Written Answers Nos. 1007-1026
1007. Deputy Catherine Connolly asked the Minister for Health the progress to date on the programme for Government commitment to establish a national leadership role for mental health in the HSE; the timeline for the role to be filled; and if he will make a statement on the matter. [40438/23]
View answerAs this is a service matter I have asked the HSE to respond directly to the Deputy as soon as possible.
1008. Deputy Catherine Connolly asked the Minister for Health the status of plans to reform the Mental Health Act 2001; the timeline for same; and if he will make a statement on the matter. [40439/23]
View answerThe General Scheme of a Bill to amend the Mental Health Act was published in July 2021. The Oireachtas Sub-Committee on Mental Health’s Pre-Legislative Scrutiny Report on the General Scheme was published on 12 October 2022.
Priority drafting for the Mental Health Bill was sought and granted for the Spring/Summer legislative sessions this year and officials in my Department are working intensively with the Attorney General’s Office and the Office of Parliamentary Counsel to progress the final text of this complex, lengthy Bill.
The publication of the Mental Health Bill is a priority for me and for the Government and I look forward to introducing the Bill to the Oireachtas as soon as possible following publication of the Bill.
The new Bill will overhaul our mental health legislation making it more person-centred and human rights focused and help to put in place a more robust framework in which mental health services can be delivered.
1010. Deputy Colm Burke asked the Minister for Health to confirm his plans for increased mental health supports; and if he will make a statement on the matter. [40441/23]
View answer1011. Deputy Colm Burke asked the Minister for Health to confirm that mental health spending will be increased to 10% of the overall health budget, in line with international standards; and if he will make a statement on the matter. [40442/23]
View answerI propose to take Questions Nos. 1010 and 1011 together.
The Department of Health is currently engaging in dialogue with the Department of Public Expenditure, NDP Delivery and Reform and the HSE in relation to the 2024 Estimates. Until these discussions are concluded it would not be appropriate for me to comment on this matter. However, I am committed to ensuring the continued enhancement of mental health services through the allocation of additional funding for mental health in 2024.
The Government’s clear commitment to enhancing mental health services is shown by significant mental health funding increases in recent years. I would note that 2023 saw a record budget for mental health of €1.2bn. Budget 2023 delivered almost €58m in additional funding, and a further €10m in once-off funding for much needed minor capital works across the Mental Health system.
As noted above, the funding secured by mental health services for this year was €1.2 billion, however this figure does not include funding for other parts of the health service that provide mental health services and supports, such as psychotropic medicines funded by the Primary Care Reimbursement Service, liaison mental health services in acute hospitals, some dual diagnosis (addiction and mental health) services and mental health and well-being promotion.
It also does not include the cost of the Mental Health Commission, nor does it include spending by other departments on services that incorporate psychological or mental health supports, such as the Prison and Probation Services, Social Protection, Defence Forces, or the Department of Education.
Funding allocated to mental health services in recent years has allowed for the continued investment in the mental health national clinical programmes and models of care, which has led to significant service improvements, including the full implementation of specialist perinatal mental health network provided for and the on-going expansion of specialist mental health teams for eating disorders, ADHD in adults, and dual diagnosis.
Importantly, as budgets increase, we need to ensure that we have plans and strategies in place so that those resources are used effectively and efficiently to the benefit of people using our mental health services. All aspects of mental health services are being improved and developed in the short to longer term through our national mental health policy Sharing the Vision . Sharing the Vision aims to enhance the provision of mental health services and supports across a broad continuum, from mental health promotion, prevention, and early intervention to acute and specialist mental health service delivery, during the period 2020-2030.
1012. Deputy Michael Healy-Rae asked the Minister for Health if consideration will be given to awarding people with spinal cord injuries medical cards without the need for means testing; and if he will make a statement on the matter. [40444/23]
View answerMedical Card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE, which assesses each application on a qualifying financial threshold.
