Written Answers Nos. 268-285
269. Deputy Peter Burke asked the Minister for Health if following the National Maternity Strategy, if a national policy has been agreed on the role of GPs in relation to homebirths; if a review of the maternity and infant scheme has taken place in relation to homebirths; and if he will make a statement on the matter. [20994/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
270. Deputy Louise O'Reilly asked the Minister for Health if he is aware of the impact of inflation on breast feeding baby formula which has increased by up to 25%; if he is also aware of reports by the European Central Bank that corporate profiteering has been one of the biggest contributors to price increases; what options are available to help parents in the face of these price hikes; and if he will make a statement on the matter. [20996/23]
View answerThe Department of Enterprise, Trade and Employment have advised that current geopolitical events, including Russia’s illegal invasion of Ukraine, have led to a complex and uncertain environment that is impacting economies around the world and affecting people in their daily lives.
In its reports, the European Central Bank (ECB) indicates that recent high inflation is due to increased energy prices and supply chain issues (which impact import charges), resulting in a loss of real income for both households and businesses. The ECB states that it is closely monitoring any exploitation of the uncertainty created by high and volatile inflation and supply-demand mismatches. The ECB predicts that over the coming years growth in profit margins and wages will moderate as a result of its efforts to lower inflation and that this will have a knock-on effect on product prices.
The increase in commodity prices such as oil, energy and grain has resulted in increases on the sale price of a number of core products such as milk, butter and bread. However, a recent study by consultants Kantar is showing that the rate of food inflation in Ireland has dropped slightly for the first time in two years, for the period February to April. This compares to Eurostat figures for the Eurozone area which shows inflation rose to 7% in April. While this is positive news for Ireland, it does little to ease the concerns of people and their families who are faced with increased costs in their everyday purchases.
Traders in Ireland are free to set and change their prices for goods and services. In general, there are no limits to the prices that a trader can set and the level of profits they make. There is no legislation explicitly stating what the maximum or the minimum price for any product or service should be (the one exception is minimum unit pricing for alcohol). Such an approach aims to promote competition amongst retailers and service providers.
Sections 61 and 62 of the Consumer Protection Act 2007 provide for the setting of maximum prices for products, to be specified, for sale to consumers (not businesses). These powers date back to when Ireland ceased World War II rationing and they have not been availed of since their enactment. Such price controls are regarded as a blunt instrument which could have serious economic impacts for individual traders and Ireland as a whole. For goods or services that are imported, or where domestic production has a high import content, the effect would be reduced supply. In other cases, the risk lies in the medium-term effects on competition in the marketplace and supply chains.
This Government remains committed to helping protect the most vulnerable, families and businesses from the rising cost of living and introduced measures to the value of €12 billion to help ease the burden of inflation. Household transfers, including electricity credits, account for around half of the overall fiscal response, with tax measures accounting for one-third and the remainder is composed of business and other expenditure supports.
On an ongoing basis, the Government responds to price increases by seeking to prevent any abuse of market power by companies. In this regard, it is illegal for competing businesses to form a cartel - that is, an agreement to fix prices - or to agree a common pricing policy or to carve up a market in order that they do not have to compete. It is also illegal for businesses to share information about their future pricing intentions. Wholesalers may not dictate the retail prices charged for their products by independent retailers. As long as businesses do not collude, however, they are free to set their own prices and may observe their competitors' prices and adjust their own prices accordingly.
The Competition and Consumer Protection Commission (CCPC) is responsible for ensuring that prices are set independently by competing businesses by enforcing laws that mean there is competitive pressure on businesses to set prices at a level that will attract customers. Where appropriate, the CCPC investigates suspected breaches of competition or consumer protection law and takes enforcement action if the investigation uncovers sufficient evidence of a breach.
A priority for both the Department of Health and the HSE is to encourage more mothers to breastfeed. National health policy, including the Healthy Ireland Framework, the National Maternity Strategy, the Obesity Policy and Action Plan, and the National Cancer Strategy, emphasise the importance of supporting mothers who breastfeed, as well as taking action to increase breastfeeding rates in Ireland.
It is important that children get the best possible start in life, and this is something all Government partners have prioritised, as stated in the Programme for Government.
Breastfeeding can improve child and maternal health, as well assist in achieving reductions in childhood obesity and chronic diseases.
Breastfeeding also has the benefit of avoiding, either totally or in part, the costs associated with the use of breast milk substitutes. The HSE Breastfeeding in a Healthy Ireland Action Plan is the framework for progressing supports for breastfeeding in Ireland.
