Written Answers Nos. 741-753
741. Deputy Pádraig O'Sullivan asked the Minister for Health the number of patients who received medicines in 2022 under section 23 of the Health (Pricing and Supply of Medical Goods) Act 2013, which refers to supply of a medicine outside of the reimbursement list; whether or not any of these medicines had an orphan designation; and if he will make a statement on the matter. [26092/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
742. Deputy Pádraig O'Sullivan asked the Minister for Health if he will outline the bodies consulted in the review by an organisation (details supplied) of the reimbursement system; and if he will make a statement on the matter. [26093/23]
View answerIn February, I published the Mazars Review which examined the governance arrangements around the HSE’s Drug Pricing and Reimbursement Process. As per their Report, the organisation undertook consultation with:
• The Health Service Executive
• Primary Care Reimbursement Service
• The Executive Management Team
• The Drugs Group
• The National Centre for Pharmacoeconomics
• The Department of Public Expenditure and Reform
• The Rare Diseases Technology Review Committee
• The National Cancer Control Programme Technology Review Committee
• Patient representatives via the Rare Diseases Taskforce
743. Deputy Colm Burke asked the Minister for Health if he will consider the development of a national strategy for hemochromatosis (details supplied) in which everyone has equal access to testing diagnosis, treatment and quality of care, regardless of where they live in the country; and if he will make a statement on the matter. [26094/23]
View answer744. Deputy Colm Burke asked the Minister for Health if he will appoint a main contact person to act as lead on haemochromatosis within his Department and-or the HSE; and if he will make a statement on the matter. [26096/23]
View answer745. Deputy Colm Burke asked the Minister for Health if he will consider sponsoring a public awareness campaign for the purposes of providing information regarding the symptoms of hemochromatosis (details supplied); and if he will make a statement on the matter. [26097/23]
View answer746. Deputy Colm Burke asked the Minister for Health if will engage with the representative associations of medical bodies to ensure that GPs and other medical professionals are fully advised of the symptoms of haemochromatosis; and if he will make a statement on the matter. [26098/23]
View answerI propose to take Questions Nos. 743 to 746, inclusive, together.
Hereditary Haemochromatosis (HH) is a common autosomal recessive disease resulting in over absorption of iron from the gastrointestinal tract. Over time, excess iron accumulates in cells of organs including the liver, pancreas and heart causing damage. Research into the condition by the HSE found that 1 in 83 people are genetically predisposed to develop HH in this country.
The HSE has previously undertaken two Model of Care reviews on Hereditary Haemochromatosis and Therapeutic Phlebotomy for Patients with Hereditary Haemochromatosis. The diagnosis, treatment and management of patients living with HH is guided by these reviews as well as the Irish College of General Practitioners’ (ICGP) ‘Hereditary Haemochromatosis- Diagnosis and Management from a GP Perspective’ guidance document.
The ICGP has been very active regarding the diagnosis and treatment of HH for many years. In addition to producing its own guidance document for the disease, HH is also specifically referenced in the Curriculum for GP training (2020). The upcoming appointment of 9 new Advanced Nurse Practitioners for the liver services nationally is also expected to help with the diagnosis and management of HH patients.
The treatment for the management of HH is regular venesections, which involves the patient having their blood taken and monitoring of bloods. The Department of Health and HSE agree that such services should be provided at the lowest level of complexity that is clinically and operationally feasible. Venesections are typically performed via a wide variety of services in Ireland including GPs, nurse-led clinics within hospitals, in outpatient departments, via private services, or at an IBTS facility.
In May 2019, agreement was reached with the IMO on a major package of GP contractual reforms and service developments which will benefit patients and GPs. As part of this agreement, and since the beginning of 2020, GPs are paid by the HSE to provide venesection for GMS patients, those who hold a medical card or GP visit card, with haemochromatosis. GMS patients with this condition can now be managed locally by their GP and may no longer have to attend hospitals for therapeutic phlebotomy.
I am aware that for many patients, treatment is still provided in hospital as an out-patient or day case. The Health (Amendment) Act 2023, which came into effect on 17 April 2023, removes the acute public in-patient charge of €80 per day for people, benefiting HH patients who attend hospital for their treatment.
The Irish Blood Transfusion Service accepts HH patients who are eligible to donate blood at their fixed and mobile donation clinics nationwide. Patients can attend, free of charge, a maximum of four times a year with a minimum of ninety days between phlebotomies. Eligible patients continue to have their condition managed by their GP, including the monitoring of ferritin levels.
