Written Answers Nos. 187-206
187. Deputy Éamon Ó Cuív asked the Minister for Health the reason that a drug (details supplied) is not eligible for a refund under the drug refund scheme is not available free to those with a medical card or is not included under the eligible drugs covered under the long-term illness scheme; if this matter is under consideration as it is an approved drug for dispensing; and if he will make a statement on the matter. [32173/20]
View answerThe 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
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 licenced 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 including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact.
HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE). The NCPE conducts health technology assessments (HTAs) for the HSE and makes recommendations on reimbursement to assist HSE decisions.
The HSE has advised that, in 2014, it notified the manufacturer of Delta-9-tetrahydrocannabinol/Cannabidiol, THC/CBD (Sativex®) that there was significant uncertainty around the cost-effectiveness of the medicine and as a consequence it did not support reimbursement of Sativex® at that time.
In February 2018, the HSE received a revised application from the manufacturer for pricing / reimbursement of Sativex® indicated as treatment for symptom improvement in adult patients with moderate to severe spasticity due to multiple sclerosis who have not responded adequately to other anti-spasticity medication and who demonstrate clinically significant improvement in spasticity-related symptoms during an initial trial of therapy.
The HSE commissioned a full HTA with respect to this indication in April 2018. On 12 August 2019, the NCPE received the applicant's submission. The HTA is currently ongoing at the NCPE. The output of this HTA will be an important input into the decision-making processes of the HSE.
Until such a time as approval for reimbursement has been granted in relation to the reimbursement of Sativex by the HSE, this product will not be available under the community drug schemes.
The application for Sativex remains under consideration with the HSE and is being assessed in line with the 2013 Health Act.
188. Deputy Claire Kerrane asked the Minister for Health if his attention has been drawn to the difficulties faced by patients accessing their medical records from private consultants in which a patient requires emergency medical care in the public health system; his views that there should be an obligation on private consultants to share information in a timely manner; and if he will make a statement on the matter. [32176/20]
View answerAs this is a service matter, I have asked the HSE to examine the issues raised and respond directly to the Deputy as soon as possible.
189. Deputy Emer Higgins asked the Minister for Health the current HSE Covid-19 advertising on social media platforms (details supplied); and if he will make a statement on the matter. [32185/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
190. Deputy John Paul Phelan asked the Minister for Health the timeframe for the completion of construction and the entrance into full operation of the new second cath lab at UHW; and if he will make a statement on the matter. [32190/20]
View answerThe Programme for Government commits to the delivery of a second Cath lab in University Hospital Waterford. As set out in the HSE’s options appraisal, the preferred option is for a second Cath lab and associated 12 bed day ward (delivering six additional beds) on the roof of the existing Cardiology Department, which will operate five days per week and provide diagnostic services only.
The HSE has advised that funding was allocated in the Capital Plan for the provision of a second Cath lab at University Hospital Waterford and planning permission was received from Waterford City and County Council in January 2020. The Disability Access certificate was granted on 23rd April 2020. The Fire certificate was granted on 30th June 2020. Preparation of contract documentation has commenced, and contractor selection is complete subject to a cooling off period.
Works and schedules were delayed due to COVID-19, however the project went to tender on the 30th September. As required by OGP, the tender is a 2-stage process for Main and Specialist contractors. This process will take approximately four months. The works to the new Cath laboratory are due to commence in Q1 of 2021 with a proposed 12-month build. It is anticipated the second Cath laboratory will become fully operational after construction and equipping has been completed.
It is important to recognise, the delivery of capital projects is a dynamic process and is subject to the successful completion of the various approval stages, which can impact on the timeline for delivery.
