Tuesday, 25 Jul 2023

Written Answers Nos. 1190-1210

Health Services

Questions (1190)

Brendan Griffin

Question:

1190. Deputy Brendan Griffin asked the Minister for Health for clarification on a matter (details supplied); and if he will make a statement on the matter. [35988/23]

Written answers

Minister of State at the Department of Health

As this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Health Services Staff

Questions (1191)

Michael Healy-Rae

Question:

1191. Deputy Michael Healy-Rae asked the Minister for Health to implement target strategies to attract and retain qualified staff by providing better wages, working conditions and professional opportunities; and if he will make a statement on the matter. [35996/23]

Written answers

Minister for Health

The HSE Resourcing Strategy was published in April 2023 outlining the specific and targeted action plans for the following health service grades Medical & Dental, Nursing & Midwifery, Health and Social Care Professions, Patient, Client Care & General Support, Management, Administration & Technical.   The HSE are specifically targeting Workforce Planning & Resourcing by Building Supply, creating Additional Practice Placement infrastructure and creating Career Pathways.  They will also focus on data gathering of leavers and they will be Quantifying 3rd level attrition to ensure a full understanding of factors.

As implementation progresses, they will be measured against the Resourcing Programme Measures. They will be monitored to deliver services and professions measured through the lens of an integrated care model aligned with the future structure of the Regional Health Authorities (RHA). We recognise that as the transition to the RHA structure progresses, the work of the Programme must continue to evolve to meet these transitions and the wider health service requirements.

There has been unprecedented growth in all staff categories in the Health Service over recent years. In June the total workforce stands at 141,397 WTE. This is an increase of 761 WTE from May figures. In 2020, 2021 and 2022 the HSE achieved the three largest increases in the workforce since the foundation of the HSE. This expansion is continuing in 2023 with an expected growth of 6,000 WTE. There are 21,584 more WTE working in our health service than there were at the beginning of 2020. This includes 6,557 nurses and midwives; 3,233 health and social care professionals; and 2,049 doctors and dentists. Work is ongoing to improve retention policies, speed up recruitment processes and to add more educational places to expand the workforce to the largest extent possible.

The Department and the HSE are working together to increase the supply of healthcare professionals across all professions. The HSE is focused on retention of existing HSE staff and maximising the number of health care graduates from Irish colleges entering the public health services.

The HSE are targeting all nursing, midwifery and health and social care graduates across all Irish colleges with the offer of permanent positions in the HSE, together with competitive relocation packages to entice our graduates from previous years home.

Medicinal Products

Questions (1192)

Duncan Smith

Question:

1192. Deputy Duncan Smith asked the Minister for Health the timeline which he has given the HSE to complete its reimbursement process regarding the provision of enhertu for the treatment of breast cancer; if he is aware of the impact of delays in access to enhertu on outcomes for Irish patients; and if he will make a statement on the matter. [35998/23]

Written answers

Minister for Health

The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.

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). There are formal processes which govern applications for the pricing and reimbursement of medicines, and new uses of existing medicines, to be funded and/or reimbursed.

In terms of the specific details of the application for pricing and reimbursement of Trastuzumab deruxtecan (Enhertu®): 

HER2-positive breast cancer

The HSE received an application for pricing and reimbursement of Trastuzumab deruxtecan (Enhertu®) on the 8th July 2022 from AstraZeneca (the applicant) as monotherapy indicated for the treatment of adult patients with unresectable or metastatic HER2- positive breast cancer who have received one or more prior anti-HER2-based regimens. 

• The first step in the process is the submission of a Rapid Review dossier (a clinical and economic dossier) to the National Centre for Pharmacoeconomics (NCPE) for assessment. The HSE commissioned the Rapid Review process on the 11th July 2022. 

• The NCPE Rapid Review assessment report was received by the HSE on the 27th July 2022. The NCPE advised the HSE that a full Health Technology Assessment (HTA) was recommended to assess the clinical effectiveness and cost effectiveness of Trastuzumab deruxtecan (Enhertu®) compared with the current standard of care. 

• The HSE commissioned a full Health Technology Assessment (HTA) on the 31st August 2022 as per agreed processes. 

• The NCPE publishes details of medicines where the HSE has commissioned a Rapid Review assessment and/or a full health technology assessment on their website. The website is updated at regular intervals and includes assessment outcomes and updates on reimbursement for each individual medicine and indication listed. Details of the assessment(s) of Trastuzumab deruxtecan (Enhertu®) are available at www.ncpe.ie/drugs/trastuzumab-deruxtecan-enhertu-hta-id-22050/. 

• The HSE Corporate Pharmaceutical Unit (CPU) is the interface between the HSE and the Pharmaceutical Industry in relation to medicine pricing and reimbursement applications. 

• The Drugs Group is the national committee which the HSE has in place to make recommendations on the pricing and reimbursement of medicines. The membership of the HSE Drugs Group includes public interest members. The pharmacoeconomic report will be reviewed by the HSE Drugs Group along with the outputs of any commercial negotiations, and any patient group submission(s) received. The HSE Drugs Group considers all of the evidence and makes a recommendation to the HSE Executive Management Team. 

• The decision making authority in the HSE is the HSE Executive Management Team. The HSE Executive Management Team decides on the basis of all the demands it is faced with (across all services) whether it can fund a new medicine, or new use of an existing medicine, from the resources that have been provided to it in line with the Health (Pricing and Supply of Medical Goods) Act 2013.  

HER2-low breast cancer

The HSE received an application for pricing and reimbursement of Trastuzumab deruxtecan (Enhertu®) on the 17th February 2023 from AstraZeneca (the applicant) as monotherapy indicated for the treatment of adult patients with unresectable or metastatic HER2 low breast cancer who have received prior chemotherapy in the metastatic setting or developed disease recurrence during or within 6 months of completing adjuvant chemotherapy. 

• The first step in the process is the submission of a Rapid Review dossier (a clinical and economic dossier) to the National Centre for Pharmacoeconomics (NCPE) for assessment. The HSE commissioned the Rapid Review process on the 20th February 2023. 

• The NCPE Rapid Review assessment report was received by the HSE on the 16th March 2023. The NCPE advised the HSE that a full Health Technology Assessment (HTA) was recommended to assess the clinical effectiveness and cost effectiveness of Trastuzumab deruxtecan (Enhertu®) compared with the current standard of care. 

• The HSE commissioned a full Health Technology Assessment (HTA) on the 30th March 2023 as per agreed processes. 

• The NCPE publishes details of medicines where the HSE has commissioned a Rapid Review assessment and/or a full health technology assessment on their website. The website is updated at regular intervals and includes assessment outcomes and updates on reimbursement for each individual medicine and indication listed. Details of the assessment(s) of Trastuzumab deruxtecan (Enhertu®) are available at www.ncpe.ie/trastuzumab-deruxtecan-enhertu/ .

• The HSE Corporate Pharmaceutical Unit (CPU) is the interface between the HSE and the Pharmaceutical Industry in relation to medicine pricing and reimbursement applications. 

• The Drugs Group is the national committee which the HSE has in place to make recommendations on the pricing and reimbursement of medicines. The membership of the HSE Drugs Group includes public interest members. The pharmacoeconomic report will be reviewed by the HSE Drugs Group along with the outputs of any commercial negotiations, and any patient group submission(s) received. The HSE Drugs Group considers all of the evidence and makes a recommendation to the HSE Executive Management Team. 

• The decision making authority in the HSE is the HSE Executive Management Team. The HSE Executive Management Team decides on the basis of all the demands it is faced with (across all services) whether it can fund a new medicine, or new use of an existing medicine, from the resources that have been provided to it in line with the Health (Pricing and Supply of Medical Goods) Act 2013. 

Both applications remain under consideration with the HSE. The HSE cannot make any comment on possible outcomes from the ongoing processes.

Health Services Staff

Questions (1193)

Duncan Smith

Question:

1193. Deputy Duncan Smith asked the Minister for Health how his Department plans to increase the workforce (details supplied); how his Department plans to fund the additional clinical placements that will be needed to train the growing workforce; if additional clinical tutors will be hired to facilitate extra clinical placements; if monetary incentives will be given for current staff to facilitate clinical placements; and if he will make a statement on the matter. [36005/23]

Written answers

Minister for Health

As this is an operational matter for the Health Service Executive, the HSE has been asked to respond directly to the Deputy.

National Children's Hospital

Questions (1194)

Catherine Murphy

Question:

1194. Deputy Catherine Murphy asked the Minister for Health the details of the legal costs incurred by the National Paediatric Hospital Development Board in challenging claims brought against it by contractors associated with the National Children's Hospital from 2017 to date in 2023, in tabular form; the projected legal costs until 2025; if the NPHDB has made requests for increased and-or additional funds for day-to-day operations in 2022, 2023 and 2024; the amount expended on public relations advice and communications by the board in 2021, 2022 and to date in 2023, in tabular form; if the board retains a third party for communications and PR services; and if he will make a statement on the matter. [36008/23]

Written answers

Minister for Health

The National Paediatric Hospital Development Board (NPHDB) has statutory responsibility for planning, designing, building, and equipping the new children's hospital. I have therefore referred your question to the NPHDB for direct reply.

Dental Services

Questions (1195)

Pádraig O'Sullivan

Question:

1195. Deputy Pádraig O'Sullivan asked the Minister for Health the number of orthodontic procedures undertaken at the CUH Dental Hospital since 1 March 2023; and if he will make a statement on the matter. [36013/23]

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.

Dental Services

Questions (1196)

Pádraig O'Sullivan

Question:

1196. Deputy Pádraig O'Sullivan asked the Minister for Health the current wait time for an orthodontic procedure at the CUH Dental Hospital, Cork; and if he will make a statement on the matter. [36014/23]

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.

Question No. 1197 answered with Question No. 1099.

Primary Care Centres

Questions (1198)

Michael McNamara

Question:

1198. Deputy Michael McNamara asked the Minister for Health the current status on the progression of the proposed primary care centre in Kilrush, County Clare; and if he will make a statement on the matter. [36020/23]

Written answers

Minister for Health

As 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.

Budget 2024

Questions (1199)

Fergus O'Dowd

Question:

1199. Deputy Fergus O'Dowd asked the Minister for Health if he has received the pre-budget 2024 submission by a group (details supplied); and if he will make a statement on the matter. [36024/23]

Written answers

Minister of State at the Department of Health (Deputy Mary Butler)

The Pre-Budget submission by the organisation referred to by the Deputy has been received and the content will be given due consideration in the context of this year’s estimate process.

Covid-19 Pandemic

Questions (1200)

Thomas Pringle

Question:

1200. Deputy Thomas Pringle asked the Minister for Health what measures are being taken to ensure that all employees who are entitled to the €1,000 pandemic payment are paid; when all the agency contractor roles will be approved for payment as in the case of a person (details supplied); if they are entitled to the payment; if so, when it will be paid; and if he will make a statement on the matter. [36026/23]

Written answers

Minister for Health

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

I would also like to remind the Deputy that it is against Department policy to comment on individual cases. 

Hospital Staff

Questions (1201)

Pádraig O'Sullivan

Question:

1201. Deputy Pádraig O'Sullivan asked the Minister for Health further to Parliamentary Question No. 725 of 27 June 2023, if he will detail the latest staff numbers in Cork University Hospital to include staff figures for the Maternity Hospital; and if he will make a statement on the matter. [36027/23]

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 Waiting Lists

Questions (1202)

Niamh Smyth

Question:

1202. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) has been waiting for an appointment in the Mater Hospital to have cataracts removed; and if he will make a statement on the matter. [36044/23]

Written answers

Minister for Health

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Medical Aids and Appliances

Questions (1203)

Paul Murphy

Question:

1203. Deputy Paul Murphy asked the Minister for Health how many spring implants have been used in Temple Street Hospital, for spinal surgery in patients with spinal muscular atrophy and spina bifida; how many have been removed; and how many have failed in situ. [36050/23]

Written answers

Minister for Health

In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Medical Aids and Appliances

Questions (1204)

Paul Murphy

Question:

1204. Deputy Paul Murphy asked the Minister for Health in relation to the spring implants which have been used in Temple Street Hospital for spinal surgery in patients with spinal muscular atrophy and spina bifida, which vendor supplied these implants; and whether their use has been marked in each patient’s notes by a sticker or otherwise. [36051/23]

Written answers

Minister for Health

In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Medical Aids and Appliances

Questions (1205)

Paul Murphy

Question:

1205. Deputy Paul Murphy asked the Minister for Health whether the invoices for the spring implants which have been used in Temple Street Hospital for spinal surgery in patients with spinal muscular atrophy and spina bifida are available and can be published. [36052/23]

Written answers

Minister for Health

In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Medical Aids and Appliances

Questions (1206)

Paul Murphy

Question:

1206. Deputy Paul Murphy asked the Minister for Health in relation to the spring implants which have been used in Temple Street Hospital for spinal surgery in patients with spinal muscular atrophy and spina bifida, whether they are CE marked; and if not, what governance process oversaw and permitted their use. [36053/23]

Written answers

Minister for Health

In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Medical Aids and Appliances

Questions (1207)

Paul Murphy

Question:

1207. Deputy Paul Murphy asked the Minister for Health in relation to the implantation of the spring implants which have been used in Temple Street Hospital for spinal surgery in patients with spinal muscular atrophy and spina bifida, what consent process did the patients and families go through for unregistered implants; and how is this documented. [36054/23]

Written answers

Minister for Health

In relation to the particular query raised, 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 (1208)

Michael Healy-Rae

Question:

1208. Deputy Michael Healy-Rae asked the Minister for Health if a scheme (details supplied) will be changed in order to allow more persons to access same; and if he will make a statement on the matter. [36056/23]

Written answers

Minister of State at the Department of Health

Following publication of the Maskey report on the CAMHS service in South Kerry, the Taoiseach committed to examining non-adversarial ways of compensating families affected, in consultation with the Attorney General. The Office of the Attorney General, the State Claims Agency, the Health Service Executive (HSE) and the Department of Health worked together to develop a settlement scheme for the children, young people and families affected by the report. The arising State Compensation Scheme was announced in April 2022 and is designed to provide full compensation, and clinical supports, if required, to those who suffered harm or injury as identified through the Maskey Report. Such a compensation scheme was called for by many mental health advocates, including families in South Kerry. Around 170 offers have been followed up to-date.

To qualify to receive compensation, patients must have suffered harm or injury whilst attending Kerry CAMHS from 1 July 2016 to 19 April 2021, be identified as being affected by the events outlined in the Maskey Report, and have been notified by CAMHS. The original Maskey Report does note that there is no definitive number of people who suffered harm. As people engage with mental health services relating to the Maskey report, evidence of levels of harm may be found so the number of people who are eligible for the scheme may change. 

The nature of State Compensation schemes is such that they are defined by clear criteria and terms of eligibility. Such schemes are not defined to be discriminatory, but rather to ensure that those who meet the relevant criteria can access the scheme.  This is not to say that the scheme in question is limited. Importantly, as evidenced by the additional eligible children in North Kerry subsequently identified by the HSE as qualifying for the Scheme, any further appropriate cases in Kerry recommended by HSE will be given full consideration by the SCA. However, aside from the inclusion of such individual eligible cases, it is not intended that there be any fundamental change to the Compensation Scheme introduced by Government relating to the Maskey report.

The State Claims Agency continues to engage with families in relation to the processes involved in the compensation scheme. Should patients or their families have any questions in relation to their eligibility for the scheme, they can contact the HSE Kerry CAMHS information line remains open on 1800 742 800, from 9am to 5pm, Monday to Friday.

Question No. 1209 answered with Question No. 1150.

Nursing Homes

Questions (1210)

Jim O'Callaghan

Question:

1210. Deputy Jim O'Callaghan asked the Minister for Health the refurbishments or replacements completed since 2020 in each of the public nursing homes; the number of additional beds provided in each facility, in tabular form; and if he will make a statement on the matter. [36067/23]

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.