Written Answers Nos. 568-587
568. Deputy Seán Canney asked the Minister for Health if an interview taken in April 1994 in a hospital setting will be released to the patient involved (details supplied); and if he will make a statement on the matter. [41350/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
569. Deputy Pa Daly asked the Minister for Health when a support worker (details supplied) who worked in a healthcare facility during the pandemic can expect their pandemic special recognition payment; and if he will make a statement on the matter. [41355/23]
View answerAs 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.
570. Deputy Michael Ring asked the Minister for Health the reason that a person (details supplied) has been refused a drug prescribed by their GP; and if he will make a statement on the matter. [41384/23]
View answerOzempic (Semaglutide); this medication is licensed by the Health Products Regulatory Authority (HPRA) in Ireland and indicated as an adjunct to diet and exercise to improve glycaemic control in adults with type 2 diabetes mellitus. Novo Nordisk markets Ozempic in Ireland.
To date, there have been particular challenges in the supply of Ozempic to all markets, including to the Irish market.
According to Novo Nordisk, production issues in August 2023 at a manufacturing site will lead to a reduction in the overall supply of the 1mg strength of Ozempic to Ireland and other EU markets during the month of September 2023. A potential further brief (approximately one week) constraint of the 0.5mg strength is anticipated in early October 2023.
Novo Nordisk has confirmed that these production issues are now resolved and it is expected that supply of the 1mg strength to Ireland will return to standard 2023 levels from October.
The pre-existing supply issues due to increased global demand, will continue into 2024. These supply issues are not unique to Ireland, increases in demand for these medications and supply constraints have been observed in the UK, throughout the EU and across the world in recent months. Shortages of Ozempic are linked to the increased demand which has been attributed to the off-label use of the product to treat obesity.
Novo Nordisk has implemented monthly allocation to pharmacies to help ensure continuity of supply and equitable distribution of Ozempic stock to Irish patients. The company has issued advisory letters to healthcare professionals to ensure they are aware of these supply issues and how to manage them. In one such recent communication to healthcare professionals, the company stated that Ozempic is only indicated for treating adults with insufficiently controlled type 2 diabetes mellitus as an adjunct to diet and exercise. Any other use, including for weight management, represents off-label use and currently places the availability of Ozempic for the indicated population at risk. Reimbursement support from the HSE is available for the licensed indication and approved dosage only.
The Department of Health, along with relevant experts from the HSE, HPRA, Pharmaceutical Society of Ireland and the Medical Council are continuing to work together during times of limited supply to mitigate the impact of the shortages on patients.
The Minister for Health has no role in the clinical decision-making process of a medical practitioner and patients that have been prescribed Ozempic by their doctor and are struggling to source it, are encouraged to speak to their doctor and to the pharmacies in their area as early as possible, in order to seek support in accessing appropriate treatment for their medical condition.
571. Deputy Bríd Smith asked the Minister for Health if he will agree to the automatic provision of medical cards to people with a spinal cord injury based on certified medical needs, rather than means; if he will 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. [41385/23]
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.
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.
572. Deputy Gino Kenny asked the Minister for Health when the clinical review of the future of the medical cannabis access programme will be finalised; and if he will make a statement on the matter. [41391/23]
View answerIt is anticipated the review of the Medical Cannabis Access Programme, to ascertain if evidence exists to broaden the scope of conditions covered by the programme, will be completed by the end of 2023.
573. Deputy Gino Kenny asked the Minister for Health how many patients to date have been enrolled in the medical cannabis access programme; if he will provide a breakdown, on those enrolments, of the conditions for which they have been prescribed; and if he will make a statement on the matter. [41392/23]
View answerSince its commencement, 49 patients have been accepted for treatment with cannabis based products for the treatment of one the stated conditions in the programme, namely:
a. Spasticity associated with multiple sclerosis resistant to all standard therapies and interventions whilst under expert medical supervision; 34 patients
b. Intractable nausea and vomiting associated with chemotherapy, despite the use of standard anti-emetic regimes whilst under expert medical supervision; 3 patients
c. Severe, refractory (treatment-resistant) epilepsy that has failed to respond to standard anticonvulsant medications whilst under expert medical supervision: 12 patients
574. Deputy Robert Troy asked the Minister for Health if he will expedite an appointment for surgery for a child (details supplied).; and if he will make a statement on the matter. [41406/23]
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.
575. Deputy Violet-Anne Wynne asked the Minister for Health the number of people approved under a scheme (detailed supplied), by county, in tabular form; and if he will make a statement on the matter. [41420/23]
View answerSince commencement of the programme applications have been made and accepted for the treatment of 49 patients in the Medical Cannabis Access Programme. For reasons of patient privacy and confidentiality we do not propose to break this number down on a county basis.
576. Deputy Violet-Anne Wynne asked the Minister for Health the number of people on a waiting list (details supplied), by county, in tabular form; and if he will make a statement on the matter. [41421/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
577. Deputy Alan Dillon asked the Minister for Health if consideration will be given in Budget 2024 to increase funding for people with diabetes; and if he will make a statement on the matter. [41435/23]
View answerAs 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.
