Written Answers Nos. 525-549
525. Deputy James Browne asked the Minister for Health if primary care counselling services will be made available free of charge for general practitioner visit card holders here; and if he will make a statement on the matter. [8359/20]
View answerThe Irish health system provides for two categories of eligibility for persons, ordinarily resident in the country, i.e. full eligibility (medical card holders) and limited eligibility (all others). Full eligibility is determined primarily by reference to income limits. Determination of an individual’s eligibility status is the responsibility of the HSE.
Adults with full eligibility can access a range of services including GP services, prescribed drugs and medicines, all in-patient public hospital services in public wards, including consultants’ services, all out-patient public hospital services including consultants’ services, dental, ophthalmic and aural services and appliances and a maternity and infant care service.
Persons with limited eligibility are eligible for in-patient and outpatient public hospital services including Consultant services, Emergency Department or minor injury care, are subject to certain charges. Other services such as allied healthcare professional services may also be made available to persons with limited eligibility.
A General Practitioner Visit Card provides for eligible individuals to visit a participating GP service without fees and also covers visits to GP out-of-hours service.
The HSE Counselling in Primary Care Service (CIPC) is for people with mild to moderate psychological difficulties. It is a short-term counselling service that provides up to eight counselling sessions with a professionally qualified and accredited Counsellor/Therapist. It is a service for medical card holders, who are 18 years of age or over, and who require help with psychological problems that are appropriate for time-limited counselling in Primary Care. It is not available to GP Card holders.
The development of all aspects of mental health services remains a priority for Government. Mental health services, including those for young people, have benefited from significant additional investment over recent years. This has resulted in an overall provision of €1.026 billion for the HSE Mental Health care programme in 2020, reflecting an increase of €315m since 2012 and an increase of €39m over 2019.
Any new service proposals have to be assessed in light of various factors. These include the spectrum of other existing counselling services provided either directly or on behalf of the HSE, emerging new service priorities in the health sector, and overall resource availability taking into account competing demands for health services over 2020 or beyond. In this context, I will keep in mind the proposal raised by the Deputy.
526. Deputy Mairéad Farrell asked the Minister for Health if construction work on a new radiation oncology unit at University Hospital Galway has commenced; when the project is set to be completed; the estimated cost of the project; and if he will make a statement on the matter. [8379/20]
View answerAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
527. Deputy Mairéad Farrell asked the Minister for Health if his Department or the HSE will launch a public awareness campaign in 2020 on the dangers of casual drug use; and if he will make a statement on the matter. [8380/20]
View answerThe Government is committed to a health-led approach to drug use and to developing harm reduction interventions for at risk groups, as set out in the national drugs strategy Reducing Harm, Supporting Recovery, a health-led response to drug and alcohol use in Ireland 2017-2020.
The Department of Health works with the HSE to raise awareness of the dangers associated with drugs through the Drugs.ie website. The site provides a comprehensive range of information and supports related to substance use.
Recently, the HSE launched Know the Score, the first national evidence-based resource on alcohol and drugs for senior cycle students. It aims to engage young people in exploring and considering a wide range of topics related to the risks associated with alcohol and drugs.
The Department of Health, as part of the introduction of the Health Diversion Programme, is providing €100,000 in 2020 to develop a national harm reduction campaign to raise awareness of the risks associated with drug use. This will include the use of club drugs, festival drug use and new trends. While this campaign was originally scheduled for the latter part of 2020, this timetable may need to be revised given the draw on resources in dealing with Covid 19.
I strongly support treating substance misuse and drug addiction as a public health issue. This does not mean we should be complacent about the risks associated with drug use, especially for young people. I believe that a multi-faceted approach, involving online resources, in-school interventions and targeted awareness campaigns, can minimise the risk of substance misuse among young people.
528. Deputy Gino Kenny asked the Minister for Health the reason epidiolex that is a cannabis-based medicine for the treatment of epilepsy and been approved by the EMA and FDA, has not be approved for reimbursement by the HSE; and if he will make a statement on the matter. [8389/20]
View answerThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
In line with the 2013 Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the reimbursement list.
Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.
In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including the health needs of the public, cost effectiveness, potential or actual budget impact and efficacy.
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).
I am advised by the HSE that it has received two applications for the reimbursement of Cannabidiol (Epidyolex®):
1. for use as adjunctive therapy of seizures associated with Lennox-Gastaut Syndrome in conjunction with clobazam, for patients two years of age and older.
In February 2020, the HSE commissioned the National Centre for Pharmacoeconomics to complete a rapid review on this medicine. The NCPE recommended a full health technology assessment to assess the clinical effectiveness and cost effectiveness of cannabidiol compared with the current standard of care. On 16 March 2020, the HSE commissioned a full pharmacoeconomic assessment for this indication.
