Tuesday, 25 Jul 2023

Written Answers Nos. 1168-1189

National Treatment Purchase Fund

Questions (1168)

Catherine Murphy

Question:

1168. Deputy Catherine Murphy asked the Minister for Health the percentage spending of the National Treatment Purchase Fund, by hospital, in tabular form. [35935/23]

Written answers

Minister for Health

In relation to the particular query raised, the National Treatment Purchase Fund has provided the attached table which sets out the payments made to public hospitals for the most recent certified financial statements, the financial year 2021. The table also provides the percentage funding paid to each hospital.

Payments to Public Hospitals - 01 January 2021 to 31 December 2021
Account	Name	31-Dec-21
CAP001	National Orthopaedic Hospital Cappagh	6,779,905	13.0%
BEA001	Beaumont Hospital	6,590,413	12.6%
SIV001	South Infirmary/Victoria Hospital	5,215,253	10.0%
SJH001	St. James's Hospital	4,496,608	8.6%
SVU001	St. Vincent's University Hospital	2,839,341	5.4%
MMH001	Mater Misericordiae Hospital	2,780,530	5.3%
EAE001	Royal Victoria Eye + Ear Hospital	2,259,248	4.3%
CUH001	Cork University Hospital	2,251,268	4.3%
WFD001	Waterford Regional Hospital	2,179,583	4.2%
MWR001	Mid Western Regional Hospital	1,874,213	3.6%
TUL001	Tullamore General Hospital	1,809,483	3.5%
OLS001	Our Lady's Hospital for Sick Children	1,725,638	3.3%
TGH001	University Hospital Kerry	1,608,320	3.1%
UCG001	University College Hospital Galway	1,140,050	2.2%
NAG001	Naas General Hospital	1,138,507	2.2%
AMI001	Tallaght University Hospital	1,132,370	2.2%
COH001	Croom Orthopaedic Hospital	897,818	1.7%
SLK001	St Lukes General Hospital	770,930	1.5%
LKY001	Letterkenny General Hospital	695,570	1.3%
ENN001	Ennis General Hospital	584,637	1.1%
NEN001	Nenagh General Hospital	517,950	1.0%
KCK001	Kilcreene Regional Orthopaedic Hospital	447,750	0.9%
MER001	Mercy Hospital	394,400	0.8%
SLI001	Sligo General Hospital	335,522	0.6%
MUL001	Mullingar Regional Hospital	316,229	0.6%
ROT001	Rotunda Hospital	295,930	0.6%
CUM001	Cork University Maternity Hospital	258,165	0.5%
CLO001	Tipperary University Hospital	197,615	0.4%
OLN001	Our Lady's Hospital (Navan)	140,370	0.3%
TCH001	The Children's  University Hospital	99,481	0.2%
WXD001	Wexford General Hospital	97,420	0.2%
COO001	Coombe  Womens Hospital	81,622	0.2%
STM001	St Michael's Hospital	65,050	0.1%
JCM001	James Connolly Memorial Hospital	59,823	0.1%
CAG001	Cavan General Hospital	56,450	0.1%
BAN001	Bantry General Hospital	46,200	0.1%
OLL001	Our Lady of Lourdes (Drogheda)	41,130	0.1%
MAL001	Mallow General Hospital	32,125	0.1%
ROS001	Roscommon University Hospital	21,500	0.0%
PRT001	Midland Regional Hospital @ Portlaoise	19,250	0.0%
MGH001	Mayo General Hospital	15,705	0.0%
POR001	Portiuncula Hospital	9,247	0.0%
STJ001	St John's Hospital	5,500	0.0%
SCO001	St Columcilles Hospital	3,900	0.0%
		52,328,020

Care of the Elderly

Questions (1169)

Catherine Murphy

Question:

1169. Deputy Catherine Murphy asked the Minister for Health the number of service users that have attended Monasterevin day care centre in 2022 and to date in 2023; and the days of the week that this day care centre is opened, in tabular form. [35936/23]

Written answers

Minister of State at the Department of Health

As these are operational matters, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Suicide Prevention

Questions (1170)

Catherine Murphy

Question:

1170. Deputy Catherine Murphy asked the Minister for Health the estimated cost in 2024 if 25 additional WTE suicide crisis assessment nurses were recruited. [35937/23]

