Written Answers Nos. 232-246
232. Deputy Neasa Hourigan asked the Minister for Health in view of the recent conclusions of the UN Committee on the Rights of the Child, his plans to devise a specific mental health strategy for Traveller children; and if he will make a statement on the matter. [11832/23]
View answerI have noted the recent conclusions on this matter by the UN Committee on the Rights of the Child.
As the Deputy will be aware, the Traveller Health Action Plan was launched in November 2022. The Department of Health and the HSE are committed to developing priorities, strategies and actions on Traveller mental health within the framework of the national Traveller Health Action Plan. These will respond to the crisis in Traveller mental health and address the social determinants of Traveller mental health through targeted and mainstreaming measures.
As a first step, the Traveller Health Action Plan contains six actions on Traveller mental health. These will be delivered through the HSE national service plan for 2023, supported by an additional ring-fenced budget of €300,000. The actions reflect the priority status of Travellers in the Government mental health policies - Sharing the Vision and Connecting for Life, and will be reported upon as part of the Sharing the Vision Implementation Plan 2022 - 2024. Progress will also be monitored under the National Traveller and Roma Inclusion Strategy.The Department and the HSE will also engage with the Traveller mental health network to develop and expand the actions as part of a mental health priority plan, within the framework of the Traveller health action plan. The newly established HSE steering group on Traveller mental health will consult with the Traveller mental health network on this task. Traveller representatives have been invited to be part of the group.
In light of the above, it is not envisaged that a separate strategy such as that suggested by the Deputy, will be developed at this time.
233. Deputy Jim O'Callaghan asked the Minister for Health if he will detail the population that each CHO area covers, reflecting the new census 2022 figures, in tabular form. [11834/23]
View answerUsing the CSO’s 2022 preliminary Census results at Electoral Division level and aggregating up to CHO level, the 2022 population estimates for the CHOs are as attached.
234. Deputy Patrick Costello asked the Minister for Health the reason the costs of the prescription medications melatonin and propranolol are not covered by the medical card; and if he will make a statement on the matter. [11851/23]
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 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 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 HSE advise that Melatonin (Circadin) has never been available under the Community Drug Schemes. Melatonin (Circadin) underwent a review in 2008 and reimbursement was not recommended by the NCPE (see www.ncpe.ie/drugs/melatonin-circadin/).
However, the HSE advise that an application for Melatonin can be made on an exceptional basis under Discretionary Hardship Arrangements for medical card holders. This is in accordance with Section 23 of the 2013 Act, which provides for the supply of items not on the reimbursement List. All applications under these arrangements are reviewed on an individual patient basis. The HSE must be satisfied that the patient requires the item for clinical reasons, and that there is no item on the reimbursement list which is a suitable alternative for that patient.
The HSE advise that Propranolol products were discontinued by the various Marketing Authorisation Holders in recent years. However, reimbursement support has been provided for some Propranolol products which are classed as Exempt Medicinal Products (EMPs). These are unlicensed in Ireland and are granted on an individual patient basis where alternative therapeutic options on the reimbursement list have been exhausted and there is an unmet clinical need. The following Propranolol EMPs 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.
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%.
235. Deputy Róisín Shortall asked the Minister for Health the reason he has not produced a Sláintecare progress report since December 2021; if he intends to publish a progress report this year; and if he will make a statement on the matter. [11859/23]
View answer238. Deputy Róisín Shortall asked the Minister for Health the timeline he is working towards for publication of the Sláintecare action plan for 2023; and if he will make a statement on the matter. [11862/23]
View answerI propose to take Questions Nos. 235 and 238 together.
The Sláintecare Progress Report 2022 and Sláintecare Action Plan 2023 have been finalised and are expected to be brought to Government for noting in the very near future after which they will be published. While a mid-year progress report was not published, progress on the implementation of Sláintecare is reported on to the Sláintecare Programme Board, the minutes of which can be found here: www.gov.ie/en/publication/fbc36-slaintecare-programme-board/
236. Deputy Róisín Shortall asked the Minister for Health if the regional health area implementation plan has been completed, given that it was due in quarter four of 2022; the timeline he is working towards for publication of this plan; and if he will make a statement on the matter. [11860/23]
View answerThe Government is committed to the implementation of Regional Health Areas (RHAs), as outlined in the Programme for Government. A memorandum on next steps, programme of work, and timelines for RHA implementation was approved by Government in April 2022.
A draft of the detailed Implementation Plan is currently being reviewed and refined with the HSE. The Implementation Plan will contain a summary of the rationale for RHAs, descriptions of the relative roles of the forthcoming RHAs, the HSE Centre and the Department of Health and will set out the clear, practical steps that will be taken for implementation.
It is intended to secure Government approval and publish the Implementation Plan in the coming weeks.
237. Deputy Róisín Shortall asked the Minister for Health the timeline he is working towards for publication of the 2023 HSE national service plan; and if he will make a statement on the matter. [11861/23]
View answerFollowing a review of the 2023 National Service Plan, the HSE has resubmitted an amended plan in line with consideration and feedback provided by the Department and other stakeholders. I am currently considering this revised plan and intend to revert to the HSE shortly.
