Written Answers Nos. 522-541
522. Deputy Colm Burke asked the Minister for Health to confirm he is aware of the report by clinicians from the National Cancer Control Programme to an Implementation Working Group (details supplied) that 25% of cancer patients do not receive standard of care due to lack of access to new medicines which are available elsewhere in Europe; if he is concerned by this; and if he will make a statement on the matter. [43726/23]
View answer569. Deputy John Lahart asked the Minister for Health if he is concerned by the warning in a presentation by senior oncologists (details supplied); if he is considering making a statement on the matter; if he is taking steps to ensure that timelines for Irish patients to access new medicines do not continue to worsen; if he is considering how much funding will be required to prevent a deterioration in 2024; and if he will make a statement on the matter. [44063/23]
View answerI propose to take Questions Nos. 522 and 569 together.
In February, I published the Mazars Review which examined the governance arrangements around the HSE’s Drug Pricing and Reimbursement Process. The Report found that the reimbursement process is operating in line with the legislation and that it is delivering results in line with international norms. 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, agencies, 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. A range of stakeholders presented their views, including consultants specialising in oncology. 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 me in the coming months.
523. Deputy Colm Burke asked the Minister for Health if he will consider increasing funding in 2024 to prevent Ireland’s average timelines for patient access to new medicines from deteriorating relative to our European peers in 2024 in view of the fact Ireland now ranks 27th out of 35 European countries according to the latest IQVIA Patients WAIT Indicator; and if he will make a statement on the matter. [43727/23]
View answerPending the outcome of the budgetary process, it is not possible to state the level of funding for new medicines in 2024. Any health measures introduced will be in the context of the implementation of the health commitments in the Programme for Government and the funding available to progress healthcare priorities.
524. Deputy Paul McAuliffe asked the Minister for Health the status of an operation for a person (details supplied). [43730/23]
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.
525. Deputy Dara Calleary asked the Minister for Health for an update on the non-EU doctor scheme; how many GPs have been recruited to date; to provide a breakdown, by county, of the number and location of GPs recruited; how many more are planned to be recruited in 2023 and 2024; the criteria for placement of recruited doctors across the country; what the national average of GPs-to-CHO population in the State currently stands at; and if he will make a statement on the matter. [43746/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
526. Deputy Carol Nolan asked the Minister for Health if he will support the request from an organisation (details supplied) for funding support to enable its vital work of providing financial assistance directly to parents of children with life-limiting or chronic complex care needs across Ireland to help with the non-medical expenses related to caring for their child; and if he will make a statement on the matter. [43757/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
527. Deputy James Lawless asked the Minister for Health to examine an urgent matter (details supplied); and if he will make a statement on the matter. [43763/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
528. Deputy David Cullinane asked the Minister for Health his views on legislating for folic acid fortification of certain staple food products to aid the prevention of certain brain and spinal conditions and neural tube defects; and if he will make a statement on the matter. [43774/23]
View answerThe Healthy Ireland Framework has brought a new focus on the importance of health promotion and the need for cross-Government and cross-sectoral co-operation to prevent ill-health. The Healthy Ireland Framework has enshrined the principles of prevention and early intervention within all policies, with a particular emphasis on the early years.
Following the publication of healthy eating guidelines for the general population in 2016, it was recognised that dietary intake of folate remains sub optimal in Ireland. A multidisciplinary Committee was established by the Department of Health(DOH) to review the evidence in support of folic acid supplementation to prevent neural tube defects (NTD). Recommendations published in the 2019 report “Folic Acid Supplementation” by the Department of Health, outline several mechanisms to improve folic acid intake for women of child-bearing age and thereby reduce the risk of neural tube defects.
One key recommendation given at the time was to consider the requirements for food fortification with folate. The Committee recognised that this option is dependent on a range of issues including food consumption patterns and preferences, supply chain issues, implications of Brexit, as well as the significant undertaking in terms of resources and timing involved. These issues would need to be worked through before any further consideration could be given to mandatory food fortification.
Ireland does not have any national mills and relies on the UK for up to eighty per cent of its flour supply. After undertaking a public consultation on the proposal to introduce mandatory fortification of UK flour with folic acid, the UK Government and devolved administrations decided to proceed with the mandatory fortification of non-wholemeal wheat flour and legislate on this basis in 2021.
Up to this point fortification of flour was conducted on a voluntary basis. The voluntary addition of vitamins and minerals to foods is regulated by means of Regulation (EC) No 1925/2006, which aims to ensure that fortified foods are safe, and to allow for the proper functioning of the internal market. This regulation permits the addition of folic acid to foods in compliance with its rules.
