Written Answers Nos. 214-234
214. Deputy Robert Troy asked the Minister for Health the money expended on private consultants in each of the years 2020, 2021, 2022 and to date in 2023, in tabular form; and if he will make a statement on the matter. [23296/23]
View answerThe Department's total expenditure from Subhead A7 - Consultancy for the years 2020, 2021, 2022 and to date in 2023 is as per the tables attached.
It is the policy in the Department only to engage the services of external consultants where highly specialised skills are not available within the Department and, in particular, when such an approach is felt to be more appropriate and cost-effective.
2023 (to date)
|
Payee Name |
Project Description |
Tran Value |
|
Alpha Healthcare Ltd |
National Taskforce on NCHD Workforce |
€ 98,769.00 |
|
Crowe Horwath |
Independent Patient Safety Council Tender: Patient Safety Complaints & Patient Safety Incidents Culture & Values Project |
€ 44,366.10 |
|
Eithne Fitzgerald |
Disability Policy Analysis Advice service |
€ 7,000.00 |
|
HSE MID-WEST AREA |
50% TRIO Project Remibursement |
€ 11,350.00 |
|
Mazars Consulting |
Internal Audit Services |
€ 25,713.44 |
|
€ 187,198.54 |
2022
|
Payee Name |
Project Description |
Transaction Amount |
|
Alpha Healthcare Ltd |
National Taskforce to focus on the Non-Consultant Hospital Doctor (NCHD) workforce |
€ 30,750.00 |
|
Archus |
External Assurance Project 1 (Electives, Cork and Galway) |
€ 141,803.10 |
|
Crowe |
Review of the National Physical Activity Plan - Joint Project with Dept of Tourism & Sport |
€ 21,406.62 |
|
Crowe |
Independent Patient Safety Council Tender: Patient Safety Complaints & Patient Safety Incidents Culture & Values Project |
€ 46,733.85 |
|
Crowe |
Review of the National Sexual Health Strategy |
€ 19,815.30 |
|
Crowe |
Review of Complaints Policy governing nursing homes |
€ 59,255.25 |
|
Eithne Fitzgerald |
Provision of Policy Analysis Expertise & Advisory Services 2021-2022 |
€ 27,125.00 |
|
Grant Thornton |
Provision of Data Protection Advisory and Support Services to ensure ongoing compliance with Data Protection obligations |
€ 36,006.76 |
|
HIQA |
Patient & Staff Stories Project under Ireland's National Action Plan on Antimicrobial Resistance (2017-2020) (iNAP2) |
€ 55,000.00 |
|
Manchester Metropolitan |
Review of the operation of the Health (Reg of Termination of Pregnancy) Act 2018 |
€ 71,540.00 |
|
Mazars |
Advice on Private Health Insurance |
€ 19,584.06 |
|
Peter Thomas Ltd. |
Facilitation Support for the work of the Public Health Reform Expert Advisory Group |
€ 11,481.91 |
|
PricewaterhouseCoopers |
NCHD Taskforce |
€ 61,461.46 |
|
PWC |
External Assurance Project 2 (Maternity Hospitals) |
€ 98,338.50 |
|
Ruth A Fitzgerald |
Legal services – To provide advice on, and the drafting of, a CTA Healthcare Memorandum of Understanding |
€ 9,131.20 |
|
Trinity College |
Evaluation of the 2001 Report of the National Advisory Committee on Palliative Care |
€ 25,255.59 |
|
€ 734,688.60 |
2021
|
Payee Name |
Project Description |
Transaction Value |
|
Conor Feeney BL |
Transfer Disability serv to Mins. CEDIY |
€ 1,845.00 |
|
Crowe Horwath |
Independent Patient Safety Council Project on Open Disclosure Policy |
€ 35,589.12 |
|
Crowe Horwath |
Review of Patient Advocacy Services |
€ 57,348.75 |
|
Eithne Fitzgerald |
Provision of disability policy analysis expertise and advisory services |
€ 42,350.00 |
|
Grant Thornton |
Provision of Data Protection Advisory and Support Services to ensure ongoing compliance with Data Protection obligations |
€ 68,173.39 |
|
Mazars Consulting |
Actuarial, accounting, insurance, and economic advice on Private Health Insurance |
€ 108,023.62 |
|
Mazars Consulting |
Embedding Risk Management |
€ 7,121.70 |
|
MCCP |
Consultancy on Women’s Health Task Force |
€ 79,875.00 |
|
Trinity College |
National Advisory Committee-Palliative Care |
€ 50,511.18 |
|
€ 450,837.76 |
2020
|
Payee Name |
Project Description |
Transaction Value |
|
Arcline |
External Document Management Consultancy Services |
€ 4,870.80 |
|
Crowe Ireland |
Review of Management, Operation and Funding of Home Support Services |
