Michael Ring
Question:1291. Deputy Michael Ring asked the Minister for Health the number of beds in a facility (details supplied) in County Mayo; and if he will make a statement on the matter. [48484/23]
View answerHospital Facilities
Questions (1291)
Written answers
As this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Mental Health Services
Questions (1292)
Rose Conway-Walsh
Question:1292. Deputy Rose Conway-Walsh asked the Minister for Health if he is aware of young people with autism being treated as in-patients in adult mental health units; the total number of people with disabilities being treated as in-patients in adult mental health facilities; the steps he is taking to have them moved to more appropriate care facilities; and if he will make a statement on the matter. [48486/23]
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.
Proposed Legislation
Questions (1293)
Pádraig O'Sullivan
Question:1293. Deputy Pádraig O'Sullivan asked the Minister for Health if he will provide an update on the work being carried out by his Department on the proposed pharmaceutical legislation revision being delivered under the European Pharmaceutical Strategy; and if he will make a statement on the matter. [48490/23]
View answerWritten answers
Background
In November 2020, the EU Commission put forward a Pharmaceutical Strategy for Europe. This Strategy aims to create a future-proof and patient-centred pharmaceutical environment in which the EU industry can innovate, flourish, and continue to be a global leader.
As a key part of this comprehensive Strategy, the EU Commission proposed an ambitious revision of the EU pharmaceutical legislation, with a view to achieving 5 main objectives:
1. Make sure all patients across the EU have timely and equitable access to safe, effective, and affordable medicines,
2. Enhance security of supply and ensure medicines are always available to patients, regardless of where they live in the EU,
3. Offer an attractive, innovation- and competitiveness friendly environment for research, development, and production of medicines in Europe,
4. Make medicines more environmentally sustainable,
5. Address antimicrobial resistance (AMR) through a One Health approach, encompassing human health, animal health and the environment.
Revision of the general pharmaceutical legislation
On April 26th , 2023, the EU Commission published its proposals to revise the general pharmaceutical legislation. This took the form of one EU Directive and one EU Regulation. This is the first full revision of the pharmaceutical legislation in over 20 years and is significant to all stakeholders involved in the medicines’ ecosystem. The general pharmaceutical legislation encompasses the regulation of the authorisation, manufacturing distribution, marketing, and monitoring of medicines. It provides for cooperation, roles, and division of responsibilities between the Commission and EU Member States.
The aim of the legislative revision is described as ensuring access to affordable, available medicines, while maintaining the competitiveness of the EU pharma industry sector, combating antimicrobial resistance, and providing for compliance measures which reinforce environmental protections ( the ‘3 A’s and 3C’s’.)
National Approach
The Department of Health (DoH) is the lead Government Department that has been tasked with negotiating this proposed legislation at EU level on behalf of Ireland. In developing the national position, the DoH has been and is engaging nationally and at EU level and will continue to as the proposal is negotiated by EU-27 and progresses through the ordinary legislative procedure (OLP.)
To inform the national position, in April 2023, the Minister for Health established a cross-Government and cross-agency working group; the ‘Pharmaceutical Strategy Working Group (PSWG)’ to support and inform the development of Ireland’s response to the legislative proposals from a national perspective and facilitate this position to be informed by a whole of government view.
The PSWG continues to meet on a regular basis to consider the Commission’s proposal in full and in detail in preparation for the negotiation of this package at EU level and to inform the negotiation mandate of IE, which of course will be kept under review as the file is reviewed and goes through the OLP.
Stakeholder Engagement
An initial structured stakeholder engagement exercise took place on 8th May 2023 at which key representative stakeholders were invited to share their perspectives to inform the IE preliminary position on the Commission’s proposal. Stakeholders that presented to the PSWG.
The DoH continues to listen to and consider the views and positions of all stakeholders in developing and informing the national position on the proposed legislation.
The DoH encourages stakeholders to submit their opinions, views and positions on the legislative proposals to the DoH for consideration by it and the PSWG - such positions and submissions can be made to the DoH via the dedicated mailbox; EUpharmastrategy@health.gov.ie .
