Written Answers Nos. 994-1013
994. Deputy Joan Collins asked the Minister for Health the reason that the next-of-kin of a person (details supplied) was informed of the revocation of their admission to a hospital for reasons which have yet to fully transpire. [54501/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
995. Deputy Barry Cowen asked the Minister for Health if he will provide an update on a case (details supplied); and when the person can expect an appointment. [54514/22]
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.
996. Deputy Dara Calleary asked the Minister for Health if there are plans to add a medication (details supplied) to the GMS scheme. [54524/22]
View answerThe 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.
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). There are formal processes which govern applications for the pricing and reimbursement of medicines, and new uses of existing medicines, to be funded and/or reimbursed.
To be included on the list of reimbursable items the medicinal product must have a marketing authorisation, as per Schedule 3 Part 1 of the Health (Pricing and Supply of Medical Goods) Act 2013.
Semaglutide (marketed as Ozempic®, Wegovy® and Rybelsus®) currently does not have a marketing authorisation for the treatment of Polycystic Ovary Syndrome.
997. Deputy Colm Burke asked the Minister for Health if his Department will put in place a strategy which will help to improve the time period where patients can get access to newly approved cancer medicines in Ireland, given that the average time period to the reimbursement decision following European Medicines Agency approval is in excess of two years, which is double the time for the EU-15 average; and if he will make a statement on the matter. [54531/22]
View answer999. Deputy Colm Burke asked the Minister for Health the strategy that his Department intends to put in place to improve the reimbursement timelines for new cancer medicines, in view of patient access to newer cancer medicines being lower and taking a longer time period in Ireland in comparison to other EU15 countries, and also taking into account that the provision of access to new, more effective treatments, whilst operating on constrained budgets, is shared by all countries; and if he will make a statement on the matter. [54533/22]
View answer1000. Deputy Colm Burke asked the Minister for Health if consideration will be given to reviewing the rigorous statutory assessment arrangements in Ireland, regarding the reimbursement process for new cancer medicines, given the five-year net survival rate for all invasive cancers averaged 65% for cancer patients diagnosed between 2014 and 2018, which is in the middle and lower end of survival rates across all invasive cancers in the EU15 countries during the same time period, to improve survival rates and save additional lives of cancer patients going forward; and if he will make a statement on the matter. [54534/22]
View answerI propose to take Questions Nos. 997, 999 and 1000 together.
The Health (Pricing and Supply of Medical Goods) Act 2013 provides a rigorous process for the assessment of new medicines for reimbursement. This allows taxpayers to be confident both that the right medicines are chosen, and that those medicines are approved at a price that can sustainably be afforded in a budget-limited health service. Economic assessment is valuable to stretch the funds granted to the HSE as far as possible, allowing them to provide a range of services as well as innovative medicines for all citizens.
The 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. Reimbursement is for licensed indications which have been granted market authorisation by the European Medicines Agency (EMA) or the Health Products Regulatory Authority. In line with the 2013 Act, and the national framework agreed with industry, a company must first submit an application to the HSE to have a new medicine added to the reimbursement list.
The timing of company applications for reimbursement in different countries can vary for a number of reasons, not least the available market share in each country. Once a company responsible for the commercialisation of a new medicine receives market authorisation, it can apply for reimbursement in the country (or countries) of its choice. Ireland, by virtue of its size and market share, may not always be prioritised by a company in the first stages of marketing a new product. Describing timelines for reimbursement from EMA approval to HSE reimbursement approval does not consider this important factor and misrepresents the process, as statutorily the HSE would not be able to approve or assess a drug until an application for reimbursement was received.
When an application is made to have a product added to the reimbursement list in Ireland, the HSE is required, under the 2013 Act, to decide within 180 days of receiving the application, to either add the medicine to the reimbursement list or refuse to reimburse the medicine. In assessing the application, the HSE is required to consider a range of criteria including the magnitude of the clinical effect, cost effectiveness, budget impact, opportunity cost and unmet need.
The principal factors in determining the speed of reimbursement are the price at which a manufacturer applies for the reimbursement of a product and the outcome of the HSE’s rigorous assessment process as to its clinical and cost-effectiveness.
In terms of the time taken from application to a decision on reimbursement, the HSE advise that the biggest impediments to achieving the 180-day timeline is often the failure of companies to provide sufficient evidence to support the efficacy of some medicines, and the need for the HSE to get involved in protracted negotiations in seeking to achieve better prices for the State.
The State is committed to providing timely access to new and innovative medicines to all patients. Budget 2021 allocated €50 million for the reimbursement of new drugs, enabling the HSE to approve fifty-two new medicines. This included twenty-seven oncology medicines and nineteen medicines for the treatment of rare diseases.
Budget 2022 has allocated a further €30 million for the reimbursement of new medicines and as of 7 November the HSE has approved reimbursement for 47 new drugs, 14 of which were for oncological use. Further dedicated funding has also been announced for new drugs in Budget 2023.
