Written Answers Nos. 291-312
291. Deputy Matt Shanahan asked the Minister for Health if he will review the Waterford and Southeast Caredoc service (details supplied) in view of communications regarding delayed access; and if he will make a statement on the matter. [10649/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
292. Deputy Mairéad Farrell asked the Minister for Health if persons in receipt of a British pension can apply for reimbursement of costs for healthcare treatment received in another EU member state under the cross-border directive scheme; if there are other arrangements in place that allow persons in receipt of a British pension to apply for reimbursement; and if he will make a statement on the matter. [10655/23]
View answerPrior to the 1st January 2021, UK pensioners residing in Ireland who had accessed healthcare under the EU Cross Border Directive were required to have their healthcare costs reimbursed by the UK as this was a requirement of the provisions of the EU Cross Border Directive. As a result of the UK’s withdrawal from the EU, the provisions of the EU Cross Border Directive no longer apply to the UK.
Separately, the Northern Ireland Planned Healthcare Scheme has been in effective operation since 1 January 2021. This Scheme was introduced to mitigate the loss of access to care from private providers in Northern Ireland under the EU Cross Border Directive, which ceased to apply as a result of Brexit. The Northern Ireland Planned Healthcare Scheme enables persons resident in the State to access and be reimbursed for private healthcare in Northern Ireland by the HSE, provided such healthcare is publicly available within Ireland.
293. Deputy Colm Burke asked the Minister for Health if consideration will be given to a further extension of the temporary inflation payment scheme into 2023 to support private and voluntary nursing homes with energy cost increases; and if he will make a statement on the matter. [10656/23]
View answer294. Deputy Colm Burke asked the Minister for Health if consideration will be given to a further extension of the temporary assistance payment scheme into 2023 to support private and voluntary nursing homes with additional costs due to Covid-19 outbreaks; and if he will make a statement on the matter. [10657/23]
View answerI propose to take Questions Nos. 293 and 294 together.
The Government remains conscious of the financial challenges faced by the Nursing Home sector, particularly in terms of inflationary cost increases. A €10m scheme (the Temporary Inflation Payment Scheme or TIPS) has been established that will cover 75% of year-on-year energy and heating cost increases in private and voluntary nursing homes up to a monthly cap of €5,250 per month per nursing home over the period of July to December 2022.
The Temporary Inflation Payment scheme will now continue until the end of March 2023. Continuation beyond this point will be subject to review.
Since the start of the pandemic, private and voluntary nursing homes have also received a wide range of non-financial supports, including over €74m in free PPE and oxygen, as well as over €147m of financial support through the Temporary Assistance Payment Scheme (TAPS). The TAPS COVID-19 Outbreak Assistance has been extended to the end of the year.
I am also currently in discussions with Departmental officials to examine ways in which funding can also continue to be used to provide support, where necessary and appropriate, to those nursing homes who are not scheduled to renegotiate their Deeds of Agreement this year.
295. Deputy Bernard J. Durkan asked the Minister for Health arising from the recent meetings between the HSE and a company (details supplied), if an agreement has been or is likely to be reached in relation to the drug, kaftrio, which is eagerly and anxiously awaited by parents and children alike; and if he will make a statement on the matter. [10684/23]
View answerThe Health Technology Assessment was received by the HSE from the NCPE on February 9, 2023. The discussions between the HSE and Vertex Pharmaceuticals are at a sensitive stage, and the Minister is not in a position to make any comment at this time.
296. Deputy Steven Matthews asked the Minister for Health the position regarding hospital parking charges for groups (details supplied); if a free parking pass system will be considered that would reduce the financial burden on these voluntary groups; and if he will make a statement on the matter. [10685/23]
View answerHospitals that charge parking fees are very cognisant of the financial implications of parking costs for patients and their families, particularly for those with long-term illnesses. Consequently, many hospitals have introduced a maximum daily fixed parking charge and reduced rate parking for long-term patients and visitors for whom the payment of the full rate would cause hardship.
The Programme for Government - Our Shared Future, makes a commitment to introduce a maximum daily car parking charge for patients and visitors at all public hospitals, where possible, and to introduce flexible passes in all public hospitals for patients and their families. This is a reflection of the Government’s appreciation of the financial challenge that can be faced by people in meeting these expenses, in particular where they are frequent users of hospital services. Accordingly, my Department and the HSE are currently examining the issue.
297. Deputy John Paul Phelan asked the Minister for Health if he intends to publish a successor to the now-expired National Rare Disease Plan; and if he will make a statement on the matter. [10710/23]
View answer298. Deputy John Paul Phelan asked the Minister for Health the status of the recruitment process for a dedicated official within his Department to have oversight of rare disease policy; the timeframe for such a process; and if he will make a statement on the matter. [10711/23]
View answerI propose to take Questions Nos. 297 and 298 together.
