Written Answers Nos. 1393-1412
1393. Deputy Emer Higgins asked the Minister for Health if he will report on the progress in delivering the primary care centre in Citywest; the services that may be provided there; and if he will make a statement on the matter. [1089/23]
View answerAs the Health Service Executive (HSE) holds responsibility for the provision, along with the maintenance and operation of Primary Care Centres, I have asked the HSE to reply directly to the Deputy as soon as possible.
1394. Deputy Sean Sherlock asked the Minister for Health if he will provide the documentation that he has received from the HSE relating to overcrowding in all Irish hospitals from 1 November 2022 to 4 January 2023. [1092/23]
View answer1401. Deputy Sean Sherlock asked the Minister for Health the contact that he has had with the HSE regarding the overcrowding crisis in hospitals; and if he will provide any written correspondence on the matter. [1118/23]
View answerI propose to take Questions Nos. 1394 and 1401 together.
I wish to acknowledge the distress overcrowded Emergency Departments (EDs) cause to patients, their families, and frontline staff working in very challenging conditions in hospitals throughout the country.
We are experiencing a very challenging winter, and our EDs are experiencing high levels of attendances and congestion compared to previous years.
In this context, I have met with HSE senior leadership frequently over the past few weeks to discuss the situation in EDs, monitor the implementation of the Winter Plan 2022/23 and seek assurance that all possible mitigating actions are being taken to alleviate pressures on our EDs.
Between the 1st of November 2022 and the 4th of January 2023, I have met with the HSE regarding EDs on the following occasions:
- 9th of November 2022
- 11th of November 2022
- 14th of December 2022
- 21st of December 2022
- 23rd of December 2022
- 3rd of January 2023
In addition, I have visited several EDs in recent weeks as follows:
- 4th of November 2022 - Our Lady of Lourdes Hospital Drogheda
- 11th of November 2022 - Letterkenny University Hospital
- 18th of November 2022 - University Hospital Waterford
- 2nd of December 2022 - Midlands Regional Hospitals Tullamore and Mullingar
- 3rd of January 2023 - St. Vincent's Hospital and Beaumont Hospital
Notwithstanding this, I would like to note that my engagement with the HSE regarding winter planning began in April 2022, in order to ensure adequate consultation could take place with frontline clinicians and staff in the development of bespoke local plans to address local challenges at site and Community Healthcare Organisation level.
In relation to your request for correspondence and documentation received from the HSE, these will be forwarded to you separately by email due to the voluminous nature of the request.
1395. Deputy Sean Sherlock asked the Minister for Health the number of hospitalisations for children and older adults afflicted with respiratory syncytial virus infection, recorded by hospital and month from September to February in each of the years 2019 to 2022 as a whole as well as data to date in 2023, in tabular form. [1093/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1396. Deputy Colm Burke asked the Minister for Health if he will provide a timeline of when works are due to commence on the development of a helipad at the Cork University Hospital site; and if he will make a statement on the matter. [1096/23]
View answerAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
1397. Deputy Colm Burke asked the Minister for Health if there are any plans to expand the reimbursement for the freestyle libre continuous glucose monitoring sensor to over-21s under the HSE's community funded scheme for aids and appliances; and if he will make a statement on the matter. [1101/23]
View answer1398. Deputy Colm Burke asked the Minister for Health the way that his Department is addressing inequalities in the uptake of the continuous glucose monitoring sensors between under 21 years of age and over 21 years age groups; and if he will make a statement on the matter. [1102/23]
View answerI propose to take Questions Nos. 1397 and 1398 together.
The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement under the community schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including clinical efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact. HSE decisions on which medical items are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE). The Minister for Health has no role in these decisions.
Currently, Consultant Endocrinologists may apply to the HSE, on behalf of specific patients with Type 1 Diabetes, for reimbursement support of FreeStyle Libre Flash Glucose Monitoring (FGM) sensors. The application process is undertaken by means of a dedicated online portal, which has been operational since 3 April 2018. In line with the recommendations of the Health Technology Assessment Group, access to this product was made available to children and young adults, aged between 4 and 21 years of age. However, the online application process does cater for the Consultant to make an application in very exceptional circumstances for a type 1 diabetic patient who is over 21 years of age.
The HSE requested that the NCPE carry out a full Health Technology Assessment (HTA) on Freestyle Libre, and the company, Abbott, were formally notified of this on 13 April 2021. Abbott had a scoping meeting with the NCPE in July 2021 and committed to submitting their HTA dossier by the end of October 2021. However, on 15 November 2021, Abbott informed the HSE that they would not be submitting the HTA dossier because they did not have the level of Randomized Controlled Trials (RCT) evidence that they stated was required for a full HTA process. Despite the HSE emphasising the importance of engaging with the HTA process to progress matters, the company have not submitted a HTA dossier to date. It remains open to Abbott to re-engage with the NCPE as they indicated they would in July 2021.