Written answers

Minister of State at the Department of Health

As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Hospital Staff

Questions (1171)

Catherine Murphy

Question:

1171. Deputy Catherine Murphy asked the Minister for Health the number of WTE consultant paediatric plastic surgeons attached to CHI Crumlin and CHI Temple Street in 2022 and to date in 2023; and the hours per week in which these surgeons are based in the hospitals, in tabular form. [35938/23]

Written answers

Minister for Health

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 Staff

Questions (1172)

Catherine Murphy

Question:

1172. Deputy Catherine Murphy asked the Minister for Health the number of full-time public health nurse positions in CHO7 in 2021, 2022 and to date in 2023; and the specific geographic within CHO7 that currently has no public health nurses in place. [35939/23]

Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Hospital Staff

Questions (1173)

Catherine Murphy

Question:

1173. Deputy Catherine Murphy asked the Minister for Health the number of WTE vacancies, by job title, currently in the regional specialists memory clinics at both St. James's Hospital and Tallaght University Hospital; and when these vacancies will be filled, in tabular form. [35940/23]

Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Medicinal Products

Questions (1174)

Jim O'Callaghan

Question:

1174. Deputy Jim O'Callaghan asked the Minister for Health if he will take steps to ensure that the drug bedaquiline which treats multi-drug resistant tuberculosis becomes widely available after the patent expires in 2023; and if he will make a statement on the matter. [35956/23]

Written answers

Minister for Health

Two new Framework Agreements on Pricing and Supply of Medicines 2021-2025 were signed in December 2021. These Agreements provide stability to the medicines reimbursement market for the State and for Industry, thus facilitating sustainable and affordable access to medicines for patients in Ireland over the next 4 years.

Negotiations towards these new Agreements with industry began in May 2021, against a backdrop of a growing annual drugs budget, up from €1.95bn in 2016 to almost €2.25bn by 2020.

The multi-annual agreements with the Irish Pharmaceutical Healthcare Association (IPHA) and Medicines for Ireland (MFI) represent an important step in facilitating access to innovative new medicines for patients. The IPHA represent the originator and on-patent biopharmaceutical industry; MFI represent the non-originator, and off-patent biopharmaceutical industry in Ireland.

There are a number of clauses set out in both agreements in detail, which provide clear pricing rules for applicant companies, that have been agreed between the State and main Pharmaceutical Industry representative groups in Ireland as appropriate and intended to provide a predictable environment for Marketing Authorisation Holders (MAHs) to supply their products (and prevent shortages). These are grossly summarised as:

The pricing application form for new medicines is based on a basket of 14 countries (13 EU Member States and the UK). Pricing is permitted to be no more than the average price based on the pricing in these 14 countries.

The pricing of non-patented medicines (i.e., generic, biosimilar or hybrid medicine marketed in Ireland) is based on the originator medicine at a specific time point.

Under the terms of the agreement, there is scope for the Department of Health, the HSE, and industry to continue to maintain their engagement throughout the lifetime of the agreement on all matters pertaining to the agreement.

The Agreements are the product of extensive collaboration between the State, HSE, and Industry. They remain current and appropriate for their purpose since their signing in December 2021.

Medical Aids and Appliances

Questions (1175, 1176, 1177)

John Paul Phelan

Question:

1175. Deputy John Paul Phelan asked the Minister for Health if he will provide an update on the integration of continuous glucose monitor devices into healthcare practice and guidance in Ireland; and if he will make a statement on the matter; and if he will make a statement on the matter. [35958/23]

John Paul Phelan

Question:

1176. Deputy John Paul Phelan asked the Minister for Health whether his Department is or will be developing national clinical guidance to underpin the provision and funding of continuous glucose monitor devices in Ireland; and if he will make a statement on the matter. [35959/23]

John Paul Phelan

Question:

1177. Deputy John Paul Phelan asked the Minister for Health whether his Department is developing national clinical guidelines for type 2 diabetes mellitus; and if he will make a statement on the matter. [35960/23]

Written answers

Minister for Health

I propose to take Questions Nos. 1175 to 1177, inclusive, together.

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Question No. 1176 answered with Question No. 1175.

