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Thursday, 21 Jan 2021

Written Answers Nos. 307-329

Covid-19 Pandemic

Questions (307)

Réada Cronin

Question:

307. Deputy Réada Cronin asked the Minister for Health if he will issue clear instructions to employers on the definition of the qualification for essential work and essential workers in order to suppress Covid-19 by preventing unnecessary travel, contact and congregation; and if he will make a statement on the matter. [3472/21]

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Written answers

As you aware, Ireland is at level 5 of the Government's medium-term Strategy Resilience and Recovery 2020-2021: Plan for Living with COVID-19. This 5-level framework sets out what is permitted for social or family gatherings, work and public transport, bars, hotels and restaurants, exercise activities and religious services, at that moment in time.

The public health measures recognise the need to reduce congregation and interactions between people to reduce the transmission of Covid-19. The number of people allowed to gather in different scenarios in the plan is 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. The measures in place for each level reflect the prevailing disease situation and recognise that we can and must prioritise some activities over others.

At level 5, people are required to stay at home except for travel for work, education or other essential purposes, and will be permitted to take exercise within 5km of home. Information relating to domestic travel at this time is available on the Government website at: www.gov.ie/en/publication/2dc71-level-5/#travel-restrictions.

At level 5 non-essential retail, and all non-essential services must remain closed. Information in relation to the current public health measures in place for essential retail and essential services at level 5 is available at: www.gov.ie/en/publication/2dc71-level-5/ and www.gov.ie/en/publication/c9158-essential-services/.

The Health Act 1947 (Section 31A - Temporary Restrictions) (COVID-19) (NO. 10) Regulations 2020 Regulation (S.I. 701 of 2020), sets out the relevant businesses or services under the current public health measures. Statutory Instruments related to the Covid-19 pandemic are available here: www.gov.ie/en/collection/1f150-view-statutory-instruments-related-to-the-covid-19-pandemic/.

SI No. 4 of 2021 also provides information on what are essential construction and developments.

Hospital Charges

Questions (308)

Fergus O'Dowd

Question:

308. Deputy Fergus O'Dowd asked the Minister for Health if he will provide an update on measures to scrap an €80 charge for venesection clinics that was introduced for haemochromatosis patients who do not have access to medical cards; the discussions that are taking place to eliminate the charge, which may deter patients from venesection treatment; and if he will make a statement on the matter. [2972/21]

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Written answers

Where venesection is classed as a day case procedure and is not carried out in an out-patient setting, the public in-patient charge applies.

The issue of the provision of therapeutic phlebotomy services for hereditary haemochromatosis patients, including the issue of charges, is still under consideration by my Department and the HSE.

It is agreed that such services should be provided at the lowest level of complexity that is clinically and operationally feasible. In time it is envisaged that the majority of this work will be done in a primary care setting.

The Irish Blood Transfusion Service accepts hereditary haemochromatosis patients who are eligible to donate blood at their fixed and mobile donation clinics nationwide. Patients can attend, free of charge, a maximum of four times a year with a minimum of ninety days between phlebotomies. The patient's hereditary haemochromatosis will continue to be managed by their physician, including the monitoring of ferritin levels.

Covid-19 Pandemic

Questions (309)

Fergus O'Dowd

Question:

309. Deputy Fergus O'Dowd asked the Minister for Health if he has explored the possibility of purchasing Covid-19 vaccines outside the standard EU collective agreements in the way Germany is doing; and if he will make a statement on the matter. [2983/21]

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Written answers

Ireland is participating in a Procurement Exercise being operated by the European Commission on behalf of Member States to procure suitable, safe and effective vaccines, in sufficient quantities, to combat COVID-19. Six APAs have been negotiated by the Commission under this process to date.

Ireland has signalled its solidarity with the EU approach and has, through its participation, gained access to a broad range of vaccines that it might not otherwise have access to, and at the cost agreed collectively by the EU.

Medicinal Products

Questions (310, 311, 312, 313)

Colm Burke

Question:

310. Deputy Colm Burke asked the Minister for Health if consideration will be given to the reimbursement of the cost of the gene therapy treatment Luxturna for persons suffering with inherited retinal diseases such as retinitis pigmentosa and Leber's congenital amaurosis, which are rare, serious and life-limiting diseases; and if he will make a statement on the matter. [2984/21]

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Colm Burke

Question:

311. Deputy Colm Burke asked the Minister for Health if he will correspond with the National Centre for Pharmacoeconomics to reconsider its decision regarding the reimbursement of the cost of the gene therapy treatment Luxturna in that early administration of this medicine can lead to greater, life-enhancing benefits for those suffering with degenerative retinal disease; and if he will make a statement on the matter. [2985/21]

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Colm Burke

Question:

312. Deputy Colm Burke asked the Minister for Health if consultations have taken place to improve the cost effectiveness of the gene therapy treatment Luxturna, a life-changing gene therapy medicine that, upon early administration, leads to better, life-enhancing benefits for those suffering with inherited retinal diseases; and if he will make a statement on the matter. [2986/21]

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Colm Burke

Question:

313. Deputy Colm Burke asked the Minister for Health if consideration will be given to the reimbursement of gene therapy treatment luxturna which complements national policy objectives as set out in the programme for Government to update the rare diseases plan and the promotion of research particularly clinical trials which are key to improving the prevention, diagnosis and treatment of rare diseases; and if he will make a statement on the matter. [2987/21]

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Written answers

I propose to take Questions Nos. 310 to 313, inclusive, together.

