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Wednesday, 9 Sep 2020

Written Answers Nos. 266-285

General Practitioner Services

Questions (266)

Michael Creed

Question:

266. Deputy Michael Creed asked the Minister for Health when the expansion of general practitioner care without charges to all children aged 12 years of age and under will come into effect. [22816/20]

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Written answers

The 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.

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.

Medical Cards

Questions (267)

Michael Creed

Question:

267. Deputy Michael Creed asked the Minister for Health when the increase to gross income limits for medical card eligibility for persons aged 70 years of age or older will come into effect. [22817/20]

View answer

Written 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 Government is finalising decisions on the associated funding for this measure and the implementation date for the commencement of this provision.

Hospital Appointments Status

Questions (268)

Niamh Smyth

Question:

268. Deputy Niamh Smyth 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. [22838/20]

View answer

Written answers

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Hospital Appointments Status

Questions (269)

Niamh Smyth

Question:

269. Deputy Niamh Smyth 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. [22839/20]

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Written 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.

Trade Fairs

Questions (270)

Jim O'Callaghan

Question:

270. Deputy Jim O'Callaghan asked the Minister for Health when business to business trade fairs will be permitted to recommence. [22840/20]

View answer

Written answers

The Government will finalise and publish a Roadmap for Resilience and Recovery in advance of 13 September. This will map how we balance public health, economic and social aspects of living with COVID-19 in the short to medium term and try to bring some greater certainty so that society and business can at least plan forward. As part of the deliberations, consideration will be given to the reopening of the Events Industry.

As I am sure the Deputy can appreciate, the evidence relating to the SARS-CoV-2 virus and the decisions necessary to protect everybody living in Ireland from its effects is constantly evolving. The public health advice relating to Covid-19 is kept under continuing review by the National Public Health Emergency Team (NPHET), by my Department of Health and by the Government. The latest public health advice on these matters is available at the links below and is updated on a regular basis.

It is not possible to say what circumstances will apply in the future due to the nature of the virus that has caused this global pandemic and the concerns that remain about the very serious threats to health that can be caused by this virus.

It’s really important to remember now, as things open up further, that personal responsibility and judgement are more important than ever. Continuing to adhere to public health advice will determine whether we continue to move forward to the remaining phases.

Hospital Services

Questions (271)

Francis Noel Duffy

Question:

271. Deputy Francis Noel Duffy asked the Minister for Health the rationale behind the decision to relocate acute services for children in the national children’s hospital to other hospitals; if this is a permanent or temporary decision; the impact this might have on the local community; and if he will make a statement on the matter. [22850/20]

View answer

Written answers

Last March as part of the response to the COVID-19 pandemic, CHI temporarily relocated paediatric services from Tallaght to its other sites at Crumlin and Temple Street and to the urgent care centre at Connolly. This freed up resources at Tallaght to support the adult service there in responding to the demands of COVID. This temporary change allowed for some CHI staff on a voluntary basis to work in the adult services supporting their colleagues including in ICU during this very challenging period for the health services.

This was a temporary measure, and paediatric services at Tallaght have now resumed. CHI advises this began with the return of outpatients in July. A 24/7 emergency care unit, medical inpatient care and day case surgery, medicine and x-ray resumed on site from 3 September.

Tallaght will now take on increased day surgeries instead of resuming in-patient surgeries, which will create theatre capacity in Temple St and Crumlin for surgeries that can only be undertaken in those hospitals. Additionally, critically ill and critically injured children will be directed to the CHI Emergency Departments at Crumlin and Temple Street.

Patient safety is central to CHI’s decision making, both in the provision and development of services. This approach is designed to ensure that resources across all CHI sites at Tallaght, Crumlin, Temple Street and Connolly are utilised as effectively as possible to maximise the level of service provided and ensure the delivery of safe, high quality services. This is crucial in the context of what is expected to be a challenging winter for paediatric services.

Disability Services Provision

Questions (272)

Pat Buckley

Question:

272. Deputy Pat Buckley asked the Minister for Health the reason a person (details supplied) will no longer be provided funding for care from 30 September 2020 despite the fact that they have severe disabilities affecting their physical and mental health and requiring 24-7 professional care; and the steps he will take to ensure that the burden of care does not fall on the elderly parents of this person that are incapable of effectively meeting their needs. [22862/20]

View answer

Written answers

As this is a service, matter I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.

