Written Answers Nos. 1337-1356
1337. Deputy David Cullinane asked the Minister for Health the process by which Resource Allocation Group applications in CHO5 are received, assessed and decided by the HSE; and if he will make a statement on the matter. [13008/23]
View answerAs this is a operational matter, I have referred it to the Health Service Executive for direct reply to the Deputy.
1338. Deputy David Cullinane asked the Minister for Health the process by which applications for funding for assistive technology for people with disabilities are assessed; which State body is responsible for assessing applications; the makeup of persons within the appointed body that make decisions; the current waiting times for decisions on assessments to be reached; what appeal options may be available following refusal; and if he will make a statement on the matter. [13009/23]
View answerAs the Health Service Executive (HSE) have responsibility for the provision of aids and appliances under the Community Funded Schemes, I have asked the HSE to respond to the Deputy directly as soon as possible.
1339. Deputy David Stanton asked the Minister for Health if an application has been submitted to the HSE to have sativex oromucosal spray added to the drug payment scheme reimbursement list; if he is aware of any report by the HSE drugs group following any such application; if a decision has been made or is expected to be made on the issue; and if he will make a statement on the matter. [13024/23]
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.
In terms of the specific details of the application for pricing and reimbursement of Delta-9-tetrahydrocannabinol (THC) / Cannabidiol (CBD) (Sativex®):
In 2014, the HSE notified Almirall (the applicant) that there was significant uncertainty around the cost-effectiveness of Sativex® (on the basis of the then application: www.ncpe.ie/wp-content/uploads/2013/01/Summary-v1.pdf) and as a consequence did not support reimbursement of Sativex® (at that time).
The HSE received a revised application from Almirall for pricing / reimbursement of Sativex® on 9 February 2018.
- The first step in the process is the submission of a Rapid Review dossier (a clinical and economic dossier) to the National Centre for Phamacoeconomics (NCPE) for assessment. The HSE commissioned the Rapid Review process on 12 February 2018.
- The NCPE Rapid Review assessment report was received by the HSE on 3 April 2018. The NCPE advised the HSE that a full HTA was recommended to assess the clinical effectiveness and cost effectiveness of delta-9-tetrahydrocannabinol (THC) and Cannabidiol (CBD) (Sativex®) compared with the current standard of care.
- The HSE commissioned a full Health Technology Assessment (HTA) on 19 April 2018 as per agreed processes.
- The NCPE publishes details of medicines where the HSE has commissioned a Rapid Review assessment and-or a full health technology assessment on their website. The website is updated at regular intervals and includes assessment outcomes and updates on reimbursement for each individual medicine and indication listed. Details of the assessment(s) of delta-9-tetrahydrocannabinol (THC) and Cannabidiol (CBD) (Sativex®) is available at www.ncpe.ie/delta-9-tetrahydrocannabinol-cannabidiol-thc-cbd-sativex/
- The NCPE Health Technology Assessment was received by the HSE on 15 July 2021. The NCPE recommended that delta-9-tetrahydrocannabinol (THC) and Cannabidiol (CBD) (Sativex®) as treatment for symptom improvement in adult patients with moderate to severe spasticity due to multiple sclerosis (MS) who have not responded adequately to other anti-spasticity medication and who demonstrate clinically significant improvement in spasticity related symptoms during an initial trial of therapy not be considered for reimbursement unless cost effectiveness can be improved relative to existing treatments.
- The HSE Corporate Pharmaceutical Unit (CPU) is the interface between the HSE and the Pharmaceutical Industry in relation to medicine pricing and reimbursement applications. CPU engaged in commercial negotiations with the applicant (Almirall) in relation to their application.
- The Drugs Group is the national committee which the HSE has in place to make recommendations on the pricing and reimbursement of medicines. The membership of the HSE Drugs Group includes public interest members. The totality of clinical and economic evidence for delta-9-tetrahydrocannabinol (THC) and Cannabidiol (CBD) (Sativex®) was comprehensively and extensively reviewed by the Drugs Group at the November 2022 meeting. The Group recommended in favour of reimbursement of delta-9-tetrahydrocannabinol (THC) and Cannabidiol (CBD) (Sativex®) subject to the establishment of a HSE Medicines Management Programme-led managed access protocol.