191. Deputy John Lahart asked the Minister for Health the number of critical care and ICU nurses employed across the health system prior to Covid-19; the number of new nurses trained with the specific skills required for critical care and ICU have been employed since Covid-19; the number in training; and the plans there are in place to train more. [32192/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
192. Deputy John Lahart asked the Minister for Health the number of permanent ICU beds there were across the health system prior to Covid-19; the number of permanent beds there are now; and the plans there are in place to provide additional ICU beds. [32193/20]
View answerAt the start of the year, permanent adult critical care capacity in Ireland stood at 255 beds, according to the National Office of Clinical Audit. This included 204 Level 3 ICU beds and 51 Level 2 HDU beds. As part of the initial response to the pandemic, funding was provided for an additional 40 adult critical care beds in March 2020 as well as two paediatric beds. The HSE has advised that between 280 and 285 critical care beds are currently open, with the number open any given day subject to fluctuation in respect of available staff and other operational considerations.
Budget 2021 will allocate funding totalling €52m in 2021 to critical care. This will retain, on a permanent basis, the 42 critical care beds put in place on a temporary basis this year and add significant new capacity. Funded adult critical care beds will increase to 321 by end 2021, an increase of 66 over the baseline number of 255 funded beds in 2020. Funding for 2021 will also include money to allow for the development of a workforce plan as well as education initiatives to grow the critical care workforce.
193. Deputy John Lahart asked the Minister for Health the breakdown of ICU staff and beds cross the public and private health hospital system [32194/20]
View answerAt the start of the year, permanent adult critical care capacity in Ireland stood at 255 beds, according to the National Office of Clinical Audit. This included 204 Level 3 ICU beds and 51 Level 2 HDU beds. As part of the initial response to the pandemic, funding was provided for an additional 40 adult critical care beds in March 2020 as well as two paediatric beds. The HSE has advised that between 280 and 285 critical care beds are currently open, with the number open any given day subject to fluctuation in respect of available staff and other operational considerations.
Budget 2021 will allocate funding totalling €52m in 2021 to critical care. This will retain, on a permanent basis, the 42 critical care beds put in place on a temporary basis this year and add significant new capacity. Funded adult critical care beds will increase to 321 by end 2021, an increase of 66 over the baseline number of 255 funded beds in 2020. Funding for 2021 will also include money to allow for the development of a workforce plan as well as education initiatives to grow the critical care workforce.
Regarding critical care capacity in private hospitals, in anticipation of the projected surge in Covid-19 cases and the expected impact on the health care system a major part of the response was to urgently ramp up capacity for acute hospital care facilities. A critical element of the strategy was to put in place an arrangement with the private hospitals to use their facilities as part of the public system, to provide essential acute hospital services for the duration of the emergency. Following negotiations with the Private Hospitals Association an overarching agreement with the 18 private acute hospitals was agreed at the end of March. Under the agreement, the HSE secured 100% of the capacity of the private hospitals until the end of June.
The utilisation rate of critical care beds in private hospitals varied throughout the three month period in which the agreement was in place. The HSE has advised the Department that in the last week of April 53% of critical care beds in private hospitals were in use, while in the last week of June 48% of critical care beds were in use.
In terms of wider critical care capacity, as part of work undertaken earlier this year to determine the capacity of the private hospital system, it was estimated that there were 47 ICU beds and 54 High Dependency Unit beds within the private hospital system.
194. Deputy Michael Healy-Rae asked the Minister for Health if he will address the case of a person (details supplied) regarding extra home help hours; and if he will make a statement on the matter. [32197/20]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
195. Deputy Catherine Murphy asked the Minister for Health if consideration has been given by him and or the HSE that a national clinical practice guideline for the management of multiple pregnancy will be put out for public consultation in order to give persons and representative organisations an opportunity to put forward their views in relation to what the revised guidelines should look like; and if he will make a statement on the matter. [32201/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
196. Deputy Catherine Murphy asked the Minister for Health if representative organisations will be key stakeholders in the revision process of the HSE national clinical practice guideline for the management of multiple pregnancy; and if he will make a statement on the matter. [32202/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible
197. Deputy Cathal Crowe asked the Minister for Health the status of planned primary health centres in County Clare. [32247/20]
View answerAs the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.
