Written Answers Nos. 647-661
647. Deputy Mairéad Farrell asked the Minister for Health further to Parliamentary Question No. 433 of 8 February 2023, the status of the pandemic recognition payment for a person (details supplied); if this matter will be escalated to the HSE; and if he will make a statement on the matter. [21694/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
648. Deputy Catherine Murphy asked the Minister for Health if programme assistants in the Irish Wheelchair Association will receive the pandemic recognition payment. [21695/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
649. Deputy Paul McAuliffe asked the Minister for Health his views on reports received by this Deputy that medical card holders are being denied the dispensing of prescribed solphedine due to shortages, despite the product being readily available for sale off the scheme in the same pharmacy store. [21713/23]
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.
The HSE advise that Solpadeine capsules in packs of 32 and Solpadeine Soluble tablets in packs of 60 are currently on the reimbursement list.
Chefaro Ireland DAC, the company responsible for supplying Solpadeine, has notified of a shortage of Solpadeine Soluble (60 and 12 pack) impacting multiple countries, not just Ireland. The company anticipates that Solpadeine Soluble (60 pack) will return in October 2023. They have not yet provided an update regarding the expected resupply of Solpadeine Soluble (12 pack).
However, several alternatives are available. The company has confirmed there is stock of Solpadeine Capsules (12, 24 and 32 packs) and also Solpadeine Soluble (24 pack).
Medical card holders should be able to access Solpadeine Capsules (32 pack), subject to the payment of the statutory prescription charge. To access other Solpadeine products that are in stock but not on the reimbursement list, they would have to pay.
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 Health Products Regulatory Authority (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 with the reason for the shortage and expected dates for the return of supply. See www.hpra.ie/homepage/medicines/medicines-information/medicines-shortages.
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.
650. Deputy Peadar Tóibín asked the Minister for Health if he will review the case and entitlement for further reimbursement of a person (details supplied) given the circumstances. [21721/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
651. Deputy John Lahart asked the Minister for Health if he will provide a list of members of the Clinical Expert Group on the free contraception scheme in the HSE; and if he will make a statement on the matter. [21724/23]
View answerThe free contraception scheme was launched on 14th September, 2022. The scheme is currently open to women aged 17-26 who are ordinarily resident in Ireland and will be extended to women aged 30 and under by September 1st, 2023. Funding through Budget 2023 was also allocated to expand the scheme to 16 year-olds, but this is subject to consultation across Government, legal advice and legislative amendment.With regard to the membership of the HSE Expert Clinical Group, these details are held by the HSE
I have therefore asked that the HSE respond directly to the Deputy, as soon as possible.
652. Deputy Pádraig Mac Lochlainn asked the Minister for Health the plans of the HSE to replace the three eye doctors in the County Donegal ophthalmology service that have vacated their positions in recent times; and if the newly appointed consultants for this service will be based in County Donegal rather than County Sligo to oversee the full ophthalmic teams there, in order that they can continue, at the very least, to deliver the same level of care to an enormous existing service and to reduce the growing waiting lists in County Donegal. [21740/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
653. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 473 of 3 May 2023, the timeline he is working towards for finalisation and publication of the RHA Implantation Plan; and if he will make a statement on the matter. [21749/23]
View answer654. Deputy Róisín Shortall asked the Minister for Health the steps that have been taken in his Department and the HSE to ensure that senior leaders have been freed up from some of their ‘business as usual’ responsibilities to devote time to Regional Health Areas implementation; if external experts and resources have been sought to assist with RHA implementation; and if so, to provide details; if he has established an implementation infrastructure as recommended in a letter from the RHA Advisory Group (details supplied); and if he will make a statement on the matter. [21750/23]
View answer655. Deputy Róisín Shortall asked the Minister for Health if the Regional Health Areas Implementation Plan will outline the proposed governance and accountability arrangements for RHAs; if consideration is being given to legislative changes required for implementation, including accountability relationships between and among RHAs, HSE Centre and his Department, as recommended in a letter from the RHA Advisory Group (details supplied); and if he will make a statement on the matter. [21751/23]
View answer656. Deputy Róisín Shortall asked the Minister for Health to provide an update on each of the ten key next steps in Regional Health Areas implementation, in tabular form (details supplied); and if he will make a statement on the matter. [21752/23]
View answerI propose to take Questions Nos. 653 to 656, inclusive, together.
The Government is committed to the implementation of Regional Health Areas (RHAs), as outlined in the Programme for Government.
RHA Implementation Plan
As the Deputy is most likely aware, a Memorandum on next steps, the programme of work, and timelines for RHA implementation was approved by Government in April 2022. This included a commitment to develop an RHA Implementation Plan, a draft of which is currently being updated following feedback from a wide range of stakeholders including key input/feedback from service and clinical leaders. This draft is due to be brought to the HSE Senior Leadership Team, the HSE Board sub-group on People and Culture, the HSE Board, and others for consideration this month. Subject to the outcomes of these engagements, I intend to bring the RHA Implementation Plan to Cabinet as soon as possible in the coming weeks.
Key Next Steps in RHA Implementation
The Deputy will also be aware that I established an independent RHA Advisory Group of patient and staff representatives from across the health and social care sector in September 2021, which is also due to meet this month. The RHA Advisory Group provides guidance, support, and advice on the design of an implementation plan for RHAs to the Department of Health and HSE officials charged with implementing this work programme under Sláintecare. All of the insights gained from the RHA Advisory Group - including the RHA Advisory Group's suggested next steps - have been considered and incorporated in the RHA Implementation Plan to be presented to Government, where appropriate.