- The decision making authority in the HSE is the HSE Executive Management Team. The HSE Executive Management Team decides on the basis of all the demands it is faced with (across all services) whether it can fund a new medicine, or new uses of an existing medicine, from the resources that have been provided to it in line with the Health (Pricing and Supply of Medical Goods) Act 2013. The HSE EMT supported reimbursement of delta-9-tetrahydrocannabinol (THC) and Cannabidiol (CBD) (Sativex®) as treatment for symptom improvement in adult patients with moderate to severe spasticity due to multiple sclerosis (MS) who have not responded adequately to other anti-spasticity medication and who demonstrate clinically significant improvement in spasticity related symptoms during an initial trial of therapy, subject to a managed access protocol being implemented.
- As a condition of reimbursement, an individual patient approval system will be put in place by the HSE, to enable reimbursement for patients who meet the pre-defined criteria as per a Medicines Management Programme (MMP) devised managed access protocol. The processes necessary to implement this required managed access protocol (MAP) are currently being developed by the HSE MMP.
The HSE cannot comment on the specific timeline for the HSE approval to be formalised while the processes required to implement the managed access protocol are ongoing.
1340. Deputy Fergus O'Dowd asked the Minister for Health if he will respond to concerns raised in respect of due back payments for retirees in Our Lady of Lourdes Hospital, Drogheda; and if he will seek an update on the matter. [13027/23]
View answerAs this is an administrative matter for the Health Service Executive, I have asked the HSE to respond directly to the Deputy.
1341. Deputy Mark Ward asked the Minister for Health if he will provide an update on the rollout of CAMHS-ID teams across the State; the cost of resourcing one CAMHS-ID team; and if he will make a statement on the matter. [13028/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1342. Deputy Holly Cairns asked the Minister for Health if he will make hormone replacement therapy, HRT, medication free for persons going through menopause; and if he will make a statement on the matter. [13055/23]
View answerThere are no plans to make the provision of hormone replacement therapy (HRT) medications free of charge. However, as announced in Budget 2023, the VAT rate for non-oral forms of HRT was reduced to zero from 1 January 2023.
The Health Service Executive (HSE) has statutory responsibility for pricing and reimbursement decisions under the community drug schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
Some HRT medications are available to medical card holders under the General Medical Services (GMS) Scheme, subject to payment of the statutory prescription charge.
These same HRT medications are also available under the Drug Payment Scheme (DPS). The DPS ensures that no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
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. 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.
Finally, individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
1343. Deputy Réada Cronin asked the Minister for Health the location and number of the minor-injury units referred to in the HSE Care Flowchart; the numbers treated in these dedicated units in tabular form over the past five years (details supplied); and if he will make a statement on the matter. [13061/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1344. Deputy Robert Troy asked the Minister for Health if he will clarify when the Covid bonus payment will be made to a person (details supplied). [13065/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
I would also like to remind the Deputy that it is against Department policy to comment on individual cases.
1345. Deputy Pearse Doherty asked the Minister for Health if he is aware of any issues having been raised with the management of Letterkenny University Hospital by staff regarding staffing levels; and if he will make a statement on the matter. [13074/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1346. Deputy Michael Fitzmaurice asked the Minister for Health when a person (details supplied) in County Roscommon who is a retired HSE staff member and who has not had their pension increased or arrears paid in respect of the National Wage Agreement, will receive this; and if he will make a statement on the matter. [13082/23]
View answerI have asked the HSE to respond directly to the Deputy on this matter.
