Written Answers Nos. 1470-1493
1471. Deputy Sorca Clarke asked the Minister for Health the salaries and expenses paid to advisers, Ministers and-or Ministers of State in his Department in 2020, 2021 and to date in 2022, in tabular form. [19748/22]
View answerThe requested salary information paid to advisers, Ministers and/or Ministers of State in my Department in 2020, 2021 and to date in 2022 is available on the Department of Public Expenditure and Reform (DPER) website at the following links:
- Members of the Oireachtas & Certain Ministerial & Parliamentary Officeholders assets.gov.ie/216182/3ab494d7-88f3-4138-83f3-4d307f81c6e8.pdf
- Special Advisers to Ministers and Ministers of State assets.gov.ie/216920/15f0f785-6f9a-416d-816b-a83cc60babe1.pdf
In relation to the requested expenses information, where expenses are incurred by staff in the performance of duties relating to their brief, the Department pays mileage, travel and subsistence at standard Civil Service Rates and in accordance with Civil Service Regulations.
1472. Deputy Mairéad Farrell asked the Minister for Health if the enabling works for the new national maternity hospital are now complete; if so, the final cost of these works; the breakdown, in tabular form, of the cost by the categories of work undertaken (details supplied). [19772/22]
View answer1475. Deputy Mairéad Farrell asked the Minister for Health the reasons for the current cost overrun for the new national maternity hospital for the enabling works rising from the initial estimate of €20 million to at least €51.2 million, broken down by cost category. [19775/22]
View answerI propose to take Questions Nos. 1472 and 1475 together.
The Government is committed to the development of the new National Maternity Hospital (NMH) planned for the St. Vincent’s University Hospital Campus at Elm Park, as set out in the Programme for Government: Our Shared Future.
Enabling works were undertaken to prepare the site of the new NMH and de-risk the campus in advance of the construction works for the new hospital. These works comprised of the carpark extension and relocating some SVUH departments that were located on the proposed site of the new NMH, such as the pharmacy, and diverting utility services to other locations on the SVUH campus.
The pharmacy and multi-storey car park extension were completed in 2021 and both are fully operational. The enabling works to prepare the site of the new NMH and de-risk the project and campus in advance of the construction works for the new maternity hospital are nearing completion.
A breakdown of the expenditure to date is detailed in the table below:
|
Enabling works |
Spend to date Incl. VAT(€m) |
|
Replacement of pharmacy and an extension to the multi-storey car park |
€28.9m |
|
Other enabling works |
€22.3m* |
|
Aspergillus protection and prevention works |
|
|
Enabling works/site preparation works |
|
|
Infrastructural, demolition and utilities diversion works |
|
|
Total |
€51.2m |
The contract for the Pharmacy and extension to existing multi storey carpark were awarded as a single construction contract and are not apportioned separately.
*As the construction contracts for a number of these works are ongoing, the individual contract costs are commercially sensitive and therefore are not broken out separately.
1473. Deputy Mairéad Farrell asked the Minister for Health the justification for an enhanced replacement pharmacy in the new national maternity hospital; and if the business case that was submitted in 2018 for same will be provided. [19773/22]
View answer1474. Deputy Mairéad Farrell asked the Minister for Health the justification for extending the existing multi-storey car park in the new national maternity hospital, which is owned by a private company (details supplied) in 2018 given that is yet to be approved. [19774/22]
View answerI propose to take Questions Nos. 1473 and 1474 together.
Planning permission for the new National Maternity Hospital (NMH) at St. Vincent's University Hospital (SVUH) was secured in 2017 and in December 2018, the then Minister for Health approved the awarding of the contract for the first phase of the new NMH relocation project to proceed-enabling works.
The purpose of the enabling works undertaken to date have been to prepare the site of the new NMH and de-risk the campus in advance of the construction works for the new hospital. These works comprise of relocating some SVUH departments currently on the site of the new NMH, such as the pharmacy, and diverting utilities to other locations on the SVUH campus. The pharmacy and multi-storey car park extension were completed in 2021 and both are fully operational.
The requirement to replace the outdated pharmacy had been recognised for some time as part of the wider SVUH Campus Development Plan and was a necessary campus project in its own right, as well as being necessary to allow the NMH development to proceed. The original SVUH pharmacy was located on the proposed site for the new NMH and needed to be relocated, commissioned, and operationalised prior to commencement of construction of the new NMH.