198. Deputy Aindrias Moynihan asked the Minister for Health if a business case regarding the resourcing for colorectal stoma clinical nurse specialists has been submitted by the CHI at Crumlin; the level of consideration for funding of this service that is being taken to form part of the HSE service planning process for 2021; and if he will make a statement on the matter. [32248/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
199. Deputy Pauline Tully asked the Minister for Health if there is a service available here that provides medical alert dogs to sufferers of epilepsy; and if he will make a statement on the matter. [32259/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
200. Deputy Holly Cairns asked the Minister for Health if he will lower the age for cervical screening to 20 years of age; and if he will make a statement on the matter. [32266/20]
View answer201. Deputy Holly Cairns asked the Minister for Health if he will lower the age for prostate cancer screening to 40 years of age; and if he will make a statement on the matter. [32267/20]
View answer204. Deputy Holly Cairns asked the Minister for Health if he will lower the age at which women are screened for breast cancer to 30 years of age as a preventative measure for the incidence and mortality from breast cancer; and if he will make a statement on the matter. [32282/20]
View answerI propose to take Questions Nos. 200, 201 and 204 together.
A National Screening Advisory Committee (NSAC) was established in 2019 and has held four meetings to date. The Committee’s role is to undertake an independent assessment of the evidence for screening for a particular condition against internationally accepted criteria and make recommendations accordingly.
As part of its body of work the Committee will implement an agreed methodology for accepting applications to consider new, or revisions to, existing population-based screening programmes in Ireland.
Ireland, has always evaluated the case for commencing a national screening programme against international accepted criteria – collectively known as the Wilson Jungner criteria. The evidence bar for commencing a screening programme should and must remain high. This ensures that we can be confident that the programme is effective, quality assured and operating to safe standards.
The addition of any new population-based screening programmes or modification to existing programmes will be incorporated as part of the Committee's work programme following a robust, methodologically sound and detailed analysis of the evidence in each and every case against internationally accepted screening criteria.
Updates in relation to screening will be posted on the NSAC website (www.gov.ie/en/campaigns/nsac/).
202. Deputy Marian Harkin asked the Minister for Health when duodopa which was approved for reimbursement in February 2020 will be sanctioned for use by patients that urgently need the medication; and if he will make a statement on the matter. [32271/20]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the pricing and reimbursement of medicines; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
203. Deputy Gary Gannon asked the Minister for Health if drug and alcohol support groups and treatment programmes are permitted to operate under potential level 5 restrictions; if so, if he will provide guidance on the safe continuation of these much needed supports; and if he will make a statement on the matter. [32274/20]
View answerThe Department of Health has published guidance for the continued operation of drug and alcohol support groups and programmes in a Covid-19 environment. In line with the National Framework for living with Covid-19, the guidance has been developed to ensure these groups can operate safely, including at levels 3 and 4 of the framework.
The Department is consulting with the Department of the Taoiseach on the development of guidance for the safe operation of drug and alcohol support groups and programmes at level 5 of the framework.
As Minister, I fully recognise 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. The 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.
205. Deputy Sean Sherlock asked the Minister for Agriculture, Food and the Marine when a felling licence will be granted to a person (details supplied). [32158/20]
View answerAs you may be aware, there is a backlog of license applications that require an Appropriate Assessment (AA). My Department has put in place a detailed project plan for dealing with this backlog which includes recruitment of additional ecologists, forestry inspectors and administrative staff where required.
In this case, a Natura Impact Statement (NIS) request letter was issued to the applicant on the 15th September 2020. This letter set out the areas that the NIS should focus on.
Submitting a NIS for this licence application will significantly reduce the length of time it will take for the Department to complete the AA process. On receipt of a satisfactory NIS, the length of time it will take to complete the AA process is estimated to be between 2 and 3 months.
206. Deputy Robert Troy asked the Minister for Agriculture, Food and the Marine if a 2019 BPS application for a person will be expedited (details supplied) [32209/20]
View answerFollowing a review of the case in question, the 2019 BPS application of the persons named has been accepted. This case will now be processed and payment will issue in the coming weeks when the next 2019 pay run take place.
