Aodhán Ó Ríordáin
Question:510. Deputy Aodhán Ó Ríordáin asked the Minister for Health if she will make pregabalin a controlled substance; and if he will make a statement on the matter. [40994/23]
View answerMedicinal Products
Questions (510)
Written answers
Pregabalin is a prescription drug used to manage a number of long-term conditions, including epilepsy, neuropathic pain and generalised anxiety disorder. Under the Medicinal Products (Prescription and Control of Supply) Regulations 2003 (SI 540/2003) it is a Schedule A product subject to prescription which may not be renewed. On its website HSE has advice on the appropriate prescribing of pregabalin while in September 2019 the Irish Medical Council advise all doctors prescribing pregabalin to follow best practice guidelines and to only prescribe when absolutely required. Given the prescription controls in place and the professional prescribing advice offered by both the HSE and the Irish Medical Council there are no current plans to control pregabalin under the Misuse of Drugs Act 1977.
Medical Cards
Questions (511)
Eoin Ó Broin
Question:511. Deputy Eoin Ó Broin asked the Minister for Health to outline the process through which a person (details supplied) can obtain a medical card without having already been accepted by a GP, where their current GP does not accept medical cards and no other GPs are taking on new medical card patients and where the person is reliant on medical care; and if he will make a statement on the matter. [40996/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Eating Disorders
Questions (512)
Steven Matthews
Question:512. Deputy Steven Matthews asked the Minister for Health the position regarding the average waiting list timeframe for adults for referral to specialist eating disorder services both at a national level and specifically for County Wicklow; and if he will make a statement on the matter. [41015/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
Eating Disorders
Questions (513)
Steven Matthews
Question:513. Deputy Steven Matthews asked the Minister for Health the position regarding funding for specialist support for adults with eating disorders; if funding was cut for the National Clinical Programme for Eating Disorders (NCPED) this year compared to previous years; and if he will make a statement on the matter. [41017/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
Eating Disorders
Questions (514)
Steven Matthews
Question:514. Deputy Steven Matthews asked the Minister for Health if he can confirm if his Department or the HSE maintain a national statistical breakdown of the types of eating disorders that adults are presenting with (details supplied); and if he will make a statement on the matter. [41020/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
Dental Services
Questions (515)
Seán Canney
Question:515. Deputy Seán Canney asked the Minister for Health what assistance is in place to assist parents who paid for orthodontic treatment with a registered orthodontist, but the practice closed; what insurances are in place to assist parents to recover their money; and if he will make a statement on the matter. [41021/23]
View answerWritten answers
Since this situation first came to my attention officials in the Department of Health have worked with the Dental Council and relevant stakeholders to ensure that everything possible was done to resolve the concerns of patients affected.
The normal course of events would be that orthodontic practices are wound down in an orderly fashion when necessary and for patients to continue to receive care in other practices as arranged by the dentist providing their care. Due to the circumstances of the dentist’s suspension this was not possible. To support patients to receive continuity of care, the Dental Council wrote to orthodontists located nearest to the practice to seek their co-operation to provide care to former patients of this practice.
The Orthodontic Society of Ireland (OSI) coordinated with its members and the appropriate bodies to seek ways to resolve this situation to ensure that ongoing care is restored as soon as possible.
The Department contacted the Dental Council regarding an update, and they have informed us that the Orthodontist’s suspension remains in place.
While I have every sympathy for the patients involved, consumer law is the responsibility of the Department of Enterprise, Trade and Employment (DETE), and so issues relating to the refunding of fees are not within the remit of the Department of Health. The Competition and Consumer Protection Commission (CCPC) is the statutory body responsible for promoting compliance with, and enforcing, competition and consumer protection law in Ireland and are best placed to advise on any concerns regarding refunding of professional fees.
Eating Disorders
Questions (516)
Steven Matthews
Question:516. Deputy Steven Matthews asked the Minister for Health the estimated cost of rolling out the proposed National Clinical Programme for Eating Disorders; the projected year on year cost of maintaining this service thereafter; and if he will make a statement on the matter. [41022/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
National Archives
Questions (517)
Patrick Costello
Question:517. Deputy Patrick Costello asked the Minister for Health if all of his Department's records relating to a constitutional action (details supplied) in relation to the criminalisation of homosexuality have been transferred to the national archives. [41023/23]
View answerWritten answers
My Department is currently finalising preparations for this year's record transfers. My Department will be engaging with the National Archives and anticipates that relevant records will be transferred in the coming weeks.
Departmental Contracts
Questions (518)
John McGuinness
Question:518. Deputy John McGuinness asked the Minister for Health if he will confirm the value of the contracts awarded to companies for the provision of homecare services in each of the past five years and the names of the successful companies; if robust due diligence was carried out on each company; if the successful companies can flip the contract once awarded; and if he will make a statement on the matter. [41024/23]
View answerWritten answers
As these are operational matters, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Health Service Executive
Questions (519)
Michael Healy-Rae
Question:519. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [41025/23]
View answerWritten answers
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.
