David Cullinane
Question:1170. Deputy David Cullinane asked the Minister for Health when he plans to commence Part 8 of the Assisted Decision-Making (Capacity) Act 2015 ; and if he will make a statement on the matter. [21485/20]
View answerCommencement of Legislation
Questions (1170)
Written answers
Part 8 of the Assisted Decision Making (Capacity) Act 2015 provides a legislative framework for Advanced Healthcare Directives (AHDs). An AHD is a statement made by a person with capacity setting out his or her will and preferences regarding treatment decisions that may arise in the future when he or she no longer has capacity.
My Department remains committed to commencing these provisions as soon as possible. The development of a code of practice to accompany the AHD provisions is a key piece of work to facilitate commencement. The AHD multidisciplinary working group which I established in 2016 has developed a code of practice for Part 8 and submitted it to the Director of Decision Support Services in December 2018 for consideration. When this has been finalised by the Director it will be submitted to me for approval prior to publication.
There are a number of other interdependencies which must be addressed before Part 8 can be commenced and work is continuing in respect of all outstanding matters. These include commencing certain other provisions of the Act outside of Part 8 that fall under the remit of the Department of Justice and Equality.
Commencement of Legislation
Questions (1171)
David Cullinane
Question:1171. Deputy David Cullinane asked the Minister for Health when he plans to progress the Patient Safety (Notifiable Patient Safety Incidents) Bill 2019; and if he will make a statement on the matter. [21486/20]
View answerWritten answers
The Patient Safety (Notifiable Patient Safety Incidents) Bill 2019 provides the legislative framework for a number of important patient safety issues, including the mandatory open disclosure of a list of notifiable patient safety incidents and the notification of same externally to the Health Information and Quality Authority, Chief Inspector of Social Services and the Mental Health Commission, as appropriate, to contribute to national learning and system-wide improvements. This mandatory requirement for open disclosure will ensure that patients and their families receive appropriate timely information in relation to an incident that may have occurred in relation to their care.
The Patient Safety (Notifiable Patient Safety Incidents) Bill 2019 will also bring the private hospitals within the remit of the Health Act 2007. The relevant provisions extend the remit of the Health Information and Quality Authority, allowing it to set standards for the operation of private hospitals, to monitor compliance with them and to undertake inspections and investigations as required. The Bill also contains provisions to support clinical audit within the health service.
The Bill was introduced into Dáil Éireann on the 12 December 2019 and passed Second Stage in the Dáil and is due to go to Dáil Committee Stage. The Bill is a Programme for Government commitment. The Patient Safety (Notifiable Patient Safety Incidents) Bill 2019 was restored to the Dáil Order paper on 28 July 2020. Following Dáil Committee stage, the Bill will be progressed to Dáil Report Stage and will then go through all Stages in the Seanad.
The Patient Safety (Notifiable Patient Safety Incidents) Bill 2019 is also part of the broader programme of legislative and policy initiatives to improve the ability of the health service to anticipate, identify, respond to patient safety issues and improve the quality and safety of health services for patients. Creating a culture of open disclosure and learning from the things that go wrong is the bedrock of making services safer.
Health Services Funding
Questions (1172)
David Cullinane
Question:1172. Deputy David Cullinane asked the Minister for Health the estimated current and capital cost of increasing base capacity of critical care beds from 255 to 350; and if he will make a statement on the matter. [21487/20]
View answerWritten answers
The cost of a critical care bed has several determining factors. However, a survey undertaken by the HSE of active and recently completed projects suggests that new critical care beds can cost up to, and sometimes above, €1m, depending on a variety of factors.
The HSE has advised that the average annual cost of running a critical care bed is €747k. However, it should be noted that this figure includes costs for both ICU and HDU beds, with the ICU beds the more expensive of the two. It should also be noted that the impacts of COVID-19 and the new recommendations on distance requirements on costs are yet to be determined.
My Department and the HSE are currently engaging in regard to critical care capacity requirements in the public hospital system. However, in order to provide the Deputy with more detail on costs associated with additional critical care beds, I have asked the HSE to respond directly to him as soon as possible.