2. for use as adjunctive therapy of seizures associated with Dravet Syndrome in conjunction with clobazam, for patients two years of age and older.
In February 2020, the HSE commissioned the NCPE to complete a rapid review. The NCPE recommended a full HTA to assess the clinical effectiveness and cost effectiveness of cannabidiol compared with the current standard of care. In March 2020, a full pharmacoeconomic assessment was commissioned by the HSE.
529. Deputy Alan Kelly asked the Minister for Health if pubs that serve food can open as part of phase 3 of the Roadmap for Reopening Society and Business; and if he will make a statement on the matter. [8391/20]
View answerThe Government’s Roadmap for Reopening Society & Business, published on 1 May 2020, sets out an indicative path to the easing of COVID 19 restrictions and other actions in order to facilitate the reopening Ireland’s society and economy in a phased manner. The Roadmap specifies that decisions in relation to which actions will be taken and which public health measures might be lifted will be made in accordance with the Framework for Future Decision-Making which is as follows:
1. Before each Government consideration of the easing of restrictions, the Department of Health will provide a report to the Government regarding the following on/off trigger criteria:
a. The latest data regarding the progression of the disease,
b. The capacity and resilience of the health service in terms of hospital and ICU occupancy,
c. The capacity of the programme of sampling, testing and contact tracing,
d. The ability to shield and care for at risk groups,
e. An assessment of the risk of secondary morbidity and mortality as a consequence of the restrictions.
2. It will also provide risk-based public health advice on what measures could be modified in the next period.
3. The Government would then consider what restrictions could be lifted, having regard to the advice of the Department of Health as well as other social and economic considerations, e.g. the potential for increased employment, relative benefits for citizens and businesses, improving national morale and wellbeing etc.
4. It is acknowledged that there is also an ongoing possibility that restrictions could be re-imposed and this process will be carried out on an ongoing basis once every 3 weeks.
As is clear from the framework, it is the Government rather than I or my Department that will decide on any modifications to the current public health measures in place and those decisions will be informed by the status of the on/off trigger criteria and the public health advice received at the time that a decision is being made.
530. Deputy Bernard J. Durkan asked the Minister for Health the provisions being made to facilitate the needs of a person (details supplied); and if he will make a statement on the matter. [8397/20]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
531. Deputy Gary Gannon asked the Minister for Health the process for the school dental screening programme in view of Covid-19 (details supplied). [8228/20]
View answerAs this is a service matter it has been referred to the HSE for attention and direct reply to the Deputy.
532. Deputy Denis Naughten asked the Minister for Health the number of beds and locations available for hospital step-down patients that are positive for Covid-19; the number occupied in each location; his plans and timeline for additional capacity; the corresponding figures for those that need to self-isolate from the community as a result of a positive Covid-19 test; and if he will make a statement on the matter. [8407/20]
View answerAs this is an operational matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
533. Deputy Pat Buckley asked the Minister for Health the status of the provision of PPE for home help and carers. [8408/20]
View answerAs this is an operational matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
534. Deputy Pat Buckley asked the Minister for Health his plans to ensure that all carers are provided with a medical card; the reason for this not being the case at present; and if he will make a statement on the matter. [8409/20]
View answerUnder the provisions of the Health Act 1970 (as amended), eligibility for health services in Ireland is based primarily on residency and means. The Act provides that persons who are unable, without due hardship, to arrange GP services for themselves and family can qualify for full eligibility (a medical card). The HSE awards medical cards in accordance with the Health Act, and assesses applicants on the overall financial situation of the applicant and his or her spouse or partner.
Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of any difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card or GP visit card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness.
It should be noted that since July 2018, persons in receipt of either full or half rate Carer’s Allowance or Carer’s Benefit receive automatic eligibility for a GP visit card.
535. Deputy Micheál Martin asked the Minister for Health his views on whether it is appropriate for delivery drivers to enter or pass through isolation wards in order to deliver materials to hospitals during the Covid-19 pandemic. [8416/20]
View answerAs this is an operational matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
536. Deputy Fergus O'Dowd asked the Minister for Health when the implementation of the €10 cap on hospital car park charges will be introduced to Our Lady of Lourdes Hospital car parks in Drogheda, County Louth; and if he will make a statement on the matter. [8444/20]
View answerIn 2018, I requested the HSE to conduct a review of all hospital car parking charges, including Our Lady of Lourdes Hospital, Drogheda, County Louth, with a view to establishing clear national guidelines in the area. The Review process included consultation with key stakeholders, including patient advocates. My Department and the HSE are currently engaging on a draft implementation plan to accompany the review report.