998. Deputy Colm Burke asked the Minister for Health the way in which his Department intends working to improve the net survival rate for all invasive cancers, in view of the fact that in the five-year average, Ireland is in the middle or the lower end of the survival rates distribution across different cancer types in the EU-15 countries; and if he will make a statement on the matter. [54532/22]
View answerSuccessive National Cancer Strategies have delivered continuing improvements in outcomes for Irish cancer patients in terms of earlier diagnosis, better treatment, and improved rates of survival.
Five-year net survival for all invasive cancers averaged 65% for cancer patients diagnosed between 2014 and 2018. This is a significant improvement compared to twenty years previously, when 42% was the average (for patients diagnosed 1994-1999).
National Cancer Registry Ireland data shows substantial progress being made to control the four major cancers (prostate, breast, lung and colorectal), with mortality rates falling or stabilising for each. These comprise over half of all invasive tumours (not including rarely fatal nonmelanoma skin cancers).
Treatment in our medical oncology, radiation oncology and surgical oncology services also continues to improve, with an estimated 200,000 people in Ireland living with and beyond cancer.
Improvements in survival and outcomes are largely attributable to earlier detection and improvements in treatment. The National Cancer Strategy seeks to build on the successes of previous strategies in the areas of prevention, early diagnosis, and treatment, while also working to maximise the quality of life for patients living with and beyond a cancer diagnosis. It is an aim of the Strategy for survival rates in Ireland to be within the top quartile of European countries by the end of the Strategy period (2026).
1001. Deputy Colm Burke asked the Minister for Health if consideration will be given to the introduction of additional nationwide organised screening programmes for two of the four major cancers in Ireland, namely, prostate cancer and lung cancer, taking into account that nationwide screening programmes for breast cancer, cervical cancer and colorectal cancer have led to the early detection of cases in recent decades; and if he will make a statement on the matter. [54535/22]
View answerI am fully committed to supporting our population screening programmes which are a valuable part of our health service, enabling early treatment and care for many people, and improving the overall health of our population.
Any decisions about changes to the screening programmes, such as introducing a new cancer screening programme, will be made on the advice of our National Screening Advisory Committee (NSAC). This independent expert group considers and assesses evidence in a robust and transparent manner, and against internationally accepted criteria. It is important we have rigorous processes in place to ensure our screening programmes are effective, quality assured and operating to safe standards, and that the benefits of screening outweigh the harms.
The Committee's first Annual Call in 2021 for proposals for new screening programmes or changes to our existing programmes, received a significant response with a total of 53 submissions received, including on lung and prostate cancer. Submissions were received from various sources, including members of the public and patient advocates, and have been undergoing consideration by the committee at its scheduled meetings during 2022. The NSAC intends to publish its full work programme in the coming weeks.
Under Europe’s Beating Cancer Plan, a Proposal for an updated Council Recommendations on cancer screening was adopted by the Commission in September 2022. The final Recommendation is expected to be formally approved by the Council of the European Union in December 2022 and published thereafter. The NSAC will consider these recommendations and advise me and the Department of Health on the evidence as it applies to Ireland.
The latest cancer trends report, published by the National Cancer Registry Ireland recently, focuses on cancer incidence, mortality, stage and survival for patients diagnosed with female breast cancer, cervical cancer and colorectal cancer. The report shows the positive impacts of our three cancer screening programmes (Bowel Screen, BreastCheck, CervialCheck) noting that they are effective, are detecting cancers earlier and saving lives. The report shows that screen-detected cancer cases were, on average, detected at a substantially earlier stage than other cases diagnosed at the same ages. Survival has improved for all three cancers, with the biggest improvements is seen in the age-groups targeted by the national screening programmes.
1002. Deputy Chris Andrews asked the Minister for Health the number of children with additional needs in CHO 7 who have had to travel outside of the CHO7 for dental care for each of the past five years; and if he will make a statement on the matter. [54547/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1003. Deputy Chris Andrews asked the Minister for Health the number of claims made under the Dental Treatment Service Scheme DTSS in CHO7 by LHO for each of the past five years; and if he will make a statement on the matter. [54548/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1004. Deputy Chris Andrews asked the Minister for Health the number of children in CHO7 who are currently on dental and orthodontics waiting lists; and if he will make a statement on the matter. [54549/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1005. Deputy Bernard J. Durkan asked the Minister for Health the steps being taken to provide a person (details supplied) who suffers from cerebral palsy and who is incapable of living independently, with full-time care and assistance; and if he will make a statement on the matter. [54554/22]
View answerAs the issue raised relates to a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1006. Deputy Jennifer Whitmore asked the Minister for Health if he will provide a breakdown of the allocation of the €19 million to paediatric orthopaedics in 2022, including detailed amounts allocated for very complex cases, scoliosis and for spina bifida; the amount allocated between Children's Health Ireland, CHI, both at Temple Street and Crumlin, and the Cappagh; the additions that the funding has provided in the way of additional staff or resources; and if he will make a statement on the matter. [54557/22]
View answerEarlier this year, I approved an ambitious plan from Children’s Health Ireland (CHI) to reduce the number of children waiting for spinal orthopaedic procedures (scoliosis/spina bifida) by the year end. More than €17 million of current and capital funding is being provided to implement the plan. A detailed breakdown of the funding is provided at the following link.