In May 2021, Minister Donnelly announced additional annual funding to the HSE of €1.58 million to fund 24 additional lactation consultants, thereby providing support to every maternity unit in the country.
The HSE is actively engaged in enhancing lactation supports, both through these dedicated infant feeding positions and through the implementation of training for all practitioners who provide advice and support in infant feeding as part of their wider service roles.
As part of our work on obesity, food and nutrition, this Department is represented on a Food Poverty group which is led by the Department of Social Protection.
271. Deputy Louise O'Reilly asked the Minister for Health if the staff at health facility (details supplied) are entitled to the pandemic special recognition payment; and if so, when they will receive said payment. [20997/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
272. 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. [20998/23]
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.
273. Deputy Cathal Crowe asked the Minister for Health the steps his Department has taken for rural Ireland since 2020. [21003/23]
View answerThis Government has delivered unprecedented levels of investment in our Health service in recent years, the net core funding allocation for our health services increased from €17.9 to €22.8 billion – that is €4.9 billion more, or a 27% increase in core funding between 2020 and 2023.
€236 million revenue and €40 million capital expenditure was provided nationally as part of the 2020/21 Winter Plan and Budget 2021 to fund an additional 1,146 acute inpatient beds, excluding critical care beds, on a permanent basis in our acute hospitals, representing a significant step towards achieving the recommendations in the 2018 Health Service Capacity Review.
As of 16 March 2023, 970 additional beds have been opened since 2020. 970 beds have been opened nationally since 1st January 2020. Of these, 516 were opened in 2020, 297 were opened in 2021, and 157 opened in 2022.
Adult critical care capacity now stands at 323 beds. This represents a very significant increase of 65 beds, or 25%, over the 2020 baseline of 258 beds. To put that in perspective, we had a total net increase of 18 beds in the three years 2017, 2018 and 2019. And more are planned – the HSE plan to add a further 29 more beds this year, bringing our critical care capacity to 352 beds by the end of this year.
Successive Winter Plans have also supported acute and community services nationwide to respond to high levels of emergency attendances and admissions across the acute sector, long waiting times in Emergency Departments (EDs) and high occupancy rates across acute hospital settings.
Furthermore, my department is continuing to engage with the HSE to ensure the timely delivery of the new Elective Hospitals in Cork, Dublin, and Galway. These Elective Hospitals will specifically cater for low complex and high-volume cases and when established will provide close to one million procedures annually. This will represent real change, helping us to utilise our resources more efficiently by separating scheduled and unscheduled care. It is expected that these Elective Hospitals will commence providing care by the end of 2027.
The National Screening Services (NSS) provide a national service, running four free population-based screening programmes in community settings across the country. Equitable access to population-based screening throughout Ireland, including rural Ireland, is a priority for the NSS. The NSS work continually to ensure all eligible people can access their services, as outlined in their recently-published 5-year strategic plan, Choose Screening.
Under the plan there are a number of objectives aimed at improving equity and participation in screening programmes to reduce health inequalities. The NSS are developing an Equity Framework, which will further ensure everyone has a chance to use population-based screening services. In addition, the NSS programmes are supported annually by large-scale communications campaigns in local and national media and social and digital media which seek to target people in the eligible age range in all areas of the country, including rural Ireland.
Information materials are also provided in up to 22 different languages, including multilingual videos for people for whom English is not their first language, and in easy-read format, in their drive to create more equitable access to information. Each of the four programmes is supported by an Access Officer, who enable greater access to services across the country. Their Equity Report details the recent work increasing access to screening for people in hard-to-reach communities.
The NSS runs four national screening programmes which are delivered equally for people living across Ireland:
• BreastCheck offers all women between the ages of 50 and 69 a breast cancer test (a mammogram) every two years. The programme aims to screen everyone as close as possible to where they live and have 4 screening units and 24 mobile clinics across the country. They have recently introduced three additional mobile units to provide further access for local communities.
• CervicalCheck provides free cervical screening tests to women and people with a cervix. The programme has over 4,500 sample takers nationwide. Women can go for screening to any of their registered providers, available on www.hse.ie/cervicalcheck.
• BowelScreen aims to reduce people’s chance of developing bowel cancer by detecting and removing pre-cancerous polyps in the lining of the bowel. It is a free, at-home test which is delivered equitably to people aged 60 to 69 living in Ireland. Over the past 3 years the programme has opened two new follow-up endoscopy units, one in Waterford and one in Mayo.
