Tuesday, 24 Jan 2023

Medicinal Products

Questions (624)

Violet-Anne Wynne

Question:

624. Deputy Violet-Anne Wynne asked the Minister for Health what his Department is doing to address medicine shortages across Ireland; and if he will make a statement on the matter. [3261/23]

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Written answers

Medicine shortages are increasingly prevalent worldwide over the past decade. The causes of such shortages are multi-factorial, including shortages of raw materials, manufacturing difficulties, increased demand, product recalls due to potential quality defects, and industry consolidations. Medicine shortages can originate at any point in the supply chain. They can involve and impact many stakeholders in different ways, as the supply models and clinical use of therapies can vary across national health systems.

Medicine shortages and their prevention are not unique to Ireland. Similar increases in demand and medicines shortages have been observed in the UK, throughout the EU and across the world at present. In the case of medicines used most often in Ireland, there are typically multiple alternatives available from various sources that remain available to ensure continuity of treatment. Of the products currently in short supply, alternative treatments are available for every single product.

Management of medicines shortages necessitates a multi-faceted, multi-stakeholder response to ensure patient safety, continuity of care and protection of public health. To that end, at the request of the Department of Health, the Health Products Regulatory Authority (HPRA) has assumed a coordinating function in Ireland’s response to managing medicine shortages when they occur. The HPRA is generally informed of a medicine shortage by the relevant pharmaceutical company. Shortages can also be notified to the HPRA by other stakeholders across the health system. In each case, the HPRA will work with relevant stakeholders as necessary, including the HSE, to coordinate an effective approach to the management of a confirmed product shortage. The HPRA engages with stakeholders to coordinate actions and share information to prevent or mitigate the impact of medicine shortages when they occur.

The HPRA publishes a list of medicines currently in short supply on its website with the reason for the shortage and expected dates for the return of supply. The information is available to assist healthcare professionals in managing medicine shortages when they arise and reduce their impact on patients. The information relating to shortages on the HPRA website is dynamic and changes depending on the current information the HPRA has to hand, including removal from the list when a shortage has been resolved.

The HPRA continues to work with all marketing authorisation holders to increase supply to the market. They also continue to offer regulatory flexibility where possible to suppliers. Through this close engagement the HPRA has secured additional stock of many products currently in short supply for the Irish market.

Patients or their carers who have any concerns in relation to temporary alternative products provided because of medicine shortages are advised to speak with their pharmacist or other healthcare professional involved in their care.

Medicinal Products

Questions (625)

Violet-Anne Wynne

Question:

625. Deputy Violet-Anne Wynne asked the Minister for Health if his Department will implement a serious shortage protocol with respect to medicine shortages; and if he will make a statement on the matter. [3264/23]

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Written answers

Minister for Health

Medicine shortages are increasingly prevalent worldwide over the past decade. The causes of such shortages are multi-factorial, including shortages of raw materials, manufacturing difficulties, increased demand, product recalls due to potential quality defects, and industry consolidations. Medicine shortages can originate at any point in the supply chain. They can involve and impact many stakeholders in different ways, as the supply models and clinical use of therapies can vary across national health systems.

Medicine shortages and their prevention are not unique to Ireland. Similar increases in demand and medicines shortages have been observed in the UK, throughout the EU and across the world at present. In the case of medicines used most often in Ireland, there are typically multiple alternatives available from various sources that remain available to ensure continuity of treatment. Of the products currently in short supply, alternative treatments are available for every single product.

Management of medicines shortages necessitates a multi-faceted, multi-stakeholder response to ensure patient safety, continuity of care and protection of public health. To that end, at the request of the Department of Health, the Health Products Regulatory Authority (HPRA) has assumed a coordinating function in Ireland’s response to managing medicine shortages when they occur. The HPRA is generally informed of a medicine shortage by the relevant pharmaceutical company. Shortages can also be notified to the HPRA by other stakeholders across the health system. In each case, the HPRA will work with relevant stakeholders as necessary, including the HSE, to coordinate an effective approach to the management of a confirmed product shortage. The HPRA engages with stakeholders to coordinate actions and share information to prevent or mitigate the impact of medicine shortages when they occur.

The HPRA publishes a list of medicines currently in short supply on its website with the reason for the shortage and expected dates for the return of supply. The information is available to assist healthcare professionals in managing medicine shortages when they arise and reduce their impact on patients. The information relating to shortages on the HPRA website is dynamic and changes depending on the current information the HPRA has to hand, including removal from the list when a shortage has been resolved.

The HPRA continues to work with all marketing authorisation holders to increase supply to the market. They also continue to offer regulatory flexibility where possible to suppliers. Through this close engagement the HPRA has secured additional stock of many products currently in short supply for the Irish market.