This funding will provide additional theatre access at Temple Street and Crumlin, diagnostic MRI capacity and enable further activity and paediatric theatre lists at Cappagh Hospital.
CHI has advised that, of the 24 additional beds provided for under the funding, 11 have opened and 13 are due to open by end Q4 2022.
Enabling work is underway in relation to the second MRI in Crumlin and it is due to open by the end of 2022. A second charitable funded MRI is being installed in CHI at Temple St. which is due to become operational in early 2023.
The additional theatre in Temple St. is due at the end of Q1/Q2 2023, with additional theatre capacity in Crumlin due in Q1 2023.
With regard to the additional staffing CHI advise that 33.2 WTE have been recruited, with recruitment for 43.4 WTE in process and recruitment to commence shortly for 15 WTE.
I have asked CHI to provide additional detail in respect of the breakdown of funding for complex cases, scoliosis and spina bifida and Cappagh to provide an update on their recruitment.
1007. Deputy Jennifer Whitmore asked the Minister for Health the number of children with scoliosis on the operation waiting list by hospital; the number of those who have complex needs; the average waiting times for those children; and if he will make a statement on the matter. [54558/22]
View answerReducing waiting times for hospital appointments and procedures remains a commitment of this Government. Earlier this year I approved an ambitious plan for Children’s Health Ireland (CHI) to reduce the number of children waiting for spinal orthopaedic procedures (scoliosis and spina bifida) by year end. Both current and capital funding totalling €17.43 million was approved for this initiative.
The funding has impacted on waiting times with a 44% reduction in those waiting over 12 months for a spinal fusion and a 24% reduction in those waiting over 4 months.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1008. Deputy Jennifer Whitmore asked the Minister for Health the waiting times for children with scoliosis, including the details for those with complex needs; the number waiting 0-4 months, 4-12, and over 12 months by hospital in tabular form; and if he will make a statement on the matter. [54559/22]
View answerReducing waiting times for hospital appointments and procedures remains a commitment of this Government. Earlier this year I approved an ambitious plan for Children’s Health Ireland (CHI) to reduce the number of children waiting for spinal orthopaedic procedures (scoliosis and spina bifida) by year end. Both current and capital funding totalling €17.43 million was approved for this initiative.
The funding has impacted on waiting times with a 44% reduction in those waiting over 12 months for a spinal fusion and a 24% reduction in those waiting over 4 months.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1009. Deputy Jennifer Whitmore asked the Minister for Health the waiting times for paediatric orthopaedic surgery, including the number waiting for fewer than 4 months, between 4 and 12 months and over 12 months by hospital in tabular form; and if he will make a statement on the matter. [54560/22]
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 are still impacted by operational challenges arising from the pandemic.
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 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.
Earlier this year I approved an ambitious plan for Children’s Health Ireland (CHI) to reduce the number of children waiting for spinal orthopaedic procedures (scoliosis and spina bifida) by year end. Both current and capital funding totalling €17.43 million (including funding under the Waiting List Action Plan) was approved for this initiative.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1010. Deputy Jennifer Whitmore asked the Minister for Health the number of tracheotomy nurses in paediatric orthopaedics in the CHI; the number of tracheotomy nurses available in the CHI in total, by hospital; and if he will make a statement on the matter. [54561/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1011. Deputy Jennifer Whitmore asked the Minister for Health the number of operations for scoliosis treatments in the CHI that have been cancelled by hospital on a monthly basis to date in 2022; and if he will make a statement on the matter. [54562/22]
View answerI fully acknowledge the distress and inconvenience for children and their families when elective procedures are cancelled, particularly for clinically urgent procedures. While every effort is made to avoid cancellation or postponement of planned procedures, the HSE has advised that planned procedures and operations can be postponed or cancelled for a variety of reasons including capacity issues due to increased scheduled and unscheduled care demand.
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.
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.
1012. Deputy Colm Burke asked the Minister for Health if he will confirm that he will carry out an independent review of radiation therapy to deal with recruitment and retention in the sector; and if he will make a statement on the matter. [54569/22]
View answerAn independent radiation therapist review has been agreed between the HSE, Department of Health and SIPTU, under the auspices of the WRC.
Cancer cases are increasing in line with our ageing and growing population. The National Cancer Control Programme estimates that up to 60% of patients will require radiation oncology for primary treatment and palliative care in coming years. Radiation Therapists are highly skilled professionals regulated by CORU. The Review will align with the National Cancer Strategy, taking account of the increasing demand for radiation oncology, the advances in technology, increased specialisation and more targeted treatment.
A Chair for the Review has been identified and agreed between the parties. An initial meeting has been scheduled to start the process in early November.
All outcomes of the review will be given due consideration by the Department of Health. Implementation of any recommendations from the review are subject to approval from the Departments of Health and Public Expenditure and Reform.
1013. Deputy Colm Burke asked the Minister for Health the measures that his Department and the HSE are taking to address recruitment and retention in the radiation therapy sector; and if he will make a statement on the matter. [54570/22]
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.
