Written Answers Nos. 385-409
385. Deputy Emer Higgins asked the Minister for Health his plans to eliminate the wait for cancer patients as a result of the reorientation of the public and private health services during the Covid-19 crisis; and if he will make a statement on the matter. [12748/20]
View answerThe National Action Plan on Covid-19 identified the continued delivery of urgent cancer care as a priority through ensuring the delivery of national specialities and maintaining urgent activity (including Rapid Access Clinics). Cancer services continued following the consideration of the risk:benefit ratio of treatment of individual patients, the prioritisation of time-sensitive treatment and the ongoing review of the location of the delivery of cancer services across all cancer clinical programmes:
- Medical oncology services continue with the relocation of day wards where necessary. Physical distancing requirements will challenge the return of patients to pre-Covid numbers;
- Radiation oncology services continue with provisions made for physical distancing and intensified cleaning regimes for the linac machines;
- Maintaining urgent surgical oncology services is a priority with many services relocating to private hospitals. Less urgent surgery was deferred at the outset and this is beginning to be addressed now:
- Rapid Access Clinics for breast, lung and prostate cancers continue. E-referrals to these clinics, compared to the pre-Covid months, are back to normal for breast patients (largest numbers attend breast clinics), but are still lower for lung (in particular) and prostate;
- Symptomatic services for other cancers also continue to operate, in line with NCCP guidance documents for treating patients during the Covid-19 pandemic. Patients are being triaged in advance of their appointments, and virtual/telephone clinics are in operation where possible.
Cancer services across all clinical programmes are currently seeking to return to activity levels to meet the increasing service demand. This will include the diagnosis and treatment of patients triaged as non-urgent who may not have presented, or who had their treatment delayed or deferred, during the Covid-period. The HSE's National Cancer Control Programme (NCCP) advises that it will be a challenge to get the numbers back to where they were while implementing physical distancing and associated precautionary measures. The challenges arising will be exacerbated by the number of patients who would normally have presented earlier coming forward in the next few months, on top of the increasing numbers arising more generally in line with an increasing and an ageing population.
My Department is continuing to engage closely with the NCCP and others in regard to cancer services and work is underway to establish the requirements to sustainably provide for the demand. The focus is on facilitating cancer services to return to pre-COVID levels, as far as possible, and on how this can be done in a safe and effective way. Planning will include for any revised arrangements with private hospitals.
386. Deputy Neale Richmond asked the Minister for Health if he will request a formal investigation by the EU Commission independent advisory panel on characterising flavours in tobacco products into the continued sale of menthol-style products in view of his comments that some tobacco companies are undermining the menthol cigarette ban that came into force in May 2020; if he will consider issuing a prohibition order on the products while the investigations by the HSE are ongoing; and if he will make a statement on the matter. [12751/20]
View answerThe Health Service Executive, as a competent authority for the EU Tobacco Products Directive, is responsible for enforcement of the prohibition on the sale of menthol flavoured cigarettes and tobacco products which came into effect on 20 May 2020. The HSE is monitoring compliance with the ban and will pursue all necessary measures, be they at national or EU level, to ensure that prohibited products are removed from the market.
387. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [12755/20]
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.
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.
388. Deputy Peter Burke asked the Minister for Health his plans to prevent the banned substance MMS from entering the market here and being sold illegally to parents of autistic children; and if he will make a statement on the matter. [12756/20]
View answerThe Health Products Regulatory Authority (HPRA) conducts ongoing monitoring activities for the supply of the product known as ‘Miracle Mineral Solution’ (MMS) in Ireland. This includes monitoring of the Internet and online platforms for the promotion of unauthorised medicinal products, including MMS. The HPRA also engages with social media platforms to require removal of any advertisements and offerings that contravene medicinal products legislation, as well as taking enforcement actions against suppliers for offences in relation to manufacture and supply of the product, where necessary.