• Diabetic RetinaScreen provides eye screening for people from age 12 who have Type 1 or Type 2 diabetes. An estimated 225,000 people in Ireland have diabetes. The programme invites people with diabetes to a diabetic retina screening units in their local area. They have 150 screening locations nationally, see www.hse.ie/diabeticretinascreen. In 2021, the programme extended the surveillance pathway for patients requiring follow-up investigations, reducing the number of hospital visits for people and moving their clinics into the community. In 2023 they are rolling out a new community screening option for women in pregnancy who have Type 1 and Type 2 diabetes.
The development of primary care services – alongside social and community care more broadly – is central to this Government's determination to deliver a high-quality, integrated and cost-effective health care system.
The provision of modern, fit-for purpose primary care infrastructure is essential to the shift in care from acute hospitals and into our communities. The development of Primary Care Centres is tangible evidence of this Government’s commitment to the expansion of Primary Care across the country. As of Q1 2023, there were 167 Primary Care Centres nationwide. These Primary Care Centres serve local communities right across the country, with 139 PCCs located outside Dublin.
In Budget 2023, annual investment of €195m was secured to enable the continued expansion of primary care services through the Enhanced Community Care (ECC) programme. This continued level of investment in primary care reform is unprecedented and is intended to address historical capacity deficits in the sector and is a key element of wider reforms being implemented to deliver on Sláintecare and the promise of care being delivered in the right place, at the right time, and as close to home as possible. The ECC programme includes a number of different elements that will bolster primary care services across the country.
Amongst other initiatives, the funding is facilitating the rollout of 96 Community Healthcare Networks (CHNs) to be completed and enabling the continued development of 30 Community Specialist Teams for Older Persons, and 30 Community Specialist Teams for the Management of Chronic Diseases. To date, over 2,6200 staff have been recruited to the Programme, with full recruitment to be completed this year.
CHNs in particular are central to the development of enhanced and improved primary care services, with each network consisting of between 4 and 6 primary care teams serving a local population of around 50,000.
The CHNs implement a population needs and stratification approach to service delivery and the services which these networks provide locally to patients are crucial to enabling those requiring care, such as older persons, to live more independently in their community, by co-ordinating and integrating services and allowing care to be delivered as close to home as possible for as long as possible.
94 of the planned 96 CHNs are operational nationwide, alongside 44 Community Specialist Teams for Older Persons and Chronic Disease Management. We have also ensured nationwide coverage with 21 Community Intervention Teams fully operational since 2021, and these continue to be expanded this year.
This Government also continues to work to increase the number of GPs practising in the State so that patients across the country, including those in rural areas, have access to GP services. Over the lifetime of the 2019 GP Agreement (2019-2023) the annual expenditure provided for general practice has been increased by over €210m. The Agreement provides for, amongst other things, a 10% increase in rural GP practice supports, significant increases in capitation fees for participating GMS GPs, new fees and subsidies for additional services, and improvements to GP’s maternity and paternity leave.
In addition, the number of doctors entering GP training has increased from 193 in 2019 to 258 in 2022; a further increase to 285 is intended for this year rising to a planned 350 training places for new entrants per year by 2026.
274. Deputy Patricia Ryan asked the Minister for Health the number of surgery's cancelled in Tullamore Hospital in January, February and March 2023; and if he will make a statement on the matter. [21015/23]
View answerI fully acknowledge the distress and inconvenience for patients and their families when elective procedures are cancelled, particularly for clinically urgent procedures. While every effort is made to avoid cancellation or postponement of planned procedures, the HSE has advised that planned procedures and operations can be postponed or cancelled for a variety of reasons including capacity issues due to increased scheduled and unscheduled care demand.
Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.
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.
275. Deputy Patricia Ryan asked the Minister for Health if ozempic will be made available to medical card patients who have had gastric by-pass/sleeve surgery and who are regaining weight due to lack of consultation since Covid; and if he will make a statement on the matter. [21016/23]
View answerThe Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines under the Community Drug Schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013. Reimbursement is for licensed indications which have been granted market authorisation by the European Medicines Agency (EMA) or the Health Products Regulatory Authority (HPRA).
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. 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.
Ozempic® (Semaglutide) was approved by the HSE in 2018 for addition to the reimbursement list for the treatment of diabetes. Ozempic® (Semaglutide) has not been approved for reimbursement for any other indication. Reimbursement support for Ozempic® (Semaglutide) for the treatment of diabetes only is available to those with eligibility under the General Medical Services (GMS) Scheme or the Long-Term Illness (LTI) Scheme.
276. Deputy Patricia Ryan asked the Minister for Health if he will expedite surgery for a person (details supplied). [21018/23]
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.
