David Cullinane
Question:372. Deputy David Cullinane asked the Minister for Health if he is considering a new contract for optometrists; and if he will make a statement on the matter. [30388/23]
View answerPublic Sector Pay
Questions (372)
Written answers
The Community Ophthalmic Services Scheme (COSS) is a national fee-per-item scheme which was introduced in 1979. Under the COSS, medical card holders aged over 16 years can be seen by ophthalmologists, community ophthalmic physicians, optometrists or dispensing opticians.
Eligible patients can receive an eye examination and be provided with prescribed optical appliances in accordance with a national schedule of approved optical appliances.
The Health Professionals (Reduction of Payments to Ophthalmologists, Optometrists and Dispensing Opticians) Regulations 2013 (SI 274 of 2013) sets the fees for optometrists and dispensing opticians under the Community Optometric Services, Community Spectacle Dispensing Services and Health Amendment Act Card Schemes.
I am committed to increasing the fees payable to contractors for a standard eye examination under the COSS. This is a priority for my Department, and work with stakeholders is ongoing to implement this change in 2023.
In addition to this, the HSE Primary Care Eye Services Review Group Report, published in June 2017, highlighted the limitations of the current model of service delivery and set out the way forward for a significant amount of eye services to be delivered in a primary care setting. The Report estimated that 60% of existing outpatient activity could be moved to primary care thus enabling hospital services to focus on patients who require more specialist diagnostics or treatments.
The National Clinical Programme for Ophthalmology has developed a model of care which details how the realignment of eye services from the acute hospitals to the community will be undertaken. Included in current priorities is transferring the care of children aged 8+ years to the care of local private optometrists.
A project team with a wide-ranging membership was established in late 2019 / early 2020 to progress this initiative. The work of the team was paused due to the requirement to focus resources on the COVID 19 pandemic. However, the project team has been reconvened and is progressing matters in relation to this initiative.
Health Strategies
Questions (373)
David Cullinane
Question:373. Deputy David Cullinane asked the Minister for Health if he will develop a population-wide strategy for ear and hearing care in the Irish population; and if he will make a statement on the matter. [30389/23]
View answerWritten answers
The National Audiology Review Group Report, published by the Health Services Executive (HSE) in 2011, identified shortcomings in the audiology services available at the time (including access issues, poor information, inadequate staffing, and unacceptable waiting times) and made recommendations to address these issues.
While most of these recommendations have been implemented, and the remaining recommendations are being progressed, there is still work to do in relation to the community audiology waiting lists. These have been exacerbated by the COVID-19 pandemic and the HSE is actively looking at all options to increase activity and minimise patient wait times nationally. Activity has now returned to pre-pandemic levels.
The rollout of a National Audiology Clinical Management system for community and acute services is facilitating accurate data collection, including for the purposes of waiting list management.
The World Health Organisation’s World Report on Hearing published in March 2021 recommends, among other things, that governments develop a comprehensive people-centred hearing care plan within their national health care plan.
The HSE published revised Best Practice Guidelines for the Provision of Hearing Aid Services for Adults in Ireland on the 7 February 2023. The HSE also published Quality Standards for Paediatric Community Audiology Services on the 13 October 2022. These standards are sequenced to reflect the patient pathway.
In light of the recent development of best practice guidelines and standards, the Department is examining further with the HSE the need for an additional hearing care plan. The Department continues to liaise with the HSE to improve health outcomes for all those suffering from hearing loss.
Healthcare Infrastructure Provision
Questions (374)
David Cullinane
Question:374. Deputy David Cullinane asked the Minister for Health in tabular form, the capital funding allocated to each level 3 and level 4 hospital from 2016 to date, broken down by year, by hospital, and by hospital group; if he will itemise each capital allocation provided; and if he will make a statement on the matter. [30390/23]
View answerWritten answers
As 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.
Healthcare Infrastructure Provision
Questions (375)
David Cullinane
Question:375. Deputy David Cullinane asked the Minister for Health to outline the changes that have been introduced to speed up delivery of capital projects in healthcare; and if he will make a statement on the matter. [30391/23]
View answerWritten answers
This Government is committed to transforming how we deliver healthcare in Ireland. The aim is to deliver universal healthcare, so that everyone has access to affordable, high-quality, sustainable care when they need it.
To date the approach to the delivery of capital projects has simply been far too slow. I have stated that the current process has too many stages and projects have been too susceptible to veto or delays.
