Written Answers Nos. 1298-1322
1298. Deputy John Brady asked the Minister for Health the status of the development of a new primary healthcare centre in Arklow, County Wicklow; the expected timeframe for the construction to completion of the project; and if he will make a statement on the matter. [15955/20]
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.
1299. Deputy Fergus O'Dowd asked the Minister for Health if he will address a matter (details supplied) on use of pelvic mesh; and if he will make a statement on the matter. [15956/20]
View answer1301. Deputy Pat Buckley asked the Minister for Health if his attention has been drawn to the findings of a review (details supplied) on vaginal mesh; his plans to implement similar responses to the issue here; and if he will make a statement on the matter. [15963/20]
View answer1302. Deputy Ged Nash asked the Minister for Health if his attention has been drawn to a recent UK report (details supplied) relating to women who have suffered injury as a result of pelvic mesh; his views on its recommendations for improving the ability of the healthcare system to respond in circumstances in which concerns have been raised regarding the safety of particular clinical interventions; if he will consider transposing recommendations from the report into the healthcare system here; and if he will make a statement on the matter. [15965/20]
View answerI propose to take Questions Nos. 1299, 1301 and 1302 together.
I note the recent publication in England of the report of the Independent Medicines and Medical Devices Safety (IMMDS) review, “First Do No Harm” which was chaired by Baroness Cumberlege.
International evidence and learning play an important role in health policy considerations to promote safe, high quality care for patients. This report may add to that evidence and learning.
Over the past two decades, Uro-Gynaecological (Transvaginal) Mesh has been widely used in the surgical treatment of Stress Urinary Incontinence (SUI) and Pelvic Organ Prolapse (POP) in women. Mesh devices are certified as compliant with relevant EU legislation, and as such, European regulatory competent authorities consider that the benefits outweigh the risks for these devices.
In Ireland, considerable work has been done to date and continues to progress on patient safety in relation to mesh implants; and the patient voice is central to our understanding of these, and similar, issues. As part of the ongoing policy response, my department officials are examining options to establish a process for an independent, compassionate engagement for women affected by mesh to have their voices heard; and will make proposals to me in this regard. Any engagement process will need to take account of the wider context relating to the COVID-19 pandemic.
Concerns were raised in Ireland regarding complications associated with the use of mesh devices in late 2017, including a number of Ministerial representations from the women affected or on their behalf. At that time, the Minister for Health requested the Chief Medical Officer (CMO) to prepare a report on the clinical and technical issues involved in ensuring both:
1. the safe and effective provision of mesh procedures in urogynaecology and
2. an appropriate response to women who suffer complications as a result of undergoing such procedures.
This CMO Report was published in November 2018.
Importantly, the CMO report was informed by the available national and international evidence and the personal experiences of women who have suffered complications following mesh surgery.
Since July 2018, the HSE has paused all mesh procedures where clinically safe to do so. This was at the request of the CMO and undertaken in advance of completion of the final CMO report. The pause was instigated pending confirmation by the HSE of the implementation of initial recommendations relating to (i) professional training requirements, (ii) patient information and consent and (iii) the development and maintenance of a national data set for all mesh procedures carried out in HSE funded hospitals.
The CMO report identifies that for many women, surgical procedures using synthetic mesh devices have provided a more effective and less invasive form of treatment than traditional procedures. However, mesh devices are associated with significant and severe complications in a minority of women, which are of concern given the difficulties of mesh implant removal.
The CMO report made a number of recommendations, the implementation of which will provide significant assurance that both women presenting for treatment and who develop mesh-related complications, receive high quality, multi-disciplinary patient centred care in accordance with the evidence and supported by robust clinical governance mechanisms.
The HSE published a detailed Implementation Plan for the recommendations in the report in April 2019. The HSE’s National Women & Infants Health Programme (NWIHP) is progressing treatment pathways and referral services for women suffering from mesh-related complications.
A multidisciplinary National Specialist Centre is being developed over 2 sites at Cork University Maternity Hospital (CUMH) and the National Maternity Hospital (NMH) Dublin. In addition, two translabial scanners, were procured by the HSE in late 2019, and are now on-site in both hospitals. However, the first scanning clinic, which was due to take place last March had to be postponed, due to the pandemic.
The HSE has published a dedicated webpage about vaginal mesh implants, including contact information for women suffering complications, which I hope is a useful resource. This can be found on the HSE website.
I would strongly encourage all women affected by mesh to engage with the relevant HSE contact points provided, to ensure that their service needs can be identified and provided for.
