Written Answers Nos. 1190-1208
1190. Deputy John McGuinness asked the Minister for Health further to Parliamentary Question No. 547 of 5 July 2020, if issues raised in correspondence (details supplied) will be addressed; and if he will make a statement on the matter. [21516/20]
View answerThe provision of orthodontic services is an operational matter for which the HSE has responsibility. The review to which the Deputy refers was initiated by the HSE. I have therefore asked the HSE to respond directly to the Deputy on this matter.
A protected disclosure has been received. It is the Department's policy not to comment on individual cases, to ensure the confidentiality of the discloser is maintained.
1191. 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. [21517/20]
View answerI received correspondence from the Commission of Investigation (certain matters relative to a disability service in the South East and related matters) ("the Farrelly Commission") on 22nd July 2020. The correspondence, in the form of an eighth interim report, included an application by the Farrelly Commission for a further time extension to allow it to complete its phase 1 work.
I have granted the Commission an interim extension to allow it to continue its work. The Minister for Disability, Anne Rabbitte, T.D. and I will meet the Farrelly Commission on 21st September 2020 to consider the its rationale for the application for this further extension in more detail. A determination on the length of the extension following this meeting.
1192. Deputy Mark Ward asked the Minister for Health the total mental health budget between 2007 and 2020, in tabular form; and if he will make a statement on the matter. [21554/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1193. Deputy Jackie Cahill asked the Minister for Health if a facility (details supplied) has a consultant psychiatrist; the services available at the facility; the services available at the facility in each of the years 2015 to 2019 and to date in 2020; and if he will make a statement on the matter. [21556/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1194. Deputy David Cullinane asked the Minister for Health if his attention has been drawn to the fact that standard general practitioner care is being denied to home birthing women due to difficulties relating to insurance cover; his plans to rectify the denial of standard post-natal care; and if he will make a statement on the matter. [21557/20]
View answerThe Maternity and Infant Care Scheme provides an agreed programme of care to expectant mothers ordinarily resident in Ireland. This combined medical service is provided by the family GP and a hospital obstetrician and includes a schedule of alternating examinations at the GP’s practice and a maternity unit/hospital, as well as two post-natal visits to the GP.
The State indemnifies enterprises on behalf of the Minister for Health under the Clinical Indemnity Scheme (CIS) when national policy confirms that this should be provided. This includes Community Midwives who have an SLA with the HSE for the provision of home births. In the case of GPs, they are private practitioners and to date services provided by them and by GP practice nurses are not covered by the CIS. Instead, as private practitioners, GPs receive professional indemnity from private medical indemnity providers. As this is an arrangement between two private parties, the medical indemnity cover provided is a matter for GPs and their private insurers.
The National Maternity Strategy aims to ensure that appropriate care pathways are in place in order that mothers, babies and families get the right care, at the right time, by the right team and in the right place. The Strategy makes it clear that women should be offered a choice regarding their preferred pathway of care, in line with their clinical needs and best practice, including in regard to the birth setting. Further discussions need to take place with relevant parties to agree national policy on the role of GPs in relation to home births, in the context of the National Maternity Strategy.
1195. Deputy David Cullinane asked the Minister for Health the estimated cost of maintaining access to the European health insurance card for citizens in Northern Ireland assuming coverage is otherwise lost as a result of Brexit. [21561/20]
View answerThe maintenance of European Health Insurance Card rights is part of the ongoing Future Relationship negotiations between the UK and the EU. This Government recognises the importance placed on continued access to the European Health Insurance Card by residents of Northern Ireland and continues to monitor developments on this closely.
In the event of there being no agreement between the EU and the UK on this issue, preparations for the implementation of an analogous scheme to the European Health Insurance Card have been ongoing. In that regard a figure of just over €5 million per annum has been estimated for such a scheme. However, it is important to note that this is a high level estimate and the actual cost will be dependent on a range of factors including the numbers that might avail of such a scheme, the potential for an ongoing impact on travel due to Covid-19 and the number of persons in Northern Ireland that may retain European Health Insurance Card rights under the EU/UK Withdrawal Agreement.
1196. Deputy David Cullinane asked the Minister for Health if the budgeted reduction of the monthly threshold for the drug payment scheme from €124 to €114 is to take place in 2020; if not, if it will be budgeted for 2021; if further reductions are planned; and if he will make a statement on the matter. [21562/20]
View answerAs 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.
1197. Deputy David Cullinane asked the Minister for Health the estimated cost of reducing the drug payment scheme threshold from €124 to €100 and from €114 to €100, respectively. [21563/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1198. Deputy Pádraig O'Sullivan asked the Minister for Health if a child (details supplied) will receive a dental appointment; if an appointment will be scheduled; and if he will make a statement on the matter. [21565/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1200. Deputy David Cullinane asked the Minister for Health the estimated cost of each of the expansions outlined in the Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020, in tabular form; the timeline for commencement of each section; and if he will make a statement on the matter. [21567/20]
View answerThe Government is committed to increasing access to GP care without charges for children, an important healthcare measure that will remove a potentially prohibitive cost barrier to accessing GP care and will help to improve children’s health as they develop.
The Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 was signed into law in August. This Act provides, amongst other things, for the phased expansion of GP care without fees to all children aged 12 years and under. The initial stage of this phased expansion will be the provision of GP care without fees to all children aged between 6 and 8.
