Written Answers Nos. 384-394
384. Deputy Louise O'Reilly asked the Minister for Health if a document (details supplied) was considered in respect of evidence in favour of giving heart failure patients high-risk priority on the vaccine priority and vaccine booster list; if this evidence was accepted; the situation in respect of heart failure patients on the vaccine booster list; and if he will make a statement on the matter. [55371/21]
View answerThe immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The NIAC makes recommendations on vaccination policy to my Department based on the prevalence of the relevant disease in Ireland and international best practices in relation to immunisation.
More than 7.6 million doses of COVID-19 vaccine have now been administered since the programme began in December last year. As the first phase of vaccination nears completion, the NIAC has been examining evidence regarding booster vaccines.
The NIAC has recommended that a booster dose of an mRNA vaccine (irrespective of whether the primary vaccination course was of an mRNA or adenoviral vector) be offered to those aged 60 years and older and healthcare workers. The booster dose should be given after an interval of six months (or at least five months) following the last dose of any authorised COVID-19 vaccine. I have accepted this advice and the HSE has made the necessary arrangements to operationalise these recommendations with the booster rollout now underway.
The NIAC has also recommended an additional mRNA dose should be given to those aged 12 years and older with immunocompromise associated with a suboptimal response to vaccination who have completed their primary vaccination course. The third dose of an mRNA vaccine should be given a minimum of two months after the last dose of the primary vaccination schedule.
You can view the NIAC recommendations regarding those with immunocompromise associated with a suboptimal response at the below link: rcpi-live-cdn.s3.amazonaws.com/wp-content/uploads/2021/09/Recommendations-re-additional-COVID-19-vaccine-dose-for-those-with-Immunocompromise-FINAL-30082021.pdf.
The NIAC continues to examine emerging evidence regarding booster vaccines for those with waning immunity and reduced effectiveness in other groups, such as those with co-morbidities (under 60 years of age) and will make further recommendations if required.
385. Deputy Michael Healy-Rae asked the Minister for Health if there is funding available for a person (details supplied) with an eating disorder; and if he will make a statement on the matter. [55372/21]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
386. Deputy Louise O'Reilly asked the Minister for Health the way in which patients with progressive, life-limiting conditions will be able to access medical cards in the future; and if he will make a statement on the matter. [55376/21]
View answerUnder the Health Act 1970, eligibility for a medical card is based primarily on means. The Act obliges the HSE to assess whether a person is unable, without due hardship, to arrange general practitioner services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure.
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.
However, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.
Furthermore, the HSE also has a system in place for the efficient provision of medical cards in response to emergency situations i.e. in circumstances where persons are in need of urgent ongoing medical care or are receiving end of life care. In these cases, a medical card is issued within 24 hours of receipt of the required patient details and completed medical report by a healthcare professional. Additionally, patients with a terminal illness and who have been certified by their treating Consultant as having a prognosis of 24 months or less to live are also now eligible for a medical card without a means assessment.
Finally, it should be noted that 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, for a period of five years.
387. Deputy Louise O'Reilly asked the Minister for Health the status of the provision of a statutory home care scheme; the way in which perceived age discrimination in the provision of home care services will be tackled; and if he will make a statement on the matter. [55377/21]
View answerEnabling people with care-needs to continue to live independently at home for as long as possible is a priority for the Government. To advance this, the Government is committed to establishing a new, statutory scheme for the financing and regulation of home-support services, which the Department of Health is currently developing.
It is envisaged that the new scheme will provide equitable and transparent access to high-quality services for people aged 18 years and above based on their assessed care-needs. Work is on-going within the Department to progress the development of the new scheme within the broader context of the Sláintecare reforms. This work encompasses the development of the regulatory framework for the new scheme; the examination of the options for the financing model for the scheme; and the development of a reformed model of service-delivery for home support services.
With the aim of ensuring that all service-users are provided with a standard, high-quality level of care which is safe, effective, and person-centred, it is envisaged that the regulatory framework will comprise: (i) primary legislation for the licensing of public and private home-support providers; (ii) minimum requirements (i.e., regulations); and (iii) HIQA National Standards for Home Support Services.
