Health Services

Questions (795)

Seán Sherlock

Question:

795. Deputy Sean Sherlock asked the Minister for Health his views on an issue raised in correspondence (details supplied); and the steps he will take to retain service levels. [37936/20]

View answer

Written answers (Question to Health)

I have been informed by the HSE that there are currently no plans to change the provision of services at the treatment centre concerned. Any changes to the provision of services would be subject to discussions with and approval by the HSE.

In relation to the issue raised in the correspondence, as GP out-of-hours providers are private organisations, the rostering of GPs is an operational matter for the service provider and the HSE has no role in this regard.

Medical Cards

Questions (796, 865)

James Lawless

Question:

796. Deputy James Lawless asked the Minister for Health when the current qualifying period of a discretionary end-of-life medical card to terminally ill patients will be extended (details supplied); and if he will make a statement on the matter. [37942/20]

View answer

Alan Kelly

Question:

865. Deputy Alan Kelly asked the Minister for Health when a terminal Illness card for persons with less than two years to live will be delivered; and if he will make a statement on the matter. [38426/20]

View answer

Written answers (Question to Health)

I propose to take Questions Nos. 796 and 865 together.

Under the Health Act 1970, eligibility for a medical card is based primarily on means. The issue of granting medical cards based on having a particular disease or illness was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.

The HSE has however a compassionate system in place for the provision of medical cards when it is informed that a patient is receiving end of life treatment – that is when patients’ unfortunately have a prognosis of less than 12 months. These applications do not require a means assessment nor are they reassessed. There are currently almost 1,800 such medical cards awarded. Separately, terminally ill patients who do not meet the end of life criteria may also qualify for a medical card under the general assessment processes. Every effort is made by the HSE, within the framework of the Health Act 1970, to support applicants in applying for a medical card and to take full account of the difficult circumstances, such as extra costs arising from an illness.

Furthermore, since 2015 medical cards are awarded without the need of a financial assessment to all children under 18 years of age with a diagnosis of cancer.

It should also be noted that the Programme for Government ‘Our Shared Future’ contains a commitment to extend discretionary medical cards to those with a terminal illness. A HSE Clinical Advisory Group (CAG) was established in December 2019 to review eligibility for medical cards in cases of terminal illness. The final Report of the CAG was recently submitted to my Department and has been published. The Report notes that there are practical and legal challenges with extending eligibility for medical cards for terminally ill patients within the framework of the current process. However, I wish to assure the Deputy that I am committed to ensuring that terminally ill patients have access to the services they need. In that regard, my Department has devised a work programme which has been initiated and which will look to address the policy and legal findings of the Report and deliver on the Programme for Government commitment.

Hospital Appointments Status

Questions (797)

Michael Healy-Rae

Question:

797. 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. [37945/20]

View answer

Written answers (Question to 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 Organisation.

Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.

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.

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 (798)

David Cullinane

Question:

798. Deputy David Cullinane asked the Minister for Health further to Parliamentary Question No. 773 of 10 November 2020, his plans to replace the residential facility service at the Keltoi facility while it is used for the Covid-19 response and other services not referenced in the response; and if he will make a statement on the matter. [37974/20]

View answer

Written answers (Question to Health)

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

National Cancer Strategy

Questions (799)

David Cullinane

Question:

799. Deputy David Cullinane asked the Minister for Health when the next mid-term review of the National Cancer Strategy will be conducted; and if he will make a statement on the matter. [37975/20]

View answer

Written answers (Question to Health)

In line with a commitment in the National Cancer Strategy 2017-2026, an annual report is published by the Department of Health setting out the progress achieved on the implementation of the 52 recommendations of the Strategy, and the degree to which the key performance indicators are being met.

The second Annual Report (covering the year to end December 2019) can be accessed at: https://www.gov.ie/en/publication/dba7f9-national-cancer-strategy-implementation-report-2019/

The 2020 report will be published early in 2021.