1347. Deputy Michael Healy-Rae asked the Minister for Health the number of people with Kerry addresses who are currently waiting on outpatient appointments for orthopaedics in UHK, CUH and the South Infirmary Cork; and if he will make a statement on the matter. [13084/23]
View answerIt is recognised that waiting times for many scheduled appointments and procedures were too long before and have been made worse by the Covid-19 pandemic. 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. On 7 March, I published the 2023 Waiting List Action Plan, which is the next stage of a new multi-annual approach to sustainably reduce and reform hospital waiting lists, and builds on the foundational work done through the short-term Waiting List Action Plan between September and December 2021, which was followed by the first full year Waiting List Action Plan for 2022, both having reversed the annual trend of rising waiting lists.
The 2023 Plan sets out the priorities to continue to address waiting lists this year. The 30 actions in the Plan, which are governed by the Waiting List Task Force, focus on delivering capacity, reforming scheduled care and enabling scheduled care reform.
For 2023, funding totalling €443 million is being allocated to tackle Waiting Lists with €363 million of this being allocated to the 2023 Waiting List Action Plan, to implement longer term reforms and provide additional public and private activity to clear backlogs exacerbated during the pandemic. This will reduce hospital waiting lists by 10% in 2023 as well as continuing to significantly reduce waiting times in line with Sláintecare recommendations. The remaining €80 million of the €443 million is being targeted at various measures to alleviate community/primary care waiting lists.
With this ambitious 2023 Waiting List Action Plan, my Department, the HSE and the NTPF are taking the next steps in the multi-annual approach towards achieving our vision of a world-class public healthcare system in which everyone has timely and transparent access to high-quality scheduled care, where and when they need it, in line with Sláintecare reforms.
In relation to the particular query raised by the Deputy, the NTPF have provided the attached information to my Department which outlines the number of people whose area of residence is Kerry and who are on the Outpatient (OPD) waiting list for Orthopaedics in University Hospital Kerry (UHK), Cork University Hospital (CUH) and the South Infirmary Victoria University Hospital, Cork.
|
Number of people waiting for Orthopaedics, Outpatient (OPD) by Area of Residence (AOR) Kerry as at 23/02/2023 |
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|
Hospital |
Total |
|
|
Kerry AOR OP Orthopaedics |
Cork University Hospital |
12 |
|
Kerry AOR OP Orthopaedics |
South Infirmary Victoria University Hospital |
307 |
|
Kerry AOR OP Orthopaedics |
University Hospital Kerry |
999 |
1348. Deputy Pearse Doherty asked the Minister for Health if a timeline will be provided for the implementation of pay increases for staff working in section 39 organisations; if he is aware of the regional imbalance in pay among staff at section 39 organisations; if there is a rationale for this; if there is any plan to address the issue; and if he will make a statement on the matter. [13090/23]
View answerFirstly, I would like to acknowledge the important role that Section 39 organisations and staff play in our health sector. They have a key role in providing services to people with disabilities and older people.
A process of engagement to examine the pay of workers in Community and Voluntary organisations was committed to by the Government in October 2022.
While the Government has committed to a process, it is worth noting that Section 39 organisations are privately owned and run, and the terms and conditions of employment of staff in these organisations are ultimately between the employer and the employee.
The Department notes that this is a cross-sectoral issue and cannot be taken in isolation.
1349. Deputy Pa Daly asked the Minister for Health the guarantees that have been sought by the HSE with respect to public patients in a proposed facility (details supplied). [13091/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1350. Deputy Matt Carthy asked the Minister for Health when legislation will be delivered to provide legal recognition to both parents who have children through surrogacy either in Ireland or abroad; and if he will make a statement on the matter. [13093/23]
View answerAs the Deputy will be aware, the Health (Assisted Human Reproduction) Bill 2022 was introduced to, and passed Second Stage in, the Dáil in March 2022 and has been referred to the Select Committee on Health for Third Stage.
The focus of this Bill is on the regulation, for the first time in this country, of a wide range of assisted human reproduction (AHR) practices undertaken within the jurisdiction.