Currently the HPRA does not have any evidence that MMS is being supplied by any website or other outlet in Ireland. This is not to suggest that such supply of this product, or other unauthorised medicinal products offered to treat autism spectrum disorder, will not appear in the future. It is also possible that information relating to and promotion of the treatment is happening via word of mouth, the dark web, or other relatively difficult-to-detect methods. The HPRA is vigilant in this area and will continue to monitor for, and investigate, such matters, including co-operating and working with An Garda Síochána, Revenue’s Customs Service and other State agencies as appropriate.
The regulations in relation to medicinal products cover their placing on the market, manufacture, wholesale and retail supply and advertising. The unauthorised medicinal product known as Miracle Mineral Solution (MMS) is governed by these regulations. Penalties for breaches of regulations are provided for by the Irish Medicines Board Acts 1995 and 2006. On summary conviction, a person may face fines not exceeding a class B fine (€4,000) and, or imprisonment for a term not exceeding one year; on conviction on indictment, fines not exceeding €100,000 and, or imprisonment for a term not exceeding 10 years, and in the case of a second or subsequent offence on indictment, fines not exceeding €250,000, and, or imprisonment for a term not exceeding 10 years.
389. Deputy Duncan Smith asked the Minister for Health the status of the land at the entrance to an estate (details supplied); if it is under the control of the HSE; and if he will make a statement on the matter. [12768/20]
View answer396. Deputy Duncan Smith asked the Minister for Health the status of the land (details supplied) at a location; and if it is still under the control of the HSE. [12809/20]
View answerI propose to take Questions Nos. 389 and 396 together.
As the Health Service Executive is responsible for the management of the public healthcare property estate, I have asked the HSE to respond directly to you in relation to this matter.
390. Deputy Louise O'Reilly asked the Minister for Health further to Parliamentary Question No. 572 of 16 June 2020, the way in which the chronic disease management programme will be rolled out over the next three years to 2023; the categories of patients that will be added to those already commenced in the programme; and if he will make a statement on the matter. [12773/20]
View answerIn line with the terms of the 2019 GP Agreement, the Chronic Disease Management (CDM) Programme which commenced at the end of January 2020 is to be rolled out on a phased basis to adult GMS and GP visit card patients over a 4-year period, starting with those aged 75 years and over. The programme will be extended to eligible patients aged 65 – 74 years from 2021 and to those aged 45 – 64 years from 2022.
Patients with an existing diagnosis of one of the specified conditions (Type 2 Diabetes, Asthma, COPD, and Cardiovascular Disease), those who are assessed by their GP on an opportunistic case finding basis, as well as those identified as high risk, will benefit under the programme.
The programme is expected to help over 400,000 patients to better manage their conditions through regular programmed contacts with their GP, resulting in the most effective use of healthcare resources and a decrease in reliance on acute hospital attendance.
Due to the COVID-19 public health emergency and in line with clinical advice, temporary changes have been agreed between the HSE and the IMO to the operation of the CDM Programme. These will allow for greater use of remote consultations and will increase the number of patients benefiting from the Programme in the current year. The revised Programme will be a combination of teleconsultations and in-surgery visits at the GP’s discretion and dependent on patient clinical requirements. In addition, the Programme will be extended to include all medical card and GP visit card patients over the age of 70.
391. Deputy Michael Healy-Rae asked the Minister for Health the status of funding for a person (details supplied); and if he will make a statement on the matter. [12779/20]
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.
392. Deputy Jackie Cahill asked the Minister for Health if he will review the case of a person (details supplied); and if he will make a statement on the matter. [12786/20]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
393. Deputy Aindrias Moynihan asked the Minister for Health if HR circular 037/2019 has been fully implemented; if not, when it will be; and if he will make a statement on the matter. [12796/20]
View answerMy Department issued policy direction in relation to the application of the pay adjustments under the Public Service Pay and Pension Act 2017 on the 17 December 2019 to the totality of the public health sector via Department of Health circular 16/2019.