The development of a National Diabetes Registry and the commencement of a National Paediatric Audit of Type 1 Diabetes, will enhance our information on diabetes patients’ services and allow better data-driven decision-making for service delivery. The HSE are currently engaged in preparatory work for phase 1 of these multi-year projects
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 Programme.
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.
578. Deputy Sean Sherlock asked the Minister for Health if the pay of a worker in the health service will be rectified to their correct scale (details supplied).; and if he will make a statement on the matter. [41453/23]
View answerAs this is a matter between the employer and employee, I have asked the HSE to look into the matter and respond directly to the Deputy.
579. Deputy Francis Noel Duffy asked the Minister for Health if he will fast-track the creation of a quiet/sensory waiting room in the Tallaght Hospital accident and emergency department where autistic people and people with intellectual disabilities can retreat to when feeling overstimulated, helping to maintain their dignity and de-escalate potential personal crisis situations; and if he will make a statement on the matter. [41470/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
580. Deputy Sean Fleming asked the Minister for Health if there is any further update regarding providing retinal screening facilities in locations in County Laois (details supplied); and if he will make a statement on the matter. [41476/23]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
581. Deputy Ged Nash asked the Minister for Health if the HSE is planning to increase investment and promotion of menopause services in Louth; if the HSE will consider the creation of a new complex menopause clinic at Our Lady of Lourdes Hospital; and if he will make a statement on the matter. [41478/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
582. Deputy Francis Noel Duffy asked the Minister for Health if his Department will consider pancreatic adenocarcinoma as an eligible illness under the long-term illness scheme; and if he will make a statement on the matter. [41479/23]
View answerThe Long-Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in 1971, 1973 and 1975, prescribing 16 illnesses covered by the Scheme. These are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide.
Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge. While there are currently no plans to extend the list of illnesses covered, it is important to remember that the LTI Scheme exists within a wider eligibility framework.
This Government has put a significant focus on improving access to and the affordability of healthcare services, advancing substantial policy, legislation and investment to deliver expanded eligibility.
In 2022, a range of measures were delivered including the abolition of public inpatient charges for children, reductions in the Drug Payment Scheme threshold to €80 per month, and the introduction of free contraception for women aged 17-25.
The significant investment in Budget 2023 also facilitated better access to affordable, high-quality healthcare, including an expansion of GP care without charges to children aged under 8 and to people earning no more than the median household income, the abolition of all public in-patient hospital charges for adults, and the extension of the free contraception scheme to include women aged 26-30. These measures continue to create a health and social care service that offers affordable access to quality healthcare.
People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card under the General Medical Services (GMS) Scheme. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. Medical card eligibility is primarily based on an assessment of means and is not granted on the basis of any particular condition.
In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness.
Under the Drug Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
Individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
583. Deputy Colm Burke asked the Minister for Health when the commitment to increase the fees payable to contractors for a standard eye examination under the community ophthalmic services scheme will occur; and if he will make a statement on the matter. [41480/23]
View answerThe Community Ophthalmic Services Scheme (COSS) is a national fee-per-item scheme which was introduced in 1979. Under the COSS, medical card holders aged over 16 years can be seen by ophthalmologists, community ophthalmic physicians, optometrists or dispensing opticians.
Eligible patients can receive an eye examination and be provided with prescribed optical appliances in accordance with a national schedule of approved optical appliances.
The Health Professionals (Reduction of Payments to Ophthalmologists, Optometrists and Dispensing Opticians) Regulations 2013 (SI 274 of 2013) sets the fees for optometrists and dispensing opticians under the Community Optometric Services, Community Spectacle Dispensing Services and Health Amendment Act Card Schemes.
I am committed to increasing the fees payable to contractors for a standard eye examination under the COSS. This is a priority for my Department, and work with stakeholders is ongoing to implement this change in 2023.
584. Deputy Bernard J. Durkan asked the Minister for Health the financial assistance, if any, available to a person (details supplied); and if he will make a statement on the matter. [41482/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
585. Deputy Michael Fitzmaurice asked the Minister for Health further to Parliamentary Question No. 658 of 7 March 2023, when staff from a nursing home (details supplied), which has since closed down will receive their Covid-19 special recognition payment; and if he will make a statement on the matter. [41484/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
586. Deputy Louise O'Reilly asked the Minister for Health if he will provide an update on the evaluation of the sugar sweetened drinks tax; if he will provide a timeline for the evaluation process, including completion and publication; and if he will make a statement on the matter. [41501/23]
View answerA Healthy Weight for Ireland, the Obesity Policy and Action Plan (OPAP), was launched in September 2016 under the auspices of the Healthy Ireland Framework (Healthy Ireland: A Framework for Improved Health and Wellbeing 2013-2025). It was developed in recognition of the growing need for a co-ordinated policy response to the increasing problem of obesity in Ireland and the increasing burden placed on individuals and society.