Health Services

Questions (800)

Seán Canney

Question:

800. Deputy Seán Canney asked the Minister for Health his views on making the drug dupilumab available for persons living with severe atopic eczema; if his attention has been drawn to the fact that the drug has been available in Northern Ireland and throughout Europe for over two years but is not yet available to the 150 to 200 persons that suffer with this type of eczema in Ireland; when a decision will be made on availability; and if he will make a statement on the matter. [37977/20]

View answer

Written answers (Question to 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 licenced indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.

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 it has received pricing and reimbursement applications for two indications of Dupilumab (Dupixent®):

- For the treatment of moderate-to-severe atopic dermatitis in adult patients who are candidates for systemic therapy.

- For the treatment of moderate-to-severe atopic dermatitis in adolescents 12 years and older who are candidates for systemic therapy.

The HSE received an application for pricing / reimbursement of Dupilumab in November 2017 from the manufacturer for the treatment of moderate-to-severe atopic dermatitis in adult patients who are candidates for systemic therapy. The HSE commissioned a full HTA on 29 November 2017 as per agreed processes. This assessment was completed on 12 December 2019 with the NCPE recommending that Dupilumab be considered for reimbursement if cost-effectiveness could be improved relative to existing treatments.

Subsequently, the HSE received an application for the pricing / reimbursement of Dupilumab on 13 December 2019 for the treatment of moderate-to-severe atopic dermatitis in adolescents 12 years and older who are candidates for systemic therapy.

The HSE commissioned the rapid review process on the 17 December 2019. Following receipt of a rapid review dossier, the NCPE advised the HSE on the 17 January 2020 that a HTA was not recommended and that Dupilumab not be considered for reimbursement for this indication at the submitted price.

The HSE engaged in commercial negotiations with the company in February 2020 regarding both the adult and adolescent populations.

The final HTA report concerning Dupilumab was reviewed by the HSE Drugs Group, along with the outputs of commercial negotiations, and the patient group submission received during the HTA process. The HSE Drugs Group considered all the evidence and gave a recommendation to the HSE EMT not to support reimbursement of Dupilumab for the treatment of moderate-to-severe atopic dermatitis in both adults and adolescents 12 years and older who are candidates for systemic therapy.

The HSE has confirmed that the applicant company was issued with notice of the proposed decision of the HSE EMT not to support reimbursement on 21 August 2020. On 18 September 2020, the applicant company submitted representations with respect to this application.

The HSE reviewed these representations, as is required in such circumstances under the 2013 Act, and has engaged in a meeting in November 2020 with the applicant company to discuss the submission. The HSE advises that that Dupilumab will be included on the agenda for the December HSE Drugs Group meeting at which the two applications and the submitted representations will be reconsidered.

Dupilumab remains under consideration with the HSE and a final decision will be made in line with the 2013 Health Act.

I wish to advise the Deputy that, while my Department does not collate information on the reimbursement status of specific medicines in other countries, I have received representations concerning Dupilumab including mention of its use in Northern Ireland and certain other European jurisdictions.

Hospital Appointments Status

Questions (801)

Róisín Shortall

Question:

801. Deputy Róisín Shortall asked the Minister for Health when a child (details supplied) in Dublin 11 will receive an appointment for the early intervention team; the reason for the delay; and if he will make a statement on the matter. [37980/20]

View answer

Written answers (Question to Health)

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 question relates to a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Health Services

Questions (802)

Róisín Shortall

Question:

802. Deputy Róisín Shortall asked the Minister for Health if his Department is considering steps to improve the uptake of vitamin D among the population in particular for older and more vulnerable persons (details supplied); if his attention has been drawn to a scheme to distribute vitamin D to those most at risk of disease in Scotland; and if he will make a statement on the matter. [37981/20]

View answer

Written answers (Question to Health)

My Department continues to welcome and consider international research and evidence surrounding COVID-19 and immune protection. Recent national research carried out by The Irish Longitudinal Study on Ageing (TILDA) regarding Vitamin D deficiency and implications for immune protection for Covid-19 was published in April, 2020. Rates of deficiency within the older population at different ages and during wintertime were considered within this research. TILDA is funded by my Department and the results of this study are available here:- https://tilda.tcd.ie/publications/reports/pdf/Report_Covid19VitaminD.pdf