The new pharmacy is designed to meet current regulatory standards and includes a Pharmacy Automated Dispensing System (PADS) and supports the implementation of the Falsified Medicines Directive, as well as bringing efficiencies to the delivery of pharmacy services for SVUH and the delivery of certain campus-wide pharmaceutical services, including the new NMH. The Pharmacy is located at roof level of the existing Main Ward Block, at the heart of the SVUH. This new central location will bring greater efficiencies in the delivery of pharmacy services within the hospital. In turn, the relocation of the pharmacy releases the existing site for of the development of the new NMH.
The early programme delivery of the additional car-parking spaces and junction upgrades is a specific requirement of the Strategic Infrastructure Development (SID) planning permission, required to reduce the impact of the NMH construction works both on the operation of the campus and on the surrounding residential area. These works also unlock key elements of the campus for the Main Development works.
The additional spaces arising from these works support the relocation of the NMH to the SVUH campus. In addition, the car park works help to deliver the optimum approach to efficient car parking on the campus. The car park works also provided enhanced facilities for disabled users, additional accommodation for cyclists, and general improvements to the surrounding public realm. As such it will serve the entire SVUH campus, including the new NMH.
The Pharmacy and extension to existing multi storey carpark works were procured in accordance with Capital Works Management Framework guidance for public works contracts and all relevant Irish and EU procurement rules and guidelines. The tender was advertised both on e-tenders and OJEU. It was a 2-stage tender process, and the Pharmacy/Car-park works was advertised and awarded as single tender/contract.
1476. Deputy Mairéad Farrell asked the Minister for Health if the business case for the new national maternity hospital that was approved by the HSE board in November 2021, as per the public spending code, will be made available; and if the business case will be published. [19776/22]
View answerThe Public Spending Code (PSC) is designed to ensure that capital investment decisions are underpinned by a clear policy rationale, and that costs are well understood. In 2019, the PSC was updated and introduced a new project lifecycle, tightening the arrangements for project decision-making, and clarifying the roles of the parties involved including the responsibilities for Sponsoring Agencies and Approving Authorities. The PSC also provides detail on the business case requirements at each stage of the new project lifecycle.
All capital development proposals must progress through several approval stages, in line with the new lifecycle approach of the updated PSC, including detailed appraisal, planning, design and procurement before a firm timeline or funding requirement can be established.
The specific requirements that must be included in a business case at the various stages of the PSC, are detailed at www.gov.ie/en/publication/public-spending-code/, including the points at which business cases are to be published.
The National Maternity Hospital (NMH) relocation project was initiated prior to the publication of the updated Public Spending Code (PSC), and therefore the NMH Project Board undertook additional work on the business case to ensure full compliance with the new PSC requirements.
A business case for relocation of NMH has been submitted to the Department by the NMH Project Board for review at Gate 2 of the PSC. The Business Case is now subject to technical review by the Department of Health, including through the External Assurance Process recently introduced by the Department of Public Expenditure and Reform. Pending favourable review under the Spending Code, a Memorandum for Government will then be brought forward to progress the programme for the NMH.
If approval in principle is granted, the project can move to preparation of tender documents in line with EU law and deployment of a tendering strategy.
A further Business Case will then be developed by the NMH Project Board, and if approval is granted at Decision gate 3, the Business Case will be published in line with the Public Spending Code.
1477. Deputy Mairéad Farrell asked the Minister for Health if he will provide a copy of a review (details supplied). [19777/22]
View answer1478. Deputy Mairéad Farrell asked the Minister for Health the analysis and justification that has been completed since 2008 that demonstrates that the relocation of the new national maternity hospital to Elm Park is still the best solution for the women in the greater Dublin area 14 years later and complements the updated relocation sites for the Rotunda and the Coombe hospitals given that a key goal of the 2008 report was to balance births evenly across the three relocated maternity hospitals. [19778/22]
View answerI propose to take Questions Nos. 1477 and 1478 together.