Medicinal Products
Questions (1294)
Pádraig O'Sullivan
Question:1294. Deputy Pádraig O'Sullivan asked the Minister for Health if he is concerned about medicine shortages this winter; what steps are being taken to ensure that a serious shortage is avoided; and if he will make a statement on the matter. [48491/23]
View answerWritten answers
The causes of medicine shortages are multifactorial, including shortages of raw materials, manufacturing difficulties, increased demand and product recalls due to potential quality defects. Shortages of medicines are not unique to Ireland and there is no evidence that shortages disproportionately impact patients in Ireland compared to other countries.
At a National level, my Department is currently progressing several work streams to enhance the national system for the management of shortages, for example:
• Medicines Shortage Framework
• Pharma Package
• Medicines Substitution Protocol (MSP)
• Exempt Medicinal Product (EMP)
Ireland has medicines shortage framework in place which is operated by the Health Products Regulatory Authority (HPRA) on behalf of the Minister for Health. The Medicines Shortages Framework’s aim is to help avert potential shortages from occurring and to reduce the impact of shortages on patients by co-ordinating the management of potential or actual shortages as they arise. The multi-stakeholder framework includes representation from the Department of Health, pharmaceutical industry, healthcare professionals, the HSE, and patients.
In the case of medicines that are used most often in Ireland, when there is a shortage, there are typically multiple forms, strengths, brands and generic medicines available from a range of sources. In the event that there are some supply issues for individual medicines, alternative options such as alternative strengths, brands and generic medicines may be available to ensure continuity of treatment. My Department maintains regular contact with the HPRA regarding medicines shortages.
Department staff are working on the proposed pharmaceutical legislation revision being delivered under the European Pharmaceutical Strategy. This aims to enhance the security of supply of medicines and to ensure medicines are available to patients, regardless of where they live in the EU.
The introduction of a Medicines Substitution Protocol (MSP) would allow Pharmacists to supply a specified medicinal product under the strict direction of a protocol drafted by clinical experts and approved by the Minister and without the need to seek authorisation from the prescriber. It would only be used when other existing measures are likely to be ineffective and in certain, defined serious shortages. It should be noted that unlike the UK’s Serious Shortage Protocol framework, implementation of a framework for MSPs is not necessary in Ireland for generic substitution as this mechanism was introduced under the Health (Pricing and Supply of Medical Goods) Act 2013 and already allows pharmacists to substitute prescribed medicines from a list of interchangeable medicines, which is published and maintained by the HPRA. Work is ongoing in the Department to progress the implementation of this protocol.
There is also a mechanism in Ireland that allows for the supply of unauthorised medicines: the Exempt Medicinal Product (EMP) route. Schedule 1 of the Medicinal Products (Control of Placing on the Market) Regulations includes an exemption which enables practitioners to prescribe a medicine as an exempt medicinal product (EMP) under that practitioner’s direct responsibility, in order to fulfil the special needs of that specific patient. If a valid prescription is issued for an EMP in line with the above Regulations, an appropriately authorised wholesaler can source that product from another market for supply to the patient via their pharmacy in line with that prescription.
As EMPs have not been granted a marketing authorisation in Ireland by the HPRA, they would not be assessed by the HPRA for quality, safety or efficacy. If sourced in response to a bona fide unsolicited order as a licensed product from another market these medicines will have undergone an evaluation of their safety, quality, and efficacy for the granting of their marketing authorisation in that country carried out by the respective competent authority for medicines in that state.
At a European Level, there are several work programmes ongoing in which Ireland is heavily involved, aimed at preventing and mitigating the impact of shortages. A Task Force on the Availability of Authorised Medicines and the European Commission’s Joint Action on Shortages was initiated in January 2023. This work is aimed at tackling the root causes of shortages as well as preventative and mitigation measures for the EU.
On 24th October the European Commission published a statement on “Addressing Medicines Shortages”. This details the wide range of measures underway or being proposed at EU level to work collectively to improve medicines availability. One measure is The European Voluntary Solidarity Mechanism, an EU wide initiative aimed at optimising medicines availability for all European residents.
Health Services Staff
Questions (1295)
Róisín Shortall
Question:1295. Deputy Róisín Shortall asked the Minister for Health the position in relation to Section 38 Organisations, whereby a Labour Court support staff evaluation scheme decision has not been fully implemented, in that funding has not been released to pay staff back-dated pay owed to them from 1 January 2021; the reason for the delay; and if he will make a statement on the matter. [48498/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy.