In relation to the operational application of these adjustments, I have asked the HSE (whose circular is 037/2019) to respond directly to the Deputy.
394. Deputy Aindrias Moynihan asked the Minister for Health if HR circular 027/2019 has been fully implemented; if not, when it will be; and if he will make a statement on the matter. [12797/20]
View answerI have requested the HSE respond to the Deputy directly on this matter.
395. Deputy James Lawless asked the Minister for Health the current schedule for the construction of the National Children's Hospital; the delays that are expected; if he will confirm that construction is reconvened as planned; and if he will make a statement on the matter. [12803/20]
View answerI am aware that construction work on the new children’s hospital stopped on 31 March 2020 as a result of the Covid-19 pandemic.
I understand that since the commencement of the easing of restrictions on 18 of May, the National Paediatric Hospital Development Board (NPHDB) has been engaging with the main contractor in relation to the earliest possible reopening of the site. I have been informed that some matters remain unresolved at this time and that construction has not recommenced.
I am anxious that the hospital be completed as quickly as possible on behalf of children, young people and their families. The NPHDB has statutory responsibility for planning, designing, building and equipping the new children's hospital and I have referred your question to the NPHDB for direct reply.
397. Deputy Louise O'Reilly asked the Minister for Health if nursing home staff being tested for Covid-19 will have their results relayed to them directly and not to their managers, in view of the fact that this was the case previously when there was mass testing of nursing home staff. [12811/20]
View answerAs the HSE has responsibility, the Executive has been asked to reply directly to the Deputy.
398. Deputy Joan Collins asked the Minister for Health if the case of a person (details supplied) will be investigated; and the reason they have not been transferred to a particular nursing home in view of the circumstances. [12812/20]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
399. Deputy Mark Ward asked the Minister for Health if he has requested the HSE to examine the finances of an organisation (details supplied); if so, the reason for the examination; when the examination will be concluded; if the results will be made public; and if he will make a statement on the matter. [12813/20]
View answerThe HSE has worked with Pieta House to ensure continued provision of its key services during and after Covid-19. The HSE has committed to provide cash flow support on a monthly basis, to begin when the Government payment schemes have ceased, with the position to be reviewed after each quarter. The provision of supplementary resources to Pieta House is linked to Action 4 in the National Action Plan in Response to Covid-19, which is focused on caring for at risk or vulnerable people and outlines the need to roll out and expand supports related to Covid-19.
The HSE is in regular communication with Pieta House to ensure that services provided to clients are in line with the revised service level agreement (SLA). As part of the agreement, Pieta House will provide financial information giving a clear outline of service delivery and associated costs before, during and after Covid-19.
I have referred this parliamentary question to the HSE for direct reply, to furnish you with further information on the revised SLA between the HSE and Pieta House, including financial monitoring and any financial examination.
400. Deputy John Lahart asked the Minister for Health if his attention has been drawn to the delays in the commencement of the mental health service for deaf adults; if his attention has been further drawn to the fact that a consultant was appointed to the service in October 2019 but no patients have been seen; and if he will make a statement on the matter. [12817/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
401. Deputy Noel Grealish asked the Minister for Health if versatis pain patches are prescribed under the GMS scheme for conditions other than shingles; the other conditions these patches are prescribed for; and if he will make a statement on the matter. [12832/20]
View answerThe Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drug schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
Following a review, the HSE introduced a new system for the reimbursement of the lidocaine 5% medicated plaster (Versatis), which is licensed only for the localised relief of post-shingles pain in adults.
Patients are reviewed by the Medicines Management Programme (MMP) for reimbursement approval, on foot of an application by the patient’s clinician, through the HSE online system.
In exceptional circumstances, the product may be approved for supply for unlicensed uses.
If an application is refused, the clinician may make an appeal, making a clear clinical case for the patient to the MMP at mmp@hse.ie.
This process ensures the appropriate use of the patch and that post-shingles patients, and other patients as clinically appropriate, can continue to have this treatment.
