Tuesday, 13 Oct 2020

Written Answers Nos. 534-551

Health Services

Questions (534)

David Cullinane

Question:

534. Deputy David Cullinane asked the Minister for Health if he will address a matter raised in correspondence (details supplied). [30173/20]

Written answers

Minister for Health

As the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to the deputy directly in relation to this matter.

Hospital Appointments Status

Questions (535)

Niamh Smyth

Question:

535. Deputy Niamh Smyth 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. [30174/20]

Written answers

Minister for Health

It is recognised that waiting times for scheduled appointments and procedures have been impacted as a direct result of the COVID-19 pandemic.

In response to the Covid-19 pandemic the HSE had to take measures to defer most scheduled care activity in March, April, and May of this year. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by the National Public Health Emergency Team (NPHET) in accordance with the advice of the World Health Organization.

The resumption of services from June onwards has allowed for increased activity, with the HSE utilising innovative methods including telemedicine to facilitate patient appointments. Patient safety remains at the forefront of service resumption. To ensure services are re-introduced in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols which has resulted in reduced capacity and activity

The HSE continues to optimise productivity through alternative work practices such the use of alternative settings including private hospitals, community facilities and alternative outpatient settings.

The National Treatment Purchase Fund has also recommenced arranging treatment in both private and public hospitals for clinically suitable patients who have been waiting for long periods on public hospital waiting lists.

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.

Hospital Data

Questions (536)

Jim O'Callaghan

Question:

536. Deputy Jim O'Callaghan asked the Minister for Health the number of patients admitted on a monthly basis to intensive care units here in each of the years 2017 to 2019, inclusive, and in the first nine months of 2020. [30188/20]

Written answers

Minister for Health

I have asked the HSE to respond to the deputy directly.

Medicinal Products

Questions (537)

Gino Kenny

Question:

537. Deputy Gino Kenny asked the Minister for Health if there is an appeals process for those who have been refused reimbursement by the HSE for the use of the breast cancer drug pertuzumab despite a consultant oncologist’s opinion that it would be beneficial to use as treatment in a particular case (details supplied); and if he will make a statement on the matter. [30191/20]

Written answers

Minister for Health

The 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. In line with the 2013 Health 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.

In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria. These include the clinical and cost-effectiveness of the product, the health needs of the population, the opportunity cost, the budget impact and the resources available to the HSE.

In reaching its decision, the HSE examines all the evidence which may be relevant, including the information submitted by the company, and will take into account such expert opinions and recommendations which it may seek (for example, from the National Centre for Pharmacoeconomics (NCPE), the National Cancer Control Programme or the HSE Drugs Group).

The HSE has advised that pertuzumab (Perjeta) for the adjuvant treatment of adult patients with HER2-positive early breast cancer at high risk of recurrence (license extension) is currently in process and has now been formally reviewed by the HSE Drugs Group and the HSE Executive Management Team (EMT). The HSE Drugs Group provides recommendations to the HSE EMT. The HSE EMT is the decision-making authority within the HSE.

The HSE EMT considered this medicine and has supported the HSE Drugs Group recommendation which was not to support reimbursement of this indication. Where the HSE EMT team has considered a recommendation of the Drugs Group, and when circumstances arise where it is minded to accept a Drugs Group recommendation of non-reimbursement, the HSE is required (in line with the Health [Pricing and Supply of Medical Goods] Act 2013) to set out in detail a notice of any proposed decision to an applicant company. The HSE met the applicant company to explore whether further clinical evidence may become available. No further supporting evidence has been received to date.

The application for pertuzumab (Perjeta) remains under consideration with the HSE and is being assessed in line with the 2013 Health Act.

Covid-19 Pandemic Supports

Questions (538)

Violet-Anne Wynne

Question:

538. Deputy Violet-Anne Wynne asked the Minister for Health if his attention has been drawn to the struggle by addiction recovery support meetings in County Clare to continue to provide adequate services in view of the public health guidelines and the resulting closure of many of their meeting facilities; and if he will make contact with the groups to support them in their request for funding to access alternative meeting spaces. [30195/20]

Written answers

Minister of State at the Department of Health

Restrictions on social interaction, the requirement for self-isolation and the restructuring of services, are particularly difficult for those accessing drug and alcohol services and supports.

I am fully aware of the vital role played by drug, alcohol support groups and treatment programmes in reducing the harms of substance use and supporting rehabilitation and recovery. They help individuals to build their recovery capital and to avoid relapse into harmful patterns of substance use.

On 6 October I published new guidance for drug and alcohol support groups and treatment programmes and other addiction treatment services. This new guidance will ensure that these groups can operate safely, including at levels 3 and 4 of the national framework for living with Covid-19.