Care Services
Questions (1296)
Sorca Clarke
Question:1296. Deputy Sorca Clarke asked the Minister for Health to provide an update on the proposed and announced refurbishments, developments and funding for St. Josephs care centre in Longford town, given the first refurbishment was due to be completed in 2021. [48507/23]
View answerWritten answers
As the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
Care Services
Questions (1297)
Sorca Clarke
Question:1297. Deputy Sorca Clarke asked the Minister for Health following the announcement in September 2023 of a ward-closure in St. Joseph's care centre in Longford, due to an issue with a roof, to provide an update on works carried out and works that remain to be completed; and the timeline for completion, in relation to this issue given the level of demand that exists for this centre. [48508/23]
View answerWritten answers
As the Health Service Executive is responsible for the management of the public healthcare property estate, I have asked the HSE to respond directly to you in relation to this matter.
Mental Health Services
Questions (1298)
Pauline Tully
Question:1298. Deputy Pauline Tully asked the Minister for Health the general wait time for accessing CAMHS, by county; and the wait time for those who have an autism diagnosis accessing CAMHS, by county, in tabular form. [48511/23]
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.
Nursing Homes
Questions (1299)
Chris Andrews
Question:1299. Deputy Chris Andrews asked the Minister for Health if he can provide HSE funding to a person (details supplied) in order that they can be granted a place in a nursing home. [48512/23]
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.
Mental Health Services
Questions (1300)
Maurice Quinlivan
Question:1300. Deputy Maurice Quinlivan asked the Minister for Health to provide details of the number of children and the length of time they have been waiting for an assessment by the child and adolescent mental health services in the CHO3 area; and if he will make a statement on the matter. [48513/23]
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.
Hospital Overcrowding
Questions (1301)
Maurice Quinlivan
Question:1301. Deputy Maurice Quinlivan asked the Minister for Health the number of attendees at University Hospital Limerick emergency department in 2021, 2022 and to date in 2023, in tabular form; and if he will make a statement on the matter. [48514/23]
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.
Hospital Staff
Questions (1302)
Maurice Quinlivan
Question:1302. Deputy Maurice Quinlivan asked the Minister for Health the current number of medical staff vacancies, per role at University Hospital Limerick, in tabular form; and if he will make a statement on the matter. [48515/23]
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.
Hospital Overcrowding
Questions (1303)
Maurice Quinlivan
Question:1303. Deputy Maurice Quinlivan asked the Minister for Health the number of days to date in 2023 that the full capacity protocol has been utilised at University Hospital Limerick; and if he will make a statement on the matter. [48516/23]
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 (1304)
Catherine Murphy
Question:1304. Deputy Catherine Murphy asked the Minister for Health the number of dentists to persons ratio in each CHO region. [48517/23]
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.
General Practitioner Services
Questions (1305)
Catherine Murphy
Question:1305. Deputy Catherine Murphy asked the Minister for Health the number of GPs to persons ratio in each CHO region. [48518/23]
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.
Health Services
Questions (1306)
Cian O'Callaghan
Question:1306. Deputy Cian O'Callaghan asked the Minister for Health if he is aware of some opticians who have not received payment from the HSE for the last number of months to continue the HSE glasses vouchers for children; if he will rectify this situation in order that parents can continue to use the vouchers; and if he will make a statement on the matter. [48521/23]
View answerWritten answers
As this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Departmental Contracts
Questions (1307)
Michael Ring
Question:1307. Deputy Michael Ring asked the Minister for Health the number of beds the HSE contracted out (details supplied) in the Mayo area from 2019 to date in 2023, in tabular form; and if he will make a statement on the matter. [48527/23]
View answerWritten answers
As this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Medical Qualifications
Questions (1308)
Jennifer Murnane O'Connor
Question:1308. Deputy Jennifer Murnane O'Connor asked the Minister for Health what plans his Department has to create pathways for internationally trained health professionals to return to Ireland to work in the HSE (details supplied); and if he will make a statement on the matter. [48530/23]
View answerWritten answers
As the Deputy may be aware, CORU is Ireland's multi-profession health regulator with responsibility for regulating health and social care professionals. CORU’s role is to protect the public by regulating the health and social care professions designated under the Health and Social Care Professionals Act 2005 (as amended), including setting the standards that health and social care professionals must meet to be eligible for registration and maintaining registers of persons who meet those standards.
