Written Answers Nos. 584-598
584. Deputy Neasa Hourigan asked the Minister for Health if current security arrangements for Millfield House, Blackpool, are expected to continue indefinitely or for a fixed timeframe; if the security arrangement will also apply to the independent living pods near Millfield House that recently received planning approval from Cork City Council; if so, if the current security costs will increase; and if he will make a statement on the matter. [21218/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
585. Deputy Catherine Murphy asked the Minister for Health if he has engaged with a person (details supplied) in respect of their request. [21224/23]
View answer596. Deputy Réada Cronin asked the Minister for Health if the case of a person (details supplied) will be urgently examined and the executive's discretion used urgently in view of the circumstances; and if he will make a statement on the matter. [21275/23]
View answerI propose to take Questions Nos. 585 and 596 together.
The 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 Minister for Health has no role in these decisions.
The HSE considers the NCPE assessment, the outputs from commercial engagements, patient interest group submissions, and any other pertinent information in advance of making a reimbursement decision.
Sacituzumab govitecan (Trodelvy®) is indicated as monotherapy for the treatment of adult patients with unresectable or metastatic triple-negative breast cancer who have received two or more prior systemic therapies, including at least one of them for advanced disease.
The NCPE Rapid Review assessment report was received by the HSE on the 8th March 2022.
The NCPE advised the HSE that a full Health Technology Assessment (HTA) was recommended to assess the clinical effectiveness and cost effectiveness of Sacituzumab govitecan (Trodelvy®) compared with the current standard of care.
The HSE commissioned a full HTA on the 1st April 2022 as per agreed processes.
The NCPE completed the HTA on the 23 March 2023 and recommended that Sacituzumab govitecan (Trodelvy®) be considered for reimbursement if cost-effectiveness can be improved relative to existing treatments (see www.ncpe.ie/drugs/sacituzumab-govitecan-trodelvy-hta-id-22007/).
The provision of medicines which are not on the reimbursement list can be made by the HSE under Discretionary Hardship Arrangements, as provided for in Section 23 of the 2013 Act.
However, the HSE must be satisfied that:
• The patient requires that item for clinical reasons, and
• There is no listed item which is a suitable alternative for that item in so far as that patient is concerned.
All applications under these arrangements are reviewed on an individual patient basis.
The medical decision to prescribe or not prescribe any treatment for an individual patient is strictly a decision for the treating clinician, in consultation with their patient. The Minister for Health has no role in this clinical decision-making process.
Section 6 of the HSE Governance Act 2013 prohibits 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.
586. Deputy Holly Cairns asked the Minister for Health the steps he is taking to address GDPR issues with the HSE online self-service portal for staff, including individuals being able to access other individuals' personal information; and if he will make a statement on the matter. [21240/23]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
587. Deputy Brendan Howlin asked the Minister for Health if he will personally intervene to ensure that a person (details supplied) is provided with home support on their discharge from hospital; if he is aware that essential surgery will not be carried out on this individual until such home support is put in place; and if he will make a statement on the matter. [21247/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
588. Deputy Pádraig O'Sullivan asked the Minister for Health the number of job advertisements for home care workers in CHO 4 that the HSE has placed in 2022 and to date in 2023; the number of home care positions that have been filled to date in CHO 4; the average timeframe between initial interview and commencement of employment, in tabular form; and if he will make a statement on the matter. [21248/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
589. Deputy Brendan Howlin asked the Minister for Health if his Department provides financial assistance to families who wish to create equipped sensory rooms in their homes for children with autism; and if he will make a statement on the matter. [21249/23]
View answerThe Housing Adaptation Grant for people with a disability is available for people with a physical, sensory, mental health or intellectual disability.
The Housing Adaptation Grant for People with a Disability scheme provides grant aid to applicants to assist in the carrying out of works that are reasonably necessary for the purposes of rendering a house more suitable for the accommodation needs of a person with a disability.
The scheme is administered by Local Authorities. You can get a copy of the application form from the Housing Grants Section of your Local Authority or download one from their website. Fully completed application forms should be returned to your Local Authority Office.
Responsibility for this scheme rests with the Department of Housing, Local Government and Heritage.
590. Deputy Pádraig O'Sullivan asked the Minister for Health the measures in place to alleviate the crisis in home care services delivery; the new initiatives that are being proposed to resolve the staffing shortages in this sector; and if he will make a statement on the matter. [21256/23]
View answerIn order to examine the significant workforce challenges in the home-support and nursing home sectors in Ireland, Minister Butler established the cross-departmental Strategic Workforce Advisory Group in March 2022. Working closely with key stakeholders, the Advisory Group made 16 recommendations to address the challenges in frontline carer roles in the home support and long-term residential care sectors.
Their report was published in October 2022 with 16 recommendations across the areas of recruitment, pay and conditions of employment, barriers to employment, training and professional development, sectoral reform, and monitoring and implementation.
Minister Butler has endorsed the Advisory Group’s recommendations and is committed to their implementation as a priority. Implementation of the recommendations will be overseen by a cross departmental Implementation Group, chaired by the Department of Health. The Department is engaging with recommendation owners to define an implementation plan.