A dedicated webpage has been developed to allow prescribers check on the live supply data as supplied by the HPRA www.antibioticprescribing.ie.

In addition, the pharmacy regulator, the PSI, has communicated to pharmacists updating them on the situation and reminding them about the necessity for a judicious supply of medicines used to treat respiratory illnesses and their symptoms, which in essence, is to try and reduce the stockpiling potential at the pharmacy and by patients.

While other countries have introduced Serious Shortages Protocols (SSPs) to allow for both generic and therapeutic substitution, Irish legislation already provides for generic substitution of therapeutically appropriate alternatives. The Department of Health continues to review whether there is merit in developing a protocol to allow for therapeutic substitution in certain circumstances.

General Practitioner Services

Questions (626)

Violet-Anne Wynne

Question:

626. Deputy Violet-Anne Wynne asked the Minister for Health if there is a timeline for the conclusion of GP contract negotiations; and if he will make a statement on the matter. [3268/23]

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Written answers

Minister for Health

My officials and the HSE have made preparations for the expansion of GP care without charges to all children aged 6 and 7. Engagements with the IMO, representing GPs, in relation to the necessary fee structures are ongoing with the intention of introducing this service as early as possible.

Furthermore, 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.

Health Services Staff

Questions (627)

Violet-Anne Wynne

Question:

627. Deputy Violet-Anne Wynne asked the Minister for Health the number of HSE carers working in community healthcare organisation CHO 3, by county, in tabular form; and if he will make a statement on the matter. [3270/23]

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Written answers

Minister for Health

As this is a service matter, I have referred it to the Health Service Executive.

Health Services

Questions (628)

Violet-Anne Wynne

Question:

628. Deputy Violet-Anne Wynne asked the Minister for Health if the HSE winter plan will be produced at an earlier stage for winter 2023-24; and if he will make a statement on the matter. [3271/23]

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Written answers

Minister for Health

The HSE Winter Plan for 2022-23 was published on the 11th of October 2022. The Plan is supporting acute and community services this winter to respond to anticipated high levels of emergency attendances and admissions across the acute sector, long waiting times in EDs and high occupancy rates across acute hospital settings. The plan is estimated to cost up to €169m to implement.

Key national initiatives of the Winter Plan 2022/23 include:

- The recruitment of 51 Emergency Medicine Consultants and associated support staff;

- The recruitment of an overall additional 608 WTE across the health system;

- Increased Community Intervention Teams, GP supports and Out of Hours services to reduce the need for attendances at EDs;

- Increased community services for mental health, disability and palliative care;

- Increase community and acute diagnostics; and

- Expansion of ambulance services, including the completion of nine Pathfinder teams and deployment of rapid handover teams to improve ambulance turnaround time.

Working for winter planning commenced in April 2022 and continued throughout summer 2022 with a series of meetings with the HSE in which it was stressed that the Plan must prepare the health system, as a whole, for the anticipated demands.

At my request, winter planning went beyond the national level this year. Instead, it adopts a bottom-up approach with bespoke local plans that seek to address hospital specific issues in conjunction with Community Healthcare Organisations.

In relation to the particular query raised regarding the 2023/24 Winter Plan, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Healthcare Infrastructure Provision

Questions (629)

Johnny Mythen

Question:

629. Deputy Johnny Mythen asked the Minister for Health the status of the construction of the 96-bed ward block in Wexford General Hospital; and if he will make a statement on the matter. [3281/23]

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Written answers

Minister for Health

A design team was appointed in September 2022 by HSE Capital & Estates, progressing the proposal for a 96-bed medical ward block at Wexford General Hospital to preliminary stage one design. This is expected to be completed by the end of January 2023.

Concurrently, the HSE is compiling a Strategic Assessment Report (SAR) for this proposal to ensure full compliance with the Public Spending Code (PSC). As the proposal could cost in excess of €100m it is expected that this SAR will be submitted to the Department of Health in Q2 2023 for review.

The delivery of capital projects is a dynamic process and is subject to the successful completion of the various approval stages, in line with the new lifecycle approach of the updated PSC. As such the timeline for construction of a new ward block cannot be estimated until after the completion of a tender competition and submission of the Final Business case to Government for approval.

The PSC is designed to ensure that 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.

These are defined processes in which all Departments and agencies are subject to and must follow to ensure that Government, as the approving authority for all major projects (i.e. those over costing over €100m) can be satisfied that the project is the best means to achieve a policy goal and that we achieve maximum value for money for the taxpayer.