Occupational Therapy

Questions (273)

Seán Sherlock

Question:

273. Deputy Sean Sherlock asked the Minister for Health the number of occupational therapists hired from each university by the HSE in each of the years 2016 to 2019 and to date in 2020; the number of graduates in each year per institution in tabular form; and his views on whether the number of occupational therapists in the HSE is appropriate. [22863/20]

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Written answers

The number of occupational therapists hired from each university as raised by the Deputy is more appropriate to my colleague at the Department of Further and Higher Education, Research, Innovation and Science and the Deputy may wish to refer his queries there.

With regard to the number of occupational therapists in the HSE, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Dental Services

Questions (274)

Mary Lou McDonald

Question:

274. Deputy Mary Lou McDonald asked the Minister for Health if an alternative dental appointment can be provided by the HSE in respect of a person (details supplied) who has been refused care in a number of DTSS services and is unable to source an alternative service. [22864/20]

View answer

Written answers

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 (275)

Colm Burke

Question:

275. Deputy Colm Burke asked the Minister for Health the date his Department received the final report by a company (details supplied) into its independent external review of the HSE medicine reimbursement process; if he will provide an overview of the findings and recommendations of the report; when it is expected to be submitted to him; and if he will make a statement on the matter. [22867/20]

View answer

Written answers

In 2019, following a tender by the Office of Government Procurement, Mazars conducted a review of the governance structures around the HSE's drug reimbursement process. The report was submitted to my Department in January 2020.

The review made recommendations in respect of the HSE’s systems, structures, processes, governance arrangements and use of specialist resources in respect of the drug reimbursement process.

The report was under consideration by officials earlier this year, however the focus of the Department of Health changed to the immediate public health considerations of the COVID-19 pandemic and the preservation of life. This meant that this work stream was temporarily suspended to reallocate resources to support essential services.

My Department aims to complete its consideration of the report’s recommendations in the near future.

Medicinal Products

Questions (276)

Colm Burke

Question:

276. Deputy Colm Burke asked the Minister for Health the medicines submitted to HSE leadership or executive management team for reimbursement approval; the date of each meeting; the outcome of each meeting from 1 January 2019 to date; and if he will make a statement on the matter. [22868/20]

View answer

Written answers

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for reply to the Deputy.

Rare Diseases Strategy

Questions (277)

Colm Burke

Question:

277. Deputy Colm Burke asked the Minister for Health his plans to publish an updated national rare disease plan as per the Programme for Government; when he expects to publish the plan; and if he will make a statement on the matter. [22870/20]

View answer

Written answers

A 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 is 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.

A number of key themes have now been identified for progression in the coming period, including: Patient Awareness; European Reference Networks; Research & Registries; Access to Services; Access to Medicines; Diagnosis; Education & Training and Legislation & Policy. This will form the basis for work in this area in the time ahead.

Hospital Waiting Lists

Questions (278)

Pa Daly

Question:

278. Deputy Pa Daly asked the Minister for Health the number of persons on the waiting list for the rheumatology department in University Hospital Kerry; and the length of time persons are awaiting an appointment there. [22872/20]

View answer

Written 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.

In relation to the particular query raised regarding the number of persons on the waiting list for the rheumatology department in University Hospital Kerry (UHK), and the length of time persons are awaiting an appointment there, the table below, extracted from the National Treatment Purchase Fund (NTPF) published waiting list figures for July 2020, provides a breakdown of the Outpatient waiting list for Rheumatology in UHK by time band:

Total

0-3 mths

3-6 mths

6-9 mths

9-12 mths

12-15 mths

15-18mths

18 mths+

549

68

83

84

83

60

36

135

A full breakdown of Outpatient waiting lists by hospital and specialty is available at: https://www.ntpf.ie/home/outpatient.htm

Rare Diseases Strategy

Questions (279)

Colm Burke

Question:

279. Deputy Colm Burke asked the Minister for Health the status of the work of the rare diseases technology review committee of the HSE; the meetings it has held to date in 2020, in tabular form; the meetings and therapies it has scheduled for the remainder of 2020; and if he will make a statement on the matter. [22873/20]

View answer

Written answers

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for reply to the Deputy.

Medicinal Products

Questions (280)

Colm Burke

Question:

280. Deputy Colm Burke asked the Minister for Health the status of the reimbursement of the drug osimertinib for lung cancer in a first line setting; and if he will make a statement on the matter. [22874/20]

View answer

Written answers

The HSE has statutory responsibility for medicine pricing and reimbursement decisions in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013 which specifies the criteria for decisions on the reimbursement of medicines.

