances.
This year, services are being stretched more than ever, with demand consistently outstripping supply, and we have seen an increase the number of delayed transfers of care. While the HSE maximises the use of resources, prioritising those requiring discharge from acute hospitals, there is a growing demand for egress support. In response, and in the context of planning and preparing for the challenges of the winter period, the Department and the HSE have been considering a comprehensive approach to the current high-level of DTOCs. However, recognising the urgency of the situation, approval was provided to the HSE to begin actions immediately to the value of €5m in 2019. As part of these measures the HSE released a significant number of funding approvals within NHSS in September, and provided additional home care and transitional care beds.
In addition, the HSE Winter Plan was launched on Thursday 14 November. The aim of the Winter Plan is to ensure that service providers are prepared for the additional external pressures associated with the winter period, including the prolonged holiday period, severe winter weather, seasonal influenza, and the spread of norovirus and other healthcare associated infections.
Nine Winter Action Teams, each aligned to a Community Healthcare Organisation and associated acute hospitals and Hospital Groups, have prepared Integrated Winter Plans. These plans focus on demand management and reduction, staffing availability, timely access to the most appropriate care pathway for patients, and appropriate timely discharge from acute hospitals.
The HSE Winter Plan is supported by an additional €26m in winter funding nationally. This winter funding will support access to the Fair Deal scheme, and will provide additional home support and transitional care to facilitate timely hospital discharge and reduce congestion in EDs over the winter period.
With regard to the Deputy's specific question, I have asked the HSE to respond to the Deputy directly with the requested information.
229. Deputy John Curran asked the Minister for Health the status of the implementation plan of his Department and the HSE to accompany the review report by the HSE of hospital car parking charges; and if he will make a statement on the matter. [52007/19]
View answerI have made it clear I want to see progress made in this area and I am working with my Department and the HSE in this regard. As such, I requested the HSE to conduct a review of hospital car parking charges with a view to establishing clear national guidelines in the area. My Department and the HSE are currently engaging on a draft implementation plan to accompany the review report.
230. Deputy Michael McGrath asked the Minister for Health the person or body responsible for the implementation of the HSE report on lymphoedema and lipoedema treatment in Ireland 2018; the details of the implementation plan; the timeline for same; his plans to ensure access to services for lymphoedema, primary and secondary patients; and if he will make a statement on the matter. [52011/19]
View answerThe HSE is undertaking a 'proof of concept' project' in advance of the roll-out of the full Model of Care for the Treatment of Lymphoedema and Lipoedema. As such, I have referred your question to the HSE for direct reply.