402. Deputy James Browne asked the Minister for Health when employees of a service (details supplied) will receive computer devices; and if he will make a statement on the matter. [12837/20]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
403. Deputy Jennifer Murnane O'Connor asked the Minister for Health when the €350,000 allocated to the ambulance base in County Carlow will be provided; when he expects works to begin; when County Carlow will have an ambulance base that is fit for purpose; and his views on whether it is unacceptable for a town the size of Carlow to not have its own ambulance base. [12842/20]
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.
404. Deputy Louise O'Reilly asked the Minister for Health if his attention has been drawn to the fact that some dentists are telling patients that they are not accepting medical card patients due to the increased cost of PPE in delivering care and the failure of his Department and the HSE to help them with such costs; and if he will make a statement on the matter. [12851/20]
View answerThe Dental Treatment Services Scheme (DTSS) provides dental care free of charge to medical card holders aged 16 and over. These services are provided by independent dental practitioners who have a contract with the HSE. Fees paid to dentists under the DTSS are set out in the Health Professionals (Reduction of Payments to Registered Dentists) Regulations 2009 and the Health Professionals (Reduction of Payments to Registered Dentists) Regulations 2012.
I understand that there are reports that medical card holders may have been refused access to treatment by a small number of dentists with DTSS contracts. The Chief Dental Officer in my Department is urgently pursuing the matter with the HSE National Oral Health Office to seek to ensure that no patients are left without a service.
I am aware that a number of dental contractors have given notice of their intention to withdraw from the DTSS but I would hope that those dentists would continue to honour their ethical and contractual obligations to patients during the notice withdrawal period to either provide a service or ensure that patients are referred to a neighbouring dentist who will provide a service.
I would also expect due process to be followed in respect of any withdrawal from the terms of a DTSS contract, in particular regarding an appropriate period of notice.
The cost of PPE should not be a key determinant in decisions on the treatment of patients. The Dental Council advises that dentists should take a case by case assessment when deciding if additional PPE is warranted. The Health Protection Surveillance Centre has advised that regular PPE, which has always been used, is generally sufficient for routine dentistry.
My understanding is that a small number of dentists had applied to the HSE for PPE until early May when the volume of requests increased. My Department, in conjunction with the HSE, is examining the issue of the provision of PPE across all parts of the health service, including health service contractors. I am not aware of any agreement between the HSE and the Irish Dental Association in this regard.
In order to support small, medium and larger businesses that are negatively impacted by COVID-19 a suite of Government measures is in place. These include a Restart grant for which application can be made online to local authorities and a Return to Work Safely Protocol designed to support employers and workers to put measures in place that will prevent the spread of COVID-19 in the workplace. The Health and Safety Authority also provides information and advice for employers and employees in this regard.
405. Deputy Louise O'Reilly asked the Minister for Health if all non-consultant hospital doctors currently working in the health service or that had previously worked in the service that were dealing with Covid-19, will be offered full-time contracts to stay working in the health service; and if he will make a statement on the matter. [12852/20]
View answerI have asked the HSE to respond to the Deputy on this matter.
406. Deputy Paul McAuliffe asked the Minister for Health his plans to deal with the rat infestation in north-western areas of Dublin; and the role of the HSE in this regard. [12860/20]
View answerThis is a matter for the HSE therefore I have referred the question to the HSE for attention and direct reply.
407. Deputy Jackie Cahill asked the Minister for Health when the intensive physiotherapy department will reopen at Our Lady’s Hospital, Cashel, County Tipperary; and if he will make a statement on the matter. [12862/20]
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.
408. Deputy Jackie Cahill asked the Minister for Health if a series of matters will be clarified in relation to the case of a person (details supplied); and if he will make a statement on the matter. [12863/20]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
409. Deputy John McGuinness asked the Minister for Health if cervical testing has been restored to normal levels of activity; if there is a backlog of appointments; if it is normal for patients to be waiting for six months or more; and if he will make a statement on the matter. [12865/20]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
