Written Answers Nos. 512-537
512. Deputy Thomas Pringle asked the Minister for Health the number of children and adults with a diagnosis of autism; the age categories and geographical location of such persons; and if he will make a statement on the matter. [10737/20]
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.
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.
513. Deputy Sean Fleming asked the Minister for Health the arrangements in place for replacement home care support for a person (details supplied), when the home care provider is on holidays or sick leave; if there are different arrangements for cover in cases in which support is being provided directly by HSE staff compared with the situation in cases in which the service is provided through an agency; and if he will make a statement on the matter. [10751/20]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
514. Deputy Niamh Smyth asked the Minister for Health if he will address concerns regarding the future of a unit (details supplied); if reports that it will close or wind down are correct; and if he will make a statement on the matter. [10762/20]
View answer515. Deputy Niamh Smyth asked the Minister for Health the number of women that availed of the services of a unit (details supplied) in each of the years 2000 to 2019 and to date in 2020, in tabular form; and if he will make a statement on the matter. [10765/20]
View answer552. Deputy Stephen Donnelly asked the Minister for Health the position on the future of both the midwifery-led and the consultant-led services in view of the current uncertainty, with regard to maternity services at Cavan General Hospital; the number of persons accessing services at both units in each of the years 2014 to 2019 and to date in 2020; and if he will make a statement on the matter. [10886/20]
View answer560. Deputy Niamh Smyth asked the Minister for Health the reason the midwifery-led unit in County Cavan has faced consistent threats of closure and downgrading from 2011 onward; and if he will make a statement on the matter. [10909/20]
View answer561. Deputy Niamh Smyth asked the Minister for Health the reason the midwifery-led unit in County Cavan has such a low take-up from women when 60 miles away the midwifery-led unit in Drogheda, County Louth is fully utilised and has recently been entirely refurbished; and if he will make a statement on the matter. [10910/20]
View answer563. Deputy Niamh Smyth asked the Minister for Health the way in which the proposed closure of the midwifery-led unit in Cavan General Hospital is compatible with the national maternity strategy. [10912/20]
View answer564. Deputy Niamh Smyth asked the Minister for Health the details of the consultation process that has taken place in Cavan General Hospital between management and staff with regard to the proposed closure of the midwifery-led unit. [10913/20]
View answer565. Deputy Niamh Smyth asked the Minister for Health the number of babies born in Cavan General Hospital in each of the years 2015 to 2019; and the number of births in each of those years in the midwife-led unit in the hospital. [10914/20]
View answer589. Deputy Louise O'Reilly asked the Minister for Health the position regarding the midwifery-led unit at Cavan General Hospital regarding reports that it is scheduled to merge with consultancy-run maternity services; and if the unit will be kept open. [10964/20]
View answer675. Deputy Brendan Smith asked the Minister for Health the status of the midwifery-led unit at Cavan General Hospital; if his attention has been drawn to a proposal to cease the service; and if he will make a statement on the matter. [11383/20]
View answerI propose to take Questions Nos. 514, 515, 552, 560, 561, 563 to 565, inclusive, 589 and 675 together.
Firstly, I would like to be clear that the Government is fully committed to the ongoing implementation of the National Maternity Strategy. The Strategy is evidence based, in line with international norms and was informed by the voices of women from across the country, drawn from the 1,324 responses received during the public consultation process. Outlined in the Strategy is a new model of care for maternity services with three care pathways - Supported, Assisted and Specialised - ensuring that women receive the right care, from the right professional, at the right time in the right place. In line with that model of care, pregnant women deemed to be at normal risk will be offered, and encouraged to avail of, care in the Supported Care pathway. Key to realising this goal is the development and expansion of community midwifery services, as recommended in the Strategy.
Good progress has been made since the Strategy’s publication in 2016, with midwifery led and community-based services increasingly available across the country. On Friday 5th of June last the National Women & Infants Health Programme applied for a drawdown of new development funding which is being provided for maternity services in 2020. This funding request was approved on 10th June and will facilitate the further development of community midwifery services around the country. The drawdown approval specifically includes funding for an Advanced Midwifery Practitioner in Cavan General Hospital to provide additional senior midwifery expertise and capability and enable the further expansion of community midwifery services in Cavan.