It is Government policy, as reiterated in the National Maternity Strategy, to co-locate stand-alone maternity hospitals with adult acute hospitals. Co-location of maternity services with adult services provides mothers with access to a full range of medical and support services should the need arise, in line with international best practice. In order to be successful in terms of enabling immediate access in an emergency, co-location requires physical adjacencies and specific corridor-linkages from one hospital to the other. The availability of these services helps ensure the delivery of an optimum, safe service, particularly for high-risk mothers and babies.
The 2008 KPMG report recommended that the NMH should be co-located with St Vincent’s, the Coombe with Tallaght and the Rotunda with the Mater, tri-located with the new children’s hospital then planned for that site. This configuration was designed to optimise access and the locations were therefore interdependent.
Following the Government decision in 2012 that the new children’s hospital would be co-located with St James’s Hospital in Dublin 8, there was a need to provide for tri-location of maternity services on that site. In the context that the project to relocate the NMH to St Vincent's had commenced and a design team was in place, a review was undertaken to determine which hospital (the Coombe or Rotunda) would be tri-located with the children's hospital and St James’s Hospital, and what the optimum location would be for the remaining hospital. The review took account of attendance patterns and access overall, as well as clinical criteria and site considerations. Further information in relation to the relocation decision is available here:
wayback.archive-it.org/11501/20190626194030/https://health.gov.ie/blog/press-release/department-of-health-announces-sites-for-redevelopment-of-coombe-and-rotunda-hospitals/
In relation to the NMH, co-location with SVUH will make the wide range of general medical, surgical and diagnostic facilities on the Elm Park campus available to any woman who needs to be transferred from the adjacent maternity hospital, resulting in care provision that is far superior to the existing situation. This co-location will also build on the longstanding working relationship between the NMH and SVUH, given that a significant proportion of the consultant staff at the NMH are employed by and work between the two hospitals.
1479. Deputy Mairéad Farrell asked the Minister for Health if the Comptroller and Auditor General is examining a value-for-money assessment of the new national maternity hospital; and if so, when his report will be completed and available for review. [19779/22]
View answer1480. Deputy Mairéad Farrell asked the Minister for Health the findings of the Comptroller and Auditor General's audit on the enabling works that were to be completed by the end of 2021; and if a copy of the report will be provided. [19780/22]
View answerI propose to take Questions Nos. 1479 and 1480 together.
The Department of Health has not received any correspondence from the Comptroller & Auditor General (C&AG) in relation to an audit as described by the Deputy. My understanding is that the HSE are engaging with the C&AG regarding an audit relating to works to support the new National Maternity Hospital project.
As this is a matter for the HSE, I've asked it to reply directly to the Deputy.
1481. Deputy Mairéad Farrell asked the Minister for Health the most recent estimated cost for the new national maternity hospital (details supplied). [19781/22]
View answerThe capital project to co-locate relocation of the National Maternity Hospital (NMH) to the St. Vincent's University Hospital (SVUH) Campus is progressing. Site preparatory and enabling works were required to support the relocation of the new NMH.
These preparatory works commenced on the campus in early 2018 with a programme of Aspergillus prevention works. Construction of the new pharmacy and the multi-storey car-park were completed in 2021 and both are fully operational. The costs of all works to date are €51m (including VAT).
With the exception of the construction works referenced above, no further contractual commitments have been entered into with respect to works to the new NMH project.
It is important to recognise that all capital development proposals must progress through a number of approval stages, in line with the Public Spending Code, before a firm timeline or funding requirement can be established.
A Final business case has been submitted to the Department by the NMH Project Board and is now subject to technical review by the Department of Health, including the External Assurance Process for major capital projects recently introduced by the Department of Public Expenditure and Reform.
Pending favourable review under the Spending Code, a Memorandum for Government will then be brought forward to progress the programme for the NMH. If approval in principle is granted, the project can move to preparation of tender documents in line with EU law and deployment of a tendering strategy.
The final decision to proceed with the construction and therefore to estimate the cost for the new NMH cannot be made until the tender process has been completed and the costings reviewed to ensure that the proposal delivers value for money and remains affordable.