537. Deputy Fergus O'Dowd asked the Minister for Health the status of the proposed Dundalk primary care centre; if a site has been secured; if so, the full list of services that will be provided on-site; the reason for the delays; and if he will make a statement on the matter. [8445/20]
View answerAs the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.
538. Deputy Fergus O'Dowd asked the Minister for Health the position in relation to the progression of the 50-bed new St. Joseph's Hospital, Ardee and other relevant details; and if he will make a statement on the matter. [8448/20]
View answerAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
539. Deputy Stephen Donnelly asked the Minister for Health if there will be a new national medicine pricing agreement in 2020 and in place before the expiry of the existing agreement later in summer 2020; the engagements and negotiations that have taken place to date to reach a new agreement; the parties he engaged with in this regard; the estimated timeline for the conclusion of a new agreement; the negotiating structure; the parties that will be a party to this agreement; the processes to reach agreement; and if he will make a statement on the matter. [8451/20]
View answerThe four-year Framework Agreement on the Supply and Pricing of Medicines commenced on 1 August 2016 and, under the terms of the agreement, shall continue in force until 31 July 2020, unless continued by mutual agreement of the parties.
The Agreement also provides that negotiations on any successor or replacement agreement should begin at least six months before the expiry of the term.
My Department, the HSE and the Irish Pharmaceutical Healthcare Association are in contact with each other, in the context of these specific provisions of the current Agreement and with a view to progressing the process of discussions on a successor agreement.
540. Deputy Fergus O'Dowd asked the Minister for Health the status of the proposed 100 bed unit at the St. Mary’s Hospital site, Dublin Road, Drogheda, County Louth; the most recent specification brief on the project; if specific commencement dates have been agreed; and if he will make a statement on the matter. [8452/20]
View answerAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
541. Deputy Sean Fleming asked the Minister for Health the detailed financial support provided to the private nursing home sector to deal with Covid-19; the amount of payments that have been paid in support of this during April and May 2020 to date; the expected payments for June, July and August 2020; and if he will make a statement on the matter. [8454/20]
View answerThe Temporary Assistance Payment Scheme which will provide funding of up to €72.5m to private and voluntary nursing homes opened for applications on 17 April. The core concept of the scheme is that the State will provide additional funding to those nursing homes that require it, to contribute towards support measures associated with COVID-19 preparedness, mitigation and outbreak management. This temporary scheme will provide support for a 3-month period - April, May and June 2020.
There are two component parts of the Scheme which are integrated:
- a support payment per month based on the number of residents; and
- enhanced assistance in the event of a nursing home actively managing an outbreak.
Under the standard support component, funding may be provided to each applicant nursing home for COVID-19 related measures and associated expected costs for the month. The maximum level of financial support under the Scheme will be calculated by reference to the number of residents in the nursing home at a specified time.
Where a nursing home has incurred significant further costs or undertaken necessary enhanced actions arising directly from a COVIDCOVID-19 outbreak, a nursing home may submit a separate business case for enhanced assistance.
There is an overall monthly funding cap, which is the maximum amount that may be paid in respect of each month to a Nursing Home under the Scheme. This amount applies to the aggregate of payments under the Standard Assistance Payment and the Outbreak Assistance Payment. It is equal to the lower of:
- twice the Standard Assistance Payment Cap for the month;
- the amount of €75,000;
I have forwarded the payment aspects of the question to the HSE for direct reply to the Deputy.
542. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [8455/20]
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 response to the Covid-19 pandemic the HSE had to take measures to defer all non-urgent elective scheduled care activity, including outpatient clinics. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by the World Health Organisation, and the National Action Plan published on 16 March. The trajectory of the disease means there is now an opportunity for increasing the provision of non-covid care including more routine care. It is envisaged that the private hospitals will play an important role in this regard.
My Department, the HSE and the National Treatment Purchase Fund are currently working together to estimate the impact of Covid 19 on Scheduled Care waiting lists, in order to be prepared to address any backlog or pent up demand. My Department continues to ensure that the resources available throughout our health system are best utilised at this unique and challenging time.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
543. Deputy Sean Fleming asked the Minister for Health the arrangements in place between the HSE and section 38 and 39 organisations in respect of an organisation and its staff that are pregnant; the special arrangements in place for these non-HSE staff that are full-time workers in the health sector; and if he will make a statement on the matter. [8456/20]
View answerAs this is an operational matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
544. Deputy Ged Nash asked the Minister for Health when ASD early intervention services and services for children with other neurodevelopmental conditions will recommence in County Louth; and if he will make a statement on the matter. [8458/20]
View answerAs the Deputy's question relates to a service issue it has been referred to the HSE for direct reply.