Recently, following a request from the HSE, the Health Information and Quality Authority (HIQA) held an initial meeting with the HSE Diabetes Clinical Programme to scope out what might be involved in undertaking a system-wide HTA across diabetes care. In the absence of a full value assessment of the product to determine cost effectiveness or value for money, the HSE is not in a position to remove the current age restriction.
1399. Deputy Colm Burke asked the Minister for Health the action that his Department is taking to provide reimbursement of required medicines for women with gestational diabetes to help protect both the mother and baby; and if he will make a statement on the matter. [1103/23]
View answerThe Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement under the community drug schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
In line with the 2013 Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the formal Reimbursement list. Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.
In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact. HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE). The Minister for Health has no role in these decisions.
The Drug Payment Scheme (DPS) and the General Medical Services Scheme (GMS) scheme offer supports that may assist patients with gestational diabetes.
Under the DPS, no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card under the GMS scheme. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card 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. The HSE afford applicants the opportunity to furnish supporting documentation to determine whether undue hardship exists and to fully take account of all relevant circumstances that may benefit them in assessment, including medical evidence of costs and certain expenses.
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.
People 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%.
1400. Deputy Colm Burke asked the Minister for Health if consideration will be given to the introduction of a national diabetes patient register considering the lack thereof has made it difficult for policy makers and academics to understand the impact of tools used to help diabetes patients; and if he will make a statement on the matter. [1104/23]
View answerDiabetes is a complex condition that can have a profound impact on the quality of life of people living with the condition. Management of the condition is required across the entire spectrum of healthcare delivery, through general practice, community specialist care and hospital inpatient specialist care.
A national diabetes registry will help to track the prevalence of the condition year on year, measure health outcomes for patients, and produce reliable data from which future services can be planned. This will help to improve diabetes care for patients across the country.
Budget 2023 provides funding for a number of initiatives aimed at improving diabetes care, including commencing the development of a National Diabetes Register. My Department and HSE National Clinical Programme for Diabetes are currently engaged in preparatory work for phase 1 of this multi-year project.
1402. Deputy Cathal Crowe asked the Minister for Health if a timeline can be provided for the delivery of a dialectical behavioural therapy team for the mid-west region (details supplied). [1127/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1403. Deputy Joe Carey asked the Minister for Health if he will sanction the development of an elective-only hospital for the mid-west region; and if he will make a statement on the matter. [1128/23]
View answerOn 7 December 2022, the Government approved the next stage of the Enhanced Provision of Elective Care Programme and progression of the development of new Elective Hospitals in Cork and Galway (with Dublin to follow in due course). The new Elective Hospitals will provide significant additional capacity, enabling the separation of scheduled and unscheduled care. This will change the way in which day cases, scheduled procedures, surgeries, scans and outpatient services can be better arranged across the country, ensuring greater capacity in the future and helping to address waiting times.
The locations chosen to implement the Elective Care Programme will enhance capacity and tackle waiting times on a national basis and enable the Elective Hospitals to cover as wide an area and patient population as possible, extending beyond existing and future health areas, including the mid-west.
The locations were also chosen in line with good practice which suggests that, in order to maximise economies of scale, dedicated, standalone elective centres should be ‘as big as is reasonably possible’ to meet identified patient demand while providing appropriate population coverage. The specific sites selected will allow for new facilities of a size and scale to maximise their capacity to fully implement this national programme.
The introduction of this new delivery capability into the Public Healthcare System will benefit the whole population, including those who do not fall within the immediate ‘traditional’ geographical catchment areas. It is envisaged that the new Cork and Galway facilities combined will cater for up to 350,000 patients/procedures annually.
Complementary to the development of the new Elective Hospitals, the HSE will work with Hospital Groups and forthcoming Regional Health Areas to progress proposals for a shorter-term measure to address waiting lists by developing ‘Surgical Hubs’ in Cork, Galway, Limerick, Waterford and Dublin with a narrower scope of procedures. These will be modelled on the successful Reeves Centre at Tallaght University Hospital (which has significantly reduced waiting times for certain day-care procedures) and will have a shorter-term impact on waiting times. This intervention will also support efforts to consider the necessary reforms and enablers needed to separate unscheduled and scheduled care pathways that will be required by the longer-term provision of the Elective Care programme.
1405. Deputy Michael Healy-Rae asked the Minister for Health if there are any plans to increase the income threshold for medical cards for people; and if he will make a statement on the matter. [1137/23]
View answerEligibility for a Medical Card is primarily based on a financial assessment which is conducted by the HSE in accordance with the Health Act 1970 (as amended). The HSE assesses each medical card application on a qualifying financial threshold. This is the amount of money that an individual can earn a week and still qualify for a card. It is specific to the individual’s own financial circumstances.