Question No. 1177 answered with Question No. 1175.

Legislative Process

Questions (1178)

John Paul Phelan

Question:

1178. Deputy John Paul Phelan asked the Minister for Health to provide an update on the Health Information Bill 2023, the proposed timeline for its passage and subsequent implementation; and if he will make a statement on the matter. [35961/23]

Written answers

Minister for Health

The Government approved the General Scheme of the Health Information Bill on 18 April of this year. 

The Oireachtas Committee on Health has now concluded its Pre-Legislative Scrutiny of the Bill and has no particular recommendations or observations on the General Scheme.  It noted that it considers this to be a significant piece of legislation and believes it will make an important and substantial contribution to the Irish health system.

The Bill is currently with the Office of Parliamentary Counsel for formal drafting.  Given the size and complexity of the General Scheme, it is expected that the drafting process will take until Q1 of 2024.  It will then be published and considered by the Oireachtas.  Implementation will be on a phased and structured basis to ensure that the new health information framework and structures can be embedded successfully.

Health Strategies

Questions (1179)

John Paul Phelan

Question:

1179. Deputy John Paul Phelan asked the Minister for Health to provide an update on the development of a National Diabetes Registry following the passage of the Health Informational Bill 2023; and the timeline for the proposed development; and if he will make a statement on the matter. [35962/23]

Written answers

Minister for Health

Budget 2023 provides funding for a number of initiatives aimed at improving diabetes care, including commencing the development of a National Diabetes Registry.

The development of a National Diabetes Registry will have a long-term benefit on patient care by facilitating benchmarking of individual care against guideline recommendations and QI feedback to practitioners, and on the provision of appropriate health services by providing reliable information to healthcare planners and policymakers.

My Department and HSE National Clinical Programme for Diabetes are currently engaged in preparatory work for phase 1 of this multi-year project.

Recruitment efforts for the development of the National Diabetes Registry are currently paused due to the temporary pause on recruitment of certain management and administration roles in the HSE. Once this pause on recruitment is lifted, recruitment for the National Diabetes Registry will recommence.

The Government approved the General Scheme of the Health Information Bill on 18 April of this year. 

The Bill is currently with the Office of Parliamentary Counsel for formal drafting.  Given the size and complexity of the General Scheme, it is expected that the drafting process will take until Q1 of 2024.  It will then be published and considered by the Oireachtas.  Implementation will be on a phased and structured basis to ensure that the new health information framework and structures can be embedded successfully.  

 

Legislative Process

Questions (1180)

John Paul Phelan

Question:

1180. Deputy John Paul Phelan asked the Minister for Health to provide an update the status of the National Research Ethics Committees Bill 2019; whether he will provide a statement on the Government's position on the legislation; and if he will make a statement on the matter. [35963/23]

Written answers

Minister for Health

National Research Ethics Committees (NRECs) are important because they ensure a robust ethical review process for health research is in place, one that relies on national expert opinions and public/patient engagement. NRECs also allow for the formation of one national ethical decision on health research. This decision eliminates the requirement for multiple ethical approvals on studies being conducted across multiple national sites. It also reduces wait times for ethical approval and strengthens the Irish health research landscape, making Ireland a more attractive location for clinical trials.

The National Research Ethics Committee (NREC) Bill is currently under review. The draft Heads of Bill were originally developed in 2019 but the Government decision was to prioritise moving ahead with secondary legislation in order to meet tight timelines emerging from EU regulation. 

Since then the National Office for Research Ethics Committees was established as a constituent unit within the Health Research Board and two NREC have become operational through Statutory Instruments:

• The NREC for clinical trials on medicinal products for human use operates under S.I. 99/2022, which is linked to EU Regulation 536/2014

• The NREC for clinical investigations of medical devices operates under S.I. 260/2021, which is linked to EU Regulation 2017/745

• S.I. 256/2022 established a national research ethics committee for the purposes of conducting ethical reviews of in vitro diagnostic devices (linked to EU Regulation 2017/746) (IVDR). In Ireland this NREC is operated under the same NREC as medical devices, with members appointed based on corresponding legislation.

It is important that the original draft heads of Bill are considered in light of the lessons learned from these developments.  

