Written Answers Nos 233-247
233. Deputy Micheál Martin asked the Minister for Health the reason medical card renewal applications which historically were granted on exceptional medical needs are being considered for renewal as a standard application on the basis of means and not under the medical criteria for which they were originally awarded where that medical need still exists; and if he will make a statement on the matter. [46911/12]
Amharc ar fhreagraUnder the provisions of the Health Act 1970, eligibility for health services in Ireland is based primarily on residency and means. There are currently two categories of eligibility for all persons ordinarily resident in Ireland i.e. full eligibility (medical card) and limited eligibility (all others). Full eligibility is determined mainly by reference to income limits, and is granted to persons who, in the opinion of the Health Service Executive, are unable to provide general practitioner, medical and surgical services to themselves and their dependents without undue hardship. There is a provision for discretion to grant a card in cases of "undue hardship" where the income guidelines are exceeded. The HSE recently set up a clinical panel to assist in the processing of applications for discretionary medical cards where there are difficult personal circumstances.
234. Deputy Ciarán Lynch asked the Minister for Health the protocol that applies to the issuance of repeat prescriptions for persons on medical cards; if prescriptions are normally issued weekly, monthly, bimonthly or for longer periods; and if he will make a statement on the matter. [46916/12]
Amharc ar fhreagraA repeat prescription facility was introduced to the General Medical Services (GMS) Scheme in March 1991. Under this facility, prescriptions for certain drugs and medicines may be renewed on a three monthly, rather than a monthly, basis. Patients who are stabilized on their medication do not need to visit their General Practitioner (GP) every month in order to have their prescriptions renewed. The facility to change prescriptions from monthly to quarterly for suitable patients provides efficiencies for GPs and patients, by reducing unnecessary consultations and journeys to the surgery and pharmacy.
235. Deputy Aengus Ó Snodaigh asked the Minister for Health if consideration has been given to making it compulsory for ID to be produced for everyone purchasing medical products containing pseudo ephedrine, that all such products are stored out of customers' reach and that a doctor prescription will be required for all products containing more than 800mg of pseudo ephedrine per pack as is the case in Australia [46922/12]
Amharc ar fhreagra236. Deputy Aengus Ó Snodaigh asked the Minister for Health the plans, if any, he has of rolling out a drug awareness programme aimed at pharmacists in particular to increase vigilance about pseudo ephedrine and the production of methamphetamine crystal meth [46924/12]
Amharc ar fhreagraI propose to take Questions Nos. 235 and 236 together.
Pseudoephedrine is a nasal decongestant contained in many cough and cold medicines. Under the Medicinal Products (Prescription and Control of Supply) Regulations, pseudoephedrine is listed as a prescription medicine which may, in limited circumstances, be supplied without a prescription. It may only be supplied without a prescription from a pharmacy, by or under the personal supervision of a pharmacist. In addition, it may only be supplied if the maximum daily dose that a patient would consume is less than 240mg per day in the case of pseudoephedrine hydrochloride products and 180mg per day in the case of pseudoephedrine sulfate products. The maximum dose of pseudoephedrine products which may be supplied without a prescription is 60 mg.
Irish medicines legislation does not currently limit the pack size of pseudoephedrine which may be supplied to a person without prescription. There is a range of pack sizes available covering solid dosage forms and liquid formulations. The maximum size authorised on the Irish market for over the counter sale is 32 tablets of 30mg pseudoephedrine/tablet (or 960mg total quantity per pack). Regarding the liquid preparations the maximum authorised pack size in Ireland is 200mls which contains a total quantity of 450mg pseudoephedrine per pack.
Pseudoephedrine products are useful and effective medicines for the treatment of symptoms of cold and flu or sinusitis. Restriction of pseudoephedrine to prescription control would require patients to visit a doctor for management of self-treatable conditions, placing additional financial burdens on patients and increased demand for GP services.
In recognition of the concern that pseudoephedrine can be used in the illicit manufacture of methylamphetamine (commonly known as “methamphetamine”, “crystal meth” or “ice”), professional guidance was issued by the Pharmaceutical Society of Ireland (PSI) to pharmacists in relation to sales of pseudoephedrine-containing products in September 2012. PSI guidelines to pharmacists recommend that the pharmacist should identify an appropriate and secure location in the pharmacy to store pseudoephedrine products, that requests for these products should be referred to the pharmacist personally and that pharmacists should use their professional judgment and discretion in deciding whether a genuine clinical need exists for the medicine and that the medicine is appropriate for the patient. Community pharmacists exercise professional judgment and can refuse to supply pseudoephedrine-containing products if deemed necessary.
The benefits and risks of all medicines are assessed by the Irish Medicines Board (IMB) on an ongoing basis, with changes to the product information and new recommendations/restrictions applied as appropriate, on the basis of new and emerging safety information. The situation regarding pseudoephedrine is being monitored closely by the Department, IMB, PSI and the other relevant agencies.