A detailed implementation plan will be published containing steps involved in delivering the recommendations in the coming months. It is envisaged that the implementation group will meet quarterly and publish progress reports thereafter.
Implementation has commenced. The first recommendation no. 9 was implemented in December 2022 with the announcement of the authorisation of 1,000 employment permits for non-EU/EEA home support workers. This promises to significantly reduce the current shortage of care workers in Ireland. The process for applying for this is through a Labour Market Needs test.
591. Deputy Neasa Hourigan asked the Minister for Health if he plans to update pay scales for non-consultant hospital doctors; and if he will make a statement on the matter. [21265/23]
View answerStaff across the public health service, including non-consultant hospital doctor grades are paid in line with the national rates set out in the Department of Health salary scales.
Building Momentum, the current public service agreement, provided for a number of increases to rates of pay enjoyed by public health sector employees including non-consultant hospital doctor grades throughout 2022 and 2023 with a further increase due in October of this year. All rates are published in the Department's salary scales which can be viewed online here:
www.gov.ie/en/circular/664e5-department-of-health-consolidated-salary-scales-circular-32023/
592. Deputy David Cullinane asked the Minister for Health if a claim relating to an employment (details supplied) has been submitted for the pandemic bonus; if the claim is eligible; and if he will make a statement on the matter. [21268/23]
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.
593. Deputy David Cullinane asked the Minister for Health the payment and subvention rates for private nursing homes via the NTPF; the total amount spent in each of the past five years; and the range and average of rates across the State, by county. [21269/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
594. Deputy David Cullinane asked the Minister for Health the manner by which a payment for a nursing home bed is calculated; and if he will make a statement on the matter. [21270/23]
View answerThe Nursing Homes Support Scheme Act 2009 sets out the basis for determining the cost of care in public centres under section 33 of the Act and maximum prices in private centres under section 40.
Cost of care in public centres
In March 2022 the HSE published its annual updated cost of providing care in its public residential care centres for older people. The report gives detailed cost of care in public nursing homes. It shows that the cost of care has increased from €1,674 per week in 2021 to €1,698 per bed per week in 2022. The 1.4% increase can be attributed to pay increases provided under the Lansdowne Road Agreement (funded separately to Nursing Homes Support Scheme (NHSS) funds allocated within the HSE Service Plan 2022). These costs do not relate to the amount a person will pay towards their care under the NHSS (Fair Deal) and it is important to note that regardless of whether a nursing home resident is in a private, voluntary or public nursing home their contribution to the cost of their own care remains the same. The HSE has committed to publishing the required, detailed additional information in respect of publicly provided long-term residential care costs from 2022 onwards. These costs are determined by the HSE and the current cost per bed per week can be found on the HSE website: www2.hse.ie/services/schemes-allowances/fair-deal-scheme/financial-assessment/
Maximum prices in private nursing homes
The National Treatment Purchase Fund (NTPF) has been designated by the Minister for Health pursuant to Section 40 of the Nursing Homes Support Scheme Act 2009 as a body authorised to negotiate with proprietors of non-HSE registered nursing homes to reach agreement in relation to the maximum price(s) that can be charged for the provision of long-term residential care services to NHSS residents. Maximum prices for individual nursing homes are agreed with the NTPF following negotiations and based on the NTPF’s cost criteria. The objective of the NTPF is to agree a price with each nursing home that offers value for money to the State having regard to the following criteria:a) the costs reasonably and prudently incurred by the home and evidence of value for money;b) the price(s) previously charged;c) the local market price; andd) budgetary constraints and the obligation of the State to use available resources in the most beneficial, effective and efficient manner to improve, promote and protect the health and welfare of the public. 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. A steering group has been established to oversee the delivery of the recommendations; this group has met on a regular basis since publication of the review and continues to work on taking these recommendations forward. The Government remains committed to ensuring that long-term residential care for older people continues to place residents’ care, wellbeing, standards and best interests at the centre of development. The Department of Health continues to engage with the NTPF to examine ways in which funding can be used to provide support to nursing homes. In addition, the NTPF will shortly be seeking up-to-date financial and operational information from nursing homes to inform further analysis and considerations of measures to support the sector.
595. Deputy Peter Burke asked the Minister for Health if he will include in the criteria for medical cards patients who received transplants. [21274/23]
View answerMedical Card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE, which assesses each application on a qualifying financial threshold.
The issue of granting medical or GP visit cards based on having a particular disease or condition was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.
However, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.
I can assure the Deputy that, to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues under review and any changes are considered in the context of Government policy and other issues which may be relevant.
597. Deputy Darren O'Rourke asked the Minister for Health the estimated full-year cost of recruiting one additional WTE pharmacist chief 1, 1 WTE pharmacist chief 2, and senior pharmacist, in tabular form. [21277/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
598. Deputy Darren O'Rourke asked the Minister for Health the estimated full-year cost of recruiting 170 additional paramedics for the National Ambulance Service. [21278/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly , as soon as possible.
