Written Answers Nos. 508-530
508. Deputy Peadar Tóibín asked the Minister for Health the current waiting time for appointments and the numbers waiting for appointments for HSE child dental services in County Meath; and the action he is taking to address the backlog due to Covid-19. [42956/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
509. Deputy Richard Bruton asked the Minister for Health if special services are being developed for long Covid; and if he will make a statement on the matter. [42966/20]
View answer510. Deputy Pauline Tully asked the Minister for Health the baseline unit cost for formal out-of-home respite services; the baseline unit cost for formal in-home respite; the baseline unit cost for recreation and holiday respite breaks; and if he will make a statement on the matter. [42970/20]
View answerThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives.
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
511. Deputy Niall Collins asked the Minister for Health if the calculation of a pension charge for a person (details supplied) will assessed; and if he will make a statement on the matter. [42971/20]
View answerI have asked the HSE to respond directly to the Deputy.
512. Deputy Jennifer Murnane O'Connor asked the Minister for Health the number of children on the HSE CAMHS waiting list by county in tabular form; and if he will make a statement on the matter. [42973/20]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
513. Deputy Denis Naughten asked the Minister for Health when a final decision will be made on an application for the reimbursement of the drug dupilumab; and if he will make a statement on the matter. [42974/20]
View answer514. Deputy Willie O'Dea asked the Minister for Health the status of the drug dupilumab (details supplied) which has been under assessment since November 2018; his plans to provide access to the drug for persons with eczema here; and if he will make a statement on the matter. [42977/20]
View answer538. Deputy Gino Kenny asked the Minister for Health if the drug dupilumab which is a treatment for atopic eczema will be approved for Irish patients soon; the reason this treatment which is available throughout Europe and in Northern Ireland has still not been approved here given its benefits as a targeted treatment for atopic eczema; and if he will make a statement on the matter. [43098/20]
View answer569. Deputy Neasa Hourigan asked the Minister for Health further to Parliamentary Question No. 165 of 18 November 2020, the status of the December HSE drugs group meeting at which two applications for dupilumab were reconsidered; and if he will make a statement on the matter. [43287/20]
View answer573. Deputy Marian Harkin asked the Minister for Health the full details of the decision made by the HSE drugs group to support reimbursement of dupilumab for the treatment of moderate-to-severe atopic dermatitis in both adults and adolescents of 12 years of age and older who are candidates for systemic therapy which was on the group’s agenda for its December 2020 meeting; and if he will make a statement on the matter. [43321/20]
View answer642. Deputy Claire Kerrane asked the Minister for Health the status of plans to make the drug dupilumab available to those living with severe atopic eczema; the timeframe for its roll-out; and if he will make a statement on the matter. [43575/20]
View answerI propose to take Questions Nos. 513, 514, 538, 569, 573 and 642 together.
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.
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 Executive Management Team (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 engaged in a meeting in November 2020 with the applicant company to discuss the submission.
The HSE has advised that the process is still ongoing and that the matter will be included on the agenda for the HSE Drugs Group’s meeting in January 2021. The HSE further advises that a Drugs Group meeting did take place in December 2020 however it was not possible to discuss Dupilumab due to time constraints.
The HSE Executive Management Team is the decision-making body for the reimbursement of medicines under the Health Act 2013 and will, on receipt of the outcome of the Drugs Group's deliberations, make the decision on whether Dupilumab will be reimbursed.
515. Deputy Thomas Gould asked the Minister for Health the duties home helps can perform; and if his attention has been drawn to a situation in which persons are being informed home helps will now only perform personal care duties. [42990/20]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
516. Deputy Brendan Griffin asked the Minister for Health his views on a matter (details supplied) regarding wearing masks during physical education in secondary school; and if he will make a statement on the matter. [43027/20]
View answerThe public health advice relating to COVID-19 is kept under continuous review by the National Public Health Emergency Team (NPHET), by my Department and the Government. The NPHET reviews international developments as a component of their overall examination of the evolving epidemiology of the Covid-19 and are informed by the international scientific evidence, and guidance by international bodies including the World Health Organization (WHO) and the European Centre for Disease Prevention and Control (ECDC). WHO and ECDC guidance is formulated in the context of considered appraisal of the international experience and accumulating scientific evidence in relation to COVID-19.
The aim of face coverings is to reduce the spread of infection by acting as a source control to stop the spread of infection by the person wearing the mask (including those who do not know they are infected, such as those with no symptoms) or to protect the wearer from droplet splashes or inhaling airborne contaminants including small (aerosol) and large particle droplets.
Since the start of the COVID-19 pandemic, the advice we are giving is that the use of face masks by persons going out in public has been recommended by an increasing number of countries. In Ireland, cloth face coverings are recommended in situations where physical distancing may not be possible, in crowded workplaces, places of worship and in busy or crowded outdoor spaces where there is significant congregation. Face coverings are also mandatory on public transport, including in taxis, as well as in bus and rail stations and in shops and other retail outlets. In restaurants, you should wear a face covering on your way to and from your table.