€ 50,676.00 |
|
Crowe Ireland |
Independent Patient Safety Council Project on Open Disclosure Policy |
€ 35,883.25 |
|
Crowe Ireland |
Independent Patient Safety Council Project on Open Disclosure Policy |
€ 35,883.25 |
|
Deloitte Ireland LLP |
Organisation Design & Review |
€ 118,230.37 |
|
Deloitte Ireland LLP |
Actuarial Work Private Health Insurance |
€ 60,925.01 |
|
Eithne Fitzgerald |
Provision of Policy Analysis Expertise & Advisory Services |
€ 30,890.00 |
|
Grant Thornton |
Development of a strategic plan for National Healthy Cities and Counties Network |
€ 9,207.71 |
|
HumeBrophy |
Consultancy Support Relocation European |
€ 25,146.00 |
|
Mazars Consulting |
Critical evaluation of international models for safeguarding vulnerable adults from various forms of abuse |
€ 41,976.51 |
|
Mazars Consulting |
Consultancy on Embedding Risk Management |
€ 36,336.30 |
|
MCCP |
Developing an External Strategy for Department of Health |
€ 38,205.03 |
|
OCC Ltd |
Support with Quality Assurance of Oral Health Policy |
€ 3,325.22 |
|
€ 491,555.45 |
215. Deputy Robert Troy asked the Minister for Health if he will confirm the engagement he has had to date with an organisation (details supplied); and the financial supports his Department is providing it. [23297/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
216. Deputy Catherine Connolly asked the Minister for Health the status of the development of legislation on safe access zones; the timeline for this legislation to come before the Houses of the Oireachtas; and if he will make a statement on the matter. [23306/23]
View answerThe Government is committed to ensuring that anyone needing a termination of pregnancy can access services in safety and with privacy and dignity.
The purpose of the Health (Termination of Pregnancy Services (Safe Access Zones)) Bill 2022 is to ensure safe access to termination of pregnancy services for women, service providers and their staff throughout the country. Government approved the General Scheme on 27th July 2022 and it was published on 5th August 2022.
Drafting of this legislation is now at an advanced stage and I expect to bring a final draft of the Bill to Cabinet in the coming weeks and progress it through the Houses thereafter.
217. Deputy Holly Cairns asked the Minister for Health if he will provide an update on all current National Development Plan 2021-2030 projects under his Department being progressed in Cork South West, including the current status of each project and the planned completion date; and if he will make a statement on the matter. [23310/23]
View answerAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
218. Deputy Holly Cairns asked the Minister for Health the steps he is taking to ensure that heel-prick screening includes testing for spinal muscular atrophy; and if he will make a statement on the matter. [23311/23]
View answerI am fully committed to supporting our population screening programmes which are a valuable part of our health service, enabling early treatment and care for many people, and improving the overall health of our population.
Any decisions about changes to our screening programmes, such as screening for Spinal Muscular Atrophy, will be made on the advice of our National Screening Advisory Committee (NSAC).
This independent expert group considers and assesses evidence in a robust and transparent manner, and against internationally accepted criteria. It is important we have rigorous processes in place to ensure our screening programmes are effective, quality assured and operating to safe standards, and that the benefits of screening outweigh the harms
The expansion of the National Newborn Bloodspot Screening (NBS) programme is a priority for me. As you know, a Health Technology Assessment (HTA) on the addition of an eleventh condition to the NBS programme, Spinal Muscular Atrophy, is now underway by HIQA. I am advised that the NSAC expect HIQA to complete this process over the coming months and that the HTA will be presented to and considered by the Committee at a meeting before the end of this year.