The public health advice relating to Covid-19 is kept under continuing review by the National Public Health Emergency Team (NPHET). Ireland is guided by the advice, guidance and protocols of the World Health Organization (WHO) and the European Centre for Disease Prevention and Control (ECDC). The expert guidance of the ECDC in particular is based upon consideration of the circumstances arising in the European Union and globally. The National Public Health Emergency Team (NPHET) reviews these international developments as part of its overall examination of the evolving epidemiology of the disease.

Micronutrients, such as vitamins D, are critical for a well-functioning immune system and play a vital role in promoting health and nutritional well-being. However, the consistent guidance from the international bodies referenced above is that there is as yet insufficient data to support the use of Vitamin D in the prevention or treatment of COVID-19.

Earlier this year, my Department requested the Scientific Committee of the Food Safety Authority of Ireland (FSAI) to examine the vitamin D status of this older population and provide scientific recommendations on vitamin D supplementation. The FSAI Report found that older people in Ireland do not get sufficient vitamin D from their diet or the effect of sunlight on their skin.

Based on the evidence provided in the FSAI Report, my Department is advising that adults aged 65 and older take a vitamin D supplement to ensure they get the essential vitamin D needed for bone and muscle health.

Consultancy Contracts

Questions (803)

Róisín Shortall

Question:

803. Deputy Róisín Shortall asked the Minister for Health the status of negotiations on the new public health consultant contract; the timeline for the introduction of same; and if he will make a statement on the matter. [37982/20]

View answer

Written answers (Question to Health)

Consultant status for public health specialists under a new public health framework was recommended in the Crowe Horwath Report on the Specialty published in December 2018. It is also consistent with the role envisaged for the specialists in Slaintecare and Professor Scally’s Report on the National Screening Service ('CervicalCheck').

I, my Department and the HSE are committed to the early introduction of a new framework for public healthcare, as provided for in the Programme for Government. This will involve the establishment of a consultant-led public health model in line with the Crowe Horwath Report on the Specialty. My Department in conjunction with the HSE have completed a substantial amount of work on a detailed framework for the future public health model that includes consultant level roles. A related business case seeking consultant status has now been submitted to the Department of Public Expenditure and Reform for early consideration.

It is intended that this will support constructive engagement with the IMO on the matter.

Health Services Staff

Questions (804)

Róisín Shortall

Question:

804. Deputy Róisín Shortall asked the Minister for Health the breakdown of the new hires in public health promised in budget 2021 by position in tabular form; and if he will make a statement on the matter. [37983/20]

View answer

Written answers (Question to Health)

The breakdown of the public health staff mix will be designed to meet the needs of the various initiatives and strategies in 2021. The full breakdown of staff categories and grades will be decided in the coming weeks between the Department and the Health Service Executive when finalising the National Service Plan.

Health Services

Questions (805)

Niall Collins

Question:

805. Deputy Niall Collins asked the Minister for Health if a response will issue to further queries from an organisation (details supplied); and if he will make a statement on the matter. [38000/20]

View answer

Written answers (Question to Health)

As the Deputy is aware, the Resilience and Recovery 2020-2021: Plan for Living with COVID-19 which was published by the Government sets out Ireland's approach to managing and living with COVID-19 in a range of areas over the next 6 - 9 months.

The Plan sets out five levels of response, each with a number of measures designed to help us all lower COVID-19 transmission and setting out what is permitted at that moment in time. It aims to allow society and businesses to be able to operate as normally as possible, while continuing to suppress the virus. The Plan is framed to account for periods during which there is a low incidence of the disease, with isolated clusters and low community transmission, through to situations where there is a high or rapidly increasing incidence, widespread community transmission and the pandemic is escalating rapidly in Ireland and globally. It recognises the need for society and business to be allowed to continue as normally as possible and is designed so that either national or county level restrictions can be applied. Each level outlines what is permitted for social or family gatherings, work and public transport, bars, hotels and restaurants, exercise activities and religious services.