The Oireachtas put in place a robust legal framework, in the Health (Pricing and Supply of Medical Goods) Act 2013, which gives full statutory powers to the HSE to assess and make decisions on reimbursement of medicines, taking account of a range of objective factors and expert opinion as appropriate.

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 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 HSE has advised that on 23 September 2019 an application was received for the reimbursement of Voretigene neparvovec (Luxturna) for the treatment of adult and paediatric patients with vision loss due to inherited retinal dystrophy caused by confirmed biallelic RPE65 mutations and who have sufficient viable retinal cells.

On 29 October 2019, following the completion by the NCPE of a rapid review, the HSE commissioned a full pharmacoeconomic assessment with respect to this indication.

On 3 April 2020, the NCPE received the applicant’s submission for this assessment. On 18 September 2020, the NCPE completed its assessment and recommended that Voretigene neparvovec not be considered for reimbursement unless cost effectiveness can be improved relative to existing treatments.

The final HTA report will be reviewed by the HSE Drugs Group, along with the outputs of commercial negotiations which took place in November 2020 and the patient group submission received during the HTA process. The HSE advises that Voretigene neparvovec is expected to be included on a Drugs Group agenda in early 2021.

The HSE Executive Management Team is the decision-making body for the reimbursement of medicines under the Health Act 2013 and it will, following receipt of the outcome of the Drugs Group's deliberations, make the decision on whether Voretigene neparvovec will be reimbursed.

A National Rare Disease Plan for Ireland (2014 – 2018) was launched by the Minister for Health in July 2014. Many of the major recommendations of the plan have already been implemented.

In December 2013 the National Clinical Programme for Rare Diseases was established as a joint initiative between the HSE and the Royal College of Physicians of Ireland. The opening of the National Rare Disease Office, (NRDO) in 2015 was a significant milestone for people living with a rare disease, their families and their healthcare professionals.

On foot of the HSE Chief Clinical Officer’s (CCO) review of all the national clinical programmes in April 2019, it was recommended that the National Clinical Programme for Rare Diseases be operationalised and incorporated into the National Rare Disease Office. From 1 September 2020, the NRDO has become the main contact point and driver for national HSE rare disease projects and initiatives. The work of the NRDO will be overseen and governed by HSE Acute Operations. This means that the National Clinical Programme for Rare Diseases is being wound down and any outstanding projects transferred to the NRDO.

Building on the significant progress to date, a number of themes for inclusion in a roadmap for the coming period have been agreed with the Rare Disease Task Force, which comprises the main rare disease advocacy groups; Rare Disease Ireland, the Medical Research Charities Group (MRCP), and the Irish Platform for Patient Organisations, Science and Industry (IPPPOSI).

In addition, a number of key themes have been identified for future progress, including: Patient Awareness; European Reference Networks; Research & Registries; Access to Services; Access to Medicines; Diagnosis; Education and Training and Legislation and Policy.

Health Services Staff

Questions (314)

Dara Calleary

Question:

314. Deputy Dara Calleary asked the Minister for Health the number of new appointments made arising from the winter initiative, by county; the speciality and location of these appointments, by county; and the number of appointments that are permanent, by county in tabular form. [2989/21]

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Written answers

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

Primary Medical Certificates

Questions (315)

Thomas Pringle

Question:

315. Deputy Thomas Pringle asked the Minister for Health further to Parliamentary Question No. 1342 of 3 November 2020, the number of applicants for the primary medical certificate programme in 2020 to date as the HSE has not yet provided a reply; and if he will make a statement on the matter. [2992/21]

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Written answers

The Disabled Drivers and Disabled Passengers (Tax Concessions) Scheme comes under the remit of the Department of Finance and the Revenue Commissioners. The extent of the involvement of Health Service Executive (HSE) personnel in the Scheme relates to making a professional clinical determination as to whether an individual applicant meets the specified medical criteria for a Primary Medical Certificate, which is a requirement for the Scheme. This determination is undertaken by Senior Medical Officers for the relevant HSE Community Health Organisation on behalf of the Department of Finance and the Revenue Commissioners.