I look forward to receiving a recommendation from the Committee following their consideration of the HTA once it is available.
219. Deputy Holly Cairns asked the Minister for Health the status of the HSE proposals to limit homebirth services for women and pregnant people living within 30 minutes of a maternity hospital. [23312/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
220. Deputy Holly Cairns asked the Minister for Health the date he is working towards for the second-stage discussion of the Health (Termination of Pregnancy Services (Safe Access Zones)) Bill 2022. [23313/23]
View answerThe Government is committed to ensuring that anyone needing a termination of pregnancy can access services in safety and with privacy and dignity.
The purpose of the Health (Termination of Pregnancy Services (Safe Access Zones)) Bill 2022 is to ensure safe access to termination of pregnancy services for women, service providers and their staff throughout the country. Government approved the General Scheme on 27th July 2022 and it was published on 5th August 2022.
Drafting of this legislation is now at an advanced stage and I expect to bring a final draft of the Bill to Cabinet in the coming weeks and progress it through the Houses thereafter.
221. Deputy Holly Cairns asked the Minister for Health the steps he is taking to ensure that workers in Section 39 (Health Act 2004) organisations receive the same annual leave entitlements as workers in Section 38 organisations. [23315/23]
View answerTerms and conditions such as annual leave allocations are a matter between the employer and the employee. I have no role in respect of Section 39 bodies and matters such as this.
222. Deputy Holly Cairns asked the Minister for Health if he will clarify when free GP care for under seven-year-olds will come into effect. [23318/23]
View answerIt is intended to commence the expansion of GP care without charges to all children aged 6 and 7 as early as possible. My officials and the HSE have made preparations for this expansion. Engagements were held by my Department and the HSE with the IMO, representing GPs, throughout last year, and engagement is ongoing in relation to the necessary fee structures for this service.
223. Deputy Mark Ward asked the Minister for Health his views on plans for peer remuneration within an organisation (details supplied); if he will provide an update on the progress of the setting-up of the Steering Committee; and if he will make a statement on the matter. [23319/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
224. Deputy Mark Ward asked the Minister for Health if there is a review underway for peer remuneration within the health service; if he will provide an update on this review; and if he will make a statement on the matter. [23320/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
225. Deputy Fergus O'Dowd asked the Minister for Health if he will provide further details on his Department’s request to HIQA to carry out two health technology assessments, one examining the cost-benefits of an enhanced vaccine for the 50–64-year-olds and the other on the >65 years cohort; if the health technology assessment into the >65 cohort will be commenced shortly; and if he will make a statement on the matter. [23349/23]
View answerTo inform decision making in relation to the current Influenza Vaccination Programme, my Department has requested that HIQA include a Health technology assessment (HTA) in its work programme, in relation to vaccination with an enhanced quadrivalent influenza vaccine for those aged 65 and older. In addition, my Department has also requested that HIQA include a HTA on the inclusion of the 50–64 year age group as an at-risk group in the influenza vaccination programme.
A HTA is a multidisciplinary research process that collects and summarises information about a health technology to provide information regarding clinical effectiveness and safety, cost-effectiveness and budget impact, organisational and social aspects, and ethical and legal issues. The information is collected and presented in a systematic, unbiased and transparent manner to inform policy decision making.
I am advised that HIQA will commence the HTA related to an enhanced quadrivalent influenza vaccine for those aged 65 and older once the HTA on the inclusion of the 50–64 year age group in the influenza vaccination programme is completed.
226. Deputy Aengus Ó Snodaigh asked the Minister for Health the options available to the family of a young person who has been prescribed and had been taking Ozempic, until earlier this year when supplies dried up, and with their hepatology team stressing the importance for their getting back on the drug for their health; if, given that the person has now spent many months without Ozempic, the person or his Department can try and source this abroad with their prescription; if such a purchase could be included in a person’s tax rebate claim at the end of year; the measures he or the EU Council of Health Ministers are taking to end this shortage; and if he will make a statement on the matter. [23351/23]
View answerShortages of the diabetes medicine Ozempic® are linked to the increased demand which has been attributed to the off-label use of the product to treat obesity.