The guidance is available on the Government of Ireland website at: www.gov.ie/en/policy-information/17d32f-drugs-and-alcohol-policy/.

The main points of the guidance are as follows:

1. It is recommended to hold meetings and deliver programmes online or outdoors where this is possible, without diluting the benefits for participants

2. Where it is decided to host a face-to-face group/programme meeting, organisers are advised to undertake a risk assessment to ensure the health, welfare and safety of participants

3. Facilities used to host support groups and treatment programmes should be for exclusive use, where possible, and not shared with other users

4. The recommended maximum number of attendees at level 3 is 15 people (including leaders), with 2 metres social distancing

5. Support groups and programmes should last a maximum of 115 minutes (1 hour and 45 minutes)

6. Individuals at higher risk from Covid-19, or in close contact with such individuals, should only attend meetings that are conducted online

I want to acknowledge the input of supports groups and service providers in the formulation of this new guidance. We all share a common goal for the safe resumption of recovery support groups.

Hospital Services

Questions (539)

Dara Calleary

Question:

539. Deputy Dara Calleary asked the Minister for Health if his attention has been drawn to the fact that many hospital groups are not availing of electronic prescribing for discharges; the reason in this regard, in view of the fact that there are benefits of electronic prescribing in particular during a pandemic; if electronic prescribing will be availed of by all public hospitals; and if he will make a statement on the matter. [30198/20]

Written answers

Minister for Health

The majority of public hospitals in Ireland do not currently have electronic prescribing in place. The implementation of ePrescribing is a significant programme of work and will take time to embed in acute and primary care settings. To support access to prescriptions during the pandemic, a new service to facilitate the secure electronic transfer of prescriptions (ETP) between GPs and community pharmacy was deployed in response to Covid-19. Electronic transfer of prescriptions is just one aspect of the large programme of work involved in the full implementation of ePrescribing.

Rapid implementation of the ETP was only possible in the pandemic because:

- the majority of GP practices avail of four accredited practice systems which the HSE rapidly upgraded to support the ETP during the pandemic,

- underpinning regulations were developed by the Department of Health,

- every community pharmacy in the country had access to the secure Healthmail system that was used to underpin ETP.

This service has proven to be successful with approximately 50,000 scripts now being transferred electronically between GPs, community pharmacies every day. To build on this work, the HSE has established an ePharmacy Programme which will address the need for electronic prescribing (which in turn will support electronic discharge). A number of key specialist posts required to lead out on the ePharmacy Programme are in the process of being recruited by the HSE.

Covid-19 Tests

Questions (540)

Michael Creed

Question:

540. Deputy Michael Creed asked the Minister for Health his views on antigen testing for Covid-19; his further views on whether this test can supplement or replace the laboratory testing of samples; and if he will make a statement on the matter. [30199/20]

Written answers

Minister for Health

The HSE is not currently using rapid antigen tests. However, it is continuously examining the issues involved in their potential use, including sensitivity, as many of the antigen tests developed to date have low sensitivity.

The HSE advises that antigen testing may well have a potential role in testing of both symptomatic and asymptomatic people in the future. Studies of these tests, similar to the one mentioned, are now starting in order to ensure that if and where deployed they would be of appropriate quality and sensitivity. However, this will not replace the requirement for large scale PCR testing which remains the “gold standard” for community testing for Covid-19.

It is also worth noting the rapid Health Technology Assessment (HTA) which the Health Information Quality (HIQA) has in recent days submitted to NPHET on alternative diagnostic approaches, including antigen tests.

Question No. 541 answered with Question No. 478.

Covid-19 Tests

Questions (542)

Donnchadh Ó Laoghaire

Question:

542. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the reason there is no Covid-19 testing centre on the southside of Cork city in view of its large population and level three restrictions; and his plans to set up a testing centre in this area [30218/20]

Written answers

Minister for Health

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 (543)

Noel Grealish

Question:

543. Deputy Noel Grealish asked the Minister for Health the membership of the National Public Health Emergency Team and its associated subgroups; if membership details have changed since the publication of the second edition of the National Public Health Emergency Team governance structures document on 26 June 2020; and if so, the members involved in such changes [30226/20]

Written answers

Minister for Health

The Deputy is advised that the NPHET’s membership is multi-disciplinary and multi-sectoral in line with best international practice. The NPHET consists of representatives from across the health and social care service including the Department of Health (DOH), Health Service Executive (HSE), Health Protection Surveillance Centre (HPSC), Health Information and Quality Authority (HIQA), Health Products Regulatory Authority (HPRA), and others with relevant expertise in health and/or other related matters. Since June 2020, two changes have occurred in respect of the HSE’s representation on the NPHET.