The ‘mandatory addition’ of vitamins and minerals for public health reasons, such as the fortification of staple foods with folic acid, is not covered by this regulation. The European Commission does not envisage the harmonisation of the mandatory addition of nutrients, such as folic acid, across the EU. It is up to Member States to decide if they wish to introduce alternative measures such as mandatory food fortification with folic acid.
In addition, the labelling of a compound food containing a fortified ingredient must comply with the provisions of Regulation (EU) No 1169/2011, to ensure that it shall not be misleading for the consumer.
In the event of any proposal to revise existing legislation a regulatory impact analysis would need to be conducted. Before any policy position is finalised on folic acid fortification, stakeholder consultation would need to be carried out on a national basis. Once a policy position has been formed, the Department would need to notify the Commission via the Technical Regulation Information System (TRIS) system of Ireland’s intention to introduce fortification of flour with folic acid. Ireland would be required to demonstrate that evidence-based analysis, public stakeholder consultation and cross Government collaboration had taken place to justify why Ireland is considering mandatory fortification. To give an estimation of predicted timelines, the consultation process is still ongoing in the UK, two years post announcement of mandatory fortification.
With this in mind, other actions are needed to optimise both Folic Acid supplement use and dietary folate in the short-term. It is recommended that all women considering pregnancy take a 400-microgram (mcg) supplement of folic acid per day when planning a pregnancy and for the first 12 weeks of pregnancy and this is described in The Nutrition in Pregnancy, national clinical guideline that was developed in 2019 to promote the link between good nutrition during pregnancy and a favourable pregnancy outcome.
Under the phase 2 of the First 5 strategy implementation plan, it has been identified that parents, families and communities will be supported to engage in and promote positive health behaviours among babies and young children, starting from the pre-conception period. Enhanced integration and communication of Folic Acid supplement advice will continue under several relevant programmes being operated by the Health and Wellbeing Division, Primary Care, Obstetrics and Gynaecology and Sexual Health services.
529. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) in County Donegal can expect to receive a date for an operation in Letterkenny University Hospital; and if he will make a statement on the matter. [43787/23]
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.
530. Deputy John Paul Phelan asked the Minister for Health when a person (details supplied) in County Wicklow will have the results of a biopsy carried out on 22 August at University Hospital, Waterford; the reason for the delay in receiving the results; and if he will make a statement on the matter. [43812/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
531. Deputy Steven Matthews asked the Minister for Health if his attention has been drawn to proposed changes for January 2024 in the way the Revenue Commissioners treat general medical services income within general practitioner partnerships; if he is concerned that this will impact the number of GPs operating; and if he will make a statement on the matter. [43811/23]
View answer553. Deputy Bríd Smith asked the Minister for Health if he, his Department and the HSE are aware of proposals to change the tax treatment of GMS income for GP partnerships (details supplied); if he or his Department was consulted on these proposed changes; if the HSE has examined the potential impact of these changes to the provision of GP care; and if he will make a statement on the matter. [43974/23]
View answer574. Deputy David Cullinane asked the Minister for Health if he has had any engagement with the Minister for Finance or the Revenue Commissioners regarding plans to prohibit GMS income being mandated to partnerships or employers, meaning that any GMS income will need to be declared as income by the individual GMS list holder in their tax return from January 2024; and if he will make a statement on the matter. [44076/23]
View answerI propose to take Questions Nos. 531, 553 and 574 together.
The collection of taxes and issues relating to the interpretation of tax law are a matter for the Revenue Commissioners. However, I am aware of the concerns raised regarding new guidance to be issued shortly by the Revenue Commissioners regarding the tax treatment of GP's GMS income.
Officials from my Department ard the HSE have engaged with the Office of the Revenue Commissioners and the Department of Finance to understand the context of the new guidance and to identify the potential operational issues which may arise following its publication.
Importantly, the guidance does not reflect a change in tax law, but clarifies how GPs’ GMS income should be treated for the purposes of tax under current tax law. To assist GPs and GP practices in complying with their obligations under tax legislation, Revenue will publish detailed guidance shortly. This will supplement the guidance issued to tax practitioners, through the Tax Administration Liaison Committee, in July of this year clarifying the correct tax treatment of GMS income. To allow GPs and GP practices time to make any necessary adjustments to their arrangements to ensure compliance with applicable tax policy and legislation, Revenue have implemented transitional arrangements up to the end of 2023. From 1 January 2024, those GPs and GP practices should account for tax on GMS income in accordance with the legislation in this area.
My Department and the HSE are also engaged with the IMO and will remain engaged with them to address the potential operational issues raised.
