Written Answers Nos. 438-453
438. Deputy Eoin Ó Broin asked the Minister for Health if his Department has undertaken research to ascertain the costs of providing financial assistance to patients on hormone replacement therapy for menopause; if his Department intends to introduce financial assistance for these patients; and if he will make a statement on the matter. [50921/22]
View answerThe Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. In line with the Act and the national framework agreed with industry, a company must submit an application to the HSE to have a medicine added to the formal Reimbursement list. 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 Reimbursement list is the same for the General Medical Services (GMS) scheme and the Drug Payment Scheme (DPS).
The HSE advise that while HRT is used as a treatment for menopause, there are also a wide range of other HRT treatments in place across multiple clinical areas, including the replacement of cortisone in Addison’s disease, and the replacement of thyroxine in thyroid disease, etc. In addition, menopause can present differently for individual women, both in symptom severity and duration. Not all women experiencing menopause may be clinically eligible for HRT, which is prescription based. Women may also choose not to take HRT and to address their symptoms through alternative therapies and/or lifestyle changes.
The HSE do currently operate two schemes which offer financial assistance to people in receipt of prescribed HRT medication on the reimbursement list.
These HRT medications are available to medical card holders, subject to the statutory prescription charge. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card under the GMS scheme is determined by the HSE. In certain circumstances, the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
Under the DPS, no individual or family pays more than €80 a month towards the cost of approved prescribed medicines, which includes some HRT medications.
In 2021, the provision of HRT under the statutory schemes cost €6.3m, comprised of €4.5m under the GMS scheme and €1.8m under the DPS. The HSE do not have access to data on the expenditure of patients receiving products privately in community pharmacies or whose expenditure for medicines falls below the threshold of the Drug Payment Scheme. This prevents the HSE from giving a robust estimation of the costs of providing HRT free to all who may need it to treat symptoms of perimenopause and menopause.
However, the HSE have estimated that the additional minimum cost to the state of providing HRT free to all who may need it clinically would likely be €4m per annum. Therefore, the total would be in excess of €10m per annum. This estimation does not take account of any associated loss of prescription charge income, any relevant future demographic changes, or how the introduction of free provision could impact on uptake.
As announced in Budget 2023, the VAT rate for non-oral forms of HRT, will be reduced to zero from 1 January 2023, thus reducing the cost of HRT for all those who need it.
Finally, individuals may also be entitled to claim tax relief on the cost of their medical expenses. This includes medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
439. Deputy Paul Kehoe asked the Minister for Health the efforts that are being made to reduce the waiting time for orthodontic treatment for children in County Wexford; and if he will make a statement on the matter. [50925/22]
View answerThe HSE has put in place a number of measures to address waiting times. These include prioritisation of the filling of permanent vacancies, treatment waiting list initiatives, services improvement initiatives and access to orthodontic services outside the jurisdiction.
A current HSE procurement framework in orthodontics covers grade 4 patients (children and young people) who can been seen in community settings and have been waiting 4 years or more to commence treatment following assessment. Patients meeting these criteria can avail of treatments with a private Specialist Orthodontist. The grade 4 HSE procurement mechanism received additional funding of €4.1m in 2022 as part of the Waiting List Action Plan. To date, over 1600 Grade 4 patients have been seen under the framework. This initiative will continue in 2023.
The option of the Northern Ireland Planned Healthcare Scheme may be available to patients, whereby patients can choose to go to Northern Ireland for treatment. This option is managed through a National Service and has a separate funding structure to the Orthodontic Service.
440. Deputy Róisín Shortall asked the Minister for Health if he will meet with an organisation (details supplied) regarding the ongoing issues facing the blood cancer community during the pandemic; and if he will make a statement on the matter. [50926/22]
View answerThe organisation in question has submitted a request to meet to my office. As with all requests submitted to my office, my officials will consider the appropriateness of meeting with them and I will revert to the requesters after considering the many competing demands on my diary.