1482. Deputy Bernard J. Durkan asked the Minister for Health the number of drug users referred to a methadone or similar programme over the past five years; the extent to which the outcome was satisfactory from the point of view of a reduction or cessation of dependency on drugs; and if he will make a statement on the matter. [19786/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1483. Deputy Bernard J. Durkan asked the Minister for Health the reason that it is held that an increased use of illegal drugs by drug users is deemed to be successful; if it is anticipated that the usage is increased, that supply is increased and that families all over the country continue to suffer as a result; if methadone treatment is sufficiently safeguarded to bring about a reduction in drug use; and if he will make a statement on the matter. [19790/22]
View answer1484. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the use of illegal drugs continues throughout Ireland notwithstanding the various measures in place to curtail the activity; if efforts are being made to measure the extent of the availability of such drugs on the street to the obvious detriment of drug users and addicts throughout Ireland; and if he will make a statement on the matter. [19793/22]
View answerI propose to take Questions Nos. 1483 and 1484 together.
The National Drug and Alcohol Survey 2019/20 is funded by the Department of Health and managed by the Health Research Board. It provides information on alcohol, tobacco, and drug use amongst the general population in Ireland.
The survey findings show that, overall, the use of illegal drugs has remained similar to that recorded in the 2014/15. Cannabis which is still the most prevalent illegal drug used in Ireland, has shown a decrease from 6.5% to 5.9% when compared to the 2014/15 survey. However there was an increase in the use of cocaine and ecstasy.
The national drug strategy, Reducing Harm Supporting Recovery, strategy provides an integrated public health approach to drug and alcohol use, focused on reducing the harms for individuals, families and communities and promoting rehabilitation and recovery. The recently completed mid-term review of the drug strategy shows significant progress in implementing the action plan for the period 2017 to 2020, with only a small number of the 50 actions outstanding.
Six strategic priorities have been identified for the remaining years of the strategy. The first strategic priority aims to strengthen the prevention of drug and alcohol use and the associated harms among children and young people.
Access and availability of drug services have been improved under the national drugs strategy, particularly services for women and people who are homeless, and those with heroin addiction. The Department provides over €150 million to provide drug and alcohol services every year.
Significant additional funding was provided to the HSE to provide for drug treatment services in 2020 and 2021. In 2021, a further €4.2 million was secured for the continued treatment of an additional 1,000 clients on opioid substitution treatment.
I am committed to the implementation of the health led approach to drug use and to supporting people on their journey to recovery.
1485. Deputy Bernard J. Durkan asked the Minister for Health the degree to which the various drug task forces are combatting the rise in drug abuse all over the country, with particular reference to open trading, injecting and usage of same; if it is possible to evaluate policy with a view to requiring that a reduction in use can be shown on foot of treatment programmes; and if he will make a statement on the matter. [19795/22]
View answer1490. Deputy Bernard J. Durkan asked the Minister for Health the total number of drug task forces throughout the country; the extent of their operation over the past five years; the amount offered in support; the number of successful outcomes achieved in terms of a reduction in the reliance on drugs; the degree to which methadone is effective or ineffective as seen over the past five years; and if he will make a statement on the matter. [19815/22]
View answerI propose to take Questions Nos. 1485 and 1490 together.
The National Drugs Strategy ‘Reducing Harm Supporting Recovery sets out the Government’s strategy to address the harm caused by substance misuse in Ireland up to 2025. The Department of Health provides over €130 million to drug and alcohol services to support the strategy.
The Department currently provides €29 million to the 24 Drug and Alcohol Task Forces to deliver community-based drug and alcohol services in local communities. The Task Forces support over 280 community projects throughout the country to tackle drug and alcohol use and misuse. A table detailing the funding to each Task Force in 2021 is attached.
Drug and alcohol task forces play a key role in implementing the national drugs strategy at the local level. They assess the extent and nature of the drug problem and initiate appropriate responses, so that there is a coordinated approach involving all sectors to the problem of substance misuse in local communities and local communities are consulted in the design and deliver services.
As part of the mid-term review of the national drugs strategy, a focused policy assessment of expenditure on drugs and alcohol services was carried out by the Irish Government Economic and Evaluation Service (IGEES), examining new data on trends and indicators in drug and alcohol for 2019/2020, and the impact of Covid-19 on drug and alcohol services. Further information is available at: assets.gov.ie/193826/4cea8a19-f991-4f92-8237-ee9fd1bf70ee.pdf.