Earlier this year, Government gave approval to draft a General Scheme and Heads of a Bill to establish a licensing framework for home-support providers. This is being progressed by the Department with a view to bringing it through the Houses of the Oireachtas at the earliest opportunity. It is expected that the primary legislation will give the Minister for Health the power to make regulations in respect of minimum requirements which will form the criteria against which a provider’s eligibility to hold a licence will be determined. The Department recently commenced a targeted stakeholder consultation on these draft minimum requirements. In addition, HIQA recently ran a public scoping consultation to inform the development of their National Standards for Home Support Services.
In relation to the development of a statutory scheme for the financing of home support, the Department is undertaking work on the potential demand for and cost of the introduction of a such a scheme.
In parallel to this, work is ongoing in relation to the development of a reformed model of service delivery for home support. Within this context, funding was provided in 2021 for the HSE to progress the roll-out of interRAI as the standard assessment tool for care-needs in the community; the pilot of a reformed model of service-delivery for home-support; and the establishment of a National Office for Home Support Services.
The testing of the reformed model of service delivery for home support commenced this month in the first of the four pilot sites: CHO 8. It is envisaged that the three other sites, CHOs 2, 4 and 7 will be fully operational by January 2022. A National Home Support Office will be established before the end of the year and recruitment of the 130 posts funded for the national rollout of interRAI as the standard assessment tool for care-needs is scheduled to commence in this quarter. A comprehensive and robust operational model for the roll-out of the interRAI has been developed which will facilitate effective, efficient, fair and transparent care needs assessment and planning and appropriate service delivery. The interRAI outputs and pilot site evaluation will be critical to the development of the new home support scheme.
The Sláintecare Implementation Strategy and Action Plan 2021–2023 commits to the advancement of the development of the new home-support scheme in 2021 and to the commencement of its implementation in 2022.
388. Deputy Violet-Anne Wynne asked the Minister for Health further to Parliamentary Question No. 439 of 7 October 2021, the status of his Department’s examination on this issue; if there is a timeline available for when these charges will be reformed; and if he will make a statement on the matter. [55387/21]
View answerAs outlined to the Deputy previously, the Programme for Government makes a commitment to introduce a cap on the maximum daily charge for patients and visitors at all public hospitals, where possible, and to introduce flexible passes in all public hospitals for patients and their families. Accordingly, consideration is being given, as I have said, to how best to ensure this commitment is addressed, taking account of existing arrangements already in place. While this remains ongoing, I can advise the Deputy that the HSE has previously advised that hospitals that currently charge car parking fees are very cognisant of the financial implications of parking costs and many hospitals have introduced maximum daily fixed parking charges and reduced rate parking for long-term patients and visitors for whom the payment of the full rate would cause hardship.
389. Deputy Paul Kehoe asked the Minister for Health the reason urgent care service funding has ceased in a surgery (details supplied); and if he will make a statement on the matter. [55396/21]
View answerUnder the General Medical Services (GMS) contract, GPs are reimbursed for a range of services they provide to medical card and GP visit card holders on behalf of the Health Service Executive. GPs are remunerated for these services primarily on a capitation basis, with a range of additional support payments and fees for specific items of service.
The HSE Primary Care Reimbursement Service (PCRS) is responsible for making payments to Primary Care Contractors, including GPs. The reimbursement payments to independent practitioners are not salary and practitioners must meet their business expenses out of same.
Following engagement with the Irish Medical Organisation, a grant-based system of funding for GP Out Of Hours Co-operatives has been in place since March 2020 to support Out of Hour services during the pandemic. In accordance with the agreed system, no Out of Hours or other claims for consultations during Co-op hours of operation are claimable by the Co-op or their members from the PCRS.
The PCRS has a legal obligation to ensure that resources are used for the purpose for which they are intended and is obliged to verify the reasonableness and accuracy of all claims submitted for payment. A validation mechanism exists for claims made by Co-op members during the hours of operation of grant aided Co-ops.
Where GPs have any queries or concerns in relation to the validation mechanism or their GMS remuneration, there is a specific email contact point provided pcrs.doctorsqueries@hse.ie. Where information is provided that clarifies that any claim held under the validation is in line with contracts PCRS ensures same is paid.
390. Deputy Robert Troy asked the Minister for Health further to Parliamentary Question No. 834 of 19 October 2021, if he will clarify a matter regarding the case of a person (details supplied). [55411/21]
View answerUnder 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.
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.
