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Wednesday, 21 Apr 2021

Written Answers Nos. 1838-1856

Health Services Staff

Questions (1838)

Mark Ward

Question:

1838. Deputy Mark Ward asked the Minister for Health the number of clinicians in each CHO that have been redeployed from early intervention and school age disability teams into assessment of needs posts; and if he will make a statement on the matter. [19100/21]

View answer

Written answers

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

HSE Data

Questions (1839)

Bríd Smith

Question:

1839. Deputy Bríd Smith asked the Minister for Health the number and name of all home care providers for older persons used by the HSE; the cost of same in 2018, 2019 and 2020; the number of home help hours provided by private contracted companies; and the number provided directly by HSE staff in the same period. [19101/21]

View answer

Written answers

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

Disabilities Data

Questions (1840)

Bríd Smith

Question:

1840. Deputy Bríd Smith asked the Minister for Health the number and name of all private providers of disability residential care for the HSE; and the number of disability residents currently in privately run residential homecare excluding residential nursing homecare for the elderly. [19102/21]

View answer

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 Funding

Questions (1841)

Bríd Smith

Question:

1841. Deputy Bríd Smith asked the Minister for Health the estimated full cost of funding to all private providers of disability residential care contracted by the HSE in 2018, 2019 and 2020 excluding nursing homecare for the elderly; and the number and cost of funding and providing services to disability residents in residential care provided directly by the HSE. [19103/21]

View answer

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.

Vaccination Programme

Questions (1842)

Mark Ward

Question:

1842. Deputy Mark Ward asked the Minister for Health if there is any priority based on age in the vulnerable at risk category of persons aged 16 to 64 years in the roll-out of the vaccine; and if he will make a statement on the matter. [19105/21]

View answer

Written answers

The COVID-19 Vaccine Allocation Strategy sets out a provisional list of groups for vaccination. The Strategy was developed by the National Immunisation Advisory Committee (NIAC) and my Department, endorsed by the National Public Health Emergency Team (NPHET), and approved by Government on 8 December 2020.

On the 23rd of February, I announced an update to Ireland’s COVID-19 Vaccine Allocation Strategy. In comprising the initial Vaccine Allocation Strategy, the NIAC listed several conditions associated with increased risk of severe disease and death. In the intervening period, national and international evidence has become available which has enabled a more detailed analysis of underlying conditions that may increase the risk of developing severe disease or death. The NIAC has now been able to more comprehensively identify those medical conditions and to distinguish between those which place a person at very high or high risk of severe disease if they contract the virus. Medical conditions and the magnitude of the risk they pose will continue to be monitored and periodically reviewed.

On the 30th of March, the Government approved a further update to the COVID-19 Vaccination Allocation Strategy. Based on clinical, scientific and ethical frameworks produced by the National Immunisation Advisory Committee and my Department, following the vaccination of those most at risk, future groups will be vaccinated by age, in cohorts of 10 years (i.e., 64-55; 54-45, etc.).

The move to an age-based model better supports the programme objectives by:- protecting those at highest risk of severe disease first, which benefits everyone most;- facilitating planning and execution of the programme across the entire country;- improving transparency and fairness.

Further details are available here: www.gov.ie/en/press-release/93f8f-minister-donnelly-announces-update-to-irelands-vaccination-prioritisation-list/.

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 (1843)

Mark Ward

Question:

1843. Deputy Mark Ward asked the Minister for Health if the HSE sent out co-correspondence to or direction to general practitioners to prioritise persons aged 18 plus within the vulnerable at risk category of the category of persons aged 16 to 64 years; and if he will make a statement on the matter. [19106/21]

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.

Covid-19 Pandemic

Questions (1844)

David Cullinane

Question:

1844. Deputy David Cullinane asked the Minister for Health his views on a matter raised in correspondence (details supplied); and if he will make a statement on the matter. [19116/21]

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Written answers

The Health Act 1947, as amended, provides that all persons arriving in Ireland from a designated state, or having travelled through a designated state in the previous 14 days, are required to undergo mandatory quarantine in a designated facility unless they are an exempted traveller under the Act. The full list of exempted travellers is available on gov.ie/quarantine.

Quarantine of persons arriving from areas with a high incidence of variants of concern is considered a deterrent against the emergence of such variants in the state and as such all persons arriving from those designated states are required to undergo mandatory quarantine in a designated facility, regardless of vaccination status, unless otherwise exempt.

The Government gives continuing consideration to wider policy on international travel as informed by the epidemiological situation and public health advice. This includes the possibility of future exemptions, including for certain categories of essential workers as appropriate.

In some limited circumstances such as the emergency repatriation of Irish citizens abroad, the Department of Foreign Affairs may be able to advise or provide assistance to such citizens when they are arranging their stay in a mandatory quarantine designated facility. Such persons should contact their local embassy or mission in such emergency situations.