In line with the Act, the NSP, when approved, will be laid before the Houses of the Oireachtas within 21 days. After this the HSE will ensure it is published at the earliest possible time.
239. Deputy Róisín Shortall asked the Minister for Health if he will publish any further progress reports on the implementation of the Covid-19 nursing homes expert panel recommendations, given that a number of reforms have yet to be implemented; if he intends to implement each recommendation; and if he will make a statement on the matter. [11863/23]
View answer240. Deputy Róisín Shortall asked the Minister for Health if he will provide an update on recommendation 15.6 of the Covid-19 nursing homes expert panel recommendations, relating to expanding access to home supports; and if he will make a statement on the matter. [11863/23]
View answer241. Deputy Róisín Shortall asked the Minister for Health if he will provide an update on the new home care tender process; the timeline he is working towards for issuing the invitation to tender; and if he will make a statement on the matter. [11863/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly as soon as possible.
242. Deputy Claire Kerrane asked the Minister for Health the actions he intends to take to support small rural nursing homes to prevent any further closures following his meeting with an organisation (details supplied); and if he will make a statement on the matter. [11870/23]
View answerI recognise the important part smaller voluntary and family-run nursing homes play in communities and I remain strongly committed to supporting them in these challenging times. The Government remains conscious of the financial challenges faced by the Nursing Home sector, particularly in terms of inflationary cost increases. I encourage all eligible providers to avail of the €10m Temporary Inflation Payment Scheme (TIPS) which covers up to 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 (up to €31,500 per nursing home for 2022). It has now been agreed that this scheme will be extended to the end of March 2023. Since the start of the pandemic, private and voluntary nursing homes have received a wide range of non-financial supports, including over €72m in free PPE and oxygen, as well as over €147m of financial support through the Temporary Assistance Payment Scheme (TAPS). It is the intention of the Department that TAPS will also continue into early 2023. The details of this are currently being finalised.I am 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. Other options to support nursing homes are also being explored.
The cost of residential care to the State was approximately €1.4 billion in 2022, including contributions from residents. Budget 2023 saw over €40 million in additional funding for the NHSS which is already providing for an uplift in the maximum prices chargeable by private and voluntary nursing homes, as negotiated.
Funding is provided in line with the long-established statutory mechanisms under the Nursing Homes Support Scheme Act 2009. This is the mechanism established by the Oireachtas to provide for the processes relating to funding under the Nursing Homes Support Scheme (NHSS) and the negotiation of prices for services for private and voluntary providers with the designated State agency, the National Treatment Purchase Fund (NTPF). Maximum prices for individual nursing homes are agreed with the NTPF following negotiations and based on the NTPF’s cost criteria. These criteria include costs reasonably incurred by the nursing home, local market prices, historic prices and overall budgetary capacity.The NTPF carry out this role independently under the NHSS Act 2009. The NTPF has statutory independence, and there is no role for Ministers or the Department of Health in these negotiations. The Department of Health published a review of the NTPF pricing system in June 2021.Important strands of reform to the nursing home sector are being, or have been, brought forward. The Government remains committed to delivering on the 86 recommendations of COVID-19 Nursing Homes Expert Panel, especially those recommendations related to long-term sectoral reform, the five recommendations of the NTPF Review of Pricing System for Long Term Residential Care Facilities and the 16 recommendations of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants. Work continues within the Department of Health to deliver on all of these recommendations, as well as analysing the outcomes of the Skills Mix and Safe Staffing pilots, all of which will serve to inform future policy-making.
243. Deputy Patricia Ryan asked the Minister for Health if he will provide an update on the status of the new build at St. Vincent's Hospital, Athy; and if he will make a statement on the matter. [11889/23]
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.
244. Deputy Patricia Ryan asked the Minister for Health the number of children waiting on occupational therapy in County Kildare; the number waiting for more than six months; the number waiting for more than one year; and if he will make a statement on the matter. [11892/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
245. Deputy Patricia Ryan asked the Minister for Health the number of people on the eye care waiting list from the CHO7 area; the number waiting for more than six months, the number waiting for more than one year; and if he will make a statement on the matter. [11893/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
246. Deputy Patricia Ryan asked the Minister for Health if anything can be done to help people with diabetes who cannot afford dressings when they have skin breakdown due to their diabetes, given that dressings are currently not covered by the medical card (details supplied). [11894/23]
View answerThe Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drug schemes, 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 medicinal product added to the formal Reimbursement list.
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.
There are a range of schemes that assist people with their medical costs. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. Medical card eligibility is primarily based on an assessment of means and is not granted on the basis of any particular condition.
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.
Another scheme that assists people with specific medical costs is the Long-Term Illness (LTI) scheme. This scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made prescribing 16 illnesses covered by the scheme. Diabetes is one of the illnesses included. Under the LTI scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