441. Deputy Richard O'Donoghue asked the Minister for Health the position regarding the pandemic payments for Section 38/39 workers; if all payments have been paid to workers; the amount paid; the amount that has yet to be paid in tabular form; the cause for the delay in the payment; and if he will make a statement on the matter. [50931/22]
View answerThe rollout of the Pandemic Recognition Payment for eligible HSE and Section 38 employees is currently receiving priority. As of Friday 30th of September, 85,463 eligible HSE staff have received payment around the country. This number excludes Section 38 agencies which are estimated to have paid 38,287 staff to date thereby bringing the total number of employees paid to 123,750 .
The HSE and the Department have been examining progressing the rollout of the Pandemic Recognition Payment to the list of 6 non-HSE/non-Section 38 organisation types covered by the Government Decision. This measure will be ring fenced to staff working ordinarily onsite in COVID-19 exposed healthcare environments. This shall cover eligible staff in:
1. Private Sector Nursing Homes and Hospices (e.g. Private, Voluntary, Section 39 etc.);
2. Eligible staff working on-site in Section 39 long-term residential care facilities for people with disabilities;
3. Agency roles working in the HSE;
4. Health Care Support Assistants (also known as home help / home care / home support) contracted to the HSE;
5. Members of the Defence Forces redeployed to work in frontline Covid-19 exposed environments in the HSE;
6. Paramedics employed by Dublin Fire Brigade to deliver services on behalf of the HSE.
The above 6 areas only are covered by this Government Decision and all eligible workers will be paid in accordance with the overarching eligibility criteria in place.
As the rollout of payments to the eligible workers in non-HSE/non-Section 38 organisations has not yet begun, and eligibility has not yet been assessed across the private sector, I cannot provide an estimated number of workers who will receive the payment. We expect the rollout to begin shortly and for eligible workers to be paid as soon as possible.
442. Deputy Richard O'Donoghue asked the Minister for Health if approval will be given to extend the age for GP care for children to 16 years (details supplied); and if he will make a statement on the matter. [50935/22]
View answerAs announced, Budget 2023 will increase the eligibility of people for General Practice (GP) access cards. The scheme will be expanded to cover all children aged 6 and 7 by the end of 2022 and, from 1 April 2023, eligibility will be extended to people who earn the median household income of €46,000 or less. It will be adjusted for people living alone and for those with children; further operational details will be made available prior to the commencement of the income-based expansion. It is envisaged that these measures will be supported by a significant package of additional capacity supports to GP practices.
Sláintecare envisions a healthcare service, including general practice, in which access is universal and delivered at low or no cost to patients. The Government will continue to work towards that goal. However, there are no immediate plans to extend eligibility on the basis of age beyond those announced in the budget.
443. Deputy Sean Sherlock asked the Minister for Health the amount that has been drawn down in each CHO for equipment for children to date in 2022, in tabular form. [50937/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
444. Deputy Sean Sherlock asked the Minister for Health the number of ceiling hoists delivered to families in each CHO compared to requests for same to date in 2022, in tabular form. [50938/22]
View answerThe Government is committed to providing services and supports for people with disabilities to meet their needs. There are also a range of services in place to protect individuals and families from excessive costs for their medical and surgical needs.
The Housing Adaptation Grants for Older People and People with a Disability assist people to have necessary adaptations, repairs or improvement works carried out to make their accommodation more suitable for their needs. The scheme is administered by local authorities under the aegis of the Department of Housing, Local Government and Heritage.
Applications to the Health Service Executive for a wide range of aids and appliances are made on foot of prescriptions from relevant health care professionals and based on an applicant's eligibility under the Health Act 1970 (as amended). These applications are made under the Community Funded Schemes and are considered by Resource Allocation Groups within each Community Health Organisation. A determination is made regarding approval based on clinical priority and the funding available within local budgets. These aids and appliances play a key role in assisting and supporting people to maintain everyday functioning and to remain living in their homes and local community. The Community Funded Schemes have not generally funded fixed ceiling-track hoists given the need for structural adaptations necessary to install them and, also, that they had been funded under the Housing Adaptation Grants.
In late 2020, the Department of Housing, Local Government and Heritage offered guidance to local authorities that fixed ceiling-track hoists should not be included in the Housing Adaptation Grants. Engagement is ongoing between the Department of Health, the Health Service Executive, and the Department of Housing, Local Government and Heritage in relation to this matter – with a view to resolving the difficult issues involved as soon as possible and ensuring that people receive the services they require.