As Minister for Health, one of my priorities has been improving the delivery of health capital projects. To that end, I have had considerable engagement with government colleagues; with my Department; the Department of Public Expenditure, NDP Delivery and Reform; and the HSE to explore all available opportunities to improve the pace of capital projects delivery.
I am delighted to confirm that significant progress has been made.
In March of this year, changes to the Public Spending Code aimed at enhancing NDP delivery were introduced that seek to streamline the appraisal and approval of projects. These include:
• increasing major project thresholds from €100 million to €200 million;
• reducing PSC approval stages from 5 to 3;
• removing Government as the approving authority for major projects and the requirement for a technical review of projects by DPER.
I have also met with the HSE, to ensure that the internal processes of the HSE on infrastructure are streamlined. I have been encouraged by the response from the HSE to this challenge.
I am working with my Department and the HSE to ensure that policies and procedures to plan and deliver capital projects are enhanced and updated. This includes:
• Development of a Strategic Health Investment Framework in my Department, due for publication in coming weeks
• Implementation of HSE’s Capital & Estates Strategy; and
• Update of the HSE Capital Projects Manual
I am currently in discussion with Government colleagues to expedite the use of modern methods of construction and rapid construction to deliver projects. In essence this is about driving time and cost efficiencies using standardised repeatable design solutions, with standard schedules of accommodation, utilising modern off-site manufacturing approaches.
I continue to work with my officials and key stakeholders including the HSE to explore all available opportunities to improve the pace of capital health projects delivery.
Departmental Expenditure
Questions (376)
David Cullinane
Question:376. Deputy David Cullinane asked the Minister for Health to provide, in tabular form, the amounts spent by the HSE and-or each individual hospital and his Department and management consultancy for the years 2016 to date, by year; and if he will make a statement on the matter. [30392/23]
View answerWritten answers
In response to your question the Department's total expenditure from Subhead A7 - Consultancy for the years 2016 to date, is set out 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.
In relation to the amount spent by the HSE and each individual hospital I have asked the HSE to respond directly to the Deputy.
If you need any further information please do not hesitate to contact myself or the Department.
Department's total expenditure from Subhead A7 - Consultancy for the years 2016 to date
Health Strategies
Questions (377)
David Cullinane
Question:377. Deputy David Cullinane asked the Minister for Health to outline, in tabular form, all health strategies in place; the total funding provided to each strategy from 2016 to date, broken down by each strategy; and if he will make a statement on the matter. [30393/23]
View answerWritten answers
Dear Deputy
I have set out in the attached file the requested data in relation to Health Strategies Funding for the years 2016-2023, broken down by year.
I trust that this information is helpful to you and please don't hesitate to contact myself or the Department if you need any additional information.
Medicinal Products
Questions (378)
Michael Healy-Rae
Question:378. Deputy Michael Healy-Rae asked the Minister for Health if the prescribing of a drug (details supplied) is correct practice; and if he will make a statement on the matter. [30400/23]
View answerWritten answers
The 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.
To date, there have been particular challenges in the supply of Ozempic® to all markets, including to the Irish market. Novo Nordisk anticipates that intermittent supply will continue throughout 2023. These supply issues are not unique to Ireland. Increases in demand for these medications and supply constraints have been observed in the UK, throughout the EU, and across the world in recent months. Shortages of Ozempic® are linked to the increased demand which has been attributed to the off-label use of the product to treat obesity.
Novo Nordisk has implemented monthly allocation to pharmacies to help ensure continuity of supply and equitable distribution of Ozempic® stock to Irish patients. The company has issued advisory letters to healthcare professionals to ensure they are aware of these supply issues and how to manage them. In one such recent communication to healthcare professionals, the company stated that Ozempic is only indicated for treating adults with insufficiently controlled type 2 diabetes mellitus as an adjunct to diet and exercise. Any other use, including for weight management, represents off-label use and currently places the availability of Ozempic® for the indicated population at risk. Reimbursement support from the HSE is available for the licensed indication and approved dosage only.
The Department of Health, along with relevant experts from the HSE, the HPRA, the Pharmaceutical Society of Ireland and the Medical Council are continuing to work together during times of limited supply to mitigate the impact of the shortages on patients. Those patients that have been prescribed Ozempic® by their doctor and are struggling to source it, are encouraged to speak to their doctor and to the pharmacies in their area as early as possible, in order to seek support in accessing appropriate treatment for their medical condition.
