Written Answers Nos. 193-212
193. Deputy Johnny Guirke asked the Minister for Health the measures being taken to ensure CervicalCheck participation rates reach 80% compliance, as per the National Cancer Strategy targets; and if he will make a statement on the matter. [15589/23]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
194. Deputy Johnny Guirke asked the Minister for Health the number of individuals who received an invitation to take part in CervicalCheck on a quarterly basis from Q1 2020 and to date in 2023; the percentage of individuals who accepted an invitation and subsequently attended a screening appointment in each of the specified months; and if he will provide that information in tabular form. [15590/23]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
195. Deputy Johnny Guirke asked the Minister for Health the total annual spend on CervicalCheck in each of the years 2018, 2019, 2020, 2021 and 2022; and if he will make a statement on the matter. [15591/23]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
196. Deputy David Cullinane asked the Minister for Health the level of outstanding inpatient charges owed to the health service and the number of patients this relates to; if there will be debt forgiveness for this following the abolition of inpatient charges; if he will continue to employ the use of debt collectors against these patients; and if he will make a statement on the matter. [15592/23]
View answerAs this is an operational matter for the HSE, it has been referred to them directly
197. Deputy Mairéad Farrell asked the Minister for Health if he is aware that no dentist in Galway now accepts medical cards; and if he will outline what steps he is taking to address this; and if he will make a statement on the matter. [15600/23]
View answerThe Dental Treatment Services Scheme (DTSS) provides dental care, free of charge, to medical card holders aged 16 and over. Since May 1st 2022, there has been additional prevention treatments included and a 40-60% increase in fees across most treatment items. Since these measures came into effect, both the numbers of treatments and patients being seen have increased.
The HSE has advised that there are dentists in Galway who are providing care to DTSS patients - 40 DTSS contractors submitted claims under the DTSS in February 2023. However, I am aware that there are some towns with no or limited DTSS dentists that have sufficient capacity to accept new patients. Where access to a dentist is difficult, local HSE services assist patients who make enquiries and make lists of DTSS contractors available to medical card holders. In exceptional circumstances, the HSE assists patients to access emergency dental treatment by directly contacting private contractors or arranging treatment to be provided by HSE-employed dentists.
An additional allocation of €15 million has been made in Budget 2023 to enhance the provision of oral healthcare services. This includes €5 million allocated on a one-off basis to support the HSE Public Dental Service to provide care this year, including through a HSE ‘safety-net’ service for adult medical card holders who are in need of emergency care and are still having difficulty accessing a local dentist.
The Government recognises that substantive reform of the DTSS is required, as set out in the National Oral Health Policy. The Department is working closely with the HSE to ensure the establishment of focused implementation structures for the Policy to drive implementation. These implementation structures include the need for new clinical leadership and reform leadership posts in the HSE for which resources will be provided. These implementation structures will help to substantively reform the provision of public oral healthcare services to all ages, in line with the National Oral Health Policy. This will include work on planning new services for medical card holders.
While it will take a number of years to bring reform to complete fruition, there will be an early emphasis in implementation on addressing the current issues, including the reform of the provision of services for medical card holders.
198. Deputy Róisín Shortall asked the Minister for Health if his attention has been drawn to a proposal from the Irish Pharmacy Union (details supplied); his views on same; and if he will make a statement on the matter. [15653/23]
View answerThe Department of Health recognises the key role of Pharmacy in the Community, and the potential role that pharmacy may play in the development and implementation of future healthcare reform, especially in regard to the aims and vision of Sláintecare.
The Department has recognised and appreciated the ongoing significant contribution made by this sector to patients and the public, particularly during the pandemic and would wish to explore and realise any and all opportunities to build on this.
I note the submission provided and appreciate that officials within my Department are considering the issues raised. I last met with representatives of the Irish Pharmacy Union on the 24 November 2022 where they outlined their considerations around the potential scope of the pharmacy sector to enhance healthcare service delivery. My officials are continuing to engage directly with the IPU in relation to matters raised. The Department is open to exploring any evidence based appropriately governed services, delivered by appropriately trained professionals which will support the delivery of the right care, in the right place at the right time.
199. Deputy Niamh Smyth asked the Minister for Health the reason pharmacies are struggling to issue prescriptions for essential drugs for patients on long-term essential medication, namely, valsartan and Krka; and if he will make a statement on the matter. [15660/23]
View answerThe Department of Health has been advised by the Health Products Regulatory Authority (HPRA) of one current shortage of a valsartan-containing medicine (Valsartan 160mg Film-Coated Tablets) from Accord, the company responsible for supplying the product in Ireland. The company has stated that the shortage is due to a manufacturing issue and is expected to return in September 2023. Alternative strengths, presentations, and generic medicines are available to ensure continuity of care. A pharmacist can generically interchange most brands of valsartan-containing products without needing additional prescriber involvement.
For clarity, KRKA is a pharmaceutical company. The only current shortage from the company KRKA is for Ezetimibe Krka 10 mg tablets, a medicine used to treat high cholesterol. There are alternative products available to ensure continuity of care.