Hospital Waiting Lists
Questions (520)
Niamh Smyth
Question:520. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) is waiting so long on a right hip replacement in Cappagh hospital; and if he will make a statement on the matter. [41027/23]
View answerWritten answers
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.
Dental Services
Questions (521)
Ruairí Ó Murchú
Question:521. Deputy Ruairí Ó Murchú asked the Minister for Health if he will provide an update on the numbers of dentists around the State still treating medical card patients; and if he will make a statement on the matter. [41030/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Medical Cards
Questions (522, 549)
Ruairí Ó Murchú
Question:522. Deputy Ruairí Ó Murchú asked the Minister for Health if consideration will be given to the automatic provision of medical cards to people with a spinal cord injury based on certified medical needs, rather than means; whether there are plans to extend the review cycle for medical card holders with a spinal cord injury to ten years; and if he will make a statement on the matter. [41031/23]
View answer
Robert Troy
Question:549. Deputy Robert Troy asked the Minister for Health if he will ensure the automatic provision of medical cards to people with a spinal cord injury based on certified medical needs, rather than means (details supplied); and if he will extend the review cycle for medical card holders with a spinal cord injury to ten years. [41177/23]
View answerWritten answers
I propose to take Questions Nos. 522 and 549 together.
Medical 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.
The HSE is also required to undertake periodic reviews of eligibility in order to ensure that a person continues to meet the qualifying criteria required to continue holding eligibility. Where any medical or GP visit card holder has a review process initiated, it should be noted that he/she will continue to retain their eligibility for the duration of the review process.
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. 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.
Hospital Deaths
Questions (523)
Richard Bruton
Question:523. Deputy Richard Bruton asked the Minister for Health if he has examined the reports of elevated death rates; and whether any research is being undertaken to evaluate underlying factors. [41033/23]
View answerWritten answers
The Department of Health does not produce estimates of excess mortality. However, the Department works closely with the Health Protection Surveillance Centre (HPSC) and other stakeholders to monitor estimates of excess mortality. Excess mortality refers to the number of deaths from all causes during a period of time above and beyond what we would have normally expected to see.
A number of different methodologies have been developed by organisations and academics internationally to try to estimate levels of excess mortality. It is important to note that estimation methods vary, for example in the years used to estimate a baseline, in how they estimate the level of expected deaths, the data source used for ‘actual’ deaths and whether statistical significance tests are applied before reporting deaths as excess. There is therefore no single source of data on estimated excess mortality.
Internationally work is currently underway to improve methods to estimate excess mortality including moving the baseline years used to calculate expected deaths forward from pre-pandemic years. The gap between the current period and the baseline period is relatively wide and growing. The gap is greater than would have been normal practice previously, which impacts on comparability between the current period and the period used to estimate ‘expected’ deaths.
In addition, most estimation methods, including Eurostat and EuroMOMO, do not currently take account of demographic changes such as population change or ageing which may have occurred since the baseline period and which can have a large impact on mortality. EuroMOMO has received four-year funding to further develop their model, including the incorporation of demographic change.
The Health Protection Surveillance Centre (HPSC) has monitored excess mortality in Ireland since 2009, using registered deaths data reported to HPSC on a daily basis from the General Register Office (GRO). HPSC participates in EuroMOMO for Ireland, a European mortality monitoring activity, aiming to detect and measure excess deaths related to seasonal influenza, pandemics and other public health threats. EuroMOMO publish a weekly update of estimates of excess mortality for all participating European countries www.euromomo.eu/graphs-and-maps. This is the primary indicator of excess mortality used in Ireland.
The latest HPSC excess mortality analysis of all registered deaths in Ireland for the 2022/2023 winter period, using the standardised European EuroMOMO algorithm, has shown:
• Excess all-cause mortality over five consecutive weeks (week 51 2022 – week 3 2023), reaching moderate levels of excess during weeks 51 and 52 2022 and week 2 2023 (data attached)
• All-cause, all ages mortality has been below the baseline and within the normal range since week 3 2023.
• EuroMOMO estimates that over the past 12 months, Ireland has experienced excess mortality during five weeks.
EuroMOMO excess mortality estimates (weekly z-scores) for all ages, Ireland, Week 37 2017 – Week 35 2023 www.euromomo.eu/graphs-and-maps#
See attached EuroMOMO_IRL_-z-scores.png
These data are provisional due to the time lag with death registration in Ireland. A country-specific adjustment function was applied to correct for the typical lag in registrations of deaths in Ireland (the legal period for death registration in Ireland is three months). Nonetheless, estimates of excess mortality for the most recent weeks are reported with some uncertainty and should be interpreted with caution.
It is important to note that excess mortality has been observed during previous periods when influenza viruses circulated at high levels in Ireland, for example in winter 2017/2018 which has previously been characterised as a severe flu season, and during certain periods of the COVID-19 pandemic (April 2020 and January 2021).
As Ireland experienced a winter of high levels of influenza cases and hospitalisations, it would not be unexpected to see excess mortality. Influenza activity was at very high levels in Ireland during December 2022 and early/mid-January 2023, with a high number of influenza hospitalisations reported (see wwwfluenza/seasonalinfluenza/surveillance/influenzasurveillancereports/20222023season/.hpsc.ie/a-z/respiratory/in). Other important factors that may impact excess mortality include the ongoing COVID-19 pandemic, circulation of other respiratory viruses, impacts of cold weather, and an ageing population.