HSE addiction services are responsible for the provision of opioid substitution treatment. Opioid substitution treatment supports patients to recover from drug dependence. HSE addiction services work within the national drugs rehabilitation framework to support progression pathways. The framework ensures that individuals affected by drug misuse are offered a range of integrated options tailored to meet their needs and to create rehabilitation pathways. The HSE implements an opioid treatment protocol, so as to provide appropriate and timely substance treatment and rehabilitation services tailored to individual needs.
There are over 11,000 on opioid substitution treatment, with an additional 1,000 clients given access to OST in 2020 and 2021 under the Covid-19 contingency plan for people who use drugs.
There is international research evidence that increased length of time in Opioid Substitution Treatment is associated with improved treatment outcomes and short-term methadone maintenance treatment is associated with poorer outcomes.
I believe that methadone treatment reflects the public health approach to drug and alcohol misuse set out in the National Drugs Strategy. It is an important tool to reduce harm and to aid people on their journey to recovery from drug use. I am committed to improving the availability of this treatment and to supporting service users to access progression pathways.
Allocations to Drug and Alcohol Task Forces by the Department of Health and the HSE -2021
|
LDATF |
2021 DOH |
2021 HSE |
|
Ballyfermot |
€255,446 |
€1,241,286 |
|
Ballymun |
€422,958 |
€707,957 |
|
Blanchardstown |
€179,305 |
€923,589 |
|
Bray |
€573,860 |
€926,271 |
|
Canal Communities |
€338,605 |
€1,151,309 |
|
Clondalkin |
€388,114 |
€1,017,948 |
|
Cork |
€57,588 |
€1,472,699 |
|
Dublin 12 |
€70,397 |
€1,003,750 |
|
Dublin NE |
€239,971 |
€787,116 |
|
Dún Laoghaire |
€94,676 |
€796,755 |
|
Finglas Cabra |
€263,277 |
€637,960 |
|
NIC |
€394,856 |
€1,844,723 |
|
SIC |
€176,043 |
€1,878,014 |
|
Tallaght |
€336,022 |
€908,930 |
|
Total LDATF |
€3,791,118 |
€15,298,307 |
|
|
||
|
RDATF |
2021 DOH |
2021 HSE |
|
East Coast Area |
€58,200 |
€518,500 |
|
Midland |
€4,000 |
€805,307 |
|
Mid-West |
€147,982 |
€1,270,007 |
|
North East |
€0 |
€937,813 |
|
North West |
€258,633 |
€471,730 |
|
North Dublin City & Co. |
€0 |
€787,264 |
|
South East |
€0 |
€1,075,760 |
|
South West |
€102,820 |
€706,497 |
|
Southern |
€0 |
€983,178 |
|
Western |
€136,994 |
€534,155 |
|
Total RDATF |
€708,629 |
€8,090,211 |
|
Overall Total |
€27,888,265 |
1486. Deputy Denis Naughten asked the Minister for Health further to Parliamentary Question Nos. 550 of 12 October 2021 and 1077 of 22 March 2022, the reason that the waiting list has increased by over two years between October 2021 and April 2022; and if he will make a statement on the matter. [19808/22]
View answerIt is recognised that waiting times for scheduled appointments and procedures have been affected by the Covid-19 pandemic. While significant work continues to positively impact on waiting times and improve pathways to elective care, acute hospitals have been impacted by operational challenges arising from surges in cases related to the Omicron variants.
The HSE has confirmed to the Department that patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.
The Department of Health continues to work with the HSE and the National Treatment Purchase Fund (NTPF) to identify ways to improve access to care, including through increased use of private hospitals, funding weekend and evening work in public hospitals, funding “see and treat” services, providing virtual clinics, and increasing capacity in the public hospital system.
The 2022 Waiting List Action Plan, which was launched on the 25th of February, allocates €350 million to the HSE and NTPF to reduce waiting lists. Under this plan the Department, HSE, and NTPF will deliver urgent additional capacity for the treatment of patients, as well as investing in longer term reforms to bring sustained reductions in waiting lists.
The plan builds on the successes of the short-term 2021 plan that ran from September to December last year. The 2021 plan was developed by the Department of Health, the HSE and the NTPF and was driven and overseen by a senior governance group co-chaired by the Secretary General of the Department of Health and the CEO of the HSE and met fortnightly.