The Government and I are fully committed to doing everything possible to assist people living with a rare disease.
I intend to bring forward a successor plan to the National Rare Disease Plan 2014-2018. However, there is no doubt that the Covid-19 pandemic slowed our progress up until now.
Nonetheless, various actions have been implemented and significant resources invested in this area in recent years.
Principal among those actions was the establishment of the HSE National Clinical Programme for Rare Diseases and a National Rare Disease Office.
Last year the HSE was nominated as the National Competent Authority in an EU Joint Action of European Reference Networks for Rare Diseases, which enables greater coordination and sharing of best practices in key areas such as genetic testing.
As a result of this collaboration, we have entered in 18 European Reference Networks (ERNs) on Rare Diseases. These ERNs include representation from five academic hospitals and three universities and is coordinated by the National Rare Disease Office. This represents a significant achievement by the health service, to drive innovation, training and clinical research for highly specialised care. Through the European Reference Networks, the National Rare Disease Office is leading out on the development of optimal care pathways across a range of rare diseases.
My Department is seeking to appoint, through the usual recruitment channels, an official to progress the commitment in the Programme for Government to bring forward a new National Rare Diseases Plan.
In terms of medicines for rare diseases, I have during my term of office significantly increased the level of funding available for new innovative medicines including medicines for rare diseases; a combined €100 million in the last three Budgets. Over one hundred new medicines have been approved including thirty-four for orphan medicines that are used to treat rare diseases. However, I accept that a new Plan is needed.
299. Deputy John Paul Phelan asked the Minister for Health when he intends to publish the review of the Obesity Policy and Action Plan; and if he will make a statement on the matter. [10712/23]
View answerA Healthy Weight for Ireland, the Obesity Policy and Action Plan (OPAP), was launched in September 2016 under the auspices of the Healthy Ireland Framework (Healthy Ireland: A Framework for Improved Health and Wellbeing 2013-2025). It was developed in recognition of the growing need for a co-ordinated policy response to the increasing problem of obesity in Ireland and the increasing burden placed on individuals and society.
OPAP covers a 10-year period up to 2025 and aims to reverse obesity trends, prevent health complications, and reduce the overall burden for individuals, families, the health system, and the wider society and economy. It recognises that obesity is a complex, multi-faceted problem and needs a multi-pronged solution, with every sector of society playing its part. Childhood obesity is a key priority under OPAP, as is reducing the inequalities seen in obesity rates, where children (and adults) from lower socioeconomic groups have higher levels of obesity.
In the context of preparing a review of the OPAP, UCC was commissioned to conduct an independent evaluation. This evaluation covers the period January 2016 to May 2021.
The Department of Health carried out a Review of the OPAP which provides an update as to the current status of some of the main deliverables in the Ten Steps to end October 2022. It also aligns the Ten Steps suite of population-health approaches in OPAP with the WHO European Regional Obesity Report 20225 and the policy options the WHO recommends on managing obesity throughout the life course, thus signposting key actions to consider out to 2025.
Both the independent evaluation of OPAP by UCC and the Review of OPAP by the Department of Health were published in November 2022 and can be found on the Healthy Ireland website at gov.ie - Healthy Ireland Policies (www.gov.ie).
300. Deputy John Paul Phelan asked the Minister for Health when the cross-departmental group on the EU Pharmaceutical Strategy last met; and if he will make a statement on the matter. [10713/23]
View answerThe Pharmaceutical Strategy for Europe, published on 25 November 2020 is the second major building block of the new EU Health Union, and is fundamentally about ensuring safe, affordable medicines for all citizens and patients.
The strategy has four key aims that are focussed on
- ensuring access to affordable therapies for patients, and addressing unmet medical needs (in the areas of antimicrobial resistance and rare diseases, for example)
- supporting competitiveness, innovation and sustainability of the EU’s pharmaceutical industry and the development of high quality, safe, effective and greener medicines
- enhancing crisis preparedness and response mechanisms, establishing diversified and secure supply chains and addressing medicines shortages
- ensuring a strong EU voice in the world, by promoting a high level of quality, efficacy and safety standards
Significant progress has been made to date on the delivery of actions laid out in the Implementation Plan, with some of the mechanisms of delivery addressing more than one of the desired actions. (55 outlined actions both legislative and non-legislative which will operationally realise the objectives of the strategy). This includes ongoing work on the revision of the General Pharmaceutical Legislation, Orphan and Paediatric legislation, work to define/set criteria for unmet need, creation of the Health Emergency Response Authority, Structured Dialogue Initiative, and Clinical Trials Regulation.