1300. Deputy David Cullinane asked the Minister for Health his plans regarding the 2017 assisted human reproduction Bill; and if he will make a statement on the matter. [15960/20]
View answerAs the Deputy will be aware, the Government approved the drafting of a bill on assisted human reproduction (AHR) and associated areas of research, based on the published General Scheme of the Assisted Human Reproduction Bill. This comprehensive piece of legislation encompasses the regulation of a range of practices for the first time, including: gamete (sperm or egg) and embryo donation for AHR and research; surrogacy; pre-implantation genetic diagnosis (PGD) of embryos; posthumous assisted reproduction; and embryo and stem cell research. The General Scheme also provides for the establishment of an independent regulatory authority for AHR.
Drafting of the bill is ongoing, in conjunction with the Office of the Attorney General. It is not possible at this time to give a definitive timeline for the publication of the Bill and its subsequent passage through the Houses of the Oireachtas. However, the recently-published Programme for Government affirms this Government’s intention to enact this legislation.
1303. Deputy Mick Barry asked the Minister for Health if the HSE can take over a nursing home (details supplied). [15990/20]
View answerThe nursing home referred to by the Deputy is a designated centre registered with the Health Information and Quality Authority (HIQA). It is an independent facility and as such its future is a matter for the provider in the first instance.
I understand that the centre requires substantial remedial works to undertaken prior to their application for re-registration by October 2020. The nursing home have made a decision to close the facility no later than 11th October 2020 and actively engaged with residents and their families to seek alternative placements to ensure the continuing needs of the residents are met.
The HSE and HIQA are aware of this decision. Further engagement is planned with the nursing home in relation to implications for the residents.
1304. Deputy Sean Sherlock asked the Minister for Health if he is in receipt of a funding request from an organisation (details supplied); and if he will ensure the resumption of services for that entity in each HSE area as quickly as possible. [16001/20]
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
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.
1305. Deputy Sean Sherlock asked the Minister for Health his plans to reduce the social distancing guidelines for an organisation (details supplied). [16002/20]
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 currently 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.
Guidance to support the Framework for the Resumption of Adult Disability Day Services was published by the HSE on 9 July 2020. The guidance document seeks to support the safe return of services in the context of ongoing public health guidance. It also recognises that the impact of public health guidance will result in services being provided at a reduced level and will require changes in how people are supported, increased use of technology where appropriate and more use of outreach supports.
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.
1306. Deputy Emer Higgins asked the Minister for Health further to Parliamentary Question No. 674 of 7 July 2020, if he will provide the specific total amount made available by his Department and the HSE in 2010; and if he will make a statement on the matter. [16013/20]
View answerIn 2010 my Department provided €3.786m in National Lottery Funding. Details of the organisations and the amount each received are available at https://www.gov.ie/en/collection/af1133-department-of-health-lottery-funding-2008-2016/.
I have asked the HSE to respond directly to the Deputy regarding the total amount of Lottery funding it provided in 2010.
1307. Deputy Alan Farrell asked the Minister for Health if Covid-19 health and safety guidelines will be issued to an organisation (details supplied) in respect of private therapist,s such as occupational therapists and speech and language therapists, who have been unable to treat patients since the public health crisis began; if these guidelines might incur costs to this sector; if grants will be provided; and if he will make a statement on the matter. [16016/20]
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
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.
1308. Deputy Thomas Gould asked the Minister for Health if increased funding has been provided to drug and alcohol treatment centres in view of the fact that their bed capacity has been significantly reduced in line with public health guidance as a result of the Covid-19 pandemic. [16018/20]
View answer1309. Deputy Thomas Gould asked the Minister for Health if increased funding has been provided to non-HSE drug and alcohol treatment centres in view of the fact that their bed capacity has been significantly reduced in line with public health guidance as a result of the Covid-19 pandemic. [16019/20]
View answer1310. Deputy Thomas Gould asked the Minister for Health if additional bed capacity in drug and alcohol treatment centres will be provided as a result of an increase in alcohol and drug addiction issues due to the lockdown resulting from the Covid-19 pandemic. [16020/20]
View answer1311. Deputy Thomas Gould asked the Minister for Health if a strategic plan will be put in place to assist persons who have developed drug or alcohol addictions or those that have had their drug or alcohol addictions increased due to the Covid-19 pandemic. [16021/20]
View answerI propose to take Questions Nos. 1308 to 1311, inclusive, together.
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, including addiction services.
I have therefore asked the Executive to investigate the matters raised by the Deputy and reply directly to him.
1312. Deputy Brian Stanley asked the Minister for Health the home services provided by HSE staff and home services provided by agencies for 2019 in terms of hours. [16023/20]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1313. Deputy Brian Stanley asked the Minister for Health the home services provided in hours by HSE staff and home services provided by agencies to date in 2020. [16024/20]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1314. Deputy Eoin Ó Broin asked the Minister for Health if his attention has been drawn to the ongoing campaign by families of persons with the hereditary blood disease ATTR amyloidosis; and the status of the licensing of the drug patisiran. [16029/20]
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. The Act specifies the criteria for decisions on the reimbursement of medicines.