Early diagnosis and subsequent management of HH is essential to prevent organ damage and normalise life expectancy. The current model of care in Ireland recommends that genetic testing should only be performed in those with a raised transferrin saturation or if there is a family history of the disease. Any decisions about changes to our national screening programmes, or the introduction of new programmes, such as screening for HH, will be made on the advice of our National Screening Advisory Committee (NSAC).
The NSAC is an independent, expert committee that makes recommendations to the Minister and the Department of Health on population screening in Ireland. The Committee's Annual Call 2022 for proposals for new screening programmes or changes to our existing programmes, received a total of 19 submissions, which included a submission on Genetic/Hereditary Haemochromatosis.
This proposal, along with proposals relating to a number of other conditions, is currently under consideration by NSAC. The Committee has published its Work Programme on its website, setting out the status of proposals currently being considered.
Any screening programme undertaken for Haemochromatosis would involve a public awareness campaign for the purposes of providing information regarding the symptoms of haemochromatosis, this would be an essential component of such a programme.
During my appearance before the Joint Committee on Health on 26 April this year, it was requested that a contact person be appointed for engagement with patient groups on Hereditary Haemochromatosis. In response, HSE Chief Clinical Officer, Dr Colm Henry, agreed to meet with Haemochromatosis Patient representatives on these issues.
748. Deputy Mark Ward asked the Minister for Health if he will provide an update on the recruitment of staff for the new primary care centre on Boot Road in Clondalkin; the breakdown of the staff to be recruited, by WTE; if they will be in place for the opening of the centre; and if he will make a statement on the matter. [26103/23]
View answerAs the Health Service Executive (HSE) holds responsibility for the provision, along with the maintenance and operation of Primary Care Centres, I have asked the HSE to respond directly to the Deputy as soon as possible.
749. Deputy Peadar Tóibín asked the Minister for Health the number of nursing staff who are missing for the rota for the emergency department in the Mater hospital; the number of positions within his Department that are unfilled; the length of time they have remained open for; and the steps, if any, he has taken to fill these positions. [26106/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
750. Deputy Anne Rabbitte asked the Minister for Health whether a dentist can charge a medical card holder a fee for dental work due to the time elapsed since their last visit (details supplied); and if he will make a statement on the matter. [26111/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
751. Deputy Jennifer Murnane O'Connor asked the Minister for Health if there are any plans to operate a weekend service for diagnostic scans in St. Luke’s Hospital, Kilkenny and Waterford University Hospital, based on evidential need (details supplied); and if he will make a statement on the matter. [26116/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
752. Deputy Róisín Shortall asked the Minister for Health the steps he is taking to address the cost of medication for inflammatory bowel disease, which is not covered by the long-term illness scheme, given that it can be an issue for some patients who do not qualify for a medical card; and if he will make a statement on the matter. [26147/23]
View answerThe Long-Term Illness (LTI) scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in 1971, 1973 and 1975, prescribing 16 illnesses covered by the scheme.
These are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide.
Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
While there are no current plans to extend the list of illnesses covered by the LTI Scheme, it is important to remember that the Scheme exists within a wider eligibility framework. The Government has put a significant focus on improving access to and the affordability of healthcare services, advancing substantial policy, legislation and investment to deliver expanded eligibility.
In 2022, a range of measures were delivered including the abolition of public inpatient charges for children, reductions in the Drug Payment Scheme threshold to €80 per month, and the introduction of free contraception for women aged 17-25.
The significant investment in Budget 2023 will facilitate better access to affordable, high-quality healthcare for people at a time when the cost-of-living crisis is impacting on everyone. In 2023 this includes:
• an expansion of GP care without charges to people earning no more than the median household income,
• all public in-patient hospital charges abolished since 17 April 2023
• an extension of free contraception to 26-year-old women since 1 Jan 2023, and further extension to 27-30 years old women from 1 September 2023.
These measures continue to create a health and social care service that offers affordable access to quality healthcare.
People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card.
In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. Medical card eligibility is primarily based on an assessment of means and is not granted on the basis of any particular condition.
In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
Under the Drug Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
Individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
753. Deputy Róisín Shortall asked the Minister for Health if his attention has been drawn to a report (details supplied); if the HSE is considering using this medication to treat long Covid in appropriate circumstances; the reason this treatment is not used in long Covid clinics; and if he will make a statement on the matter. [26148/23]
View answerAs this is a service matter, I have asked the Health Service Executive to reply to the Deputy directly