Health Services Funding
Questions (1173)
David Cullinane
Question:1173. Deputy David Cullinane asked the Minister for Health the estimated cost of returning the throughput of cancer services to pre-Covid-19 levels by medical oncology, radiation oncology and surgery and by capital and current costs; and if he will make a statement on the matter. [21488/20]
View answerWritten answers
Funding is being sought to address the delivery of cancer services in the context of the Covid pandemic, and in the context of an increasing and an ageing population, through the Winter/Continuity planning and the 2021 Estimates processes.
This funding would support the restoration of cancer treatment services towards pre-Covid levels. The areas for which funding is sought include medical oncology, radiation oncology and surgery. Some minor capital works are included to facilitate physical distancing and Infection Prevention & Control measures.
Health Services Funding
Questions (1174)
David Cullinane
Question:1174. Deputy David Cullinane asked the Minister for Health the estimated cost of increasing the income limits for medical card assessments for persons 70 years of age and over by increasing the income thresholds to €550 per week for a single person and €1050 for a couple; and if he will make a statement on the matter. [21489/20]
View answerWritten answers
The Health (General Practitioner Service and Alteration of Criteria for Eligibility) Bill 2020 was enacted on 2nd August 2020. This Act provides, amongst other things, for the necessary legislative amendments to the Health Act 1970 (as amended) to increase the weekly gross medical card income limits for those aged 70 and over to €550 per week for a single person (currently €500 per week) and to €1050 per week for a couple (currently €900 per week).
The precise cost of increasing the medical card gross income limits for those aged 70 and over is difficult to estimate as it will be dependent on a number of factors, including the number of additional applications made to the HSE, the timescale within which these are made and the number of applicants who are deemed eligible. The Government is finalising decisions regarding the provision of funding for this measure and the implementation date for the commencement of this provision.
Health Services Funding
Questions (1175)
David Cullinane
Question:1175. Deputy David Cullinane asked the Minister for Health the estimated cost of clearing the backlog for all those waiting for funding for new or additional home support under the home support service; and if he will make a statement on the matter. [21490/20]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Cancer Services
Questions (1176)
David Cullinane
Question:1176. Deputy David Cullinane asked the Minister for Health the details of the most recent projected workforce planning requirements to meet demand in cancer services by specialty; and the number of these posts that are filled in tabular form. [21494/20]
View answerWritten answers
I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Cancer Services
Questions (1177)
David Cullinane
Question:1177. Deputy David Cullinane asked the Minister for Health the number of unfilled posts in cancer services nationally; the number which have been vacant for over six months by hospital in tabular form; and if he will make a statement on the matter. [21495/20]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
Disabilities Assessments
Questions (1178)
Bernard Durkan
Question:1178. Deputy Bernard J. Durkan asked the Minister for Health when an assessment of need will be facilitated in the case of a person (details supplied); and if he will make a statement on the matter. [21497/20]
View answerWritten answers
The Programme for Government, Our Shared Future, recognises the need to improve services for both children and adults with disabilities through better implementation and by working together across Government in a better way.
The Government commits to prioritising early diagnosis and access to services for children and ensuring that the most effective interventions are provided for each child, to guarantee the best outcomes.
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Statutory Instruments
Questions (1179)
David Cullinane
Question:1179. Deputy David Cullinane asked the Minister for Health his views regarding the changing of the status of naloxone hydrochloride from Schedule 1a to Schedule part 1 under the S.I. No. 540/2003; if the change of status has been considered; and if he will make a statement on the matter. [21498/20]
View answerWritten answers
Naloxone is a medicine used to reverse the effect of opioid drugs such as heroin, morphine and codeine. It is contained in a number of medicinal products and presentations authorised on the Irish market for different indications including: in combination with opioid analgesics to counteract opioid-induced constipation; emergency treatment for respiratory depression associated with known or suspected opioid overdose or intoxication; or in combination with another drug to treat opioid dependence in persons who are also receiving medical, social and psychological support. Based on these authorised indications, use of naloxone on a regular basis should be subject to ongoing medical supervision.
Naloxone is listed in Part A of the First Schedule to the Medicinal Products (Prescription and Control of Supply) Regulations 2003 (S.I No. 540 of 2003), as amended (the ‘Prescription Regulations’). This essentially means that where it is supplied against a prescription, it may be dispensed one occasion only, also known as being non-repeatable.