391. Deputy Michael Ring asked the Minister for Health if vaccination is compulsory for certain students in order that they can take up a placement (details supplied); and if he will make a statement on the matter. [55412/21]
View answerThe HSE has informed my Department that the position regarding student nurses and midwives taking up clinical placements has not changed since Dr Colm Henry, HSE Chief Clinical Officer, wrote to all Higher Education Institutes (HEIs) earlier this year.
Following his first letter on 26 March 2021, Dr Henry, wrote an additional memo to the HEIs stating, among other things, that “clinical placements for all healthcare students (those who have and have not received/taken a vaccine) may continue in HSE facilities subject to students' continuing compliance with public health recommendations and infection prevention and control practice.”
Dr Henry stated that this memo superseded his memo of 26 March 2021.
Subsequently, in August 2021, HSE issued a document entitled " HSE Guidance on Clinical Placements in HSE Facilities". This document stated that HSE remained committed to working with key partners to support clinical placements for the coming academic year to the greatest practical degree subject to the priority of protecting the safety of patients, staff and students. The HSE Guidance further stated that the HSE was not seeking to impose vaccination on students.
392. Deputy Bernard J. Durkan asked the Minister for Health the extent to which ongoing testing of new and orphan drugs continues; the number of cases approved in each of the past 12 months to date; the extent to which availability of such drugs can be enhanced by way of specific changes or accelerated process; the extent to which remuneration continues to play an important role in making such drugs available to suitable patients; and if he will make a statement on the matter. [55461/21]
View answerThe Health (Pricing and Supply of Medical Goods) Act 2013 gives full statutory powers to the HSE to assess and make decisions on the reimbursement of all medicines taking account of a range of objective factors, clinical benefits, cost effectiveness and expert opinion as appropriate. 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 Drugs Group is the national committee which the HSE has in place to make recommendations on the pricing and reimbursement of medicines. The role of the Drugs Group is to make a recommendation to the HSE Executive Management Team (EMT) in relation to each individual application having considered the criteria under the Health (Pricing and Supply of Medical Goods) Act 2013.
The Drugs Group considers the NCPE assessment, the outputs from commercial engagements, patient interest group submissions, and any other pertinent information in advance of providing its recommendation to the HSE EMT.
As the decision-making authority within the HSE, the HSE EMT decides on the basis of all the demands with which it is faced (across all services) whether it can fund a new medicine, or new uses of an existing medicine, from the resources that have been provided to it in line with the Health (Pricing and Supply of Medical Goods) Act 2013.
While the 2013 Health Act does not include provision for a different ruleset when assessing orphan medicines, the criteria that apply to the evaluation process allow the HSE to take account of evidence of the benefits associated with each given medicine. The budget allocation of €30m funding for new medicines in Budget 2022 will provide for the reimbursement of both orphan and non-orphan medicines.
The number of orphan drugs approved across the past 12 months is an operational issue. I have therefore referred this matter to the HSE for their attention and direct reply to the Deputy.
393. Deputy Aodhán Ó Ríordáin asked the Minister for Agriculture, Food and the Marine if his attention has been drawn to an initiative (details supplied); and if his Department will help support and progress the initiative to create a native woodland forest for the children of Ireland. [55382/21]
View answerI am delighted to hear of this initiative and my colleague Minister of State, Senator Pippa Hackett has already written to offer support and practical advice. Providing the project meets the requirements, it may be eligible for grant aid, under the Creation of Woodlands on Public Lands Scheme. Or, if the project is to take place on privately owned land, it may be eligible for support under the Afforestation Grant and Premium Scheme.
Trees have an important part to play in meeting our Climate Action Plan targets. Increasing our annual afforestation rate consistent with realising the ambitious target of 8,000 ha yearly planting set out in the Climate Action Plan 2021, will not be easy. I am encouraged by initiatives such as Foraoise na bPáistí, which drive forward the establishment of woodlands in creative and innovative ways.
I wish the students the very best of luck with this initiative.
394. Deputy Michael Healy-Rae asked the Minister for Agriculture, Food and the Marine if he will address a matter (details supplied) regarding the allocation of funding; and if he will make a statement on the matter. [55246/21]
View answerHorse Racing Ireland (HRI) is a commercial state body established under the Horse and Greyhound Racing Act, 2001, and is responsible for the overall administration, promotion and development of the horse racing industry.
The question raised by the Deputy is an operational matter for HRI and I have requested my officials to refer the question to them for direct reply.
In relation to the earlier question referred to, HRI replied directly to the Deputy on 28th October 2021 in response to PQ 50192/21.