I was very surprised at media reports of the proposed closure of the Midwifery Led Unit in Cavan as neither I, nor my Department, was advised of any intended change in relation to maternity services at the hospital. It is clear that any cessation or diminution of midwifery led services is not in line with the recommendations of the Strategy. Therefore, my Department has requested, and is currently awaiting, a full report from the National Women & Infants Health Programme (NWIHP) on the situation in Cavan General Hospital. Assurances have also been sought from the Programme that maternity services within the RCSI Hospital Group are, and will continue to be, developed in line with Government policy.
Once the full report has been received, my Department will work with the NWIHP to ensure that any additional supports which are required to secure the future of community midwifery services in Cavan, will be put in place. This will ensure that the choice of the Supported Care pathway remains available to women attending Cavan General Hospital for maternity services.
With regard to your particular queries in relation to the numbers of women attending the Cavan Midwifery Led Unit, as these are operational issues, I have asked the Health Service Executive to reply to you directly.
516. Deputy Jack Chambers asked the Minister for Health if a special needs unit can re-open as part of the Covid-19 easing of restrictions in line with other health services (details supplied); and if he will make a statement on the matter. [10780/20]
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.
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.
517. Deputy Brendan Smith asked the Minister for Health the status of the establishment of voluntary tracing apps arising from Covid-19; the proposals relating to the working of such apps at EU level; and if he will make a statement on the matter. [10414/20]
View answerAs part of the national response to Covid-19, work is underway to develop a national contact tracing app for Ireland that will help the public health service improve the speed and completeness of contact tracing and to map and predict the spread of Covid-19.
Developing contact tracing capability in mobile phones is a non-trivial engineering and public health exercise.
Development of the contact tracing app for Ireland is now complete and validation testing is underway to prove the functionality of the app in real world scenarios. The app will be released when validation testing is complete, and all appropriate approvals are in place. The results of validation testing will inform the go live date.
Apps are also being developed in many EU countries. Each is tailored to meet the needs of the national public health service and specifically the way in which contact tracing operations has been set up to work.
DG Sante, DG Connect and other key stakeholders at EU level are leading the way in developing interoperability standards to enable national apps to work in other members states, to support EU citizens as they travel between countries. Ireland is actively engaged in these activities through its membership of the EU eHealth network, which is acting as the forum for these discussions and agreements. Last week, the eHealth network agreed to pilot a solution for interoperability between members states using ‘decentralised’ contact tracing apps.
518. Deputy Éamon Ó Cuív asked the Minister for Health the number of Covid-19 cases detected to date among residents in direct provision centres; the number of centres that these occurred in; if the residents of such centres were subsequently tested for Covid-19 in addition to the staff; and if he will make a statement on the matter. [10209/20]
View answer520. Deputy Louise O'Reilly asked the Minister for Health the number of residents in direct provision centres who have been exposed to Covid-19 and require a test; and if he will make a statement on the matter. [10452/20]
View answer521. Deputy Louise O'Reilly asked the Minister for Health the details of the care pathway for a person in direct provision who needs to be tested for Covid-19; the persons who can order these tests; and if he will make a statement on the matter. [10453/20]
View answer522. Deputy Louise O'Reilly asked the Minister for Health the details of the testing programme for residents in direct provision in tabular form; the number of centres that have been tested; the number of persons who have been tested; if a plan for the remaining tests to be completed is in place; and if he will make a statement on the matter. [10454/20]
View answerI propose to take Questions Nos. 518, 520 to 522, inclusive, together.
As this is a service matter, the questions have been referred to the HSE for direct reply to the Deputies.