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 licensed indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.
HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).
The NCPE conducts health technology assessments (HTAs) for the HSE and makes recommendations on reimbursement to assist HSE decisions. The NCPE uses a decision framework to systematically assess whether a drug is cost-effective as a health intervention.
I am advised by the HSE that it has received an application for the reimbursement of patisiran (Onpattro®) for the treatment of hereditary transthyretin-mediated amyloidosis (hATTR amyloidosis) in adult patients with stage 1 or stage 2 polyneuropathy.
In January 2019, a full health technology assessment was commissioned by the HSE. This assessment was completed in February 2020 with the NCPE recommending that patisiran (Onpattro®) is not considered for reimbursement unless cost-effectiveness can be improved relative to existing treatments.
The HTA report will be an important input into the decision making processes of the HSE. The HSE is currently reviewing the report received and has recently met with the applicant company to discuss this.
Once negotiations between the HSE and the applicant company are complete, this application must then be formally considered by the HSE Drugs Group. The HSE Drugs Group is the national committee which the HSE has in place to make recommendations on the pricing and reimbursement of medicines. The decision making authority in the HSE is the HSE Executive Management Team.
I can confirm that I have received representations in relation to the reimbursement of patisiran (Onpattro®).
1315. Deputy Donnchadh Ó Laoghaire asked the Minister for Health if his attention has been drawn to plans to restore or increase respite hours in the Cork area for families of children with special needs that had been reduced or paused during the Covid-19 pandemic, with particular reference, but not exclusively, to the respite services at Garretstown. [16030/20]
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.
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
1316. Deputy Denis Naughten asked the Minister for Health when an application by a person (details supplied) will be processed; and if he will make a statement on the matter. [16031/20]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1317. Deputy David Cullinane asked the Minister for Health when an updated national rare diseases plan will be published; and if he will make a statement on the matter. [16034/20]
View answerA National Rare Disease Plan for Ireland (2014 – 2018) was launched by the Minister for Health in July 2014. This is a generic policy framework for rare diseases. The scope of the plan is broad given that there are approximately 8,000 rare diseases affecting millions of EU citizens; and consequently, there can be a dearth of expertise and knowledge about some rare diseases, simply because they are so rare.
Many of the major recommendations of the plan have already been implemented including the establishment of a National Clinical Programme for Rare Diseases and a Rare Disease Office. Building on this progress to date, themes for inclusion in a roadmap for the coming period have been agreed with the Rare Disease Task Force, which comprises the main rare disease advocacy groups; Rare Disease Ireland, the Medical Research Charities Group (MRCP), and the Irish Platform for Patient Organisations, Science and Industry (IPPPOSI). The Rare Disease Plan is now firmly embedded in the work of the HSE Clinical Programme for Rare Diseases and the Rare Disease Office. This programme operated under the governance of the Office of the Chief Clinical Officer.
Meetings to ensure that the input and the voice of the patient is represented in the continuing work ongoing in relation to Rare Diseases take place at regular intervals with the Rare Disease Task Force, the HSE National Clinical Programme for Rare Diseases and the Rare Disease Office.
In addition, a number of key themes have been identified for future progress, including: Patient Awareness; European Reference Networks; Research & Registries; Access to Services; Access to Medicines; Diagnosis; Education & Training and Legislation & Policy.
1318. Deputy Mairéad Farrell asked the Minister for Health the reason work has stopped on the national children’s hospital; if there are legal proceedings under way on the project; the estimated cost to the State of such legal proceedings; the number of days lost due to legal proceedings; and the cost to the State per day of delays to the project. [16108/20]
View answerThe proceedings currently before the Commercial Court are related to the validity of the instruction given by the NPHDB to begin the Phase B above ground construction works in January 2019. As this matter is now before the Courts it would be inappropriate to comment further at this time.
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.
1319. Deputy Brendan Smith asked the Minister for Health when day services for persons with disabilities will resume; and if he will make a statement on the matter. [16111/20]
View answerAs part of the overall effort to contain the spread of COVID-19 and in line with public health advice, day service locations closed in March.
Since then, HSE Disability Services have been working to develop national guidance on the part of the disability sector to direct how all day services can be delivered. The Guidance to support the Framework for the Resumption of Adult Disability Day Services was published by the HSE on 9 July 2020.
In developing the guidance document to guide providers, the HSE worked closely with service providers through representative organisations such as the National Federation of Voluntary Service Providers, Disability Federation of Ireland and the Not for Profit Association, in addition to Inclusion Ireland, who represent people with intellectual disabilities and their families.