In both the primary and post-primary setting, it is a requirement that staff wear a face covering when a physical distance of 2m from other staff or students cannot be maintained. Children in the post-primary setting should also wear a face covering when a physical distance of 2m from other staff or students cannot be maintained. It is not recommended that children attending primary school wear face-coverings. The requirements in relation to use of face coverings in schools are clearly outlined in the sectoral guidance available on the ‘Back to School’ webpage at gov.ie.
The WHO in their Guidance on the use of masks in the context of COVID-19 advise that the general public should be encouraged to use medical and non-medical masks in public settings, including schools. This advice can be found at www.who.int/publications/i/item/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak
The ECDC advise that “in secondary schools, the use of face masks is recommended for both students and adults” and that “The use of masks should be seen as a complementary measure, rather than a single measure to prevent transmission within schools”.
The Health Protection Surveillance Centre (HPSC) has also issued guidance on use of face-coverings in childcare and educational settings to provide advice for staff and children, which is available at: www.gov.ie/en/publication/532b6-health-advice-provided-by-the-health-protection-surveillance-centre-hpsc-for-the-safe-reopening-of-schools-and-educational-facilities/
I would also direct you to the HPSC recommendations for sports activities for children and adolescents which is available at: www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/sportandrecreation/COVID%2019%20Recommendations%20for%20Sports%20for%20children.pdf.
It is important to note that face coverings complement other non-pharmaceutical intervention such as social distancing, hand washing, respiratory/cough etiquette, reducing number of contacts, in reducing transmission of the SARS-CoV-2 virus.
517. Deputy Richard Boyd Barrett asked the Minister for Health the numbers of teachers, special needs assistants and classroom assistants who have contracted Covid-19; and if he will make a statement on the matter. [43038/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
518. Deputy Cormac Devlin asked the Minister for Health the changes arising from budget 2021 in relation to specific supports for persons suffering from Parkinson's; and if he will make a statement on the matter. [43044/20]
View answer519. Deputy Michael Healy-Rae asked the Minister for Health if he will address the case of a person (details supplied); and if he will make a statement on the matter. [43056/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly as soon as possible.
520. Deputy Paul McAuliffe asked the Minister for Health his views on the wait time for speech and language therapy assessments in CHO area 9; and if he will make a statement on the matter. [43057/20]
View answer521. Deputy Paul McAuliffe asked the Minister for Health the expected time frame for a speech and language therapy assessment for a person (details supplied). [43058/20]
View answerI propose to take Questions Nos. 520 and 521 together.
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, as soon as possible.
522. Deputy David Cullinane asked the Minister for Health if there are supports to assist low-income persons or households with transport to hospitals; and if he will make a statement on the matter. [43060/20]
View answerPatient transport is the responsibility for the Health Service Executive (HSE). Therefore I have referred the Deputy's question to the HSE for direct reply.
In addition, the Deputy may wish to note that under the Supplementary Welfare Allowance scheme, administered by the Department of Social Protection, a person may be eligible to apply for an Exceptional Needs Payment to help meet essential, one-off, exceptional expenditure, which a person could not reasonably be expected to meet out of their weekly income.
523. Deputy Fergus O'Dowd asked the Minister for Health if under level 3 of the Covid-19 framework all nursing home operators should facilitate an indoor visit once a week for one family member for a duration of up to one hour while also providing window visits; and if he will make a statement on the matter. [43064/20]
View answer525. Deputy Fergus O'Dowd asked the Minister for Health if residents of nursing homes will be able to leave their nursing homes to spend a period of time celebrating Christmas and the New Year with their respective families in their own homes, as in previous years; and if he will make a statement on the matter. [43066/20]
View answerI propose to take Questions Nos. 523 and 525 together.
The Health Protection Surveillance Centre (HPSC) has recently published new public health advice in relation to visiting long-term residential care services. This new guidance outlines an updated definition for ‘critical and compassionate circumstances’, which now provides that residents may be facilitated to receive:
- up to one visit by one person per week under Levels 3 and 4 of the framework of restrictive measures;
- up to one visit per two weeks under Level 5;
It also notes that at all levels of the framework for restrictive measures in the Government’s Resilience and Recovery 2020-2021: Plan for Living with COVID-19, every practical effort should be made to accommodate an additional visit on compassionate grounds during the period of major cultural or religious festivals or celebrations of particular significance to the resident, such as the Christmas/New Year period.
An external visit to a private home over Christmas will usually mean meeting quite a few people and it won't be possible to be sure that everyone who comes to the house has been checked for COVID-19 symptoms and is careful about social distancing. As such, there may be significant risk of the unwitting introduction of COVID-19 into nursing homes associated with such external visits, particularly as there may be increased spread of infection in the community at Christmas. During this period, in order to mitigate the risk of ongoing transmission of COVID-19 and the risk COVID-19 may have on vulnerable persons, particularly those in high risk settings such as nursing homes, the overarching public health advice and policy in the context of the current level, Level 3, of the framework for restrictive measures is that residents should not undertake such external visits.
I appreciate that this may be disappointing for some residents and their family members and acknowledge that 2020 has been a most difficult year for families. However, this must be considered in the context of the current rate of transmission and the ongoing risk. The European Centre for Disease Control recently published it latest risk assessment in respect of long-term residential care services. It clearly concluded that the risk related to COVID-19 infection in EU/EEA and UK is currently considered very high for residents of these services.
The current guidance reflects the fact that we are at Level 3 and the risks associated with same. We must be vigilant in ensuring that residents who may be very vulnerable to adverse outcomes as a result of COVID-19 continue to be protected through these public health measures.
I encourage all nursing homes to facilitate visits in line with public health advice and to communicate with family and friends.
Given the importance of facilitating visiting over the Winter period and over Christmas, the Temporary Assistance Payment Scheme (TAPS) has been expanded on a once-off basis to allow a claim of up to €2,500 per eligible nursing home. This will enable them to create additional safe visiting spaces and enhance current visiting spaces.
Enhancement of safe visiting spaces is aligned with the overriding aim of TAPS, which is to support nursing homes in keeping residents safe and reduce the risk of infection and transmission into the nursing home. It is recognised that residents and their families will prioritise visiting over this period and these spaces will provide for these visits to be undertaken in a way that reduces the health and other risks of outdoor visiting on residents and their visitors, who may themselves be older and more vulnerable.
524. Deputy David Cullinane asked the Minister for Health if mesh injury will be recognised as a long-term illness; his plans for reparations for mesh injury; if there will be a public inquiry; and if he will make a statement on the matter. [43065/20]
View answer526. Deputy Pa Daly asked the Minister for Health the way in which nursing shifts, lunch breaks and toilet breaks have been affected at University Hospital Kerry due to the Covid-19 pandemic; and if he will make a statement on the matter. [43069/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
527. Deputy Pa Daly asked the Minister for Health the monthly breakdown of patient-to-nurse ratio across all acute hospitals to date in 2020, in tabular form; and if he will make a statement on the matter. [43070/20]
View answerThe Safe Staffing Framework is an evidence-based methodology to determining the staffing required based on patient acuity and dependency.
On 16 April 2018, the Minister for Health launched the Final Report and Recommendations by the Taskforce on Staffing and Skill Mix for Nursing, on a Framework for Safe Nurse Staffing and Skill Mix in General and Specialist Medical and Surgical Care Settings in Adult Hospitals.
The report set out for the first time, an evidenced based method to determine optimum nurse staffing and skill mix levels across general and specialist medical and surgical patient care settings in acute hospitals. This is Phase 1 of the Framework and was implemented and tested through a pilot project across three hospital sites; Beaumont Hospital, Our Lady of Lourdes Hospital, Drogheda and St Columcille's, Loughlinstown.
The impact reports, using the data collected over two years with the support of a specific ICT system, have validated the initial findings form the pilot test. There is evidence of sustained improvements to patient outcomes, service and financial efficiencies and a number of staff benefits including increased retention in areas where the Framework has been fully implemented.
This phase of The Framework was handed over to the HSE in October 2019 for national rollout. To date the first three Model 4 hospitals have received their uplift and the sequential roll out is continuing. The next three Model 4 hospitals have been engaged with and baseline data collection has started. The contract for the ICT system was delayed due to Covid-19 but will be signed shortly.
The Framework for Safe Nurse Staffing and Skill Mix and the international research and evidence do not support a nurse-to-patient ratio based approach to meet both patient and staff outcomes. A core assumption of the Framework is that ‘all patient care needs are different’, this would be undermined if a ratio-based approach was taken as it presume all patients require the same level of nursing care.
528. Deputy Pa Daly asked the Minister for Health the number of solely administrative staff recruited to University Hospital Kerry in each of the years from 2015 to 2019 and to date in 2020; the number that were new positions; the number that were filling vacancies left by retired or departed staff, in tabular form; and if he will make a statement on the matter. [43071/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
529. Deputy Pa Daly asked the Minister for Health the details of protocols in relation to staff wearing of masks within acute hospitals; and if he will make a statement on the matter. [43072/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
530. Deputy Pa Daly asked the Minister for Health the amount allocated to mental health and wellness supports for staff within the acute hospital system; the breakdown of this allocation for each acute hospital, in tabular form; and if he will make a statement on the matter. [43073/20]
View answerI have asked the HSE to respond to the Deputy directly on this matter.