Funding in respect of the expansion of GP care without fees to all children aged between 6 and 8, as well as other measures provided under the Act, has been provided for within the Budget 2020 package of family friendly measures, which amounted to €45m in total. Introduction of the expansion of GP care without fees will be the subject of negotiation with the IMO, representing general practitioners, and the exact cost will depend on the outcome of those negotiations.
The appropriate date for commencing the expansion remains under consideration in light of COVID-19 and the additional pressures the expansion might place on general practice in that context and in anticipation of the usual increase in demand for healthcare services over the winter period. This date will be determined in consultation with the IMO. It is important to ensure that any additional pressures placed on general practice will not limit its capacity to meet the needs of all patients in the community.
1202. Deputy Francis Noel Duffy asked the Minister for Health if his attention has been drawn to the fact that a hospital (details supplied) is retracting free parking for healthcare workers; if he will liaise with the HSE and local authorities to ensure that free parking will remain for the duration of the Covid-19 national public health emergency; and if he will make a statement on the matter. [21574/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1203. Deputy Michael Healy-Rae asked the Minister for Health if an appointment will be expedited for a person (details supplied); and if he will make a statement on the matter. [21577/20]
View answerIn 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.
1204. Deputy Peter Fitzpatrick asked the Minister for Health when the drug kalydeco will be made be available to patients for the treatment of cystic fibrosis in view of the fact the clinical trial for same has finished; and if he will make a statement on the matter. [21578/20]
View answerThe 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.
Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency (EMA) or the Health Products Regulatory Authority.
Ivacaftor (Kalydeco®) has received marketing authorisation from the EMA for a number of indications. I am advised by the HSE that reimbursement has been approved for all ivacaftor monotherapy indications for which the EMA has granted market authorisations and that there is no market-authorised indication or cohort of cystic fibrosis patients eligible for ivacaftor monotherapy for which reimbursement is not in place.
The HSE advises that it has also approved reimbursement for the combination regimen with tezacaftor. The HSE expects that cystic fibrosis patients in Ireland will be able to avail of the combination regimen with ivacaftor75mg/tezacaftor50mg/elexacaftor100mg tablets in Q4 of 2020.
1205. Deputy John McGuinness asked the Minister for Health if the case of a person (details supplied) will be examined; the reason an appointment for diagnostic investigations was cancelled; and if the matter will be expedited. [21586/20]
View answerIn 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.
1206. Deputy Louise O'Reilly asked the Minister for Health the CHO areas in which heart failure community integration teams are operating; the gaps that exist; the work carried out by the teams in each area; his plans to standardise same; and if he will make a statement on the matter. [21588/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1207. Deputy Louise O'Reilly asked the Minister for Health the access general practitioners have to carry out BNP testing in each CHO area; the reason there is no national general practitioner access to the tests; his plans to develop the service; the estimated amount national general practitioner access to BNP testing would cost (details supplied); and if he will make a statement on the matter. [21589/20]
View answerAs this question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
1208. Deputy Louise O'Reilly asked the Minister for Health his views on whether the number of heart failure nurses is sufficient to fully meet standards in relation to the treatment and management of heart failure in hospitals and in the community; if there is a deficit, the number of additional heart failure nurses required; the other staffing deficits that exist within heart failure services; and if he will make a statement on the matter. [21590/20]
View answer1210. Deputy Louise O'Reilly asked the Minister for Health his plans to ensure the successful resumption and maintenance of heart failure services with particular emphasis on developing such services in the community and providing greater integration between these and hospital services; if there will be no redeployment of staff working in acute cardiac and stroke services in view of the fact such patients are particularly susceptible to such disruption; the research taking place to establish the exact impact of disruption to services on excess deaths since the outbreak of Covid-19 here; and if he will make a statement on the matter. [21592/20]
View answerI propose to take Questions Nos. 1208 and 1210 together.
The COVID-19 pandemic led to an unprecedented interruption to normal health services both in the community and acute hospitals system.
It is important to recognise that many vital services have continued throughout the pandemic, ensuring that priority care needs were addressed and the most vulnerable protected even at the height of this crisis. To ensure that services were restored in a prioritised manner with investments targeted at rebuilding services guided by Sláintecare - shifting service provision from Hospital to community-based care, the HSE published in June 2020, a Strategic Framework for Delivery of Service Continuity in a COVID Environment. This ensures a safer environment for patients and service users
The Department of Health continues to work closely with the HSE on the resumption and maintenance of usual healthcare services as a key priority. This includes ongoing consideration of the how best to deliver such services in the context of the ongoing COVID-19 pandemic and in line with the HSE Strategic Framework.
With regards to heart failure and cardiology services more generally, the National Review of Specialist Cardiac Services commenced in January 2018 with Professor Phillip Nolan as Chair of the Steering Group. Stroke services are not included in the scope of this Review.
This Review aims to achieve optimal patient outcomes at population level with particular emphasis on the safety, quality and sustainability of the services that patients receive by establishing the need for an optimal configuration of a national adult cardiac service.
Substantial progress has been made on the Review. However, the COVID-19 Pandemic has impacted on the progress of the review during 2020, as the Chair of the Cardiac Services Review has played a key role in the national COVID-19 response as a member of the NPHET and Chair of the Irish Epidemiological Modelling Advisory Group. It is planned that work on the Cardiac Services Review will progress again in the Autumn.
As the Deputy's question also relates to operational matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for attention and for direct reply on these matters to the Deputy.