Following the making of the Medicinal Products (Control of Placing on the Market) Regulations 2007 (S.I. No. 540 of 2007), as amended, the criteria for the determination of the classification of a medicinal product, is no longer ultimately determined by reference to the First Schedule to ‘Prescription Regulations’. The classification decision is now a matter for the marketing authorisation holder and the appropriate regulatory authority.
For a medicinal product to be available on the market in Ireland it must be granted a marketing authorisation by the Health Products Regulatory Authority (HPRA) or by the European Commission, following a recommendation by the European Medicines Agency (EMA).
Regulation 9 of the 2007 Regulations requires that the marketing authorisation holder, at the time of application or renewal of a marketing authorisation should indicate whether the medicinal product is one which should be available either: on foot of a prescription; only from a pharmacy; or on general sale.
Regulation 12 of the 2007 Regulations then outlines the criteria that the HPRA must consider when making a determination of this supply classification. These criteria are transposed from EU requirements detailed in the Pharmaceutical Directive, Dir 2001/83/EC.
Therefore, it is up to the marketing authorisation holder to apply for a reclassification for its medicinal product and to supply the necessary evidence to support the safety of any such reclassification.
For injectable forms of naloxone, under EU law, any medicinal products which are typically prescribed by a doctor to be administered parenterally (injected) shall be subject to a prescription. For intranasal forms of naloxone, indicated for emergency treatment for respiratory depression associated with known or suspected opioid overdose or intoxication, it would again be up to the marketing authorisation holder to seek a reclassification from the appropriate regulatory authority.
The only intranasal naloxone product currently marketed in Ireland, Nyxoid® is authorised via the centralised procedure by the European Commission and is currently subject to prescription. Any applications to a change in supply classification would have to be made by the marketing authorisation holder to the EMA on behalf of the Commission. It could not be reclassified at a national level.
The marketing authorisation for Nyxoid® states that it, “should only be made available once the suitability and competence of an individual to administer naloxone in the appropriate circumstances has been established. Patients or any other person who might be in a position to administer Nyxoid® must be instructed in its proper use and the importance of seeking medical assistance.”
In addition, the Nyxoid® marketing authorisation requires that a post-authorisation efficacy study on the effectiveness of intranasal naloxone administration by lay people in reversing opioid overdose be conducted. This study is scheduled for completion by the end of 2022. Therefore, it is unlikely that the EMA would consider any application for reclassification without a positive review of this data.
Nevertheless, in Ireland, there are mechanisms to ensure access to naloxone in emergency situations. The HSE operates a take home naloxone scheme- where naloxone can be prescribed to a person who is at risk of overdosing on opioids and the person who uses drugs and a friend or family member will be trained in its safe and appropriate use.
Additionally, naloxonecan be sourced and held by listed organisations and administered for suspected opioid overdose by suitably trained persons as provided for by Regulations 4C-E of the 'Prescription Regulations'.
People who use drugs, or their family members, are encouraged to speak to their doctor about naloxone. Organisations interested in accessing and holding naloxone for emergency administration are encouraged to follow the information in the following links:
http://www.hpra.ie/homepage/medicines/emergency-medicines
https://www.phecit.ie/PHECC/Publications_and_Resources/Newsletters/Newsletter_Itmes/2016_Summer/Emergency_life-saving_medicines.aspx
Maternity Services
Questions (1180)
Mark Ward
Question:1180. Deputy Mark Ward asked the Minister for Health if the birthing pool in the Coombe Women and Infants University Hospital is being removed; if so, the reason for same; and if he will make a statement on the matter. [21500/20]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Eating Disorders
Questions (1181)
Mark Ward
Question:1181. Deputy Mark Ward asked the Minister for Health the budget allocation and description of expenditure for the clinical care programme on eating disorders in 2018, 2019 and to date in 2020; the reason for underspends; the number of posts progressed to date; and if he will make a statement on the matter. [21501/20]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
Cancer Services
Questions (1182, 1183)
David Cullinane
Question:1182. Deputy David Cullinane asked the Minister for Health his plans regarding rapid access clinics for cancer diagnoses; the planned expansions to the service; the estimated cost of an expansion to the service; and if he will make a statement on the matter. [21503/20]
View answerDavid Cullinane
Question:1183. Deputy David Cullinane asked the Minister for Health the estimated cost of a 10% increase in funding for rapid access clinics [21504/20]
View answerWritten answers
I propose to take Questions Nos. 1182 and 1183 together.