I understand that the European Commission intends to publish its proposal to update the general pharmaceutical legislation in March. Ireland welcomes and eagerly anticipates the actions that will emanate from and underpin the delivery on the aims of the Pharmaceutical Strategy for Europe, which is premised essentially on ensuring access to safe, affordable effective medicines for all European patients. Once the legislative proposal and Impact Assessment are available my Department will be participating as appropriate in the deliberative process.
The Department of Health has established a Cross Departmental/Agency Group with key stakeholders, holding differing perspectives, which are shared so as to best inform national engagement as the implementation actions of the strategy progress. The Group has met on four occasions to date. The last meeting was on 17th January with a further meeting planned for later this month. Views are shared at these meetings, and the learnings gleaned utilised as appropriate by my officials as we respond in accordance with the obligations derived from our membership of the EU.
301. Deputy Aengus Ó Snodaigh asked the Minister for Health the amount being spent per month on maintaining the Covid tracker app; how many people log in daily; how many close contacts have been contacted as a result of engagement with the app, on average monthly, since its inception; and if he will make a statement on the matter. [10733/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
302. Deputy Michael Healy-Rae asked the Minister for Health if he can assist a person (details supplied) with an issue; and if he will make a statement on the matter. [10745/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
303. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [10746/23]
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.
304. Deputy Bríd Smith asked the Minister for Health the reason melatonin and propranolol are not covered by a student medical card while venlafex, which has been prescribed as part of a trio of medication, is; if his attention has been drawn to the fact that having to pay for these two medications is having a significant financial impact, especially when other college costs are also factored in; if there are any other supports or schemes a student can access to cover the cost of their medications; and if he will make a statement on the matter. [10748/23]
View answerThe Health Service Executive (HSE) has statutory responsibility for medicine pricing and reimbursement decisions, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
In line with the 2013 Health 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 reimbursement list. Reimbursement is for licensed 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). I, as the Minister for Health, have no role in these decisions.
The HSE advise that Melatonin (Circadin) has never been available through the Reimbursement List under the Community Drug Schemes. Melatonin (Circadin) underwent a review in 2008 and reimbursement was not recommended by the NCPE as there was insufficient evidence to support the reimbursement of this product under the Community Drug Schemes (available at www.ncpe.ie/drugs/melatonin-circadin/).
Exceptional arrangements are, however, considered under Section 23 of the Health (Pricing and Supply of Medical Goods) Act 2013 - Supply of items not on the Reimbursement List. An application for melatonin can be considered on an exceptional basis under Discretionary Hardship Arrangements for medical card holders. All applications under these arrangements are reviewed on an individual patient basis under Section 23. A reimbursement form is required to be completed and submitted by the prescribing consultant and contain sufficient information to enable a positive decision. The HSE must be satisfied that:
(a)The patient requires that item for clinical reasons, and
(b) There is no listed item which is a suitable alternative for that item in so far as that patient is concerned.
Propranolol products were discontinued by the various Marketing Authorisation Holders in recent years. However, reimbursement support has been provided for Exempt Medicinal Products (EMPs) which are unlicensed in Ireland, on an individual patient basis whereby alternative therapeutic options on the Reimbursement list have been exhausted and there is an unmet clinical need.The following Exempt Medicinal Products are available:
- Propranolol (ULM) Oral Soln. 50mg./5ml. 150ml.
- Propranolol (ULM) Tabs. 40 mg. 50.
- Propranolol (ULM) Tabs. 10 mg. 28.
- Propranolol (ULM) Tabs. 10 mg. 100.
The Drug Payment Scheme (DPS) provides for the refund of the amount by which expenditure on approved prescribed medicines or medical and surgical appliances exceeds a named threshold in any calendar month. The DPS is not means tested and is available to anyone normally resident in Ireland.
The DPS threshold is currently €80 per month. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
Finally, individuals may 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%.
305. Deputy Colm Burke asked the Minister for Health if he will provide details of the terms of reference given to HIQA to carry out health technology assessments related to influenza vaccines; if he will detail the proposed timelines for these assessments to be commenced and completed; and if he will make a statement on the matter. [10751/23]
View answer306. Deputy Colm Burke asked the Minister for Health the steps he and his officials are taking to ensure vulnerable groups including those aged over 65 years of age have the greatest level of protection for the 2023-2024 winter flu season; if he has considered NIAC’s advice to offer an enhanced influenza vaccine for this age cohort; and if he will make a statement on the matter. [10752/23]
View answerI propose to take Questions Nos. 305 and 306 together.