The Strategic Review of General Practice, which is now underway, will examine the current contractual arrangements for the GMS, as well as other issues, and will propose measures necessary to modernise the contract.
532. Deputy Verona Murphy asked the Minister for Health the number of persons approved for homecare supports who are currently waiting on delivery of support hours in County Wexford as of 30 September 2023; and if he will make a statement on the matter. [43815/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
533. Deputy Verona Murphy asked the Minister for Health the number of current clients approved for additional homecare support hours awaiting allocation of those additional hours in County Wexford as of 30 September 2023; and if he will make a statement on the matter. [43816/23]
View answer534. Deputy Verona Murphy asked the Minister for Health the number of new persons approved for HSE homecare support hours since 1 January 2023 who are currently awaiting delivery of support hours in County Wexford as of 30 September 2023; and if he will make a statement on the matter. [43817/23]
View answerI propose to take Questions Nos. 533 and 534 together.
As these are operational matters, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible
535. Deputy Peadar Tóibín asked the Minister for Health the reason the Irish National Accreditation Board accreditation was not obtained before opening the new cervical screening laboratory in December 2022; the reason the laboratory was shut in March 2023; and if he will provide an update on the current status of the project. [43838/23]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
536. Deputy Peadar Tóibín asked the Minister for Health the total number of women screened by CervicalCheck in each of the past ten years and to date in 2023. [43839/23]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
537. Deputy Peadar Tóibín asked the Minister for Health the total number of CervicalCheck slides sent abroad to foreign laboratories in each of the past ten years and to date in 2023. [43840/23]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
538. Deputy Ivana Bacik asked the Minister for Health if the Health Information and Quality Authority owns properties or sites which are vacant or derelict; if so, the number and addresses of such properties; if they are recorded on the vacancy or dereliction registers; and the reason for which they are vacant or derelict, in tabular form. [43858/23]
View answerI have been informed by the Health Information and Quality Authority (HIQA) that they do not own properties or sites which are vacant or derelict.
539. Deputy Ivana Bacik asked the Minister for Health if the Food Safety Authority owns properties or sites which are vacant or derelict; if so, the number and addresses of such properties; if they are recorded on the vacancy or dereliction registers; and the reason for which they are vacant or derelict, in tabular form. [43863/23]
View answerThe Food Safety Authority of Ireland (FSAI) has advised my Department that it does not have any properties or sites which are vacant or derelict.
540. Deputy Brendan Smith asked the Minister for Health his views on the present rate of the minimum excise duty on cigarettes, with particular reference to public health; and if he will make a statement on the matter. [43914/23]
View answerTobacco Free Ireland set an overarching goal of having Ireland tobacco free by 2025 (i.e., to achieve a smoking prevalence rate of less than 5% in the Irish population). Tobacco Free Ireland has a series of recommendations to facilitate achieving this goal which seek to denormalise tobacco use and to prevent young people from becoming addicted to tobacco products. This broad-based suite of recommendations includes, inter alia, the following measures related to raising taxes on tobacco products:
• Annual excise duty increases on tobacco products should be applied over a continuous five-year period.
• Increase duty on roll-your-own and other tobacco products to reduce the price differential between cigarettes and other tobacco products.
Significantly increasing the price of all tobacco products will decrease the initiation of tobacco use in younger and less well-off populations and will precipitate more cessation attempts in current smokers leading to a reduction in health inequalities and a positive impact on the health of the population. It would also begin to reduce the economic burden that tobacco use places across all aspects of our economy. It should also be noted that increasing the price of tobacco through taxation is regarded by World Health Organisation economists as a best-buy (effective and cost-effective) intervention.
Government Decision S180/20/10/1633, relating to Tobacco Free Ireland, recognised the evidence that pricing is a key means of reducing tobacco consumption and contains a commitment that “in recognition of the evidence that pricing is a key means of reducing tobacco consumption, that the Ministers for Health and Finance will together consider additional fiscal measures and those related to illicit trade”.
The level of taxation is ultimately a decision of the Minister for Finance. However, each year I make a pre-Budget submission to the Minister for Finance in relation to the excise duty on tobacco. The excise duty on a packet of 20 cigarettes has increased yearly by 50 cent since Budget 2016. I will continue to engage with the Minister For Finance in relation to the Minimum Excise Duty on tobacco products in order to achieve a smoking prevalence rate of less than 5% in the Irish population.
541. Deputy Alan Kelly asked the Minister for Health for a breakdown of all the radiotherapy machines in UHL; the type of machine; when it was first used in the hospital; and any gaps in service for any machine, between 1 January 2020 to date, in tabular form. [43928/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