Novo Nordisk, the marketing authorisation holder for Ozempic, has notified the Health Products Regulatory Authority (HPRA) of intermittent supply issues with Ozempic® products due to increased global demand. The company anticipates that intermittent supply will continue throughout 2023. Similar supply constraints are being experienced in other EU countries.
Novo Nordisk has implemented monthly allocations to help ensure continuity of supply and equitable distribution of Ozempic® stock to Irish patients. The company has issued letters to relevant stakeholders, including healthcare professionals, to ensure they are aware of this supply issue and its management.
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, operated by the HPRA on behalf of the Department of Health.
Information relating to medicines shortages, including particular information relating to Ozempic®, can be found on the HPRA's website (Medicines Shortages (hpra.ie) . Information on shortages is dynamic and changes depending on the current information the HPRA has to hand, including removal from the list when a shortage has been resolved.
Regarding pricing and reimbursement , The Health Service Executive (HSE) has statutory responsibility for decisions on the 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 licenced indications which have been granted market authorisation by the European Medicines Agency (EMA) or the 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). I, as Minister for Health, have no role in these decisions.
Semaglutide, which is marketed as Ozempic®, was approved by the HSE in 2018 for addition to the Reimbursement List for the treatment of Diabetes. Semaglutide has not been approved for reimbursement for any other indication. Controls are currently in place in relation to Semaglutide (Ozempic®) to restrict reimbursement support to the HSE approved indication of Diabetes. The HSE advise that reimbursement for Semaglutide (Ozempic®) is confined to those with eligibility under the General Medical Services Scheme (GMS) or the Long-Term Illness (LTI) scheme. This medicine is not available on the Drugs Payment Scheme.
Regarding sourcing abroad , Directive 2011/24/EU on patients’ rights in cross-border healthcare sets out the conditions under which a patient may travel to another EU country to receive medical care and reimbursement. It covers healthcare costs, as well as the prescription and delivery of medications and medical devices.
This provides that a prescription issued in one EU country is valid in all other EU countries - practitioners however are only entitled to prescribe medicinal products for which they are legally entitled to do in the EEA state in which the prescription is issued. Additionally, a medicine prescribed in one country might not be available or it may have another name in a different Member State and the prescription will be dispensed in accordance with the rules applicable in the state in which the prescription is presented.
Rules on cross-border prescriptions only state which information should be included on the prescription; there is no specific form or format for the prescription. In most cases, the prescription a patient uses in the home Member State should contain sufficient information to facilitate its use in another EU Member State. Further information may be accessed at europa.eu/youreurope/citizens/health/prescription-medicine-abroad/prescriptions/faq/index_en.htm .
It should be noted that the supply of prescription medicines under the cross border healthcare Directive only covers prescription presented in person (either by the person named on the prescription or their nominated representative) to a registered pharmacy business.
227. Deputy Neasa Hourigan asked the Minister for Health how the National Gender Service implements operational standards and guidance in fulfilling its remit under the Health Act 2004: Your Service, Your Say on dealing with complaints and feedback; if there is work ongoing in that implementation; and if he will make a statement on the matter. [23362/23]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
228. Deputy Neasa Hourigan asked the Minister for Health if he will outline any interventions, memorandums of understanding or guidance provided to the National Gender Service from national oversight bodies such as the Mental Health Commission or the Patient Advocacy Service on improving the service and patient experience in the past 12 months; and if he will make a statement on the matter. [23363/23]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
229. Deputy Sean Sherlock asked the Minister for Health if he will address an issue with the fair deal scheme (details supplied). [23379/23]
View answerThe closure of nursing homes can put pressure on other local health and social care facilities. It is vital that the welfare of residents is ensured.
In December 2021, the Department of Health published the independently chaired Value for Money (VFM) review on nursing home costs. The VFM Review sought to identify, quantify and analyse the reasons for any cost differential between private/voluntary nursing homes and public Community Nursing Units (or CNUs) and, following analysis, to make recommendations for improving the value for money obtained by the Health sector.