519. Deputy Éamon Ó Cuív asked the Minister for Health the discussions he has had on a controlled reduction of social distancing from 2 m to 1 m; and if he will make a statement on the matter. [10212/20]
View answerWhile the evidence relating to the SARS-CoV-2 virus is evolving, it is clear now that the risks of transmission of any respiratory pathogens such as the type that causes Covid-19 are lessened when greater distance is maintained between people. The current advice is that you should follow social distancing guidance everywhere outside the home, including keeping a physical distance of 2 metres apart. It is also recommended that face coverings be worn in situations where social distancing is difficult to maintain, such as shops, and on public transport, or when meeting someone who is vulnerable to the virus, for example people who are cocooning. The recommendation applies to those people aged over 13 who can tolerate them.
This advice is kept under review by the National Public Health Emergency Team on a continuing basis. Arising from their meeting of 4 June, 2020, the National Public Health Emergency Team has requested that the Health Protection Surveillance Centre develop guidance on the application of existing social distancing requirements in specific, defined and controlled environments in the hospitality industry during periods of low incidence of the disease. This guidance will then be considered by the National Public Health Emergency Team on completion.
523. Deputy Louise O'Reilly asked the Minister for Health the work undertaken to review evidence for fiscal measures on products that are high in fat, sugar and salt to reduce their consumption as per Action 1.10 of A Healthy Weight for Ireland: Obesity Policy and Action Plan 2016–2025; and if he will make a statement on the matter. [9618/20]
View answerA Healthy Weight for Ireland’, the Obesity Policy and Action Plan (OPAP), was launched in September 2016 under the auspices of the Healthy Ireland agenda. The OPAP covers a 10-year period up to 2025 and aims to reverse obesity trends, prevent health complications and reduce the overall burden for individuals, families, the health system, and the wider society and economy. The OPAP is based on the best available evidence in the Irish and international literature, and is informed by established international models and frameworks.
In relation to measures dealing with the level of consumption of products high in fat, sugar and salt (HFSS), the Sugar Sweetened Drinks Tax has already been introduced and commenced on 1 May 2018. The current focus in this area is on putting in place a reformulation programme for HFSS food and drink, under Action 3.1 of the OPAP, “Agree food industry reformulation targets and review progress”. To this end the Reformulation sub-group of the Obesity Policy Implementation Oversight Group (OPIOG) has been working on a roadmap for reformulation, including targets for reductions in salt, sugar, saturated fats and calories, and a proposed approach to achieve these targets. A draft roadmap has been considered by the OPIOG and a consultation with stakeholders subsequently took place. The submissions received as a result of that consultation process are being examined and it is expected that a report with the targets and final version of the roadmap will be submitted in the coming months.
Additionally, Ireland is participating in a Joint Action under the 3rd EU Health Programme called Best ReMaP (which stands for Best practice in Reformulation, Marketing and Public Procurement). The Joint Action is awaiting final approval form the EU Commission, but it is hoped that work will commence in the autumn. One of the work packages under this Joint Action is on reformulation, and this will be beneficial in assisting Ireland to achieve progress in its actions under the reformulation roadmap.
524. Deputy Duncan Smith asked the Minister for Health if his Department or the HSE has put in place support services or access to counselling for those bereaved by Covid-19; and if he will make a statement on the matter. [10842/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
525. Deputy Róisín Shortall asked the Minister for Health the number of persons on a waiting list for home care packages; the number of persons experiencing delayed discharge from hospital due to a delay accessing home care; and the waiting lists for home care packages by CHO and LHO on the latest date available in tabular form. [10843/20]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
527. Deputy Peadar Tóibín asked the Minister for Health the date for the re-opening of cervical and breast screening cancer services in view of the fact that other non-essential services and businesses are now able to resume while patients awaiting life-saving health procedures have been left waiting; and if he will make a statement on the matter. [10846/20]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
528. Deputy Joe Flaherty asked the Minister for Health if he will consider permitting local public health nurses to take bloods and administer the 'flu jab in the homes of elderly persons and especially those suffering from dementia (details supplied) in advance of the winter 'flu jab programme. [10848/20]
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.