This rigorous level of governance and scrutiny of waiting lists has continued into this year with the oversight group evolving into the Waiting List Task Force. The Task Force will meet regularly to drive progress of the 2022 plan.
This is the first stage of an ambitious multi-annual waiting list programme, which is currently under development in the Department of Health. Between them, these plans will work to support short, medium, and long term initiatives to reduce waiting times and provide the activity needed in years to come.
Waiting list reductions and maximum waiting time targets apply to all acute hospital scheduled care active waiting lists. The HSE is engaged with hospital groups in a process to focus on specialties and procedures towards which the waiting list fund needs to be specifically directed to ensure the targets are achieved by year end.
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.
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.
1487. Deputy Denis Naughten asked the Minister for Health the current waiting time for respiratory patients awaiting an appointment at the chest clinic in University Hospital Galway; the number of patients currently on the waiting list; and if he will make a statement on the matter. [19809/22]
View answerIt is recognised that waiting times for scheduled appointments and procedures have been affected by the Covid-19 pandemic. While significant work continues to positively impact on waiting times and improve pathways to elective care, acute hospitals have been impacted by operational challenges arising from surges in cases related to the Omicron variants.
The HSE has confirmed to the Department that patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.
The Department of Health continues to work with the HSE and the National Treatment Purchase Fund (NTPF) to identify ways to improve access to care, including through increased use of private hospitals, funding weekend and evening work in public hospitals, funding “see and treat” services, providing virtual clinics, and increasing capacity in the public hospital system.
The 2022 Waiting List Action Plan, which was launched on the 25th of February, allocates €350 million to the HSE and NTPF to reduce waiting lists. Under this plan the Department, HSE, and NTPF will deliver urgent additional capacity for the treatment of patients, as well as investing in longer term reforms to bring sustained reductions in waiting lists.
The plan builds on the successes of the short-term 2021 plan that ran from September to December last year. The 2021 plan was developed by the Department of Health, the HSE and the NTPF and was driven and overseen by a senior governance group co-chaired by the Secretary General of the Department of Health and the CEO of the HSE and met fortnightly.
This rigorous level of governance and scrutiny of waiting lists has continued into this year with the oversight group evolving into the Waiting List Task Force. The Task Force will meet regularly to drive progress of the 2022 plan.
This is the first stage of an ambitious multi-annual waiting list programme, which is currently under development in the Department of Health. Between them, these plans will work to support short, medium, and long term initiatives to reduce waiting times and provide the activity needed in years to come.
The information requested by the Deputy concerning the waiting time for respiratory patients, is outlined in the attached document.
1488. Deputy Neale Richmond asked the Minister for Health the status of the provision of funded IVF for couples; and if he will make a statement on the matter. [19812/22]
View answerAs the Deputy may be aware, a commitment to “introduce a publicly funded model of care for fertility treatment” is included in the Programme for Government. The model of care for infertility was developed by my officials in conjunction with the HSE’s National Women & Infants Health Programme in order to ensure that infertility issues are addressed through the public health system at the lowest level of clinical intervention necessary.
This model of care comprises three stages, starting in primary care (i.e., GPs), extending into secondary care (i.e., Regional Fertility Hubs) and then, where necessary, tertiary care (i.e., IVF and other advanced assisted human reproduction (AHR) treatments), with patients being referred onwards through structured pathways.
Phase One of the roll-out of the model of care has involved the establishment, at secondary care level, of Regional Fertility Hubs within maternity networks, in order to facilitate the management of a significant proportion of patients presenting with infertility issues at this level of intervention. The completion of Phase One of the roll-out of the model of care, envisaged before the end of this year, will result in fully operational Regional Fertility Hubs in each of the six Hospital Groups across the country.
Phase Two of the roll-out will see the introduction of tertiary infertility services, including IVF, in the public health system, but will not commence until such time as infertility services at secondary level have been developed across the country, required resources have been allocated and the AHR legislation commenced.
As the Deputy might be aware the Health (Assisted Human Reproduction) Bill 2022 passed Second Stage in the Dáil on 23rd March 2022 and has been referred to the Select Committee on Health for Third Stage. I am fully committed to progressing this important legislation as quickly as possible.