There are two forms of application to CORU; applications for the recognition of qualifications received outside the State and applications for registration. Professional qualifications awarded outside the State are assessed through a process of “recognition” which involves expert assessment of a qualification’s alignment with the standards of proficiency required in Ireland, and assessment of professional experience and lifelong learning where required.
This involves an assessment which is undertaken on a case-by-case basis by academic and professional assessors which seeks to determine the alignment between an applicant’s qualification and the standards of proficiency required for physiotherapists in Ireland. The standards of proficiency are available on the CORU website here: coru.ie/files-recognition/standards-of-proficiency-for-physiotherapists.pdfstandards-of-proficiency-for-physiotherapists.pdf .
If deficiencies in the qualification are identified, an applicant’s post-qualification training and professional work experience will be considered. If deficits remain, an applicant will be offered a choice between compensation measures: a period of adaptation or an aptitude test.
The recognition process is a document-based assessment process where key verified documentation is requested from an applicant and assessed. Proportionality is key in the assessment process to ensure applicants have demonstrated the required learnings to ensure public protection and to become a registered professional in Ireland.
CORU cannot predict outcomes of applications until an application has been received/assessed and reviewed by the Physiotherapist Registration Board, who are the Competent Authority for the profession. This is in accordance with Health and Social Care Professionals Act 2005 and the EU Directive 2005/36/EC. CORU, through the Registration Board, must be satisfied that the individual applicant has met all the criteria to grant registration. This is to ensure public confidence in registered professions.
Whilst it is not within CORU’s remit to secure adaptation periods for applicants where a requirement for compensation measures has been identified, several measures have been put in place by CORU to assist applicants, including discussions with potential providers of adaptation periods to establish a range of pathways for applicants needing to access placements. CORU is also finalising research work on stakeholders’ responses to, and suggestions for, the process and will be updating procedures to reflect the outcome of that study in the coming months. Video guidance on compensation measures has been developed and will shortly be released to support graduates who qualified outside the State. A new Compensation Measure Manager has also been recently appointed in CORU; this role is intended to provide coordination with potential providers of placements.
My Department is working with the HSE to progress a sustainable framework for clinical placements for health and social care professionals, including an increase in clinical training places and additional clinical placement supports for health and social care professions. Alongside this work, the HSE is working to establish a pathway and process for health and social care professionals to allow candidates who have trained abroad the opportunity to complete a period of adaptation and the compensatory measures required by the regulator.
Students undertaking degree programmes outside of Ireland are advised to seek support from their university in arranging placement hours as part of their undergraduate programme.
Acht na dTeangacha Oifigiúla
Questions (1309)
Catherine Connolly
Question:1309. D'fhiafraigh Deputy Catherine Connolly den Aire Sláinte an aithníonn sé na deacrachtaí atá roimh chainteoirí dúchais Ghaeilge i gcóras sláinte a chaitheann leo amhail is go bhfuil Béarla acu, cén obair atá ar bun ag a Roinn le cinntiú go bhfreastalófar ar riachtanais na gcainteoirí sin ag gach céim den chóras sláinte; agus an ndéanfaidh sé ráiteas ina thaobh. [48531/23]
View answerWritten answers
Toisc go mbaineann an cheist seo le seirbhísí, d’iarr mé ar Fheidhmeannacht na Seirbhíse Sláinte freagra díreach a thabhairt don Teachta chomh luath agus is féidir.
Acht na dTeangacha Oifigiúla
Questions (1310)
Catherine Connolly
Question:1310. D'fhiafraigh Deputy Catherine Connolly den Aire Sláinte an bhfuil an t-ainm fearainn moleanbh.ie nó a chomhionann ceannaithe ag an Roinn nó ag Feidhmeannacht na Seirbhíse Sláinte le cinntiú go mbeidh an suíomh mychild.ie agus an t-ábhar a ghabhann leis ar fáil go hiomlán trí Ghaeilge don phobal; agus an ndéanfaidh sé ráiteas ina thaobh. [48532/23]
View answerWritten answers
As this PQ relates to the purchase of an Irish domain name for mychild.ie which is owned by the HSE, it is an IT matter and I have referred the question to the HSE for direct reply to the Deputy.