Vaccination Programme

Questions (1845)

Alan Dillon

Question:

1845. Deputy Alan Dillon asked the Minister for Health the Covid-19 vaccine drug product manufacturing and supply strategy to combat variants of the Covid-19 virus; the way in which vaccine booster supplies will be procured; if it is planned to use third party or generic manufacturers based here to ensure guaranteed vaccine supply; and if he will make a statement on the matter. [19120/21]

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Written answers

Ireland is participating in an EU led procurement process, where the Commission has negotiated a range of contractual agreements with various vaccine suppliers and across a range of technologies on behalf of Member States. Ireland has, through its participation in this process, 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.

Recently, the Commission has engaged in negotiations with Pfizer / BioNTech with a view to securing a Purchase Agreement for 900m doses of its vaccine on behalf of Member States, with provision for an additional 900m doses, for 2022/2023. Pfizer / BioNTech's vaccine is based upon mRNA technology, providing scope for it to be adjusted to deal with variants of Covid-19. The vaccine could also be used to provide booster shots, where required. The appropriate mix of vaccine technologies to provide boosters and variants is also being considered by the Steering Board, comprised of the Commission and EU Member States, for the EC procurement process.

In conjunction with this, the new European bio-defence preparedness plan against COVID-19 variants called “HERA Incubator” will work with researchers, biotech companies, manufacturers and public authorities in the EU and globally to detect new variants, provide incentives to develop new and adapted vaccines, speed up the approval process for these vaccines, and ensure scaling up of manufacturing capacities.

Vaccination Programme

Questions (1846)

Seán Canney

Question:

1846. Deputy Seán Canney asked the Minister for Health when patients that suffer from asthma can expect to receive the Covid-19 vaccine; and if he will make a statement on the matter. [19122/21]

View answer

Written answers

The COVID-19 Vaccine Allocation Strategy sets out a provisional list of groups for vaccination. The Strategy was developed by the National Immunisation Advisory Committee (NIAC) and my Department, endorsed by the National Public Health Emergency Team (NPHET), and approved by Government on 8 December 2020.

On the 23rd of February, I announced an update to Ireland’s COVID-19 Vaccine Allocation Strategy. In comprising the initial Vaccine Allocation Strategy, the NIAC listed several conditions associated with increased risk of severe disease and death. In the intervening period, national and international evidence has become available which has enabled a more detailed analysis of underlying conditions that may increase the risk of developing severe disease or death. The NIAC has now been able to more comprehensively identify those medical conditions and to distinguish between those which place a person at very high or high risk of severe disease if they contract the virus. Medical conditions and the magnitude of the risk they pose will continue to be monitored and periodically reviewed.

On the 30th of March, the Government approved a further update to the COVID-19 Vaccination Allocation Strategy. Based on clinical, scientific and ethical frameworks produced by the National Immunisation Advisory Committee and my Department, following the vaccination of those most at risk, future groups will be vaccinated by age, in cohorts of 10 years (i.e., 64-55; 54-45, etc.).

The move to an age-based model better supports the programme objectives by:

- protecting those at highest risk of severe disease first, which benefits everyone most;

- facilitating planning and execution of the programme across the entire country;

- improving transparency and fairness.

Further details are available here: www.gov.ie/en/press-release/93f8f-minister-donnelly-announces-update-to-irelands-vaccination-prioritisation-list/.

Vaccination of Group 4 began in March. People with severe asthma will be vaccinated in Group 5.

Ophthalmology Services

Questions (1847)

James Lawless

Question:

1847. Deputy James Lawless asked the Minister for Health if he will address a matter in relation to an ophthalmologist (details supplied) in County Kildare; and if he will make a statement on the matter. [19123/21]

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.

Question No. 1848 answered with Question No. 1831.

Medical Internships

Questions (1849)

Ruairí Ó Murchú

Question:

1849. Deputy Ruairí Ó Murchú asked the Minister for Health further to Parliamentary Question No. 1356 of 24 March 2021 (details supplied), if he will guarantee that student radiographers will be treated the same as student nurses and midwives in receiving standardised travel and accommodation allowances, a pandemic payment grant and an internship payment in their fourth year; and if he will make a statement on the matter. [19133/21]

View answer

Written answers

As previously stated, radiography students do not receive an allowance to support time spent on placement as part of their course and there are no plans to change this.

Student nurses and midwives are unique in that there is, in the final year, a paid salary when they are specifically employed on an internship placement. In the context of COVID-19, I appointed Professor Tom Collins to undertake a short-term review of the current allowances available to student nurses and midwives. His report was submitted to me on 31 December 2020.

The key recommendation in this Report is that an additional and exceptional Student Nurse/Midwife Pandemic Placement Grant of €100 per week for each week spent on supernumerary placement be introduced from January 2021 for the duration of the pandemic. I have confirmed my full acceptance of the Report’s recommendations and my Department has directly engaged with nursing/midwifery union representatives in this respect.