Departmental Reports

Questions (630)

Pauline Tully

Question:

630. Deputy Pauline Tully asked the Minister for Health if the evaluation report of the pilot on the statutory home support scheme is completed; the timeframe for when the report will be made public; and if he will make a statement on the matter. [3300/23]

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Written answers

Minister of State at the Department of Health

As this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Care Services

Questions (631)

Pauline Tully

Question:

631. Deputy Pauline Tully asked the Minister for Health if he will detail the current unmet need with regard to home care provision; and if he will make a statement on the matter. [3301/23]

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Written answers

Minister of State at the Department of Health

The Government is committed to supporting people with care needs to continue to live independently in their homes and communities for as long as possible. As of November 2022, 19,038,523 home support hours had been delivered nationally over the preceding year and, as at the end of November 2022, there were 56,429 people in receipt of the service. However, there were also 3,240 new applicants who had been approved for funding but who were awaiting supports; 2,819 people already receiving supports but not the full number of hours recommended; and 7 people waiting for funding for home support.

Within this context, the Government is committed to addressing the critical shortage of care workers in Ireland as an urgent priority. For this reason, I established the cross departmental Strategic Workforce Advisory Group in March 2022 to examine, and formulate recommendations to address, the challenges in frontline carer roles in the home support and long term residential care sectors.

The Report of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Healthcare Assistants was published on 15th October 2022. Providing an overview of the work of the Group and its key findings, the report presents a suite of 16 recommendations spanning the areas of areas of recruitment, pay and conditions of employment, barriers to employment, training and professional development, sectoral reform, and monitoring and implementation.

I have strongly endorsed all of the Advisory Group’s recommendations and I am committed to their full implementation as a priority. Implementation of the recommendations will be overseen by a cross departmental Implementation Group, chaired by the Department of Health.

I can confirm that implementation of the recommendations has commenced with the announcement on 16th December 2022 of the Government’s authorisation of 1,000 employment permits for non EU/EEA home support workers, as recommended by the Advisory Group. This promises to significantly reduce the shortage of home support workers in the immediate future. I have contacted the Department of Enterprise, Trade and Employment, which has oversight of the recruitment of non EU/EEA home support workers, for direct reply to you in respect of this initiative.

Care Services

Questions (632)

Pauline Tully

Question:

632. Deputy Pauline Tully asked the Minister for Health what actions he has taken to establish a commission to examine care and supports for older people, which is a commitment in the programme for Government; and if he will make a statement on the matter. [3302/23]

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Written answers

Minister of State at the Department of Health

The Government is committed to supporting healthy, positive ageing and ensuring that older persons can continue to live independently in their homes and communities for as long as possible.

The Programme for Government (2020) commits to the establishment of a commission on care that will ‘assess how we care for older people and examine alternatives to meet the diverse needs of our older citizens’, learning the lessons from COVID-19.

In 2022 preliminary desk research was undertaken within my Department in preparation for the establishment of a commission on care. In 2023 the scoping and planning for the commission on care will be further advanced as a priority.

Disability Services

Questions (633)

Pauline Tully

Question:

633. Deputy Pauline Tully asked the Minister for Health the name and contact details of the liaison officer attached to each children's disability network team, CDNT; the name and contact details of the assessment officer attached to each CDNT; the name and contact details of the complaints officer attached to each CDNT; the name and contact details of the appeals officer attached to each CDNT, in tabular form; and if he will make a statement on the matter. [3303/23]

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Written answers

Minister of State at the Department of Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Disability Services

Questions (634)

Pauline Tully

Question:

634. Deputy Pauline Tully asked the Minister for Health if he will provide this Deputy with a copy of the findings of the latest CDNT expression of preference process; and if he will make a statement on the matter. [3304/23]

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Written answers

Minister of State at the Department of Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Disability Services

Questions (635)

Pauline Tully

Question:

635. Deputy Pauline Tully asked the Minister for Health the estimated staff to service user ratio for each CDNT post (details supplied), in tabular form; and if he will make a statement on the matter. [3305/23]

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Written answers

Minister of State at the Department of Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Health Services Waiting Lists

I recognise that medicines are the most common healthcare intervention within the health system and that both the use and complexity of medicines are increasing. Pharmacists are the healthcare professional optimally placed by virtue of their training to deliver on the critical role within the health system to ensure the rational use of medicines by maximising the benefits and minimising the potential for patient harm with regard to medicines.

I acknowledge that various forms of pharmacist prescribing are in place internationally ranging from collaborative, supplementary and independent prescribing, contextualised within the health care service model that the activity is delivered in. The focus of Sláintecare is to develop primary and community care, and make it possible for people to stay healthy in their homes and communities for as long as possible. The underpinning objective and rationale for any pharmacist prescribing model should be to enhance patient safety and timely access to medicines and I am open to the consideration of any evidence based, appropriately governed services delivered by appropriately trained professionals which will support the holistic functioning of the healthcare system for best patient outcome.