As this question also relates to a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
445. Deputy Sean Sherlock asked the Minister for Health the amount of specialist car seats that the HSE has provided by CHO, versus the number of requests received to date in 2022, in tabular form. [50939/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
446. Deputy Sean Sherlock asked the Minister for Health his views on matters raised in correspondence (details supplied). [50956/22]
View answerAn independent review of the Radiation Therapist profession has been agreed under the auspices of the Workplace Relations Commission. Discussions are ongoing between the parties to finalise a Terms of Reference and appoint an independent chair.
As this is an ongoing Industrial Relations process it would be inappropriate to comment further at this stage.
447. Deputy Catherine Connolly asked the Minister for Health the expected timeline for the promised independent radiation therapist review; if he will provide an update on the development of the terms of reference of the review; when he expects the terms of reference to be finalised; and if he will make a statement on the matter. [50958/22]
View answerAn independent review of the Radiation Therapist profession has been agreed under the auspices of the Workplace Relations Commission. Discussions are ongoing between the parties to finalise a Terms of Reference and appoint an independent chair.
As this is an ongoing Industrial Relations process it would be inappropriate to comment further at this stage.
448. Deputy Robert Troy asked the Minister for Health if he will outline any planned upgrade works or investment in the health centre, Ballymore, County Westmeath. [50959/22]
View answerAs this is a service matter I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
449. Deputy David Stanton asked the Minister for Health his views on the need for an extension of the Medical Rights Directive and the Active Implantable Medical Device Directive (AI) MMD certificates; if he will work to have this addressed in time for the next EPSCO meeting in December 2022; and if he will make a statement on the matter. [50964/22]
View answer450. Deputy David Stanton asked the Minister for Health his views on the need to abolish the medical device regulation warehousing deadline; and if he will make a statement on the matter. [50966/22]
View answer451. Deputy David Stanton asked the Minister for Health his views on the need to allow conditional and temporary medical device regulation certification; if he will work to have this addressed in time for the next EPSCO meeting in December 2022; and if he will make a statement on the matter. [50967/22]
View answerI propose to take Questions Nos. 449, 450 and 451 together.
Regulation (EU) 2017/745 on medical devices (‘MDR’) has been fully applicable as of 26 May 2021 and Regulation (EU) 2017/746 on in vitro diagnostic medical devices (‘IVDR’) became fully applicable as of 26 May 2022.
The overarching objectives of these new regulations is to significantly strengthen the regulatory system for medical devices and provide a framework that is robust and consistent and serves to enhance public health across the EU by ensuring that medical devices are safe, perform as intended and afford benefits to patients and healthcare systems.
Implementation of the new regulations has not been without challenge and I am aware that one of the key challenges in implementing these regulations relates to the capacity of the system in certifying devices under the new framework, which has been compounded by the Covid-19 pandemic and there are indeed other challenges associated with implementation of the new regulatory framework. My officials are kept in full brief on these issues through engagements with the Health Products Regulatory Authority (HPRA) and EU fora and my department is working via these fora in considering and addressing these challenges and working towards the effective implementation of the regulations, ensuring that healthcare systems and patients have access to safe medical devices. My Department is fully committed to continuing to work with key stakeholders in this regard, in identifying and reaching pragmatic and necessary solutions to these challenges.
It remains imperative that we continue to work collectively across the EU in identifying harmonized solutions to these challenges in order to ensure that the new regulatory system is effective in practice and delivers on its objectives.
The full and effective implementation of these important regulations remains a key priority for my Department and I. We will continue to work collaboratively with stakeholders to address and overcome the challenges faced with the overall objective of ensuring that the benefits of these regulations are ultimately achieved in practice.
452. Deputy Joan Collins asked the Minister for Health his views on matters raised in correspondence (details supplied). [50972/22]
View answerAs the payment of pensions is an operational matter for the Health Service Executive, the HSE has been asked to reply directly to the Deputy.
453. Deputy John McGuinness asked the Minister for Health if speech and language therapy will be provided immediately in the case of a child (details supplied) given that their assessments were carried out in August 2020 and again on 21 May 2021, and that they are now experiencing difficulty in obtaining a school placement due to their issues and the lack of support thus preventing their proper development and education; and if he will expedite the matter. [50982/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