Attendance at the NPHET is recorded in the minutes of each NPHET meeting, published at:

https://www.gov.ie/en/collection/691330-national-public-health-emergency-team-covid-19-coronavirus/#nphet-governance

The work of the NPHET has been supported by a number of Subgroups, the Chairs of which are members of the NPHET. Of the NPHET’s Subgroups, only the Irish Epidemiological Modelling Advisory Group (IEMAG) Subgroup continues to meet. All of the NPHET's other Subgroups have met their original terms of reference and have been realigned into the appropriate policy and operational functions of the Department of Health or other Departments, organisations, or bodies. The IEMAG Subgroup will continue its work in anticipation of building up additional statistical, analytical, and disease modelling capacity within the HPSC.

Details of the membership of the NPHET and its associated Subgroups are referenced in the NPHET’s Governance Structures document, available here:

https://www.gov.ie/en/publication/de1c30-national-public-health-emergency-team-nphet-for-covid-19-governance-/

The above governance document will be reviewed to reflect the changes in relation to subgroups outlined above, and the establishment of the COVID-19 oversight group by Government on September 15th.

Question No. 544 answered with Question No. 478.

Health Services

Questions (545)

Gerald Nash

Question:

545. Deputy Ged Nash asked the Minister for Health the date on which documentation will be issued relating to confirmation of service requested by a person (details supplied); and if he will make a statement on the matter. [30228/20]

Written answers

Minister for Health

This is an administrative matter for the HSE therefore I have asked the HSE to respond directly to the Deputy.

Hospital Charges

Questions (546)

Alan Kelly

Question:

546. Deputy Alan Kelly asked the Minister for Health the amount spent by the HSE in contracting debt collection agencies to pursue unpaid statutory charges in each of the years 2013 to 2019, inclusive, and to date in 2020, in tabular form; and if he will make a statement on the matter. [30231/20]

Written answers

Minister for Health

Patient charges are a key element of the overall funding envelope of the Irish health system and are taken into account when agreeing the Annual Estimates and the subsequent preparation of the annual National Service Plan.

These charges typically include:

- Out-patient charges;

- Emergency Department charges;

- Daily in-patient charges; and

- Long-term stay charges.

There are cohorts of people who are exempt from these charges, including, but not limited to persons with full eligibility, women receiving services in respect of motherhood, children up to the age of six weeks, children suffering from diseases prescribed under section 52 (2) of the Act, and persons receiving services for the diagnosis or treatment of infectious diseases.

In addition, patients who opt for private in-patient services in public hospitals are liable for a range of private accommodation charges. There are no exemptions from these charges.

Non collection of debts owed directly impacts on the affordability of services provided by the Health Service Executive in any year. It is therefore incumbent on the HSE to take all reasonable steps to pursue amounts owed for services delivered. Debt collection agencies are engaged when normal billing arrangements have been unsuccessful

The operational detail of this question is a matter for the HSE and I have asked them to respond to you directly in relation to that detail.

Hospital Charges

Questions (547)

Alan Kelly

Question:

547. Deputy Alan Kelly asked the Minister for Health the costs incurred by each public hospital in contracting external debt collection agencies to pursue unpaid statutory charges in each of the years 2013 to 2019, inclusive, and to date in 2020, in tabular form; and if he will make a statement on the matter. [30232/20]

Written answers

Minister for Health

Patient charges are a key element of the overall funding envelope of the Irish health system and are taken into account when agreeing the Annual Estimates and the subsequent preparation of the annual National Service Plan.

These charges typically include:

- Out-patient charges;

- Emergency Department charges;

- Daily in-patient charges; and

- Long-term stay charges.

There are cohorts of people who are exempt from these charges, including, but not limited to persons with full eligibility, women receiving services in respect of motherhood, children up to the age of six weeks, children suffering from diseases prescribed under section 52 (2) of the Act, and persons receiving services for the diagnosis or treatment of infectious diseases.

In addition, patients who opt for private in-patient services in public hospitals are liable for a range of private accommodation charges. There are no exemptions from these charges.

Non collection of debts owed directly impacts on the affordability of services provided by the Health Service Executive in any year. It is therefore incumbent on the HSE to take all reasonable steps to pursue amounts owed for services delivered. Debt collection agencies are engaged when normal billing arrangements have been unsuccessful

The operational detail of this question is a matter for the HSE and I have asked them to respond to you directly in relation to that detail.