Disease Management

Questions (1181)

John Paul Phelan

Question:

1181. Deputy John Paul Phelan asked the Minister for Health to provide an update on the commitment in the HSE's National Service Plan 2023 to roll-out 30 new specialist teams for the management of chronic diseases, which includes T2DM in communities; and if he will make a statement on the matter. [35964/23]

Written answers

Minister for Health

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 (1182)

John Paul Phelan

Question:

1182. Deputy John Paul Phelan asked the Minister for Health the funding streams available for diabetes care for women with gestational diabetes mellitus; and if he will make a statement on the matter. [35965/23]

Written answers

Minister for Health

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 (1183)

John Paul Phelan

Question:

1183. Deputy John Paul Phelan asked the Minister for Health to provide an update on the funding provided for diabetes care in Budget 2023 and the priorities for funding of diabetes care in Budget 2024; and if he will make a statement on the matter. [35966/23]

Written answers

Minister for Health

As part of Budget 2023, €2.6 million was allocated to implement a number of initiatives aimed at improving diabetes care, including commencing the development of a National Diabetes Registry, the commencement of a National Paediatric Audit of Type 1 Diabetes, and two further initiatives related to gestational diabetes. These initiatives focus on improving our information on diabetes patients and health services and improving the provision of care for women with gestational diabetes.

Data collected by audits and registers allow for better planning in the provision of diabetes health services and improved patient care. The HSE National Clinical Programme for Diabetes are currently engaged in preparatory work for phase 1 of the multi-year project for the development of a National Diabetes Registry, and are working closely with the National Office for Clinical Audit (NOCA) on a plan to set up a national registry for children and young people.

As part of the recently published GP Agreement of 2023, agreement was secured to include all women who have been diagnosed with gestational diabetes or pre-eclampsia since January 2023 in the CDM Preventative Progamme. The commencement of Phase 3 of the CDM programme is anticipated in Autumn 2023.

With regard to future funding for Diabetes care in Budget 2024, any decisions regarding funding will be subject to the annual Estimates process and will require Government approval.

Disease Management

Questions (1184)

John Paul Phelan

Question:

1184. Deputy John Paul Phelan asked the Minister for Health if he intends to appoint a liaison officer to oversee implementation of diabetes policy within the Department; and if he will make a statement on the matter. [35967/23]

Written answers

Minister for Health

Diabetes is a complex condition that can have a profound impact on the quality of life of people living with the condition. If not well managed, it can lead to debilitating complications. Management of the condition is required across the entire spectrum of healthcare delivery including self-management support as well as care delivered through general practice, community specialist care and hospital inpatient specialist care. 

Budget 2023 provides funding for a number of initiatives aimed at improving diabetes care, including commencing the development of a National Diabetes Registry.

Guidelines for Diabetes prevention and management include the Model of Integrated Care for Patients with Type 2 Diabetes, the Model of Care for the Diabetic Foot (2021) and the National Clinical Guideline for the Management of Adult Type 1 Diabetes. Guidelines are reviewed and amended in line with the most up to date evidence to support best clinical practice and standardisation of care for diabetes patients.

Furthermore, the National Framework for the Integrated Prevention and Management of Chronic Disease in Ireland 2020-2025, sets out a national framework for an integrated approach to the prevention and management of chronic disease in Ireland over the coming years. This framework was developed in relation to four major chronic diseases including type 2 diabetes. The framework builds on the existing policies and guidelines, with a focus on health promotion, disease prevention, diagnosis, treatment, disease management and rehabilitation services that are coordinated across different healthcare providers and healthcare settings.

With respect to oversight of implementation of diabetes policy, there is a relevant unit in the Department of Health that deals with Diabetes policy matters.

Healthcare Policy

Questions (1185)

John Paul Phelan

Question:

1185. Deputy John Paul Phelan asked the Minister for Health to outline the timeline and next steps of the Working Group overseeing his Department's response to a report (details supplied) into Ireland's reimbursement system; and if he will make a statement on the matter. [35968/23]

Written answers

Minister for Health

An Implementation Working Group has been established with members from the Department, HSE CPU, NCPE, National Cancer Control Programme, and HSE Drugs Group. Its terms of reference include the progression of a proposal for an application tracker, which the HSE has been asked to prepare. Following this, the Group is to examine the feasibility and options for the prioritised recommendations in the implementation plan.