Unfortunately, medicine shortages are a feature of modern health systems worldwide which have been exacerbated by recent worldwide events. There are a multitude of reasons why a medicine may not be available including: shortages of raw materials; manufacturing difficulties; sudden unexpected increase in demand; or product recalls due to potential quality issues. Ireland has a multi-stakeholder medicine shortage framework in place, coordinated by the HPRA, to prevent, wherever possible, and to manage medicine shortages when they occur. The HPRA maintains regular contact with the Department of Health regarding medicines shortages.
The HPRA publishes a list of medicines currently in short supply on its website (Medicines Shortages (hpra.ie) 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.
200. Deputy Carol Nolan asked the Minister for Health the actions that termination of pregnancy providers, including GPs and community providers, must take in instances where they suspect coercion in a request for a termination of pregnancy; the steps being taken to ensure that termination of pregnancy providers can identify possible instances of coercion; and if he will make a statement on the matter. [15674/23]
View answerMedical practitioners are obliged to comply with the Medical Council’s Guide to Professional Conduct and Ethics. The Guide includes information on the principles underpinning consent and the importance in ensuring that patients have given full and informed consent prior to a procedure or examination. The HSE’s National Consent Policy, revised in December 2022 also contains extensive guidelines for health practitioners and includes information on decisions made under duress. These apply to all medical procedures.
In relation to termination of pregnancy services in the community, on April 6th 2020 the Model of Care for Termination of Pregnancy was revised temporarily for the duration of the COVID-19 public health emergency to facilitate remote consultation in early pregnancy. No formal research or analysis on remote consultation has been conducted in Ireland however, there has been positive feedback from providers and patients and there is strong evidence from published literature in the UK and Europe that remote provision of abortion care is safe and effective. In light of the easing of Covid-19 restrictions in Q4 of 2021, the Department requested the HSE to revisit the Model of Care to review its operation and consider whether it should be retained going forward.
This review has shown that including remote consultation as part of the termination of pregnancy service is safe, effective and acceptable to both service users and providers. It improves access for many women and addresses geographical and logistical barriers. It also alleviates some of the difficulty associated with the mandatory 3-day waiting period. Availability of remote consultation places the woman at the centre of the process and supports her reproductive autonomy. There is a growing body of evidence that telemedicine use in termination of pregnancy care has outcomes that are consistent with in-person care and it is now becoming normalised in many other countries. The majority of providers feel that a blend of remote and in-person care is optimal. Timely access to care, as close to home or the community as possible is a key principle of the vision of Sláintecare. The review of the changes to the Termination of Pregnancy model of care adopted during the pandemic is an appropriate and timely initiative. The Department is continuing its engagements with the HSE regarding the final considerations, vis-a-vie adopting the blended model as the enduring model of care for termination of pregnancy services. The outcome of the review will be made available once this deliberative process concludes. In the meantime, it is important to reflect that the temporary model of care, along with the relevant public health advice remain in place.
201. Deputy Kathleen Funchion asked the Minister for Health if he will clarify what healthcare facilities in counties Carlow and Kilkenny are still waiting on the pandemic payment, as some staff in Camphill communities are still awaiting payment. [15675/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
202. Deputy Niall Collins asked the Minister for Health if he will extend a scheme (details supplied); and if he will make a statement on the matter. [15686/23]
View answerThe Scheme the Deputy is referring to is due to conclude on 30th June this year. I have asked officials from my Department to examine options that may provide continuing support to staff in this regard.
203. Deputy Brendan Griffin asked the Minister for Health if he will provide details of the current average waiting times for urgent and routine paediatric neurologists' appointments in each of the seven hospital groups; and if he will make a statement on the matter. [15690/23]
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 the 7th 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, the National Treatment Purchase Fund has advised my Department that it only collects data on patients currently on the waiting list. The time to treatment of patients who have already received their care is not collected. As a result, the health system does not have the data necessary to calculate true average wait times. The table attached outlines the average time by hospital group that the children currently on the waiting list for a neurology outpatient appointment have been waiting.
205. Deputy Neasa Hourigan asked the Minister for Health if he has engaged with the relevant stakeholders in relation to the Oireachtas Joint Committee on Justice Report on an Examination of the Present Approach to Sanctions for Possession of Certain Amounts of Drugs for Personal Use recommendation that 'the practice of cultivation of currently illicit substances at a modest, non-profit level be examined in light of above recommendations in order to regulate such activity'; and if he will make a statement on the matter. [15702/23]
View answerAs the Deputy is aware the cultivation of scheduled one controlled drugs for personal use is contrary to the provisions of the Misuse of Drugs Act.
In his foreword to the report, the Cathaoirleach of the Justice Committee stated that "The Committee has made a number of recommendations for these areas and a copy of this report will be sent to the Minister for Justice. The Committee looks forward to working proactively and productively with the Minister to engage with the issues and recommendations identified within its report".
As this report is intended for the Minister for Justice it is not appropriate for the Department of Health to offer comment on it.