The Deputy will be aware that following a Supreme Court decision of June 2020, the assessment process for Primary Medical Certificates was suspended at the request of the Minister for Finance. In order to allow for the Primary Medical Certificate assessments to recommence, the Minister for Finance brought forward amendments to the Finance Bill to provide for the existing medical criteria in primary legislation.

Following a request from Minister Donohoe, my colleague the Minister for Health, Stephen Donnelly T.D. issued an instruction to the Chief Executive Officer of the Health Service Executive (HSE) on 22nd December, 2020, to the effect that Primary Medical Certificate assessments can recommence with effect from 1st January, 2021.

As the question raised by the Deputy relates to a service matter, I have arranged for the question to be referred to the HSE again for investigation and direct reply to the Deputy.

Registration of Nurses

Questions (316)

Niall Collins

Question:

316. Deputy Niall Collins asked the Minister for Health if he will advise regarding correspondence (details supplied); and if he will make a statement on the matter. [2994/21]

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Written answers

The 2021 annual registration renewal for nurses and midwives is under way online through a new MyNMBI portal. As at close of business on 19 January, almost 55,000 nurses and midwives had renewed their registration, equating to 70% of registrants.

As this is the first year of the new online system, NMBI provided information to each registrant on the steps required when they first engage with the online system. This information was provided in correspondence that was sent to each registrant’s home address at the end of November 2020. Additional support mechanisms to assist registrants include a user guide and video are available at https://my.nmbi.ie/. Registrants also have the facility to email NMBI outlining any problem encountered.

In certain circumstances registrants, who have no access to a personal computer or secure internet connection, can request a paper employment form on which the additional information around employment will be captured. Registrants can request the form via the NMBI helpline on 1890 200 116, or by posting their request to Registration Department, Nursing and Midwifery Board of Ireland, 18-20 Carysfort Avenue, Blackrock, A94 R299. They can complete the form and return it with a postal order for the annual renewal fee. This material will then be manually entered into the system by NMBI staff and a certificate will be generated which will be emailed (or posted if necessary ) to the registrant.

Vaccination Programme

Questions (317)

Seán Crowe

Question:

317. Deputy Seán Crowe asked the Minister for Health when the Covid-19 vaccine roll-out IT records system will be fully operational; the official title of same; if he will commit that all paper records will be promptly inputted; and the body or agency that has overall responsibility for the management and operation of the system. [2999/21]

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Written answers

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

Vaccination Programme

Questions (318)

Seán Crowe

Question:

318. Deputy Seán Crowe asked the Minister for Health the body or agency that has overall responsibility for the Covid-19 vaccine roll-out. [3000/21]

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Written answers

The Department of Health has overall responsibility for policy development on matters related to COVID-19, including the Vaccine Allocation Strategy.

In this regard, a High-Level Taskforce on COVID-19 was established to support my Department and the HSE in developing a national strategy and the implementation plan for the immunisation programme.

Operational matters, including implementation of the rollout of the COVID-19 vaccination programme, is the responsibility of the HSE.

Vaccination Programme

Questions (319)

Seán Crowe

Question:

319. Deputy Seán Crowe asked the Minister for Health the full list of duties and responsibilities that the Secretary General of the Department of Health has in the Covid-19 vaccine roll-out. [3001/21]

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Written answers

As Accounting Officer, the Secretary General of the Department of Health has specific obligations and responsibilities in relation to accountability to the Oireachtas for the work and expenditure of the Department of Health, including overseeing major decisions on investment for the health sector.

The Department of Health has overall responsibility for policy development on matters related to COVID-19, including the Vaccine Allocation Strategy.

In this regard, a High-Level Taskforce on COVID-19 was established to support my Department and the HSE in developing a national strategy and the implementation plan for the immunisation programme.

Operational matters, including implementation of the rollout of the COVID-19 vaccination programme, is the responsibility of the HSE.

Disability Services Data

Questions (320)

Michael Moynihan

Question:

320. Deputy Michael Moynihan asked the Minister for Health the number of persons with disabilities in receipt of home support hours in each local health office area as of 1 January 2021 or the latest date available, in tabular form; the number of persons currently on the waiting list for same in each local health office area, in tabular form; the number waiting from zero to three months, three to six months and six to 12 months, and for more than 12 months. [3002/21]

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Written answers

The HSE provides a range of assisted living services including Home Support Services to support individuals to maximise their capacity to live full and independent lives.

Home Support Services are provided either directly by the HSE or through a range of voluntary service providers. The majority of specialised disability provision (80%) is delivered through non-statutory sector service providers.

Services are accessed through an application process or through referrals from public health nurses or other community based staff. Individuals’ needs are evaluated against the criteria for prioritisation for the particular services and then decisions are made in relation to the allocation of resources. Resource allocation is determined by the needs of the individual, compliance with prioritisation criteria, and the level of resources available. As with every service there is not a limitless resource available for the provision of home support services and while the resources available are substantial they are finite. In this context, services are discretionary and the number of hours granted is determined by other support services already provided to the person/family.