Cancer Rapid Access Clinics continued to operate throughout the Covid-19 pandemic, with appropriate physical distancing and infection prevention and control measures. At this point, attendance numbers at urgent Breast Disease Clinics have returned to pre-Covid levels. While attendances are down for Rapid Access Lung Clinics, Rapid Access Prostate Clinics and non-urgent Breast Disease Clinics, they are showing a steady recovery.
Funding is being sought to address the delivery of services during the Covid pandemic, and in the context of an increasing and an ageing population, through the Winter planning and 2021 Estimates processes.
Hospital Appointments Status
Questions (1184)
Michael Healy-Rae
Question:1184. 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. [21506/20]
View answerWritten answers
In response to the Covid-19 pandemic the HSE had to take measures to pause most elective scheduled care activity with effect from the end March 2020. 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 National Public Health Emergency Team (NPHET) and in accordance with World Health Organisation guidelines, and the National Action Plan.
To ensure services are re-introduced in a safe, clinically-aligned and prioritised way, the HSE launched its Strategic Framework for ‘Service Continuity in a Covid Environment’ on 24 June. Its implementation will ensure service resumption is done in an integrated way. This will involve a phased approach to ensure community services are strengthened. The Framework will also consolidate new ways of working and build on international knowledge. Further detail regarding the phases of service resumption are contained in the HSE’s ‘A Safe Return to Health Services’ document, published on their website on 22 July.
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. 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 is a standardised approach used by the HSE to manage scheduled care treatment for in-patient, day case and planned procedures. It sets out the processes that hospitals are to implement to manage waiting lists and was developed in 2014 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.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Medicinal Products
Questions (1185, 1290)
David Cullinane
Question:1185. Deputy David Cullinane asked the Minister for Health further to Parliamentary Question No. 745 of 8 May 2019, the position regarding new medication for the preventative treatment of chronic migraine (details supplied); the status of same; and if he will make a statement on the matter. [21509/20]
View answer
Róisín Shortall
Question:1290. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 745 of 8 May 2019, if the National Centre for Pharmacoeconomics has completed its full health technology assessment of the new anti-calcitonin gene-related peptide used for the preventative treatment of chronic migraine; and if he will make a statement on the matter. [22004/20]
View answerWritten answers
I propose to take Questions Nos. 1185 and 1290 together.
The HSE has statutory responsibility for medicine pricing and reimbursement decisions, 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.
The HSE has advised that on 16 April 2019, it received an application for pricing / reimbursement of Fremanezumab (Ajovy®) from the applicant company for the prophylaxis of migraine in adults who have at least 4 migraine days per month.
The HSE commissioned the rapid review process and on 17 April 2019, the National Centre for Pharmacoeconomics (NCPE) advised the HSE that a full Health Technology Assessment (HTA) was required for this medicine.
On 01 May 2019, the HSE commissioned a full Health Technology Assessment. On 07 September 2020, the HSE received the NCPE health technology assessment report. The NCPE recommends that Fremanezumab (Ajovy®), for the prophylaxis of migraine in adult patients with chronic migraine who have failed three or more migraine-preventive treatments be considered for reimbursement.
For the prophylaxis of migraine in adult patients with episodic migraine who have failed three or more migraine-preventive treatments, the NCPE recommends reimbursement be considered if cost-effectiveness can be improved relative to existing treatments.
The HSE confirmed that on 10 August 2018, it received an application for pricing / reimbursement of Erenumab (Aimovig®) from the applicant company for the prophylaxis of migraine in adults who have at least 4 migraine days per month
On 19 July 2018, the HSE commissioned the rapid review process. Following receipt of a rapid review dossier, on 15 August 2018, the NCPE advised the HSE that a full HTA was required for this medicine
On 28 August 2018, the HSE commissioned a full HTA as per agreed processes. On 30 September 2019, the NCPE report was received by the HSE. For chronic migraine, the NCPE recommended that Erenumab (Aimovig®) be considered for reimbursement if cost-effectiveness can be improved relative to existing treatments. For episodic migraine, the NCPE recommended Erenumab (Aimovig®) not be considered for reimbursement
The decision making authority in the HSE is the HSE Executive Management Team. The HSE Executive Management Team decides on the basis of all the demands it is faced with (across all services) whether it can fund a new medicine, or new uses of an existing medicine, from the resources that have been provided to it in line with the Health (Pricing and Supply of Medical Goods) Act 2013.