The issue of granting medical or GP visit cards based on having a particular disease or illness was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.
However, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.
The HSE also has a compassionate system in place for the efficient provision of medical cards in response to emergency situations i.e., where persons are in need of urgent ongoing medical care or when a patient is receiving end of life treatment. In these cases, a medical card is issued within 24 hours of receipt of the required patient details and completed medical report by a healthcare professional. In addition, since March 2021, persons who have been certified by their treating Consultant as having a prognosis of 24 months or less are now also awarded a medical card on an administrative basis. This measure delivered the Programme for Government commitment to extend eligibility for medical cards to persons with a terminal illness and work is continuing to develop a legislative framework to underpin this administrative scheme. Medical cards awarded on end of life grounds are never re-assessed by the HSE thereby providing reassurance and comfort to patients and their families.
I can assure the Deputy that, to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues under review and any changes are considered in the context of Government policy and other issues which may be relevant.
1013. Deputy Denis Naughten asked the Minister for Health when a person will receive an appointment (details supplied); the reason for the delay; and if he will make a statement on the matter. [40459/23]
View answerAs this is a service matter, I have asked the HSE to respond to the Deputy directly, as soon as possible.
1014. Deputy James Lawless asked the Minister for Health for an update on the service provision (details supplied); and if he will make a statement on the matter. [40460/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1015. Deputy Noel Grealish asked the Minister for Health if he will make the drug Vydura (rimegepant), available on the DPS scheme; if there is any other scheme available to help an individual with the cost of this drug; and if he will make a statement on the matter. [40546/23]
View answerThe 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.
The HSE is committed to providing access to as many medicines as possible, in as timely a fashion as possible, from the resources available to it.
The HSE robustly assesses applications for pricing and reimbursement to make sure it can stretch available resources as far as possible and to deliver best value in relation to each medicine and ultimately more medicines to Irish citizens and patients.
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 Rimegepant (Vydura®):
• The HSE received a complete application for pricing and reimbursement of Rimegepant (Vydura®) on the 13th July 2022 from Pfizer (the applicant) indicated for the acute treatment of migraine with or without aura in adults; and for the preventive treatment of episodic migraine in adults who have at least four migraine attacks per month.
• The first step in the process is the submission of a Rapid Review dossier (a clinical and economic dossier) to the National Centre for Phamacoeconomics (NCPE) for assessment. The HSE commissioned the Rapid Review process on the 13th July 2022.
• The NCPE Rapid Review assessment report was received by the HSE on the 12th September 2022. A full HTA was recommended to assess the clinical effectiveness and cost effectiveness of Rimegepant (Vydura®) compared with the current standard of care. (www.ncpe.ie/rimegepant-vydura-hta-id-22051/)
• The HSE commissioned a full Health Technology Assessment (HTA) on the 28th September 2022 as per agreed processes.
• The NCPE Health Technology Assessment report was received by the HSE on the 18th May 2023. The NCPE recommended that Rimegepant (Vydura®) be considered for reimbursement if cost-effectiveness can be improved relative to existing treatments and that a managed access programme is introduced. (www.ncpe.ie/wp-content/uploads/2022/09/Rimegepant-technical-summary-22051.docx.pdf)
• The HSE Corporate Pharmaceutical Unit (CPU) is the interface between the HSE and the Pharmaceutical Industry in relation to medicine pricing and reimbursement applications. CPU engaged in commercial negotiations with Pfizer in July 2023 regarding their application for Rimegepant (Vydura®).
• 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 Rimegepant (Vydura®) remains under consideration. The HSE cannot make any comment on possible outcomes from the ongoing process.
1017. Deputy Charles Flanagan asked the Minister for Health if he will provide details of the model of care, assessment procedure, governance structure and legal and service arrangement in place between the HSE and a private gender service clinic in Antwerp, Belgium (details supplied); and if he will make a statement on the matter. [40560/23]
View answerThis is more suitable for answer by the HSE as it is an operational question.
1018. Deputy Charles Flanagan asked the Minister for Health if he will confirm the existence of a funding arrangement under the EU cross-border healthcare directive between the HSE and a private gender service clinic (details supplied) in Antwerp, Belgium. [40570/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1019. Deputy Cian O'Callaghan asked the Minister for Health the number of people waiting for home support services, broken down by CHO area; and if he will make a statement on the matter. [40578/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1020. Deputy Cian O'Callaghan asked the Minister for Health the number of home support services hours currently provided by each CHO area; and if he will make a statement on the matter. [40579/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1021. Deputy Cian O'Callaghan asked the Minister for Health the number of persons waiting for a CAMHS appointment, by CHO, LHO and time waiting; and if he will make a statement on the matter. [40581/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1022. Deputy Pearse Doherty asked the Minister for Health the number of adults and children in Donegal on HSE dental waiting lists at the end of May and June of each year 2019 to 2023, broken down by standard waiting times, by clinic, in tabular form. [40593/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1023. Deputy Pearse Doherty asked the Minister for Health the number of adults and children in Donegal on HSE orthodontic waiting lists at the end of May and June of each year 2019 to 2023, broken down by standard waiting times, by clinic, in tabular form. [40594/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1024. Deputy Neasa Hourigan asked the Minister for Health whether the full investigation report into the handling of Covid-19 at a facility (details supplied) in the Phoenix Park, Dublin, in 2020 will be published; whether he has discussed this report with the HSE CEO; and if he will make a statement on the matter. [40607/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1025. Deputy Pádraig O'Sullivan asked the Minister for Health if he will report on the progress made in developing a new rare disease plan; when further information will be published; and if he will make a statement on the matter. [40609/23]
View answerMy Department is currently in the process of reviewing the National Rare Disease Plan 2014-2018. In parallel to this review, initial work has commenced on the development of a new Rare Disease Plan and is progressing with due consideration being given to how it can best meet the needs of patients and families affected by a rare disease. In the coming weeks my Department will make further information available with respect to the process for the development of a new the plan.
The development of a new Plan, along with the ongoing review of the 2014 Plan, will allow us to 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.
1026. Deputy Pádraig O'Sullivan asked the Minister for Health when the implementation working group established following the publication of the Mazars report and tasked with reviewing the policy, legal and institutional framework within which the HSE operates, in particular the requirements as set out in the Health (Pricing and Supply of Medical Goods) Act 2013, is due to report to the Minister; if he will outline the patient groups, industry representatives and stakeholders consulted; and if he will make a statement on the matter. [40610/23]
View answerIn February, I published the Mazars Review which examined the governance arrangements around the HSE’s Drug Pricing and Reimbursement Process. I fully support the recommendations contained in the Mazars report around improving the process, increasing transparency, providing easier access, and supporting value for money.
An implementation group has been established between my Department and the HSE to consider and progress the various recommendations contained in the Report. The membership of the Group includes representatives of the Drugs Group, the HSE, the NCPE, and the Department of Health. The Working Group has met frequently since its establishment, to consider the involvement of patients, industry, and clinicians, in each stage of the reimbursement process.
Targeted stakeholder consultation commenced on the 31st of May and concluded on the 20th of June. The insights gained from stakeholders will be considered by the Group as it continues its work on progressing the various recommendations of the Review. A report on this will be submitted to the Minister in the coming months. Submissions to the Group were received from:
Alliance of Rare Disease Companies Ireland
AstraZeneca
BioMarin
Cystic Fibrosis Ireland
Fighting Blindness
Irish Cancer Society
Irish Haematological Society
Irish Pharmaceutical Healthcare Association
Irish Platform for Patient Organisations, Science and Industry
Irish Society of Medical Oncologists
Medicines for Ireland
Multiple Sclerosis Ireland
National Cancer Control Programme
Rare Diseases Ireland
Rare Disease Technology Review Committee