As I am sure the Deputy can appreciate, COVID-19 spreads when individuals and groups come into close contact with one another, enabling the virus to move from one person to another. COVID-19 is infectious in a person with no symptoms, or for the period of time before they develop symptoms. For this reason, we are all asked to be extra careful when socialising and working with others. For now, we must act like we have the virus to protect those around us from infection.

The number of people allowed to gather in different scenarios in the Government Framework are based on a review of international practice and the judgment of public health experts. It seeks to balance the risks of different types of gatherings against the desire to allow normal activities to proceed in so far as possible.

It is advised to socialise safely and within the capacity limits. These various limits in the Levels are all designed to reduce the number of households mixing with each other and cut down the virus’s chances of spreading into more homes.

The Deputy should note, that the numbers should not be considered a target - they are the maximum recommended number. It’s always safer to meet less people, less often, for less time. If we do this, we have a better chance of keeping to the lower Levels in the Framework, and continuing to keep businesses, schools, and healthcare services open, while also protecting the most vulnerable.

The ‘Framework for Restrictive Measures in Response to COVID-19’ in the Living with Covid Plan provides for restrictions on gatherings of people outdoors at all level's of the Plan.

As the Deputy is aware, ?Ireland is now on level 5 of the framework. At level 5, no organised outdoor gatherings can take place. The information on organised outdoor gatherings at level 5 can be viewed at: https://www.gov.ie/en/publication/2dc71-level-5/#organised-outdoor-gatherings? . ??At level 3 and 4, organised outdoor gatherings of up to 15 people can take place.

I and my Cabinet colleagues recognise the immense sacrifices that are being made be people across the country at this difficult time.

Covid-19 Pandemic

Questions (806)

Bríd Smith

Question:

806. Deputy Bríd Smith asked the Minister for Health the number and location of each nursing home that applied for and received the temporary assistance payment scheme. [38002/20]

View answer

Written answers (Question to Health)

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

Hospital Appointments Status

Questions (807)

Bernard Durkan

Question:

807. Deputy Bernard J. Durkan asked the Minister for Health when appointments will be arranged in the case of a person (details supplied); and if he will make a statement on the matter. [38024/20]

View answer

Written answers (Question to 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 Organisation.

Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.

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.

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.

Drug Treatment Programmes

Questions (808)

Michael McNamara

Question:

808. Deputy Michael McNamara asked the Minister for Health when a tendering process was last carried out for the provision of prefilled packs that are provided to pharmacies for distribution to drug users as part of needle exchange programme; when the contract for the provision of the said goods expired; when the next tendering process will take place; and if he will make a statement on the matter. [38027/20]

View answer

Written answers (Question to Health)

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

Hospital Services

Questions (809)

James Browne

Question:

809. Deputy James Browne asked the Minister for Health the position regarding a hospital unit (details supplied); his plans for the development of the unit; and if he will make a statement on the matter. [38028/20]

View answer

Written answers (Question to Health)

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 (810)

Michael Healy-Rae

Question:

810. Deputy Michael Healy-Rae asked the Minister for Health the status of an operation for a person (details supplied); if the matter will be expedited in view of the circumstances; and if he will make a statement on the matter. [37306/20]

View answer

Written answers (Question to 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 Organisation.

Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.

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.

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.

Tribunals of Inquiry

Questions (811)

John McGuinness

Question:

811. Deputy John McGuinness asked the Minister for Health the number of tribunals, inquiries or investigations being undertaken currently by his Department; the number that are in the process of being set up; the number in which the terms of reference are not complete or not agreed; the cost of all to date; and if he will make a statement on the matter. [38043/20]

View answer

Written answers (Question to Health)

The information requested by the Deputy is not immediately available. I will ask my officials to collate the information and will respond to the Deputy as soon as possible.