The HSE has advised that the applications for both Fremanezumab and Erenumab is currently under consideration in line with the 2013 Health Act.
Child and Adolescent Mental Health Services
Questions (1186)
Barry Cowen
Question:1186. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) will receive a referral to child and adolescent mental health services. [21510/20]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
Health Services Provision
Questions (1187)
Pearse Doherty
Question:1187. Deputy Pearse Doherty asked the Minister for Health if a person (details supplied) can receive the remainder of their treatment; and if he will make a statement on the matter. [21511/20]
View answerWritten answers
In response to the Covid-19 pandemic the HSE had to take measures to pause most elective scheduled care activity with effect from the end March 2020. 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 National Public Health Emergency Team (NPHET) and in accordance with World Health Organisation guidelines, and the National Action Plan.
To ensure services are re-introduced in a safe, clinically-aligned and prioritised way, the HSE launched its Strategic Framework for ‘Service Continuity in a Covid Environment’ on 24 June. Its implementation will ensure service resumption is done in an integrated way. This will involve a phased approach to ensure community services are strengthened. The Framework will also consolidate new ways of working and build on international knowledge. Further detail regarding the phases of service resumption are contained in the HSE’s ‘A Safe Return to Health Services’ document, published on their website on 22 July.
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. 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 is a standardised approach used by the HSE to manage scheduled care treatment for in-patient, day case and planned procedures. It sets out the processes that hospitals are to implement to manage waiting lists and was developed in 2014 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.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Health Services
Questions (1188)
John McGuinness
Question:1188. Deputy John McGuinness asked the Minister for Health if matters raised in correspondence (details supplied) will be addressed; and if he will make a statement on the matter. [21513/20]
View answerWritten answers
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.
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. It 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. The HSE has published a dedicated webpage about vaginal mesh implants, including contact information regarding the pathways for women suffering complications. This can be found on the HSE website.
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 onsite 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 pathways for women experiencing mesh complications, established by the HSE, have been in place for over a year. All appointments offered to women through these pathways have been to the public system. 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.
The Treatment Abroad Scheme is not available for patients wishing to have mesh related surgery for SUI or POP as there is currently a pause on mesh surgeries for these specific ailments. The TAS scheme is not available for mesh removal, full or partial, as the treatment is available publicly in Irish hospitals.
On an interim basis, Translabial Scanning has been made available under the Treatment Abroad Scheme until the two scanners which have been purchased by the HSE are operational in the two Mesh Complications Centres. As Translabial scanning is a diagnostic tool and not a “treatment” it does not normally qualify for this scheme however having listened to the requests from women for this specific type of scanning to be made available this interim measure was taken.
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.
Prescriptions Charges
Questions (1189)
John McGuinness
Question:1189. Deputy John McGuinness asked the Minister for Health further to Parliamentary Question No. 1306 of 16 October 2018, if issues raised in correspondence (details supplied) will be addressed; and if he will make a statement on the matter. [21515/20]
View answerWritten answers
As part of Budget 2020, the previous Government announced two measures intended to reduce the cost of medicines:
- GMS prescription charges would be reduced by €0.50c for all medical card holders. The charge would be reduced by €0.50c to €1 per item for the over 70s and by €0.50c to €1.50 for persons under 70. The maximum monthly charge would also be reduced to €10 and €15 respectively.
- The monthly threshold of €124 for the Drug Payment Scheme (DPS) would be reduced by €10 to €114 per household.
The funding of these measures was predicated on the achievement of corresponding savings in the health budget in 2020. It has not been possible to achieve these savings to date and therefore I am not in a position at present to progress the changes to prescription charges. I will keep this matter under review in the light of the funding available to the health service in 2020 and 2021.