The National Immunisation Programme in Ireland, which includes the influenza immunisation programme, is based on the advice of the National Immunisation Advisory Committee (NIAC). The committee's recommendations are based on the prevalence of the relevant disease in Ireland and international best practice in relation to immunisation. NIAC make recommendations on vaccination policy to the Department of Health.
NIAC continue to revise recommendations to allow for the introduction of new vaccines in Ireland and to keep abreast of changes in the patterns of disease. Therefore, the immunisation schedule will continue to be amended over time.
For the 2022/2023 flu season, the flu vaccine is available free of charge to adults over 65 years, individuals in specified at-risk groups and children aged from 2 to 17 years. This approach ensures that those most vulnerable to the effects of influenza will have access to the flu vaccination without a charge.
To inform decision making in relation to the immunisation programme, HIQA can be asked to carry out Health technology assessments (HTA). A HTA is a multidisciplinary research process that collects and summarises information about a health technology to provide information regarding clinical effectiveness and safety, cost-effectiveness and budget impact, organisational and social aspects, and ethical and legal issues. The information is collected and presented in a systematic, unbiased and transparent manner to inform policy decision making.
307. Deputy Michael Healy-Rae asked the Minister for Health if home help hours can be reinstated for a person (details supplied); and if he will make a statement on the matter. [10761/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
308. Deputy Steven Matthews asked the Minister for Health the position regarding the number of persons from County Wicklow currently undergoing dialysis treatment; if any review is ongoing into the potential to offer this treatment in a primary care setting; and if he will make a statement on the matter. [10777/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
309. Deputy Bernard J. Durkan asked the Minister for Health the extent to which a refused medical card application in the case of a person (details supplied) can be reviewed given the health circumstances of their case; and if he will make a statement on the matter. [10787/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
310. Deputy Bernard J. Durkan asked the Minister for Health the procedure in place to ensure an adequate coverage of GPs to replace those retiring and provide a service to new residents who have not yet been able to source a GP; and if he will make a statement on the matter. [10792/23]
View answerGPs are self-employed practitioners and therefore may establish practices at a place of their own choosing. There is no prescribed ratio of GPs to patients and the State does not regulate the number of GPs that can set up in a town or community.
Under the GMS scheme, the HSE contracts GPs to provide medical services without charge to medical card and GP visit card holders. Currently there are 2,529 GPs contracted to provide services under the GMS Scheme.
Where a GP GMS vacancy is set to arise in a practice, the HSE is notified in advance and becomes actively involved in the recruitment process to find a replacement GP. As of 1st of February 2023 there are 32 GMS vacancies across the country.
Where a GMS patient experiences difficulty in finding a GP to accept them as a patient, the person concerned having unsuccessfully applied to at least three GPs in the area (or fewer if there are fewer GPs in the area) can apply to the HSE National Medical Card Unit which has the power to assign that person to a GP's GMS patient list.
People who do not hold a medical card or GP visit card access GP services on a private basis and can make enquiries directly to any GP practice they wish to register with. As private contractors, it is a matter for each individual GP to decide whether to accept additional private patients. Where a GP practice has a full list of patients and cannot take on new patients, patients should contact other GP practices in the surrounding areas.
Under the 2019 GP Agreement, the Government is increasing annual investment in general practice by approximately 40% (€210 million) between 2019 and 2023. The Agreement provides for an increase in capitation fees for GPs, additional services, improved family arrangements as well as a targeted €2 million fund to support to practices in deprived urban areas.
A steady increase has been seen in the number of doctors entering GP training over recent years, rising from 120 in 2009 to 258 in 2022. The transfer of GP training from the HSE to the Irish College of General Practitioners (ICGP), which was concluded in 2021, will allow for the introduction of a new service model for GP training in Ireland and the further expansion GP training capacity in the years ahead. The ICGP aims to have 350 training places available for new entrants per year by 2026.
These measures will see an increase in the number of GPs working in the State, improving access to GP services for patients throughout the country.
311. Deputy Bernard J. Durkan asked the Minister for Health the availability of speech and language therapy in the case of the son of a person (details supplied); and if he will make a statement on the matter. [10796/23]
View answerAs this question refers to service matters, I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
312. Deputy Colm Burke asked the Minister for Health the steps the Government has taken to implement the Commission Delegated Directive (EU) 2022/2100 on the withdrawal of certain exemptions in respect of heated tobacco products, which was published in the Official Journal of the European Union on 3 November 2022 and entered into force on 23 November 2022 ahead of the deadline of 23 July for the transposition of the directive into the national framework; and if he will make a statement on the matter. [10804/23]
View answerMy Department is working with the Office of the Parliamentary Counsel to draft legislation to transpose Commission Delegated Directive (EU) 2022/2100.