Among the issues raised were the pay costs of staff in nursing homes and CNUs, the dependency levels of residents, energy costs, and medical supplies charges to the NHSS. The report found that the cost differential is largely driven by variances in staff-to-resident ratios and the skill mix in public CNUs and private nursing homes. However, the review also found that establishing like-for-like comparisons was complex and not always possible, especially when considering differences in dependency levels. The review found that the cost differential is largely driven by variances in staff-to-resident ratios and the skill mix in public CNUs and private nursing homes. It should be note that the VFM review reiterated that the data compiled cannot be interpreted as being a representative sample of either a public or private provision, due to the extremely small (<1%) sample size and is therefore not statistically relevant.
The Department of Health acknowledges that there are variations in the cost of care across public HSE-run Community Nursing Units (CNUs) as well as across private nursing homes, with public CNUs generally having a higher cost of care. The HSE has a statutory responsibility as provider of last resort and will always step in where a resident’s needs are sufficiently complex that they are not able to be cared for elsewhere in the community and needs to be staffed to deliver that kind of complex care. This function of the HSE extends beyond long-term residential care for older people.
Overall, €1.4 billion of the total Health Budget was allocated last year to support over 22,700 people under Fair Deal. This will increase to nearly €1.5 billion for 2023 and the budget has to support all residents under the Nursing Home Support Scheme (NHSS) for the full calendar year. In addition over €149m of financial support has been provided to private and voluntary nursing homes through the COVID-19 Temporary Assistance Payment Scheme (TAPS). The provision of free PPE and oxygen to private nursing homes continues, costing approximately €75 million to date, and €10 million for the Temporary Inflation Payment Scheme (TIPS) to support energy cost increases.
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; and
d) 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 Nursing Homes Support Scheme Act 2009 also sets out the basis for determining the cost of care in public centres under Section 33 of the Act, which are determined and managed by the HSE.
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.
The reform of the pricing system for private and voluntary nursing homes should not be viewed in isolation but in the context of wider sectoral reforms, many of which are being or have already been brought forward. The Government remains committed to delivering on the nine recommendations that emerged from the Value for Money Review on Nursing Home Costs, the 86 recommendations of COVID-19 Nursing Homes Expert Panel, especially those recommendations related to long-term sectoral reform, the five recommendations of the NTPF Review of Pricing System for Long Term Residential Care Facilities and the 16 recommendations of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants. Work continues within the Department of Health to deliver on all of these recommendations, as well as analysing the outcomes of the Skills Mix and Safe Staffing pilots which will serve to inform future policymaking.
As I understand, engagement continues between the private provider referenced in the details supplied and the NTPF.
230. Deputy Claire Kerrane asked the Minister for Health if he will provide an update on the new home care tender; if he has engaged with representative organisations to ensure there are no delays to the 2023 tender; and if he will make a statement on the matter. [23380/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
231. Deputy Catherine Murphy asked the Minister for Health the names of external cleaning companies that have provided cleaning services to his Department in the years of 2021, 2022 and to date in 2023; and the amount paid to each company for such works, in tabular form. [23409/23]
View answerThe following table outlines the requested information.
|
Year |
Company |
Cost |
|
2021 |
OCS One Complete Solution Ltd. |
€183,300 |
|
2022 |
OCS One Complete Solution Ltd. |
€197,795 |
|
2023 (to date) |
OCS One Complete Solution Ltd. |
€87,148 |
232. Deputy Catherine Murphy asked the Minister for Health the number of vascular surgeries performed in St. James's Hospital in the years of 2022 and to date in 2023, in tabular form. [23421/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
233. Deputy Catherine Murphy asked the Minister for Health the number of WTE consultant neurologists attached to the Mater Hospital in the years of 2022 and to date in 2023, in tabular form. [23422/23]
View answerAs the issues raised in this PQ are service related issues, I have asked the HSE to respond directly to the Deputy.
234. Deputy Catherine Murphy asked the Minister for Health the number of persons that presented at the accident and emergency department of Naas General Hospital in the years of 2022 and to date in 2023, in tabular form. [23423/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