While advanced AHR treatment, such as IVF, is not currently funded by the Irish public health service, a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Arrangements administered by the HSE. Medicines covered by the High Tech Arrangements must be prescribed by a consultant/specialist and authorised for supply to the client's nominated community pharmacy by the High Tech Hub managed by the Primary Care Reimbursement Service. The cost of the medicines is then covered, as appropriate, under the client’s eligibility, i.e., Medical Card or Drugs Payment Scheme. Given the costs associated with certain fertility medicines, I understand that these schemes can have a material impact on the total cost of AHR treatment for individuals who avail of them.
In addition, there is other support available in that patients who access IVF, or other advanced AHR treatment, privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme.
Nevertheless, my Department and the Government is fully committed, through the full implementation of the model of care for infertility, to ensuring that patients always receive care at the appropriate level of clinical intervention and then those requiring, and eligible for, advanced treatment such as IVF will be able to access same through the public health system. The underlying aim of the policy to provide a model of funding for AHR, within the broader AHR regulatory framework, is to improve accessibility to AHR treatments, while at the same time embedding safe and appropriate clinical practice and ensuring the cost-effective use of public resources.
1489. Deputy David Cullinane asked the Minister for Health the ratio of clinical staff to managerial staff whole-time equivalents factoring in clinical staff time spent on managerial responsibilities across service divisions of the HSE for January in each of the years 2016 to 2022, in tabular form; and if he will make a statement on the matter. [19814/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.
1491. Deputy James Lawless asked the Minister for Health the number of houses currently tied up in the HSE fair deal scheme in Cork city, County Cork and nationwide; and if he will make a statement on the matter. [19818/22]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1492. Deputy David Cullinane asked the Minister for Health the number of children who have had magic rods implanted in Ireland to date; the number of children's magic rods that have been sent for analysis post explant; and if he will make a statement on the matter. [19844/22]
View answerAs this is an operational matter, the question has been referred to the Health Service Executive for their attention and direct reply to the Deputy.
1493. Deputy David Cullinane asked the Minister for Health the number of notifications that have been made to the Health Products Regulatory Authority in regard to defective devices used by treating surgeons to date; and if he will make a statement on the matter. [19845/22]
View answerWithin the medical device framework, the Heath Products Regulatory Authority (HPRA) does not approve or certify medical devices for sale in Ireland or any other country. Medical devices placed on the Irish or European market must conform to the requirements of the relevant European legislation. These require that medical devices perform safely while achieving the purpose intended by the medical device manufacturer. In its role as market surveillance authority, the HPRA monitors the safety of medical devices after they are placed on the Irish market.
The aim of the medical devices vigilance system is to reduce the risk of death or serious deterioration in the state of health associated with the use of a medical device that is already placed on the market. Within this context, the HPRA evaluates serious incidents and field safety corrective actions associated with medical devices. With respect to incident reporting, please note that while there is no mandatory reporting requirement for users, patients, care-givers and healthcare professionals, the HPRA strongly encourages all relevant stakeholders, including those already listed, to report any safety issues they have experienced with a medical device. Manufacturers are required to submit medical device serious incident reports to the HPRA within specified reporting timelines outlined in the legislation.
The HPRA has an ongoing market surveillance review related to the safety and performance of the MAGEC Spinal System, elements of which have been carried out in conjunction with the UK MHRA. As part of the review, the HPRA has carried out an assessment of the technical documentation related to the device. Implantation of MAGEC rods remains on hold in Ireland since April 2020 following issuance of a manufacturer field safety notice by the manufacturer, NuVasive Specialized Orthopaedics (NSO). HPRA continues to assess information provided by the manufacturer and other stakeholders in relation to suspected adverse events and risk assessment reports, among other documentation, to determine whether the benefits of using these devices outweigh the known and potential risks. As part of this ongoing review, the HPRA has liaised with relevant stakeholders including healthcare professionals who use this device and a patient advocacy group.
The HPRA has confirmed to the Department that it has received no reports from healthcare professionals regarding individual cases of defective devices in Ireland, however the HPRA has engaged with healthcare professionals in Ireland who use these devices as part of our ongoing market surveillance activities.