Hospital Staff
Questions (379)
Violet-Anne Wynne
Question:379. Deputy Violet-Anne Wynne asked the Minister for Health the vacancies that currently need to be filled in a hospital (details supplied), in tabular form; and if he will make a statement on the matter. [30404/23]
View answerWritten answers
As this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Hospital Staff
Questions (380)
Violet-Anne Wynne
Question:380. Deputy Violet-Anne Wynne asked the Minister for Health the vacancies that currently need to be filled in a hospital (details supplied), in tabular form; and if he will make a statement on the matter. [30405/23]
View answerWritten answers
As this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
General Practitioner Services
Questions (381)
Violet-Anne Wynne
Question:381. Deputy Violet-Anne Wynne asked the Minister for Health the GPs in County Clare currently engaged in the general medical services scheme, in tabular form; and if he will make a statement on the matter. [30406/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
General Practitioner Services
Questions (382)
Violet-Anne Wynne
Question:382. Deputy Violet-Anne Wynne asked the Minister for Health the practices in County Clare that are in receipt of a grant (details supplied), in tabular form; and if he will make a statement on the matter. [30407/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Health Services
Questions (383)
Seán Canney
Question:383. Deputy Seán Canney asked the Minister for Health what plans he has to end geographical inequality in children’s eye care across the country; and if he will make a statement on the matter. [30409/23]
View answerWritten answers
Sight testing, eye examinations and optical appliances are provided to medical card holders by ophthalmologists, optometrists and dispensing opticians through the Community Ophthalmic Services Schemes (COSS). Patients may access these services following a referral by a healthcare professional such as their general practitioner.
All children, including those not covered by a medical card, receive a vision screen while in national school from a Public Health Nurse. The Health Service Executive (HSE) provides optical services free of charge to pre-school children and national school children referred from child health service and school health service examinations who are discovered to have sight problems. These children are referred to the appropriate consultant for treatment. In such circumstances, these services will continue to be provided until the child has reached the age of 16.
The HSE Primary Care Eye Services Review Group Report, published in June 2017, highlighted the limitations of the current model of service delivery and set out the way forward for a significant amount of eye services to be delivered in a primary care setting. The Report estimated that 60% of existing outpatient activity could be moved to primary care thus enabling hospital services to focus on patients who require more specialist diagnostics or treatments.
The National Clinical Programme for Ophthalmology has developed a model of care which details how the realignment of eye services from the acute hospitals to the community will be undertaken. Included in current priorities is transferring the care of children aged 8+ years to the care of local private optometrists.
A project team with a wide-ranging membership was established in late 2019 / early 2020 to progress this initiative. The work of the team was paused due to the requirement to focus resources on the COVID 19 pandemic. However, the project team has been reconvened and is progressing matters in relation to this initiative.
As this also involves a service matter, I have asked the HSE to respond to the Deputy directly in regards to progress made, as soon as possible.
Question No. 384 answered with Question No. 302.
Departmental Budgets
Questions (385)
John Paul Phelan
Question:385. Deputy John Paul Phelan asked the Minister for Health how much of the allocated budget for reimbursement of medicines has been spent to date since 2020; and if he will make a statement on the matter. [30428/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Disease Management
Questions (386)
John Paul Phelan
Question:386. Deputy John Paul Phelan asked the Minister for Health if a new liaison person within his Department has been appointed to oversee implementation of the national rare disease plan; if a review conducted by the former liaison person will be published; and if he will make a statement on the matter. [30429/23]
View answerWritten answers
In February I announced a plan to develop a revised National Rare Disease Plan, in line with the commitment in the Programme for Government.
The development of the new Plan is currently being progressed through the Office of the Chief Medical Officer in conjunction with the HSE's National Rare Disease Office, and will include a review of the previous National Rare Disease Plan 2014-2018.
This review will consider areas of the previous Plan that need to be further progressed, while also looking to the future and the needs of those patients and families living with a rare disease diagnosis.
An interim report on the National Rare Disease Plan 2014-2018 is published at the following link: www.gov.ie/en/publication/e45dd9-interim-report-on-national-rare-disease-plan-for-ireland-2014-2018/
Disease Management
Questions (387)
John Paul Phelan
Question:387. Deputy John Paul Phelan asked the Minister for Health his views on the ARDCI Rare Disease Pledge; whether he agrees with each of its recommendations; and if he will make a statement on the matter. [30430/23]
View answerWritten answers
While my Department is not familiar with the organisation referenced in the parliamentary question, the Deputy will be aware that I recently announced a plan to develop a revised National Rare Disease Plan, in line with the commitment in the Programme for Government.