The guidance document seeks to support the safe return of services in the context of ongoing public health guidance. It also recognises that the impact of public health guidance will result in services being provided at a reduced level and will require changes in how people are supported, increased use of technology where appropriate and more use of outreach supports.
Day services will gradually resume during the month of August. Service providers are already working to get day services ready to reopen safely, and in line with public health guidance. Service providers will be in touch with all families and service users during the month of July to discuss when they may expect the resumption of their service and what that service will consist of.
I want to acknowledge the many challenges experienced by individuals and their families over this difficult time. Families across the country have had their routines upended due to the impact of COVID-19 and I hope that this will be the first step towards returning to some sense of normalcy.
The Guidance to support the Framework for Resumption of Adult Disability Day Services is available on the New Directions website: www.hse.ie/newdirections. The HSE have also issued monthly communications updates for service users and their families, the latest leaflet “Adult Disability Day Services and COVID-19 - What’s Happening? July 2020” is available at the above link.
1320. Deputy Michael Ring asked the Minister for Health the position regarding a facility (details supplied); and if he will make a statement on the matter. [16122/20]
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.
1321. Deputy Michael Ring asked the Minister for Health the details of facilities that were block booked or taken over in County Mayo for use during the Covid-19 pandemic; the location, capacity and costs involved of each; the facilities that were used; the number of persons who were placed in the facilities; and if he will make a statement on the matter. [16123/20]
View answerAs this is an operational matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1322. Deputy Peadar Tóibín asked the Minister for Health the number of tribunals, public investigations and commissions of investigations in process; the length of time each has been under way; when each will conclude; the cost to date of each; and the estimated cost of each at completion. [16135/20]
View answerDetails in relation to a commission of investigation and a tribunal in process under the remit of the Minister for Health are set out below.
1. The Commission of Investigation (Certain matters relative to a disability service in the South East and related matters), “the Farrelly Commission”, was established by Government under S.I No. 96 of 2017, Commission of Investigation Certain matters relative to a disability service in the South East and related matters) Order 2017 to investigate the care and protection of “Grace” (pseudonym) and others in a former foster home in the South East, which has been the subject of abuse allegations.
The first phase of the Farrelly Commission’s work is to investigate the role of public authorities in the care and protection of Grace, who resided with a former foster family in the South East of Ireland between 1989 and 2009. Phase 2 will commence following consideration of the Phase 1 Final Report and the Commission’s written statement on the scope of its further investigations.
The Farrelly Commission commenced work on 15 May 2017 and was due to submit its Final Phase 1 Report within one year of commencing its work.
The Farrelly Commission wrote to my predecessor as Minister for Health (Simon Harris, T.D.) to request a ten-week preliminary extension until Friday, 24 July 2020, to allow it to identify the time needed to complete its Phase 1 Final Report. Minister Harris granted the extension. He made this decision following discussion with his colleague, the Minister of State with Special Responsibility for Disabilities, Finian McGrath and his Cabinet colleagues.
This is the Farrelly Commission’s third extension. It is in addition to the two twelve-month extensions that were granted by Minister Harris in May 2018 and May 2019.
The Farrelly Commission’s costs to date are €5,247,054.55. The final cost of the Commission will be determined by my decision on the submission that the Farrelly Commission will provide to me by 24 July 2020 setting out the length of time that it has identified to allow it to complete its Phase 1 work and make its report.
2. The Hepatitis C Compensation Tribunal was established on a non-statutory basis in December 1995 to compensate people who had contracted Hepatitis C through the administration of Anti-D immunoglobulin, whole blood, or other blood products within the State. It was put on a statutory footing in November 1997 by means of the Hepatitis C Compensation Tribunal Act. The Tribunal’s remit was extended in 2002 to include individuals who had contracted HIV and to provide for additional heads of claim for the dependants of infected persons – loss of consortium, dependency losses, loss of society, post-traumatic stress disorder/nervous shock and future care claims. In 2006, the Hepatitis C Compensation Tribunal Act was further amended to provide for the establishment of an insurance scheme.
The Hepatitis C and HIV Compensation Tribunal will continue in existence until the last person infected with Hepatitis C dies and any claim lodged by their dependents is heard.
The total cost of the Hepatitis C and HIV Compensation Tribunal from 1995 to end December 2018 is €1.195bn. The estimated cost of the Tribunal in 2019 is €16.62m. These figures are provisional pending the publication of the Annual Report for 2019. This Scheme is demand led and it is impossible to know precisely how much it will cost from year to year. The Scheme has cost an average of approximately €20m per annum over the last 5 years.