529. Deputy Joe Flaherty asked the Minister for Health if he will request that staff assigned to a facility providing care through the share-a-break scheme and a foundation can resume the service (details supplied). [10849/20]
View answerAs the Deputy's question relates to a service issue, it has been referred to the HSE for direct reply.
530. Deputy Michael McGrath asked the Minister for Health if certain products (details supplied) are covered under the general medical card scheme for persons in each county; and if he will make a statement on the matter. [10850/20]
View answerAs this is a service matter it has been referred to the HSE for attention and direct reply to the Deputy.
531. Deputy Eoin Ó Broin asked the Minister for Health the reason persons with multiple sclerosis wait a longer period of time for access to new drugs than their counterparts across the EU; the action he is taking to reduce this differential; and the time frame within which all persons with MS will have full and equal access to all forms of treatment including new drugs. [10853/20]
View answerThe 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.
"League tables" comparing speed of reimbursement in Ireland with that of other countries are often misleading as several countries have quite different and often less rigorous assessment arrangements than Ireland. Furthermore, many of the newer products being licensed are falling well short of cost-effectiveness thresholds, with limited clinical benefits.
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.
As a country, we invest heavily in medicines, to the tune of almost €2 billion annually. In 2019, the HSE approved 31 new medicines and 5 new indications for existing medicines for reimbursement in the public healthcare system. The approvals represent an additional investment by the HSE over five years of approximately €220m in providing access to new and innovative treatment for Irish patients.
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 received 2 applications for pricing and reimbursement of ocrelizumab (Ocrevus). Application 1 was 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. This indication was approved for funding from October 2019, on a patient-specific basis.
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.
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.
In a further effort to identify solutions to the challenges which we face, I proposed a dialogue with Industry to explore ways in which new medicines might be more easily introduced in Ireland. An Open Policy Forum took place in 2018 between the Department of Health, the Department of Finance, Public Expenditure and Reform and the Irish Healthcare Pharmaceutical Association (IPHA) and an Open Dialogue meeting took place in 2019 between the Department of Health, the HSE and IPHA in relation to new medicines.
532. Deputy James Browne asked the Minister for Health the number of persons with disabilities in receipt of home support hours in each LHO area at the end of May 2020 or the latest date available; the number on the waiting list for same in each LHO area; and the number waiting zero to three, three to six, six to 12 and 12 months plus, in tabular form. [10860/20]
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.
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.
533. Deputy James Browne asked the Minister for Health the number of persons with disabilities in receipt of personal assistance hours in each LHO area at the end of May 2020 or the latest date available; the number on the waiting list for same in each LHO area; and the number waiting zero to three, three to six, six to 12 and 12 months plus, in tabular form. [10861/20]
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.
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.
534. Deputy James Browne asked the Minister for Health the number of residential places for persons with a disability being provided at the end of May 2020 or the latest date available; and the breakdown by CHO area of same in tabular form. [10862/20]
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.
As the Deputy will be aware, specialist disability services are provided by a range of organisations. In some cases the HSE itself delivers these services directly and in other circumstances, the HSE relies upon funded providers to deliver these services on its behalf. Organisations such as XXX provide services for people with a disability on a contract for services basis with the HSE, underpinned by Section XX of the Health Act 2004. Service Level Agreements are set out between the HSE and the individual organisations.
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.
535. Deputy James Browne asked the Minister for Health the number of new emergency places provided to persons with a disability at the end of May 2020; and the breakdown by local health office area of same in tabular form. [10863/20]
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.
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.
536. Deputy James Browne asked the Minister for Health the number of children at the end of May 2020, or the latest date available, who were awaiting a first assessment from the HSE under the Disability Act 2005 by LHO in tabular form. [10864/20]
View answerAs the Deputy's question relates to a service issue, it has been referred to the HSE for direct reply.
537. Deputy James Browne asked the Minister for Health the number of persons on the physiotherapy waiting list in each local health area at the end of May 2020 or the latest date available; the number waiting less than four, four to 12 and more than 12 months, respectively; and the number waiting aged zero to four, five to 17, 18 to 64 and 65 years of age plus, respectively in tabular form. [10865/20]
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.