Following the approval in mid-December 2022 by the Government of the policy approach in respect of both the regulation of international surrogacy and the recognition of certain past surrogacy arrangements (domestic and international) the formal drafting process by the Office of the Parliamentary Counsel, in conjunction with the three Departments, as appropriate, is well underway. These new provisions will need to be approved by Government following the completion of this process.
The process of drafting new provisions is being undertaken in tandem with the drafting of potentially substantial proposed amendments to the 11 Parts and 134 pages of the published Bill. It is intended that the new Parts dealing with international surrogacy, as well as recognition of certain past surrogacy arrangements, will be introduced at Committee Stage.
As the Deputy will appreciate,?I am not in a position at this juncture to give a definitive timeline as to when these new Parts and other proposed amendments will be brought to Committee Stage and the subsequent passage of the Health (Assisted Human Reproduction) Bill though the Houses of the Oireachtas; however, I wish to reiterate my commitment to ensuring both that the goal of providing for a route to formal recognition by the State of past surrogacy arrangements or surrogacy arrangements in other jurisdictions is achieved and that a robust regulatory framework for AHR more broadly is put in place.
1351. Deputy Michael Lowry asked the Minister for Health if patients with hemochromatosis can still be treated in the day ward at Nenagh General Hospital by a person (details supplied); if he will review correspondence from a person and hemochromatosis patient living in Nenagh, County Tipperary; and if he will make a statement on the matter. [13094/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1352. Deputy Ivana Bacik asked the Minister for Health his plans to prescribe dedicated training for HSE-funded personnel administering sexually transmitted infection tests, and providing support to persons living with HIV to ensure that patients do not experience stigma in individual clinics. [13097/23]
View answerThe development of sexual health services is being implemented in accordance with the recommendations set out in the National Sexual Health Strategy 2015 - 2020 and is a priority item for this Government. The Strategy's lifetime was extended to 2022. An independent Review of the Strategy has been completed and will be published on the Healthy Ireland website shortly.
The Strategy will be refreshed, following the publication of the Review, and its recommendations will be taken into account in terms of the development of the new Strategy. The views and recommendations of clinicians, service providers including the HSE Sexual Health and Crisis Pregnancy Programme, academics and representative organisations, amongst others, will be taken into account.
In terms of the details of current and future clinical protocols, healthcare professional training and service provision for those at risk of HIV and living with a positive diagnosis, as this is a service matter,
I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1353. Deputy Ivana Bacik asked the Minister for Health his plans to ensure holistic supports for persons with a HIV+ diagnosis. [13098/23]
View answerThe development of sexual health services is being implemented in accordance with the recommendations set out in the National Sexual Health Strategy 2015 - 2020 and is a priority item for this Government. The Strategy's lifetime was extended to 2022 and an independent Review has been completed and will be published on the Healthy Ireland website shortly.
The prevention of HIV infection and treatment of those who test positive is a priority under the Strategy and other programmes, such as HIV Fast-Track Cities, in which Ireland is participating
Key achievements in relation to HIV prevention and treatment to date include:
- PrEP HIV prevention programme - Implementation of the national roll-out of a HIV pre-exposure prophylaxis (PrEP) programme. PrEP is a medicinal treatment which prevents HIV and is provided to populations at substantial risk of sexual acquisition of HIV, including those with HIV+ partners. Over 2,000 individuals, mostly gay men, are currently registered with the national programme.
- HPV (human papillomavirus) vaccine extension to men and women living with HIV up to and including 26 years; and to gay, bisexual and other men who have sex with men (MSM), including MSM living with HIV. Over 7,400 MSM and people living with HIV have commenced the vaccine to date.
- Online STI (sexually transmitted infection) testing - This service is now available on a national basis and allows people to test for STIs in the comfort and privacy of their own homes, reaching those who may be reluctant to visit an STI clinic in person. The service is free at the point of use, avoiding both cost and stigma related barriers to access and facilitating higher detection rates, thereby preventing both onward transmission of infection and significant morbidity and mortality for those who test positive and who can then access treatment in person.