The Working Group met twice in May. The Group engaged in a targeted consultation with stakeholders from industry, patient organisations, and clinical practice. Invitations were issued to identified key stakeholders to submit their feedback on the Report. The targeted stakeholder consultation commenced on the 31st of May and concluded on the 20th of June when the Working Group heard presentations from a range of these stakeholders. The insights gained from the stakeholders will now be considered by the Group.

The Working Group is scheduled to meet on a fortnightly basis over the coming months, to consider the involvement of patients, industry, and clinicians, in each stage of the reimbursement process. The Group is tasked to report to the Minister on measures undertaken to address the priority recommendations in the Report, and to provide other ambitious proposals to increase access to new medicines for patients.

Abortion Services

Questions (1186)

Carol Nolan

Question:

1186. Deputy Carol Nolan asked the Minister for Health the number of claims for the combined termination procedure and aftercare made to the HSE via the primary care reimbursement scheme which were successfully remunerated in 2019, 2020, 2021, and 2022, in tabular form; and if he will make a statement on the matter. [35970/23]

Written answers

Minister for Health

As the Deputy’s question relates to a service area, I have referred this question to the HSE for direct response.

Departmental Reports

Questions (1187)

Verona Murphy

Question:

1187. Deputy Verona Murphy asked the Minister for Health the number of external consultant reports commissioned by his Department in each of the years 2020, 2021, 2022 and to-date in 2023; the cost of same; the company involved; the title and publication date, by report, in tabular form; and if he will make a statement on the matter. [35977/23]

Written answers

Minister for Health (Deputy Stephen Donnelly)

In response to your question, the information requested is set out per the table attached.

It is the policy in my 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.

External consultant reports commissioned

Departmental Reports

Questions (1188)

Verona Murphy

Question:

1188. Deputy Verona Murphy asked the Minister for Health the number of external consultant reports commissioned by the bodies under his Department's aegis in each of the years 2020, 2021, 2022 and to-date in 2023; the cost of same; the company involved; the title and publication date, by report, in tabular form; and if he will make a statement on the matter. [35978/23]

Written answers

Minister for Health (Deputy Stephen Donnelly)

In response to your question, the number of external consultant reports commissioned by the bodies under the aegis of the Department of Health in each of the years 2020, 2021, 2022 and to-date in 2023, is set out per the table attached.

It is the responsibility of each individual agency to only engage the services of external consultants where highly specialised skills are not available within their own organisation and, in particular, when such an approach is felt to be more appropriate and cost-effective.

External consultant reports commissioned

Disease Management

Questions (1189)

Michael Healy-Rae

Question:

1189. Deputy Michael Healy-Rae asked the Minister for Health if he will provide funding for MS care (details supplied); and if he will make a statement on the matter. [35983/23]

Written answers

Minister of State at the Department of Health

The Sláintecare Integration Fund formed part of the Sláintecare Action Plan 2019, which established the building blocks for a significant shift in the way in which health services are delivered in Ireland. Budget 2019 provided €20 million for the establishment of a ring-fenced Sláintecare Integration Fund or SIF, to support service delivery which focuses on prevention, community care and integration of care across all health and social care settings.

The SIF Round 1 supported 123 HSE and NGO sector projects, to test and evaluate innovative models of care providing a ‘proof of concept’ with a view to mainstreaming and scaling of successful projects through the annual budget estimates process.

The selection criteria for funding were: 

• To encourage innovations in the shift of care to the community or provide hospital avoidance measures;

• To scale and share examples of best practice and processes for chronic disease management and care of older people; 

• To promote the engagement and empowerment of citizens in the care of their own health. 

Successful SIF projects were mainstreamed via NSP 2021 and 2022 at an estimated cost of €24 million.

The MS Ireland “Active Neuro” project was mainstreamed with ringfenced funding allocated in Budget 2022 to the HSE to continue the project in 2022, and this has continued in 2023.

Any consideration for whether, and how best, to expand this service within the HSE, would be matter for the HSE to consider and to make a business case to the Department of Health, as part of the annual Estimates process in advance of the Budget later in the year.