206. Deputy Patricia Ryan asked the Minister for Health if he will ensure the HSE provides a dedicated funding line to deliver the necessary health and mental health support required to assist homeless people with complex needs.; and if he will make a statement on the matter. [15725/23]
View answerThe Programme for Government commits to addressing the health needs of people who are homeless. This includes the development of health and social interventions, based on an inclusion health approach, to target people who are homeless and with complex needs and to ensure a dedicated funding line and resources to deliver the necessary health and mental health supports for this population group.
Housing for All, the national housing plan, sets out the Government policy for reducing and preventing homelessness. It commits to a housing-led approach as the primary response to all forms of homelessness. It acknowledges that suitable housing conditions are a key social determinant of health and that collaborative delivery of housing and health supports are an integral component of a return to independent living. The plan contains five actions to support the health needs of people are homeless., which build on the co-ordination and actions developed to minimise the impact of Covid-19 on people who are homeless, including individual healthcare plans, tailored drug and alcohol treatment services and mental health supports, especially for rough sleepers.
In 2022, the HSE expenditure for health and mental health supports for people who are homeless was €50,116,409. This includes ‘in-reach’ service in emergency accommodation, integrated care and case management, and addiction and mental health supports, along with additional measures as part of the public health response to Covid-19 and the Housing First national implementation plan.
This figure is likely an underestimation on what is spent on services that people who experience homelessness can avail of, as certain services categorised as “addiction” would be also serving people experiencing homelessness. Additionally, the figure does not include a range of HSE funded general health services which homeless persons avail of including: acute hospital inpatient/outpatient services; Primary Care services, HSE mental health services.
In 2023, the Department has allocated an additional €1.3 million to provide wrap around health supports for up to 270 new tenancies under the Housing First national implementation plan. Further details on this and other measures to enhance access to healthcare services for people who are homeless will be set out in the forthcoming HSE national service plan 2023.
I am committed to continuing to provide dedicated funding and resources to deliver the health, addiction and mental health services to meet the complex needs of people who are homeless.
207. Deputy Patricia Ryan asked the Minister for Health the number of advanced nurse practitioners available in older persons services in CHO 7; and if he will make a statement on the matter. [15726/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
208. Deputy Patricia Ryan asked the Minister for Health the reason sertaline is no longer available on medical card to the most vulnerable people with mental health needs; and if he will make a statement on the matter. [15727/23]
View answerThe Health Service Executive (HSE) has statutory responsibility for pricing and reimbursement decisions under the community schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. Therefore, this matter has been referred to the HSE for attention and direct reply to the Deputy.
209. Deputy Patricia Ryan asked the Minister for Health how people on medical cards can be charged extortionate amounts of money for generic medicines as they are told the original form is out of stock. [15728/23]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes.
The 2013 Act permits community pharmacists to dispense generic medicines where a brand name medicine has been prescribed, provided they have been designated as interchangeable by the Health Products Regulatory Authority.
Under the 2013 Act, pharmacists are obliged to offer the lowest cost product on interchangeable list. Reference pricing means a single reimbursement price, or reference price, for a group of interchangeable medicines that are on the reimbursement list. This is the maximum price that the HSE will pay community pharmacies for all medicines in this group, regardless of the individual medicines’ price.
Under the 2013 Act, all marketing authorisation holders must apply to the HSE to add their medicine onto the reimbursement list. If a generic manufacturer chooses not to apply to the HSE, their medicine will not be listed for reimbursement by the HSE under the community drug schemes.
Exempt Medicinal Products (EMPs), which are not licensed by the Health Products Regulatory Authority or European Medicines Agency, may be available on an exceptional basis under Discretionary Hardship Arrangements and the Drugs Payment Scheme (DPS).
210. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Questions Nos. 403 and 404 of 8 February 2023, to respond to matters raised in correspondence (details supplied); and if he will make a statement on the matter. [15739/23]
View answerThe Minister sanctions the Health Sector Consolidated Salary Scales in accordance with the FEMPI Acts, the Public Service Agreements and the Public Service Pay and Pensions Act 2017. Only grade codes included in the Health Sector Consolidated Salary Scales may be used to remunerate Health Sector Staff.
As the HSE provided the answer to Parliamentary Questions 403 and 404 of 8th February 2023, and this is a follow up question, I am referring to the HSE to reply directly to the Deputy.
211. Deputy Brendan Griffin asked the Minister for Health the number of children currently awaiting urgent and routine paediatric neurologist appointments in the South/South West Hospital group; and if he will make a statement on the matter. [15743/23]
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 the 7th 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, the National Treatment Purchase Fund has provided my Department with the attached table which outlines the number of children awaiting an initial outpatient appointment for neurology in the South/South West Hospital Group by time-band at the end of February 2023.
212. Deputy Violet-Anne Wynne asked the Minister for Health further to Parliamentary Question No. 348 of 9 March 2023, the effect the relocation of homebirth services from community operations to acute operations will have on rural women; and if he will make a statement on the matter. [15780/23]
View answer213. Deputy Violet-Anne Wynne asked the Minister for Health further to Parliamentary Question No. 348 of 9 March 2023, what significant additional investment has been made to assist integration and the delivery of safe and high-quality care; and if he will make a statement on the matter. [15781/23]
View answerI propose to take Questions Nos. 212 and 213 together.
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible
