Written Answers Nos. 1734-1754
1734. Deputy Bernard J. Durkan asked the Minister for Health when a person (details supplied) will be urgently treated for cataract removal; the likely waiting time for such a procedure; and if he will make a statement on the matter. [38255/23]
View answerUnder 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.
1735. Deputy Verona Murphy asked the Minister for Health the total number of persons under 18 years of age who are currently waiting to commence orthodontic treatment in County Wexford; and if he will make a statement on the matter. [38256/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1736. Deputy Verona Murphy asked the Minister for Health the number of persons awaiting to commence orthodontic treatment in County Wexford who have been removed from the treatment waiting list and placed into care with private providers via the Waiting List Action Plan 2023; and if he will make a statement on the matter. [38257/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1737. Deputy Verona Murphy asked the Minister for Health the number of patients over the age of 18 awaiting commencement of orthodontic treatment in County Wexford who were identified as requiring treatment before 18 years of age; and if he will make a statement on the matter. [38258/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1738. Deputy Verona Murphy asked the Minister for Health the number of persons awaiting orthodontic treatment in County Wexford for 36 months or longer; 48 months or longer and 60 months or longer; and if he will make a statement on the matter. [38259/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1739. Deputy Patrick Costello asked the Minister for Health for an update on the family support aspect of the national drugs strategy; and if he will make a statement on the matter. [38323/23]
View answerThe National Drug Strategy, Reducing Harm, Supporting Recovery, sets out government policy on drug and alcohol use for the period 2017 to 2025. The strategy provides an integrated public health approach to drug and alcohol use, focused on reducing the harms for individuals, families and communities and promoting rehabilitation and recovery. The strategy recognises the importance of service users and their families in contributing to the planning, design, and delivery of effective services.
The Midterm Review identified six strategic priorities for the remaining years of the strategy until 2025. Strategic Implementation Group 2 (SIG 2) was set up to enhance access and delivery of drug and alcohol services in the community, in line with the Sláintecare population health model of ‘right care, right place, right time’.
In line with the above, in August I announced additional recurring funding in the amount of €240,000 allocated to the HSE to fund family support measures. For further information see
gov.ie - Minister Naughton announces additional funding for Family Support under the national drugs strategy (www.gov.ie)
Among the specific goals of the allocation are to:
• develop and broaden the range of supports for family members affected by addiction with a particular focus on virtual accessibility and supports through the RISE Foundation
• continue the coordination of training and support available for practitioners to deliver the 5-Step Method Intervention through C&F Training
• enable a mapping of family support services nationally in order to identify priority areas and maximise and strengthen the provision of services
Drug use by a family member doesn’t just affect the user; it can have a profound impact on family members, particularly children. I am very aware that families provide valuable support to a loved one affected by substance on their journey to recovery. I also recognise that families also have their own needs at this difficult time.
I am committed to continuing to support interventions like the five-step method that specifically supports families in their own right and not just as the main supporter for their loved one’s treatment.
1741. Deputy Patrick Costello asked the Minister for Health for a breakdown in tabular form of the number of staff employed by each drug and alcohol task force; the number at each staff level; the number of vacant positions; and if he will make a statement on the matter. [38339/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1742. Deputy Patrick Costello asked the Minister for Health for an update on the work of the HSE-led initiative to reduce the health-related harms from cocaine and ‘crack’ cocaine; and if he will make a statement on the matter. [38340/23]
View answerIn June 2023, I announced increased funding of €500,000 for cocaine and crack cocaine services. This funding will expand the provision of cocaine services to all areas.
The Health Service Executive (HSE) has now advised that submissions from CHO 1, CHO 2, CHO 5, CHO 6, CHO 7, CHO 8 and CHO 9 were successful. Further details of the locations and host agencies of the successful applications are below.
|
CHO area |
Location/host agency |
|
CHO 1 |
CHO 1 Addiction Services/Across CHO1 |
|
CHO 2 |
Western Region Drug and Alcohol Task Force (WRDATF) in conjunction with the HSE Community Healthcare West Drugs Service (CHWDS) |
|
CHO 5 |
Cornmarket Project |
|
CHO 6 |
Dun Laoghaire Rathdown Outreach Project (DROP) |
|
CHO 7 |
Community Addiction Response Programme (CARP), Jobstown Assisting Drug Dependency (JADD) Project, South Inner City Drug and Alcohol Task Force, Coolmine Therapeutic Community and partners |
|
CHO 8 |
CHO 8 Addiction Services/Section 39 partners |
|
CHO 9 |
Dublin North City and County (across HSE Addiction Services and several Section 39 agencies) |
This new funding will build on the cocaine-specific services that were funded last year with €850,000 being provided for four Community Healthcare Organisations (CHO) areas to deliver community-based responses, which included specific training for staff as well as supports to empower communities to tackle this issue.
Enhancing access to, and the delivery of, drug and alcohol services in the community is a strategic priority under the national drugs strategy. It is vital that services are available to those who need them.
1743. Deputy Duncan Smith asked the Minister for Health the number of WTE senior physiotherapists in elective orthopaedics based at University Hospital Kerry in 2022 and to date in 2023, in tabular form. [38345/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1744. Deputy Duncan Smith asked the Minister for Health the number of WTE gastroenterology nurse specialists based in Letterkenny University Hospital in 2021, 2022 and to date in 2023, in tabular form. [38346/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1745. Deputy Duncan Smith asked the Minister for Health the number of WTE advanced nurse practitioner in enhanced arthplasty at Croom Orthopaedic Hospital in the years of 2022 and to date in 2023, in tabular form. [38347/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1746. Deputy Mark Ward asked the Minister for Health the amount of money spent by the HSE on legal cases, by year, from 2018 to date; the amount spent on covering legal fees of plaintiffs in the cases the HSE did not win; the types of cases brought against the HSE in this period; and if he will make a statement on the matter. [38348/23]
View answerThe State Claims Agency (SCA) has a statutory remit to manage personal injury claims on behalf of Delegated State Authorities including the Health Service Executive. The SCA have informed me that the information below has been extracted from the National Incident Management System (NIMS).
Please note that it is not possible for the SCA to report on plaintiff legal fees in the manner asked by the Deputy, therefore the data provided relates to all plaintiff legal costs paid in relation to the HSE in the years concerned.
Response from SCA:
• The information contained in this report has been extracted from the National Incident Management System (NIMS).
• HSE claims relate to claims against the HSE locations, i.e. Acute and Community settings, Section 38 service providers and the National Services and Disability sector locations. It does not contain any private scheme locations.
• Amounts include VAT.
• This report is correct as of 01/09/2023.
Criteria Used:
Table 1: Amount Paid
• Transaction Report Date: 2018 – 2023 (End of Aug).
• Total amount paid includes Damages, Agency Legal Costs, Plaintiff Legal Costs and Expert Costs
Table 2: Claims Created
• Claim Create Date: 2018 – 2023 (End of Aug).
• Coverage excludes PDR.
Table 1: Amount paid for HSE for the period 2018-2023 (End of Aug)
|
Transaction Type |
|
|
Amount Paid (€) |
|
|
|
|
|
|
2018 |
2019 |
2020 |
2021 |
2022 |
2023 (End of Aug) |
Grand Total |
|
Total Amount Paid |
315,630,980 |
378,468,829 |
380,223,320 |
450,346,118 |
484,207,735 |
344,202,647 |
2,353,079,629 |
|
Plaintiff Legal Costs* ** |
47,198,485 |
58,420,098 |
60,839,946 |
58,966,487 |
83,377,472 |
58,224,226 |
367,026,715 |
*The increased plaintiff legal cost from 2021 to 2022 is partly driven by the H1N1 vaccination claims.
**As noted above re plaintiff legal fees.
Table 2: HSE Claims Created between 2018-2023 (End of Aug) by Incident/ Hazard Category
Claim Create Year
|
Incident / Hazard Category |
2018 |
2019 |
2020 |
2021 |
2022 |
2023 (End of Aug |
Grand Total |
|
Clinical Care |
819 |
821 |
882 |
718 |
730 |
525 |
4,495 |
|
Exposure to Physical Hazards |
399 |
447 |
334 |
287 |
305 |
204 |
1,976 |
|
Exposure to Psychological hazards |
305 |
375 |
392 |
387 |
260 |
227 |
1,946 |
|
Crash/Collision |
211 |
211 |
178 |
167 |
242 |
164 |
1,173 |
|
Exposure to Behavioural Hazards |
204 |
196 |
132 |
112 |
143 |
100 |
887 |
|
Other* |
142 |
176 |
121 |
164 |
178 |
124 |
905 |
|
Grand Total |
2,080 |
2,226 |
2,039 |
1,835 |
1,858 |
1,344 |
11,382 |
* Others Incident/Hazard categories include Exposure to Biological Hazards, Exposure to Chemical Hazards, Property Damage/Loss (non crash/collision) and null categories.
Definitions:
National Incident Management System (NIMS): Incidents (which include claims) are reported using the “National Incident Management System”, hosted by the State Claims Agency (SCA). An incident can be a harmful Incident (Adverse Event), no harm incident, near miss, dangerous occurrence (reportable circumstance) or complaint.
Transaction Reporting Date: This refers to the date that payments were issued. These payments include damages, legal fees and other expert fees.
Damages Payments: Can includes both General Damages and Special Damages.
Plaintiff Legal Costs: Legal Costs incurred by the Plaintiff and paid by the SCA.
Agency Legal Costs: Fees paid to solicitors and barristers engaged by the SCA.
Other costs: Fees paid to experts engaged by the SCA e.g. medical experts, private investigators etc.
Claim: A claim refers to notification of intention to seek compensation for personal injury and/or property damage where it is alleged the State was negligent. The application may be in the form of a letter of claim, an InjuriesBoard.ie application, or a written/oral request.
Claim Create Date: The date the claim was created on NIMS either directly or as a result of an incident being upgraded.
Incident/Hazard Category: The incident/hazard category is a high level classification used to describe the cause of an incident. This is based on international recognised hazard classifications but which has been further developed to denote hazards that can have a direct or indirect impact on a person or property. This high-level classification is a grouping together of like type hazards which are broken down in further detail in the sub-hazard type. The high-level hazards include “Clinical Care”, “Exposure to Physical Hazards”, “Exposure to Psychological Hazards”, “Exposure to Chemical Hazards”, “Exposure to Biological Hazards”, “Crash/Collision” and “Property damage/loss (non-crash collision)”.
1748. Deputy Martin Browne asked the Minister for Health his plans to work with Trinity College with the intent of reinstating its specialist MSc in children’s mental health; to outline how the discontinuation of this course will not pose recruitment problems for CAMHS, as attributed to the HSE in recent media reports; and if he will make a statement on the matter. [38353/23]
View answerThe course referenced is a postgraduate MSc course in Mental Health, which has a number of specialist sections including CAMHS. It is not considered the main pathway or qualification required to work within CAMHS, but it is an additional academic qualification that some clinicians may decide to pursue. Completion of this course is not required to work in CAMHS. Many CAMHS staff will undertake other, shorter postgraduate skills-based training. It is not anticipated that the cancellation of this specific course will lead to further recruitment problems in CAMHS.
Over the past number of months, the HSE has been working to create the first Health Service Executive Strategic Resourcing Plan, which will create resourcing action and implementation plans for each staff category for the short, medium and long term. The HSE has been proactive in addressing recruitment challenges by funding targeted initiatives from within mental health resources including targeted engagement with Colleges/Training Bodies and undergraduate students/new graduates to promote opportunities in health and social care professional roles within mental health services.
The HSE has also invested €6m annually since 2016 to generate additional Nurse training capacity, €1.5m annually since 2020 in a Higher Specialist Training course to train 40 additional consultant psychiatrist posts each year and €5m annually since 2016 to recruit 130 assistant psychology posts to help in part to alleviate staffing shortages within mental health.
1749. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [38361/23]
View answerUnder 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.
1750. Deputy Denis Naughten asked the Minister for Health the steps he has taken to implement the motion approved by Dáil Éireann on dental services on 19 January 2023; the steps being taken to ensure that medical card patients have access to a dental service; and if he will make a statement on the matter. [38362/23]
View answerThere are challenges in the provision of dental services and I am aware that patients of all ages have been waiting longer than they should have to, to access care. I am committed to fundamentally reforming dental services through implementation of the National Oral Health Policy, Smile agus Sláinte. I have allocated an additional €21 million across Budget 2023 and Waiting List Action Plan 2023 to enable reforms to progress implementation and to deal with immediate difficulties patients are experiencing in accessing oral healthcare services.
From this additional allocation for 2023, €5 million is being invested to address backlogs in the HSE Public Dental Service which provides services to children. It is also supporting the HSE to provide emergency care for adult medical card holders who are having difficulty accessing a local dentist under the Dental Treatment Services Scheme (DTSS). The HSE have used this funding to increase capacity, in some cases establishing additional clinics and providing services outside normal hours.
The number of patients seen and treatments provided in the DTSS have increased since May 2022 when the Scheme was extended to include Scale and Polish for all medical card patients along with an expansion of the oral examination to include provision of preventative advice. From January to July this year, 131,626 additional treatments have been provided under the Scheme, with over 24,500 extra unique patients treated when compared with the same period last year.
Orthodontic patients are also benefitting from the additional investment. A private procurement initiative, which received a considerable funding uplift of €8.65m in 2023 across Budget 2023 and the Waiting List Action Plan, is progressing well with 1,541 patients of a full year projection of 2,288 patients transferred into private care between 1 January and 4 August 2023.
For orthodontic patients who require surgical input, the HSE is developing a model of care for oral and maxillofacial surgery through the National Clinical Programme for Surgery. €1.35m has been allocated in Budget 2023 to allow surgery to be procured for 45 patients waiting over 4 years for jaw surgery, which requires a lengthy hospital stay. The HSE is finalising the arrangements for this initiative to commence.
Policy implementation will continue to prioritise access issues and investment of €4.75 million of the additional Budget allocation is providing for the development of prevention-focused oral healthcare for children aged from 0-7 years.
Workforce planning is an essential component of the National Oral Health Policy. Additional resources have been allocated to commence this work which will include a census approach across the oral healthcare profession and also reviewing direct access and scope of practice for dental auxiliaries.
My Department is currently supporting the HSE to put clinical leadership and policy implementation leadership in place to drive necessary reform.
1751. Deputy Denis Naughten asked the Minister for Health the number of dental practices in counties Roscommon and Galway that have ceased providing medical card services in the past five years; the medical card dental services currently available to medical card users; the provision in place for those whose local dentist withdraws from the provision of medical card services; and if he will make a statement on the matter. [38363/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1752. Deputy Denis Naughten asked the Minister for Health when adjuvant abemaciclib will be approved to reduce the risk of breast cancer for patients; and if he will make a statement on the matter. [38364/23]
View answerThe 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 Abemaciclib (Verzenios®), the HSE have advised:
Advanced or Metastatic Breast Cancer
The HSE received an application for pricing / reimbursement for Abemaciclib (Verzenios®) on the 3rd July 2020 from Eli Lilly (the applicant) for the treatment of women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative locally advanced or metastatic breast cancer in combination with an aromatase inhibitor or Fulvestrant as initial endocrine-based therapy, or in women who have received prior endocrine therapy.
• 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 6th July 2020.
• The NCPE Rapid Review assessment report was received by the HSE on the 27th August 2020. The NCPE advised the HSE that a full HTA was recommended to assess the clinical effectiveness and cost effectiveness of Abemaciclib (Verzenios®) compared with the current standard of care, on the basis of the proposed price relative to currently available therapies. (www.ncpe.ie/drugs/abemaciclib-verzenios-hta-id-20033/)
• The HSE commissioned a full Health Technology Assessment (HTA) on the 1st September 2020 as per agreed processes.
• To date a HTA submission has not been received by the NCPE.
• Eli Lilly communicated to CPU in January 2022 that, at this point in time, they did not intend to progress their application for pricing and reimbursement for Abemaciclib (Verzenios®) for the treatment of women with hormone receptor (HR) positive, human epidermal growth factor receptor 2 (HER2) negative locally advanced or metastatic breast cancer in combination with an aromatase inhibitor or Fulvestrant as initial endocrine-based therapy, or in women who have received prior endocrine therapy.
Early Breast Cancer
The HSE received an application for pricing / reimbursement on the 11th April 2022 from Eli Lilly (the applicant) for a new indication for Abemaciclib (Verzenios®) in combination with endocrine therapy for the adjuvant treatment of adult patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, node positive early breast cancer at high risk of recurrence.
• 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 April 2022.
• The NCPE Rapid Review assessment report was received by the HSE on the 6th May 2022. The NCPE have advised the HSE that a full HTA is recommended to assess the clinical effectiveness and cost effectiveness of Abemaciclib (Verzenios®) compared with the current standard of care.
• The HSE commissioned a full Health Technology Assessment on the 26th May 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 Abemaciclib (Verzenios®) are available at (www.ncpe.ie/drugs/abemaciclib-verzenios-for-adjuvant-hr-positive-her2-negative-node-positive-early-breast-cancer-hta-id-22020/)
• 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 commercial negotiations, and any patient group submission(s) received. The HSE Drugs Group will consider all of the evidence and make 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.
The application for the early breast cancer indication remains under consideration. The HSE cannot make any comment on possible outcomes from the ongoing process.
1753. Deputy Claire Kerrane asked the Minister for Health what services are available under the dental treatment services scheme in County Roscommon; what action is being taken to ensure that medical card holders can access dental services in Roscommon; and if he will make a statement on the matter. [38366/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1754. Deputy Brian Stanley asked the Minister for Health to take action to ensure an occupational therapist is recruited in Laois for the elderly, and also to provide a service to three nursing units in the county. [38367/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