- Establishment of the National Condom Distribution Service (NCDS) in 2015 - The NCDS functions as a central point for distributing free condoms and lubricant sachets to HSE services and other organisations working directly with individuals and groups who may be at increased risk of negative sexual health outcomes. These include young people; migrants; gay, bisexual and other men who have sex with men; sex workers; people living with addiction issues and people living with HIV.
- Over 2 million condoms and over 1 million lubricant sachets have been ordered by 155 organisations since the NCDS was launched. Products are available through public sector bodies, including STI clinics, hospitals, and HSE health promotion & improvement, third-level institutions, public STI clinics, and NGOs. Funding has been provided through Budget 2023 to expand the NCDS to GPs, family planning clinics and other primary care service providers who are also providing any of the following services: PrEP, HIV/STI testing, the free contraception scheme and/or termination of pregnancy.
- In 2019, Ireland’s four main cities (Cork, Dublin, Galway and Limerick) signed up to the HIV Fast-Track Cities Initiative, committing to fast-track city-level responses to HIV, as part of a global partnership to end the HIV epidemic. One of the targets of the Fast-Track Cities Initiative is Zero stigma and discrimination. Ending stigma is also one of the core targets set out in the Sustainable Development Goals.
- The Fast-Track Cities Initiative is led by the HSE Sexual Health & Crisis Pregnancy Programme (SHCPP) who received funding from the Department of Health in 2019 to kick-start the initiative and included the development of a national campaign to address HIV-related stigma.
- Comprehensive information on HIV testing, treatment, how to access services and other matters relating to sexual health and wellbeing is available through www.sexualwellbeing.ie.
In relation to the details of HIV treatment and supports for those with positive diagnoses, as this is a service matter, I have also asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1354. Deputy Neasa Hourigan asked the Minister for Health if he will provide an update on the review of the legislation the Health (Regulation of Termination of Pregnancy) Act 2018; when this will be published; and if he will make a statement on the matter. [13122/23]
View answerThe Minister can confirm that he has received the Report of the Review of the operation of the Health (Regulation of Termination of Pregnancy) Act 2018.
The Report assesses whether services mandated under the Act are being delivered and makes certain recommendations in relation to service improvement.
The Minister will review this comprehensive Report and make the necessary arrangements to submit it for the consideration of the Government.
1355. Deputy Pauline Tully asked the Minister for Health if the National Treatment Purchase Fund can be availed of for those seeking an assessment of need; and if he will make a statement on the matter. [13125/23]
View answer1356. Deputy Pauline Tully asked the Minister for Health the average waiting time for reimbursement under the National Treatment Purchase Fund; and if he will make a statement on the matter. [13126/23]
View answer1357. Deputy Pauline Tully asked the Minister for Health if he will consider altering the National Treatment Purchase Fund to remove the onus on patients availing of this scheme from having to pay up front for the cost before claiming this back and instead allow payment to come directly from the NTPF; and if he will make a statement on the matter. [13127/23]
View answerI propose to take Questions Nos. 1355, 1356 and 1357 together.
The National Treatment Purchase Fund was established under the Health (Corporate Bodies) Act 1961, with the function of providing hospital treatment for citizens and the collection and validation of information in relation to waiting lists. Its role was extended in 2009, via the Nursing Home Support Scheme Act 2009, to provide for negotiations with private nursing homes in the context of fees payable for Fair Deal Clients.
In providing treatment the NTPF works with public hospitals, as opposed to patients directly, to offer and provide the funding for treatment to clinically suitable long waiting patients. Treatment can be provided in either public or private hospitals but in either case the NTPF deals directly with the hospital concerned to arrange payment for the treatment provided. Individual patients do not have to pay for treatment provided.
As noted above under its establishment legislation the NTPFs remit is to provide hospital treatment only and it has not statutory remit to arrange or fund any non-hospital services, incluidng assessments of need for patients.