545. Deputy Emer Higgins asked the Minister for Health the circumstances under which a person can acquire cannabis-based products (details supplied); the details of the clinical guidance required; the Department responsible for international controlled drug export licensing requirements; and if he will make a statement on the matter. [8463/20]
View answerIn June 2019, I signed legislation to underpin the operation of the Medical Cannabis Access Programme (MCAP). This is a 5-year pilot programme, restricted to prescribing of cannabis-based products by medical consultants, for patients with certain medical conditions who have exhausted all other available medical treatment options. For more information relating to the MCAP and the clinical guidelines, please see my Department's website.
Commercial suppliers whose cannabis products have been reviewed and are considered to have met the specified requirements set out in the legislation and are in line with the clinical guidance for the MCAP, will have their products added to Schedule 1 of the Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) Regulations 2019. Once the products are listed in Schedule 1 of these Regulations the suppliers will be permitted to supply these products to the Irish market, in line with legal and regulatory requirements. Cannabis products will only be listed in Schedule 1 of the Regulations once they have been assessed as suitable for medical use under the MCAP.
To date three products have been added to Schedule 1 of the Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) Regulations 2019. The three products are:
1. Aurora High CBD Oil Drops
2. CannEpil ™
3. Tilray Oral Solution THC10:CBD10 25ml.
The HSE has engaged in discussions with the suppliers of these products, regarding pricing and supply information. The HSE will consider such information, in line with the Health (Pricing and Supply of Medical Goods) Act 2013. The programme will not become fully operational until pricing and supply matters are agreed.
Once the Medical Cannabis Access Programme commences the HSE will establish and maintain a Register to facilitate the enrolment and recording of certain data including patient identifiers (in anonymised format), prescribers enrolled in the Programme, as well as prescribed/supplied medical cannabis products. I can advise that while the MCAP register is not currently operational, engagement is ongoing with the HSE in regard to progressing same.
Pending full operation of the MCAP and for medical indications not included in the MCAP, Doctors may continue to utilise the Ministerial licencing route to prescribe medical cannabis for their patients, should they wish to do so. In line with the Chief Medical Officer's advice, the granting of a licence for cannabis for medical purposes must be premised on an appropriate application being submitted to the Department of Health, which is endorsed by a consultant who is responsible for the management of the patient and who is prepared to monitor the effects of the treatment over time.
This information, including the clinical guidelines, can also be found on the Department's website at the following address:
https://www.gov.ie/en/collection/fb8912-cannabis-for-medical-use/
It is important to note that the medical decision to prescribe or not prescribe any treatment, including cannabis treatment, for an individual patient is strictly a decision for the treating clinician, in consultation with their patient. I have no role in this clinical decision-making process.
Operators require a controlled drug licence or registration processed by the Health Products Regulatory Authority (HPRA), on behalf of the Department of Health, if they wish to produce/manufacture, possess, supply, import or export any controlled drug in the schedules to the Misuse of Drugs Regulations 2017.
546. Deputy Dara Calleary asked the Minister for Health if his attention has been drawn to the serious concerns and worries amongst affected families, staff and the wider public regarding Covid-19 procedures at Mayo University Hospital; if a report on the matter to Dáil Éireann will be supported; and if he will make a statement on the matter. [8467/20]
View answerI am advised by Saolta Hospital Group that appropriate control measures are currently in place in Mayo University Hospital in relation to Covid-19.
As the Deputy is aware, I am also requesting a report from the CEO of the HSE on the Covid-19 measures taken at Mayo University Hospital from the outset of the pandemic, his views on the appropriateness of these measures at the particular points in time involved and his reassurance that all reasonable measures are now being taken to protect the safety of patients and staff in Mayo University Hospital.
Meanwhile, the number of confirmed cases off Covid-19 in the hospital is continuing to decrease.
547. Deputy Dara Calleary asked the Minister for Health the capital investments that have been sought by the Saolta group for Mayo University Hospital; the status of each application; the status of the planned capital development at Mayo University Hospital; and if he will make a statement on the matter. [8468/20]
View answerAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
548. Deputy Peter Burke asked the Minister for Health the free mental health supports in place for young persons in counties Longford and Westmeath during the Covid-19 pandemic; if an organisation (details supplied) has engaged with his Department or the HSE in relation to the establishment of a service in the counties similar to those in places such as County Offaly; if so, if funding will be provided for such a service; and if he will make a statement on the matter. [8472/20]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
549. Deputy Kathleen Funchion asked the Minister for Health if partners of women having an elective caesarean section at St. Luke’s Hospital, Kilkenny are not allowed to attend the birth; and the reason for same in view of the fact partners in the same hospital are allowed attend a normal delivery. [8475/20]
View answerAs this is a service issue, I have asked the Health Service Executive to reply to you directly.