OPAP covers a 10-year period up to 2025 and aims to reverse obesity trends, prevent health complications, and reduce the overall burden for individuals, families, the health system, and the wider society and economy. It recognises that obesity is a complex, multi-faceted problem and needs a multi-pronged solution, with every sector of society playing its part. Childhood obesity is a key priority under OPAP, as is reducing the inequalities seen in obesity rates, where children (and adults) from lower socioeconomic groups have higher levels of obesity. OPAP is well aligned with the World Health Organisation in terms of the breadth of policy measures that have been introduced or are being considered in order to address the obesity epidemic.
With regard to fiscal measures as a policy option to address obesity, in its “Foundations for the Future” report published in 2022, the Commission on Taxation and Welfare recognised that the taxation system is “one of a number of policy tools that can be used to support better public health” and made recommendations that the Government develop fiscal measures to encourage a reduction in the consumption of ultra-processed foods, support reformulation measures to reduce the harm of such foods and promote healthier eating.
Under OPAP, commitment was given to “develop proposals for a levy on sugar-sweetened drinks”, “develop proposals on the rollout of evidence-based fiscal measures to support healthy eating and lifestyles” and “review the evidence…for fiscal measures on products that are high in fat, sugar and salt.”
Following a proposal developed by this Department in consultation with stakeholders, the Department of Finance introduced the Sugar-Sweetened Drinks Tax (SSDT) in 2018. The SSDT has now been in operation for five years. There is anecdotal evidence that the tax has had a positive impact, particularly in terms of encouraging drinks producers to reduce the sugar content in their products. The Department recognised that a more comprehensive analysis of the effects of the tax is needed in order to inform any further fiscal policy considerations.
A literature review was carried out by the Department to make an assessment of the potential approaches to evaluate the impact of the tax. Following this, the Department recently issued a request for quote(s) to carry out a review of the Sugar Sweetened Drinks Tax. An agreement has just been reached with the successful tenderer and work on the external evaluation will now commence. This work is expected to be completed in the new year. The Department will publish the findings of the evaluation upon completion.
587. Deputy Louise O'Reilly asked the Minister for Health if the recommendation of the Committee on Budgetary Oversight report on the Examination of the Commission on Taxation and Welfare Report that completion and the publication of the evaluation of the sugar sweetened drinks tax be prioritised, will be considered and prioritised in his Department; and if he will make a statement on the matter. [41502/23]
View answerA Healthy Weight for Ireland, the Obesity Policy and Action Plan (OPAP), was launched in September 2016 under the auspices of the Healthy Ireland Framework (Healthy Ireland: A Framework for Improved Health and Wellbeing 2013-2025). It was developed in recognition of the growing need for a co-ordinated policy response to the increasing problem of obesity in Ireland and the increasing burden placed on individuals and society.
OPAP covers a 10-year period up to 2025 and aims to reverse obesity trends, prevent health complications, and reduce the overall burden for individuals, families, the health system, and the wider society and economy. It recognises that obesity is a complex, multi-faceted problem and needs a multi-pronged solution, with every sector of society playing its part. Childhood obesity is a key priority under OPAP, as is reducing the inequalities seen in obesity rates, where children (and adults) from lower socioeconomic groups have higher levels of obesity. OPAP is well aligned with the World Health Organisation in terms of the breadth of policy measures that have been introduced or are being considered in order to address the obesity epidemic.
With regard to fiscal measures as a policy option to address obesity, in its “Foundations for the Future” report published in 2022, the Commission on Taxation and Welfare recognised that the taxation system is “one of a number of policy tools that can be used to support better public health” and made recommendations that the Government develop fiscal measures to encourage a reduction in the consumption of ultra-processed foods, support reformulation measures to reduce the harm of such foods and promote healthier eating.
Under OPAP, commitment was given to “develop proposals for a levy on sugar-sweetened drinks”, “develop proposals on the rollout of evidence-based fiscal measures to support healthy eating and lifestyles” and “review the evidence…for fiscal measures on products that are high in fat, sugar and salt.”
Following a proposal developed by this Department in consultation with stakeholders, the Department of Finance introduced the Sugar-Sweetened Drinks Tax (SSDT) in 2018. The SSDT has now been in operation for five years. There is anecdotal evidence that the tax has had a positive impact, particularly in terms of encouraging drinks producers to reduce the sugar content in their products. The Department recognised that a more comprehensive analysis of the effects of the tax is needed in order to inform any further fiscal policy considerations.
A literature review was carried out by the Department to make an assessment of the potential approaches to evaluate the impact of the tax. Following this, the Department recently issued a request for quotes to carry out a review of the Sugar Sweetened Drinks Tax. An agreement has just been reached with the successful tenderer and work on the external evaluation will now commence. This work is expected to be completed in the new year. The Department will publish the findings of the evaluation upon completion.
The Department notes the recommendation by the Committee on Budgetary Oversight report on the Examination of the Commission on Taxation and Welfare Report to prioritise the completion and publication of the evaluation of the sugar sweetened drinks tax. The outcome of this analysis will assist the Department of Health in terms of identifying and exploring any possible further measures, which might be considered by the Department of Finance in due course.