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

Disability Services Data

Questions (321)

Michael Moynihan

Question:

321. Deputy Michael Moynihan asked the Minister for Health the number of persons with disabilities in receipt of personal assistance hours in each local health office area as of 1 January 2021 or the latest date available, in tabular form; the number of persons currently on the waiting list for same in each local health office area, in tabular form; the number waiting from zero to three months, three to six months and six to 12 months, and for more than 12 months. [3003/21]

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Written answers

The area of disability services is a priority area for this Government. To support people with a disability, significant resources have been invested by the health sector in disability services, and the Government has ensured that an additional €100 million is being provided for new disability measures this year, under Budget 2021. These measures will include an additional 80,000 personal assistant hours.

The Government is working to ensure that People with Disabilities be allowed to live an independent life of their own choosing, the same as any other person, and this is consistent with the disability reform policy - “transforming lives”.

The HSE provides a range of assisted living services including Personal Assistant (PA) services to support individuals to maximise their capacity to live full and independent lives.

Personal Assistance Services are accessed through an application process or through referrals from public health nurses or other community based staff. Individual’s needs are evaluated against the criteria for prioritisation for the particular services and then decisions are made in relation to the allocation of resources.

Resource allocation is determined by the needs of the individual, compliance with prioritisation criteria, and the level of resources available. It is important to note that the level of service delivered is varied to ensure that each client’s needs are reflected. Therefore there is no average agreed number of PA hours per person. PA and Home Support Services are provided either directly by the HSE or through a range of voluntary service providers. The majority of specialised disability provision (80%) is delivered through non-statutory sector service providers.

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

Disability Services Data

Questions (322)

Michael Moynihan

Question:

322. Deputy Michael Moynihan asked the Minister for Health the number of residential places for persons with a disability currently being provided as of 1 January 2021 or the latest date available by community health organisation area, in tabular form. [3004/21]

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Written answers

The 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.

Disability Services Data

Questions (323)

Michael Moynihan

Question:

323. Deputy Michael Moynihan asked the Minister for Health the number of new emergency places provided to persons with a disability as of 31 December 2020 by local health office area, in tabular form. [3005/21]

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Written answers

The 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.

Disability Services Data

Questions (324, 326, 327, 328, 329)

Michael Moynihan

Question:

324. Deputy Michael Moynihan asked the Minister for Health the number of children as of 1 January 2021 or the latest date available who were awaiting a first assessment from the HSE under the Disability Act 2005, by local health office area, in tabular form. [3006/21]

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Michael Moynihan

Question:

326. Deputy Michael Moynihan asked the Minister for Health the number of persons on the speech and language therapy assessment waiting list as of 1 January 2021 or the latest date available; the number waiting less than four months, from four to 12 months, and for more than 12 months, by local health office area in tabular form, and the number in each category waiting aged between zero and 17 years and over 18 years. [3008/21]

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Michael Moynihan

Question:

327. Deputy Michael Moynihan asked the Minister for Health the number of persons on the speech and language therapy initial treatment waiting list as of 1 January 2021 or the latest date available; the number waiting less than four months, from four to 12 months, and for more than 12 months, by local health office area in tabular form, and the number in each category waiting aged between zero and 17 years and over 18 years. [3009/21]

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Michael Moynihan

Question:

328. Deputy Michael Moynihan asked the Minister for Health the number of persons on the speech and language therapy further treatment waiting list as of 1 January 2021 or the latest date available; the number waiting less than four months, from four to 12 months, and for more than 12 months, by local health office area in tabular form, and the number in each category waiting aged between zero and 17 years and over 18 years. [3010/21]

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Michael Moynihan

Question:

329. Deputy Michael Moynihan asked the Minister for Health the number of persons on the occupational therapy first-time assessment waiting list as of 1 January 2021 or the latest date available; the number waiting for less than four months, from four to 12 months, and for more than 12 months, by local health office area, in tabular form, and the number in each category waiting aged between zero and four years, five and 17 years and 18 and 64 years, and from 65 years upwards. [3011/21]

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Written answers

I propose to take Questions Nos. 324 and 326 to 329, inclusive, 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.

Physiotherapy Services

Questions (325)

Michael Moynihan

Question:

325. Deputy Michael Moynihan asked the Minister for Health the number of persons on the physiotherapy waiting list as of 1 January 2021 or the latest date available; the number waiting for less than four months, from four to 12 months, and for more than 12 months, by local health office area, in tabular form, and the number in each category waiting aged between zero and four years, five and 17 years and 18 and 64 years, and from 65 years upwards. [3007/21]

View answer

Written answers

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

Questions Nos. 326 to 329, inclusive, answered with Question No. 324.
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