Assisted Human Reproduction
Questions (1311, 1336, 1337)
Violet-Anne Wynne
Question:1311. Deputy Violet-Anne Wynne asked the Minister for Health if he will review the upper age limit for a scheme (details supplied); and if he will make a statement on the matter. [48556/23]
View answerMichael Ring
Question:1336. Deputy Michael Ring asked the Minister for Health if any allowances can be made for a person who has just missed the age cut-off point for publicly funded IVF; and if he will make a statement on the matter. [48610/23]
View answerMichael Ring
Question:1337. Deputy Michael Ring asked the Minister for Health if any allowances can be made for a person who has just missed the age cut-off point for publicly funded IVF in view of their medical circumstances (details supplied); and if he will make a statement on the matter. [48612/23]
View answerWritten answers
I propose to take Questions Nos. 1311, 1336 and 1337 together.
As the Deputy may be aware, a commitment to “introduce a publicly funded model of care for fertility treatment” is included in the Programme for Government.
The Model of Care for Fertility was developed by the Department of Health in conjunction with the HSE’s National Women & Infants Health Programme (NWIHP) in order to ensure that fertility-related issues are addressed through the public health system at the lowest level of clinical intervention necessary.
This Model of Care comprises three stages, starting in primary care (i.e., GPs) and extending into secondary care (i.e., Regional Fertility Hubs) and then, where necessary, tertiary care (i.e., IVF (in-vitro fertilisation) and ICSI (intra-cytoplasmic sperm injection)), with patients being referred onwards through structured pathways.
Phase One of the roll-out of the Model of Care has involved the establishment, at secondary care level, of Regional Fertility Hubs within maternity networks, in order to facilitate the management of a significant proportion of patients presenting with fertility-related issues at this level of intervention. Patients are referred by their GPs to their local Regional Fertility Hub, which provides a range of treatments and interventions. All six Regional Fertility Hubs are currently operational.
Phase Two of the roll-out of the Model of Care relates to the introduction of AHR treatment, including IVF, provided through the public health system at tertiary level. In particular, the first steps have been taken towards achieving the ultimate objective of Government, which is a wholly publicly-provided fertility service.
As an interim measure, funding has been made available to support access to AHR treatment via private providers from September 2023. As well as IVF and ICSI, this allocation is also being used to provide, initially through private clinics, IUI (intrauterine insemination), which can, for certain cohorts of patients, be a potentially effective, yet less complex and less intrusive treatment.
Referrals for AHR treatment by private providers commenced on September 25th 2023 after details of how the new initiative would be initially rolled out – including regarding the set of criteria which prospective patients should meet in order to access fully-funded AHR services and the specific services to be initially funded – were agreed by the Department and NWIHP and then brought to Cabinet in July 2023. The criteria were agreed following consultation with experts in the field of reproductive medicine and include limits in respect of the age of the intending birth mother, body mass index (BMI) and the number of children a couple already have. They are very much in keeping with those applied in other jurisdictions, even though in most European countries, for instance, such treatments are only partially funded and require often significant out-of-pocket payments by patients. More details on public fertility services generally, including information on the new publicly-funded AHR treatment initiative, are available from the HSE at: www2.hse.ie/conditions/fertility-problems-treatments/fertility-treatment/
Advanced maternal age, unfortunately, is associated with a decrease in the number of eggs retrieved and an increase in the miscarriage rate. Most public fertility programmes in other jurisdictions apply an age restriction on the provision of IVF/ICSI treatment to women, commonly set at 39 or 40 years of age. It is proposed that in Ireland the maximum age for intending birth mother means that she must be referred from her GP to a Regional Fertility Hub prior to her 41st birthday. Therefore, she may be older by the time she actually avails of publicly-funded IVF treatment. Nevertheless, all aspects of the newly-introduced scheme here will be kept under ongoing review as new evidence becomes available, an understanding of how the service provision is working in practice emerges and the AHR legislation comes into operation.
My Department and the Government are focused, through the full implementation of the Model of Care for Fertility, on ensuring that patients receive care at the appropriate level of clinical intervention and then those requiring, and eligible for, advanced AHR treatment such as IVF will be able to access same through the public health system. The underlying aim of the policy to provide a model of funding for AHR, within the broader new AHR regulatory framework, is to improve accessibility to AHR treatments, while at the same time embedding safe and appropriate clinical practice and ensuring the cost-effective use of public resources.