In line with the 2013 Health Act and the national framework agreed with industry, if a company would like a medicine to be reimbursed by the HSE, the company must submit an application to the HSE to have the new medicine added to the reimbursement list.

Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.

I am advised by the HSE that it has received an application for the reimbursement of osimertinib (Tagrisso) indicated for the first-line treatment of adult patients with locally advanced or metastatic NSCLC with activating epidermal growth factor receptor (EGFR) mutations.

In respect of this indication, a health technology assessment was completed on 6 August 2019 with the NCPE recommending that osimertinib not be considered for reimbursement unless cost effectiveness can be improved relative to existing treatments.The final decision-making authority in the HSE is the HSE Executive Management Team (EMT). Osimertinib remains under consideration with the HSE EMT for the above indication and a final decision will be made in line with the 2013 Act.

Health Services Staff

Questions (281)

Róisín Shortall

Question:

281. Deputy Róisín Shortall asked the Minister for Health if he will address the recruitment shortfall in the medical science profession; the reason for staff shortages in hospital laboratories; and if he has had engagement with the HSE and CORU on this matter. [22876/20]

View answer

Written answers

My officials recently met with the Medical Laboratory Scientists Association (MLSA) and the HSE in relation to a range of issues including on the area of recruitment. We have not engaged with CORU specifically on this issue. I have also asked the HSE to reply directly to the Deputy in relation to this question.

Commencement of Legislation

Questions (282)

Róisín Shortall

Question:

282. Deputy Róisín Shortall asked the Minister for Health when he will commence the Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020; and if he will make a statement on the matter. [22878/20]

View answer

Written answers

The Health (General Practitioner Service and Alteration of Criteria for Eligibility) Bill 2020 was enacted on 2nd August 2020. This Act provides 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 Government is finalising decisions on the associated funding for this measure and the implementation date for the commencement of this provision.

The Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 also provides 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.

The 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 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.

Vaccination Programme

Questions (283)

Róisín Shortall

Question:

283. Deputy Róisín Shortall asked the Minister for Health if the HPV vaccine is available under the drugs payment scheme for an adult that has gone through a colposcopy and that has received a prescription for the HPV vaccine from their consultant; if not, the reason; and if he will make a statement on the matter. [22880/20]

View answer

Written answers

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Vaccination Programme

Questions (284)

Darren O'Rourke

Question:

284. Deputy Darren O'Rourke asked the Minister for Health the budget allocation for the National Immunisation Office in 2019 and 2020, in tabular form. [22885/20]

View answer

Written answers

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Covid-19 Pandemic

Questions (285)

Seán Haughey

Question:

285. Deputy Seán Haughey asked the Minister for Health if a toddler group or play café can continue to operate in a parish hall or community centre for more than six persons; and if he will make a statement on the matter. [22896/20]

View answer

Written answers

You will be aware that the situation regarding COVID- has been, and continues to be, an evolving situation. COVID-19 is still having a major impact both here in Ireland and elsewhere. The measures in place and the public health advice have been adapted to the changing circumstances and this will continue to be the case for the foreseeable future.

Progress has been made on suppressing the virus due to the huge effort of our citizens. By working together, we have saved lives and limited the impact of the disease on society in Ireland. We all must continue to do everything possible to avoid the virus spreading.

The public health advice relating to Covid-19 is kept under continuing review by the National Public Health Emergency Team (NPHET), and it provides advice to Government in line with the current epidemiological position. The latest public health advice on these matters is available at the links below and is updated on a regular basis.

The latest public health advice is available at the following links and is updated on a regular basis:

https://www.gov.ie/en/organisation/department-of-health/

https://www2.hse.ie/coronavirus/

https://www.gov.ie/en/

The recently introduced regulations [(S.I. 326 of 2020) Health Act 1947 (Section 31a – Temporary Restrictions) (Covid-19) (No. 4) Regulations 2020], which state that events being organised indoors may have no more than 6 attendees apply to social, recreational, exercise, cultural, entertainment and community events.

Those who are responsible for organising community groups should ensure that a controlled environment is in place for such groups.

Not every type of gathering and group is easily categorised as the categorisation of such groups depends on the structure of the individual group, how they are organised and how they operate.

The HPSC has produced guidelines for the childcare sector

(https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/childcareguidance/)

which is specifically targeted at early learning and care and school age childcare services. However, it does include some guidance on the safe operation of parent and toddler groups during Covid-19. It is important to note, however, that the guidance does not state when such groups may operate but rather gives guidance on how they may operate safely when allowed to do so.

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