277. Deputy Patricia Ryan asked the Minister for Health the reason utrogesten 100ml tablets are no longer available under the DPS; and if he will make a statement on the matter. [21019/23]
View answerThe Health Service Executive (HSE) has statutory responsibility for medicine pricing and reimbursement decisions, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013.
Reimbursement is for licensed indications which have been granted market authorisation by the European Medicines Agency (EMA) or the Health Products Regulatory Authority (HPRA).
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.
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 Utrogestan 100mg capsules, which contain progesterone, is an Exempt Medicinal Product (EMP). However, due to the unmet clinical need, this product is reimbursable under an exceptional arrangement on the community drug schemes, including the Drug Payment Scheme (DPS). This arrangement enables practitioners to prescribe a EMP under that practitioner’s direct responsibility, in order to fulfil the special needs of that specific patient.
For reimbursement support under the community drug schemes, EMPs must be consultant initiated. The HSE will accept a GP prescription subsequent to the initial consultant’s prescription for approved patients.
278. Deputy Patricia Ryan asked the Minister for Health how many psychiatrist positions and how many mental health nurses are available to persons in the Athy area of south County Kildare. [21020/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
279. Deputy Patricia Ryan asked the Minister for Health what funding is available for mental health services in the Athy area of south County Kildare . [21021/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
280. Deputy Patricia Ryan asked the Minister for Health if the home support legislation which provides home care supports for all will make sure older people are equal in inclusion of supports (details supplied); and if he will make a statement on the matter. [21022/23]
View answerWork is ongoing in my Department to progress the development of the new home support scheme within the broader context of the ongoing reform of our health and social care system, as envisaged in the Sláintecare Report. The scheme will provide equitable access to high-quality services based on a person’s assessed care-needs.
My Department is currently developing a regulatory framework for home-support providers with the aim of ensuring that all service-users are provided with high-quality care. This framework will comprise primary legislation for the licensing of providers, secondary legislation in the form of regulations (minimum requirements), and HIQA national standards. The statutory home support scheme will incorporate a reformed model of service-delivery, which will include the roll out of interRAI as the standard care needs assessment tool.
281. Deputy Patricia Ryan asked the Minister for Health if staff in an organisation (details supplied) will be included in Covid funding; if so, when they will receive their payments, given staff continued to provide a full range of services on behalf of the HSE to service users during the pandemic; and if he will make a statement on the matter. [21024/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
282. Deputy Róisín Shortall asked the Minister for Health the reasons for the further delay to the HSE Home Support Tender 2023; the steps he is taking to ensure that the tender is not delayed any further; and if he will make a statement on the matter. [21034/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
283. Deputy Róisín Shortall asked the Minister for Health the funding proposals he has considered for the HSE Home Support Tender 2023; and if he will make a statement on the matter. [21035/23]
View answerThe existing tender for home support services was extended by the HSE at the end of 2022 and is now due to expire at the end of April. The process of developing the new tender is underway. Officials in the Department are engaging at a senior level with the HSE. HSE has ongoing engagements with home care providers to progress the new tender. No final decisions on the tender content have been reached. The HSE has proposed an extension of the existing contract arrangements to allow further time to finalise tender arrangements.
284. Deputy Róisín Shortall asked the Minister for Health his plans to make orally inhaled levodopa (details supplied) available under the long-term illness scheme to treat Parkinson’s symptoms; and if he will make a statement on the matter. [21038/23]
View answerThe Health Service Executive (HSE) has statutory responsibility medicine pricing and reimbursement decisions, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013.
Reimbursement is for licensed indications which have been granted market authorisation by the European Medicines Agency (EMA) or the Health Products Regulatory Authority (HPRA).
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.
The HSE has not, to date, received a pricing and reimbursement application for Inbrija® (levodopa) inhalation powder capsules.
Therefore, reimbursement support for Inbrija® is not available under any community drug schemes, including the Long Term Illness Scheme.
285. Deputy Paul Kehoe asked the Minister for Further and Higher Education, Research, Innovation and Science when funding for an organisation will be released (details supplied); and if he will make a statement on the matter. [20909/23]
View answerI understand that Ramsgate Men’s Shed has applied to Waterford and Wexford Educational and Training Board (WWETB) for funding under the 2023 REACH Fund which places a strong focus on community education as a mechanism to continue to support and engage with disadvantaged learners. In addition, there is a focus on enabling the investment in building the digital infrastructure of providers and their capability to ensure that online learning/blended learning can be delivered in a way that meets the complex needs of learners.
I understand that WWETB is reviewing the applications received under its Call for Proposals under the 2023 REACH Fund. Applicants will be advised on the outcome of their applications on completion of this review.