The development of this new plan will consider areas of the previous Plan that need to be further progressed, while also looking to the future and the needs of those patients and families living with a rare disease diagnosis.
Initial work for the new plan has commenced, and due consideration is being given to how it can best meet the needs of patients and families affected by a rare disease.
Medicinal Products
Questions (388)
John Paul Phelan
Question:388. Deputy John Paul Phelan asked the Minister for Health if he will outline Ireland's national position in respect of the European Commission's proposed pharmaceutical strategy; and if he will make a statement on the matter. [30431/23]
View answerWritten answers
On the 26 April 2023, the European Commission’s proposal to revise the general pharmaceutical legislation was published - this is in the form of a Directive and a Regulation. The Minister for Health welcomed the publication of the legislation.
The objective of the revised framework is to impose safeguarding controls across the full spectrum of the supply chain, from “raw material” to a “medicine being placed in a patient’s hand”, with national and EU competences working synergistically to conserve patients’ best interests.
The Department of Health is the lead department tasked with responding and engaging nationally as the EU commission proposal is negotiated by all 27 Member States. It should be noted that the legislative proposal is complex and will need to be considered comprehensively in order to ensure that the national position is fully informed. Structured stakeholder engagement is a component of developing the national position as consideration of this proposal continues. The Minister for Health established a Pharmaceutical Strategy Working Group (PSWG) to support the development of Ireland’s response to the proposal from a national perspective and facilitate this position to be informed by a whole of government view.
Ireland (IE) supports the policy objectives of the proposal and welcomes the commitment to optimise the EU regulatory framework to improve supply chain resilience and to address the risks of medicine shortages. We are also supportive of the commitments to enhancing environmental protection and counter antimicrobial resistance as well as the measures aimed at addressing unmet need and rare diseases.
As a smaller Member State, IE particularly welcomes measures aimed at improving access to medicines. Patients and health systems need access to new, innovative treatments, as well as older (off patent) products, generics, and biosimilars. Proposals relating to adaptive clinical trials and the promotion of real-world evidence are particularly welcomed, given the importance of the ongoing assessment of the effectiveness of new medicines in promoting positive health outcomes
IE advocates for ensuring predictability, consistency, equity, sustainability, and transparency in the medicines legislative ecosystem across the EU. IE believes that the proposed reduction of the baseline RDP and its further modulation needs to be critically analysed. We need to support the competitiveness of the EU pharma ecosystem, while achieving and maintaining the critical balance between access and innovation.
Overall, IE acknowledges that this proposal is a component part of a suite of complex and complementary legislative instruments and policies that seek to deliver on the primary goals of the Pharmaceutical Strategy. These include the HTA Regulation, the Cross Border Directive, extension of the EMA mandate (Regulation EU 123 of 2022), the establishment of HERA and others.
Legislative Measures
Questions (389)
John Paul Phelan
Question:389. Deputy John Paul Phelan asked the Minister for Health to outline the expected legislative timeline of the Public Health (Tobacco Products and Nicotine Inhaling Products) Bill 2023; and if he will make a statement on the matter. [30432/23]
View answerWritten answers
The Public Health (Tobacco Products and Nicotine Inhaling Products) Bill will introduce a suite of measures to reduce the appeal and availability of nicotine inhaling products such as electronic cigarettes to young people. In particular, it will prohibit the sale of these products to minors.
The Bill has been notified under the EU Technical Standards Directive which means that it has entered a standstill period until 8 September this year. It is my intention that the Bill will be enacted as soon as possible after that date. I intend to commence the prohibition on the sale of nicotine inhaling products to minors with immediate effect as soon as possible after enactment.
Dental Services
Questions (390)
Robert Troy
Question:390. Deputy Robert Troy asked the Minister for Health to address the long waiting lists for orthodontic treatment in Westmeath. [30442/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Mental Health Services
Questions (391)
Bernard Durkan
Question:391. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he can assist the mother of a person (details supplied) who is psychotic and requires urgent residential care; if arrangements can be urgently made for such care to be provided as a matter of priority; and if he will make a statement on the matter. [30465/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.