The position on the implementation of the Collins Report remains that I have accepted the recommendations of the report and my Department officials are continuing to engage with representative bodies.

Again, I wish to acknowledge the extremely important work that student radiographers are doing at present and the valuable contribution they are making to the fight against Covid-19.

Hospital Appointments Status

Questions (1850)

Michael Healy-Rae

Question:

1850. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [19134/21]

View answer

Written answers

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

The HSE is currently recommending that only critical time dependent elective procedures are undertaken at this time due to the on-going and significant increased demand for bed capacity related to COVID-19.

This decision was made arising from the rapid increase in COVID-19 admissions and to ensure patient safety and that all appropriate resources were made available for COVID-19 related activity and time-critical essential work.

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.

On 23 March the HSE published the “Safe Return to Health Services Plan”. This plan outlines a three phased approach for the proposed restoration of services across Community Services, Acute Hospital Operations, Cancer Services and Screening Services. It sets target times for their safe return and details the conditions and challenges that will have to be met.

Every phase of the plan has been informed by clinical guidance and putting patient and staff safety first.

Decisions in relation to the type and volume of activity will be made at site level based on local COVID-19 numbers, available capacity and guidance from national clinical leads.

The schedule outlined in the plan for resumption of services will be regularly monitored by the HSE and updated as appropriate, dependant on public health advice and healthcare capacity.

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.

Medicinal Products

Questions (1851)

Paul Murphy

Question:

1851. Deputy Paul Murphy asked the Minister for Health if his attention has been drawn to the fact that in September 2020 the National Centre for Pharmacoeconomics refused reimbursement for the life-changing gene therapy luxturna unless cost effectiveness can be improved relative to existing treatments; if his attention has been further drawn to the fact that there are no existing treatments for inherited retinal disease (details supplied); if he will request that the National Centre for Pharmacoeconomics review its decision and include the drug in the list of drug treatments approved for reimbursement; and if he will make a statement on the matter. [19135/21]

View answer

Written answers

Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

Medicinal Products

Questions (1852)

Alan Kelly

Question:

1852. Deputy Alan Kelly asked the Minister for Health when patients will have access to fremanezumab; and if he will make a statement on the matter. [19140/21]

View answer

Written answers

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.

In line with the 2013 Health Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the reimbursement list.

Reimbursement is for licensed indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.

In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria 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 16 April 2019, it received an application for the reimbursement of Fremanezumab (Ajovy) for the prophylaxis of migraine in adults who have at least 4 migraine days per month.

On 1 May 2019, following the completion by the NCPE of a rapid review, the HSE commissioned a full pharmacoeconomic assessment with respect to this indication, as per agreed processes.

On 26 September 2019, the NCPE received the applicant’s submission for this assessment. On 7 September 2020, the NCPE completed its assessment and recommended that:

- Fremanezumab for the prophylaxis of migraine in adult patients with chronic migraine who have failed three or more migraine-preventive treatments be considered for reimbursement

- Fremanezumab for the prophylaxis of migraine in adult patients with episodic migraine who have failed three or more migraine-preventive treatments be considered for reimbursement if cost-effectiveness can be improved relative to existing treatments.

In March 2021, the HSE Drugs Group considered Fremanezumab for the prophylaxis of migraine in adult patients with chronic migraine who have failed three or more migraine-preventive treatments. This was the defined subgroup of the full licensed indication for which the applicant sought reimbursement approval.

The HSE Drugs Group considered the final HTA report, alongside the outputs of commercial negotiations which took place in November 2020 and the patient group submission received during the HTA process. The Drugs Group recommended that reimbursement for Fremanezumab should be supported for the above subgroup of the full licensed indication, conditional on the establishment of a HSE managed access programme to support reimbursement for that patient subgroup.

The HSE will now implement an individual patient approval system to enable reimbursement for patients who meet the pre-defined criteria, as per the HSE Medicines Managed Programme devised managed access protocol which is currently in development.

Processes required to implement the managed access programme, as per the HSE Drugs Group’s recommendation, are currently ongoing with a view to formalising the HSE’s approval of this application.

The HSE Executive Management Team is the final decision-making body for the reimbursement of medicines under the Health Act 2013.

Question No. 1853 answered with Question No. 1768.

Maternity Services

Questions (1854)

Seán Sherlock

Question:

1854. Deputy Sean Sherlock asked the Minister for Health the status for birthing partners in maternity wards with the easing of restriction. [19144/21]

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.

Question No. 1855 answered with Question No. 1783.

Dental Services

Questions (1856)

Michael Healy-Rae

Question:

1856. Deputy Michael Healy-Rae asked the Minister for Health if he will address a matter in relation to dental care for children attending primary school (details supplied); and if he will make a statement on the matter. [19158/21]

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.

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