Excess mortality was also observed in other European countries over the course of winter 2022/2023. In Europe, the overall pooled EuroMOMO estimates of all-cause excess mortality in all age groups for the participating European countries have shown elevated mortality in all age groups for late 2022/early 2023.
Separately, Eurostat publishes monthly estimates of excess mortality for EU (and some non-EU) countries. This data only incudes excess mortality estimates from January 2020 onwards. Eurostat use the following methodology, ‘The excess mortality indicator simply takes the number of people who died from any cause, in a given period, and compares it with a historical baseline from previous years in a period which was not affected by the pandemic. In this case, the baseline consists of the average number of deaths that occurred in each month during the period 2016-2019’.
The methodology does not require a statistically significant difference to report excess deaths. As noted above, it also does not take account of factors such as demographic change. The recent Census 2022 summary results have shown that the number of persons in Ireland aged 65 years and over increased by 22% between 2016 and 2022. Within this category, the highest increases were among those aged 75-84 years (28%) and 85 years and over (25%). Over the same period, the total population only increased by 8.1% with declines in some younger age.
The 22% increase in the population aged 65 years and older in Ireland between 2016 and 2022, was more than double the 10% increase which occurred for the EU27 over the same period. For the 75-84 years age category the difference was greater, with a 3% increase across the EU27 compared with a 28% increase in Ireland. The extent of the demographic changes in Ireland between the baseline period (2016-2019) and the current year (2023) reduces the value of comparing current deaths with deaths in 2016-2019.
In relation to Ireland, it is also important to note that data from 2020 onwards is based on data provided by the CSO based on a web-scraped series from rip.ie. The comparison baseline (2016-2019) is built using official data on registered deaths. Caution is required in interpreting this indicator.
The latest data published by Eurostat (published 9 August 2023 ec.europa.eu/eurostat/statistics-explained/index.php?title=Excess_mortality_-_statistics), refers to deaths in June 2023. Based on the Eurostat methodology, it is estimated that Ireland experienced 13.6% additional deaths in June and has experienced additional deaths every month for the past 12 months (data attached). This means the number of deaths in each month was higher than the average number of deaths in that same month during the years 2016-2019. It does not account for population growth, ageing or other factors impacting on long-term mortality trends.
The Central Statistics Office (CSO) publishes official statistics on mortality in Ireland and publishes quarterly and yearly statistics on registered deaths through their Vital Statistics publications. The latest published data is for deaths registered in Quarter 1 2023 and data is provisional. Data on deaths in each quarter from Quarter 2 2022 to Quarter 1 2023 by cause of death is attached.
The Department of Health is actively monitoring and reviewing all available data on mortality as it becomes available to gain a better insight on the underlying mortality trends and factors influencing these. The Department supports the clear national commitment to learn from the COVID-19 pandemic, in particular with a view to ensuring the State’s preparedness for future public health threats.
Attached
Medical Cards
Questions (524)
Paul Kehoe
Question:524. Deputy Paul Kehoe asked the Minister for Health if a medical card patient should be charged for an MRI with a healthcare provider (details supplied) following a contract change on 1 August 2023, which would previously have been covered; and if he will make a statement on the matter. [41034/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Disability Services
Questions (525)
Michael Healy-Rae
Question:525. Deputy Michael Healy-Rae asked the Minister for Health when an appointment can be given to a person (details supplied); and if he will make a statement on the matter. [41035/23]
View answerWritten answers
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 Qualifications
Questions (526)
Ivana Bacik
Question:526. Deputy Ivana Bacik asked the Minister for Health if he has made representations to the Health Service Executive in relation to the exclusion of graduates of medicine in Northern Ireland from working in hospitals here by reason of the Health Service Executive requiring a transcript from their higher education institution at an earlier date than is possible to arrange; and if he will make a statement on recruitment of healthcare staff from Northern Ireland more generally. [41046/23]
View answerWritten answers
As recruitment is a matter for the Health Service Executive, the HSE has been asked to respond directly to the Deputy.
Hospital Facilities
Questions (527)
Seán Canney
Question:527. Deputy Seán Canney asked the Minister for Health for an update on the provision of x-ray facilities at Tuam primary care centre; when work will commence and when the facility will be operational; and if he will make a statement on the matter. [41070/23]
View answerWritten answers
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.
Mental Health Services
Questions (528)
Verona Murphy
Question:528. Deputy Verona Murphy asked the Minister for Health the current staffing levels within the Wexford CAMHS services; the current vacancies that are presently available within the Wexford CAMHS services, in tabular form; the vacancies that are currently with the national recruitment services; and if he will make a statement on the matter. [41071/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible
Mental Health Services
Questions (529)
Verona Murphy
Question:529. Deputy Verona Murphy asked the Minister for Health the current number of referrals for support services to Wexford CAMHS services awaiting assessment; and if he will make a statement on the matter. [41072/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.