Hospital Charges

Questions (548)

Alan Kelly

Question:

548. Deputy Alan Kelly asked the Minister for Health the number of inpatients or inpatient day cases with unpaid inpatient charges whose debt was referred to a debt collection or legal agency in each of the years 2013 to 2019, inclusive, and to date in 2020, in tabular form; and if he will make a statement on the matter. [30233/20]

Written answers

Minister for Health

Patient charges are a key element of the overall funding envelope of the Irish health system and are taken into account when agreeing the Annual Estimates and the subsequent preparation of the annual National Service Plan.

These charges typically include:

- Out-patient charges;

- Emergency Department charges;

- Daily in-patient charges; and

- Long-term stay charges.

There are cohorts of people who are exempt from these charges, including, but not limited to persons with full eligibility, women receiving services in respect of motherhood, children up to the age of six weeks, children suffering from diseases prescribed under section 52 (2) of the Act, and persons receiving services for the diagnosis or treatment of infectious diseases.

In addition, patients who opt for private in-patient services in public hospitals are liable for a range of private accommodation charges. There are no exemptions from these charges.

Non collection of debts owed directly impacts on the affordability of services provided by the Health Service Executive in any year. It is therefore incumbent on the HSE to take all reasonable steps to pursue amounts owed for services delivered. Debt collection agencies are engaged when normal billing arrangements have been unsuccessful

The operational detail of this question is a matter for the HSE and I have asked them to respond to you directly in relation to that detail.

Hospital Charges

Questions (549)

Alan Kelly

Question:

549. Deputy Alan Kelly asked the Minister for Health the expenditure by the HSE and public hospitals on referral of statutory charges to external debt collection or legal agencies; the breakdown of expenditure per charge, that is, inpatient charge, outpatient and emergency charge in each of the years 2013 to 2019, inclusive, and to date in 2020, in tabular form; and if he will make a statement on the matter. [30234/20]

Written answers

Minister for Health

Patient charges are a key element of the overall funding envelope of the Irish health system and are taken into account when agreeing the Annual Estimates and the subsequent preparation of the annual National Service Plan.

These charges typically include:

- Out-patient charges;

- Emergency Department charges;

- Daily in-patient charges; and

- Long-term stay charges.

There are cohorts of people who are exempt from these charges, including, but not limited to persons with full eligibility, women receiving services in respect of motherhood, children up to the age of six weeks, children suffering from diseases prescribed under section 52 (2) of the Act, and persons receiving services for the diagnosis or treatment of infectious diseases.

In addition, patients who opt for private in-patient services in public hospitals are liable for a range of private accommodation charges. There are no exemptions from these charges.

Non collection of debts owed directly impacts on the affordability of services provided by the Health Service Executive in any year. It is therefore incumbent on the HSE to take all reasonable steps to pursue amounts owed for services delivered. Debt collection agencies are engaged when normal billing arrangements have been unsuccessful

The operational detail of this question is a matter for the HSE and I have asked them to respond to you directly in relation to that detail.

Hospital Charges

Questions (550)

Alan Kelly

Question:

550. Deputy Alan Kelly asked the Minister for Health the number of inpatients or inpatient day cases who have had unpaid inpatient charges partly or entirely waived on hardship grounds in each of the years from 2013 to 2019, inclusive, and to date in 2020, in tabular form; and if he will make a statement on the matter. [30235/20]

Written answers

Minister for Health

Patient charges are a key element of the overall funding envelope of the Irish health system and are taken into account when agreeing the Annual Estimates and the subsequent preparation of the annual National Service Plan.

These charges typically include:

- Out-patient charges;

- Emergency Department charges;

- Daily in-patient charges; and

- Long-term stay charges.

There are cohorts of people who are exempt from these charges, including, but not limited to persons with full eligibility, women receiving services in respect of motherhood, children up to the age of six weeks, children suffering from diseases prescribed under section 52 (2) of the Act, and persons receiving services for the diagnosis or treatment of infectious diseases.

In addition, patients who opt for private in-patient services in public hospitals are liable for a range of private accommodation charges. There are no exemptions from these charges.

Non collection of debts owed directly impacts on the affordability of services provided by the Health Service Executive in any year. It is therefore incumbent on the HSE to take all reasonable steps to pursue amounts owed for services delivered. Debt collection agencies are engaged when normal billing arrangements have been unsuccessful

The operational detail of this question is a matter for the HSE and I have asked them to respond to you directly in relation to that detail.

Covid-19 Tests

Questions (551)

Alan Kelly

Question:

551. Deputy Alan Kelly asked the Minister for Health if home help staff are receiving regular Covid-19 tests; and if not, the reason (details supplied). [30236/20]

Written answers

Minister for Health

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