Persons aged 69 and under are assessed under the general means tested medical card thresholds which are based on an applicant’s household income after tax and the deduction of PRSI and the Universal Social Charge. Certain expenses are also taken into account, i.e. mortgage payments, which help to increase the amount a person can earn and still qualify for a medical card.
Persons aged 70 or older are assessed under the over 70s medical card income thresholds which are based on gross income. It should be noted that, in November 2020, the weekly gross medical card income thresholds for those aged 70 and over were increased to €550 per week for a single person and €1,050 for a couple.
However, It should be noted that those aged over 70 can also be assessed under the general means tested scheme where there are particularly high costs, e.g., medication, nursing home fees.
I can advise the Deputy that, to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues, such as the current medical card income thresholds under review and any changes are considered in the context of Government policy and other issues which may be relevant.
1406. Deputy Neasa Hourigan asked the Minister for Health further to Parliamentary Question No. 559 of 15 November 2022, if he will provide a breakdown of the payments agreed by the HSE to each of the companies and individuals involved in renovations and adaptations of Glenwood House, Carrigaline, since its purchase by the HSE in January 2021 to date in tabular form; the names of those companies and individuals, alongside relevant costings; if he will provide details of any tendering process involved in the commissioning of those works on Glenwood House by the HSE; the funding sources for each of these works; and if he will make a statement on the matter. [1143/23]
View answerAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
1407. Deputy Neasa Hourigan asked the Minister for Health the current status of the HSE's use of Glenwood House as a mental health facility, two years after its purchase (details supplied); and if he will make a statement on the matter. [1144/23]
View answerAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
1408. Deputy Neasa Hourigan asked the Minister for Health further to Parliamentary Question No. 196 of 23 November 2022, the date that, according to the HSE a change in service requirements was identified by CHO 4 Mental Health Services for Glenwood House necessitating a full refurbishment of the property for future accommodation use as a community residence on a permanent basis (details supplied); and if he will make a statement on the matter. [1145/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1409. Deputy Neasa Hourigan asked the Minister for Health if any potential conflicts of interest among HSE managers were made known to the CHO 4 chief officer in respect of contracts of any kind offered by the HSE or in respect of any purchases made by the HSE during the years 2019 to 2022; if such declarations have been made, the number that were made during the timeframe in question in CHO 4; and if he will make a statement on the matter. [1146/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1410. Deputy Neasa Hourigan asked the Minister for Health the number of residents placed in a mental health facility (details supplied) in County Laois on 30 December 2019, 30 December 2020, 30 December 2021, and 30 December 2022; and if he will make a statement on the matter. [1147/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1411. Deputy Neasa Hourigan asked the Minister for Health the HSE's intentions with regard to the use of a location (details supplied) as a mental health facility; if the HSE plans to use the location as a community mental health residence into the future; if so, the number of service-users who will be placed there; the extent of the HSE's engagement with residents and their families regarding future plans for the location; and if he will make a statement on the matter. [1148/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1412. Deputy Joe Carey asked the Minister for Health his views on matters raised in correspondence (details supplied) in relation to the hyperemesis gravidarum drug, cariban, for pregnant women in Ireland; and if he will make a statement on the matter. [1151/23]
View answer1444. Deputy Cathal Crowe asked the Minister for Health the reasoning behind the decision to fund the Hyperemesis gravidarum drug cariban for three months of pregnancy only; if there are plans to extend for the duration of pregnancy; and if he will make a statement on the matter. [1290/23]
View answer1448. Deputy Cathal Crowe asked the Minister for Health if he will provide an update on the status of plans to reimburse pregnant people for the costs of the Hyperemesis Gravidarum drug Cariban; and if he will make a statement on the matter. [1297/23]
View answer1510. Deputy Martin Browne asked the Minister for Health his views on the provision of free medication for women suffering from hyperemesis gravidarum (details supplied). [1538/23]
View answerI propose to take Questions Nos. 1412, 1444, 1448 and 1510 together.
As part of Budget 2023, I announced €32.2 million in funding for Women’s Health Initiatives in 2023, to include dedicated funding for Cariban® (doxylamine/pyridoxine). The dedicated funding for Cariban® will help women who experience hyperemesis gravidarum, a severe form of morning sickness, during pregnancy. Cariban® is an Exempt Medicinal Product, i.e., it is not licensed with the Health Products Regulatory Authority (HPRA) in Ireland.
The Health Service Executive (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. Following the recommendations of the HSE Medicines Management Programme, Cariban® is now available on an individual patient basis for those patients who meet the criteria under the community drug schemes – the General Medical Services scheme (GMS) and the Drugs Payment Scheme (DPS) – from January 2023 where Consultant Obstetrician initiated.
Under the community drug schemes, Exempt Medicinal Products must be Consultant initiated. However, whilst the original prescriber of Cariban® must be a Consultant and specialist in the relevant field, the HSE will accept a GP prescription subsequent to the initial hospital prescription for approved patients.