The Deputy will understand that the draft RHA Implementation Plan has not yet been approved by Government and is still undergoing changes. It would not, therefore, be appropriate to detail the proposed next steps in tabular form, though I can assure the Deputy that the published plan will include a set of critical actions for implementation which has been informed by consultation with stakeholders. The plan outlines the approach to RHA planning and design in line with the overall design principles and objectives of Sláintecare, and sets out a high-level programme of work for 2023, with a view to RHAs commencing operation in 2024. Further reforms and devolution of authority will take place on a phased basis through 2024 and 2025.
Governance and Accountability Arrangements including Implementation Infrastructure and Resourcing
Within the HSE, the RHA implementation programme has been moved under the CEO’s office. The draft RHA Implementation Plan is being finalised with direct input from the HSE CEO and RHA Implementation Lead.
An initial high level impact assessment has been completed for the realignment of the current Community Healthcare Organisations (CHOs) and Hospital Groups (HGs) to the new RHA geographies. Further engagement is taking place with service delivery leaders on this matter. Initial work to align these structures into regional pods has already been initiated.
Work has also commenced on agreeing the organisational structure for the national HSE Centre and RHAs. This will be informed by high-level design outcomes, international evidence, and further collaboration with stakeholders to agree an integrated service delivery (ISD) model.
Options for the ISD model - to ensure the optimum structures at RHA level in supporting integrated patient-centred care - have been drafted and considered by the HSE Executive Management Team. These options are built upon the 96 Community Healthcare Networks and hospitals as geographically-aligned with RHAs, underpinned by strong national frameworks. An ISD Working Group has been established that includes service leaders, service users, and multidisciplinary teams (MDT)/clinical representatives to consider and agree a preferred ISD model. Senior leaders from both the HSE and the Department of Health have made themselves available to partake in this group, and continue to engage and prioritise RHA implementation in their respective areas as the programme progresses.
Ongoing engagements aligned to the stakeholder engagement plan have continued to inform both the draft RHA Implementation Plan and further design of the RHA programme (covering in excess of 600 people engaged since January 2023). Key stakeholder groups have included patient representative fora, voluntary organisation representative bodies, and individual staff groups as well as national HR in relation of workforce considerations.
In addition to the above deliverables, an RHA HSE Programme Management Team has been established and is fully in place since the end of March 2023 with external support and experts where required. There has been a dedicated unit in the Department of Health working on RHA design, collaboration, and implementation since 2021 and additional staff/resources are in the pipeline.
In line with the Government Decision in April 2022, RHAs will continue to be part of the HSE rather than their own legal entities and as such will not have their own boards. As internal divisions of the HSE, RHAs will report to the HSE Board via the HSE CEO and the HSE Board retains a governance and oversight role as currently set out in legislation. As such, the primary accountability for corporate governance remains with the HSE Board, sub-committees of the Board, and the HSE CEO. The HSE Board remains accountable to the Minister and Department of Health for all regional and national service provision in line with strategic priorities.
Funding of €5m was approved and allocated to RHA implementation in Budget 2023. This includes funding for the appointment of RHA senior leadership teams. Sanction will be sought from the Department of Public Expenditure, NDP Delivery and Reform for the creation of six new RHA Chief Executive Officer posts. It is planned to advertise and recruit for these senior posts in 2023 with the intention to appoint new leadership teams as soon as possible.
RHA Chief Executive Officers (RHA CEOs) will be fully accountable and responsible for all regional health and social care services in each of the six geographic regions. However, RHA CEOs will report directly to the HSE CEO on the operation and management of the RHAs. RHA CEOs will form part of the core HSE EMT, providing regional input into the development of national policies and standards.
More detailed RHA governance arrangements and accountability relationships - at all levels across the system as a whole - will be clarified as part of the ongoing development of the integrated service delivery model and associated governance. A priority action for 2023 includes the review/revision of the HSE code of governance to include RHAs (corporate and clinical), taking into account wider health system including GPs, patients and Section 38 and 39 organisations, for example. Consideration will continue to be given to any potential legislative changes required for implementation as part of the overall implementation programme and as the RHA integrated service delivery model evolves.
657. Deputy Mark Ward asked the Minister for Health when the money for the fourth phase of eating disorder team progression will be released from budget 2023; the CHOs it will be used for; and if he will make a statement on the matter. [21766/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
658. Deputy Mark Ward asked the Minister for Health the number of adults who presented to the HSE seeking treatment for eating disorders who received specialist inpatient treatment in a dedicated eating disorder service in each of the years 2018 to 2022 and to date in 2023, in tabular form; and if he will make a statement on the matter. [21767/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
659. Deputy Mark Ward asked the Minister for Health if he will provide an update on the nine community eating disorder teams; if timelines for their provision are being met; if there are any delays; and the reason; and if he will make a statement on the matter. [21768/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
660. Deputy Mark Ward asked the Minister for Health if he will provide an update on the roll-out of the eating disorder network and the implementation of the HSE national model of care plan for eating disorders; the target operational dates for the remaining adult and CAMHS teams for eating disorders; and if he will make a statement on the matter. [21769/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
661. Deputy Mark Ward asked the Minister for Health the additional funding in budget 2023 that has been allocated for eating disorders, excluding existing levels of service; the way in which this funding will be spent; and if he will make a statement on the matter. [21770/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