237. Deputy Noel Harrington asked the Minister for Health if he will ensure that all CFR volunteers are inoculated against hepatitis B by the Health Service Executive (details supplied); and if he will make a statement on the matter. [46929/12]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for direct reply.
238. Deputy Éamon Ó Cuív asked the Minister for Health his policy in relation to ensuring that school leavers with mental health disabilities who will leave school in 2013 will have suitable placements available to them in 2013; and if he will make a statement on the matter. [46936/12]
Amharc ar fhreagraDay services for adults with disabilities and mental health issues provide a network of support for over 25,000 people who have a wide spectrum of need, ranging from those with severe and profound disabilities who are likely to need long-term specialist service provision to people with lower support needs and greater potential for community participation and inclusion. The HSE, through its Occupational Guidance Service, works with schools, service providers, service users and families to identify the needs of young people with disabilities who are due to complete their second level education. The aim is to address the needs of individuals in the following ways:
- Health-funded rehabilitative (life skills) training (RT);
- Health-funded day services;
- FÁS-funded vocational training;
- Approval to extend education placement for a specified time.
The demand for services for school-leavers continues to grow. In 2012, almost 700 school-leavers required RT places or day services and the position in 2013 is expected to be similar. Budgetary constraints and the moratorium on staff recruitment give rise to challenges in service provision. In addition the physical capacity to provide further services may not be present in all agencies. However both the voluntary sector and the HSE are committed to the best use of available resources in a creative and flexible manner so as to be as responsive as possible to the needs of this cohort. While the HSE makes every effort to provide day services or RT places to school-leavers with special needs, this has always been dependant on the availability and location of appropriate places coupled with the needs of the individual school-leaver. The HSE is currently reviewing the outcomes for 2012 school-leavers in terms of placements achieved and scoping out the likely requirements for 2013.
There is evidence that an accelerated move towards a new model of individualised, person-centred service provision in the community can help to achieve efficiencies, particularly in relation to services for those with mild or moderate intellectual disability. The HSE has established an implementation project team to oversee the implementation of the recommendations in the report of the National Working Group for the Review of HSE-funded Adult Day Services. The report, published in February 2012, titled 'New Directions', proposes that day services in the future take the form of a menu of 12 individualised, outcome-focussed supports which will provide adults with disabilities with the support necessary to live a life of their choosing in accordance with their own wishes, aspirations and needs. The guiding principle for the future is that supports will be tailored to individual need and will be flexible, responsive and person-centred.
239. Deputy Denis Naughten asked the Minister for Health the number of persons issued with decisions by each primary, community continuing care since 1 September 2012 stating that home help cannot be provided; the number of persons in each PCCC area who are in receipt of reduced hours since 1 September 2012; the corresponding number of persons that received a home help allocation since 1 September 2012; and if he will make a statement on the matter. [46962/12]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply.
240. Deputy Billy Kelleher asked the Minister for Health when a person (details supplied) in County Cork will receive a Cochlear implant; and if he will make a statement on the matter. [46965/12]
Amharc ar fhreagra241. Deputy Billy Kelleher asked the Minister for Health the safeguards that have been put in place to prevent further errors in audiology diagnoses as arose in a recent case (details supplied); and if he will make a statement on the matter. [46968/12]
Amharc ar fhreagraI propose to take Questions Nos. 240 and 241 together.
As these are service issues, they have been referred to the HSE for direct reply.
242. Deputy Catherine Murphy asked the Minister for Health the reason the Health Service Executive remove children (details supplied) from their occupational and speech and language therapy lists when a child has been diagnosed by another service provider even in situations in which that provider does not provide such services; the safeguards that are in place to ensure children with occupational and speech and language needs are seen; and if he will make a statement on the matter. [46995/12]
Amharc ar fhreagraAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
243. Deputy Tom Fleming asked the Minister for Health when she will meet with a delegation representing patients, families, staff, community and the Iveragh Mental Health Association in respect of the proposed closure of a hostel (details supplied) in County Kerry and also in respect of plans for the development of mental health services in south Kerry; and if he will make a statement on the matter. [46996/12]
Amharc ar fhreagraI will be happy to meet with a delegation in relation to the closure of Island View High Support Hostel in Caherciveen. My Office will make contact in the coming days to make the necessary arrangements.
244. Deputy Billy Kelleher asked the Minister for Health when a person (details supplied) in County Roscommon who has been assessed as urgent will be seen by a urologist; and if he will make a statement on the matter. [47003/12]
Amharc ar fhreagraAs this is a service issue, it has been referred to the HSE for direct reply.
245. Deputy Billy Kelleher asked the Minister for Health if there will be a continuation of respite in respect of a person (details supplied) in County Cork who has turned 18 years; and if he will make a statement on the matter. [47005/12]
Amharc ar fhreagraAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
246. Deputy Billy Kelleher asked the Minister for Health if he will provide in tabular form the waiting list for orthotics on a county basis; and if he will make a statement on the matter. [47006/12]
Amharc ar fhreagraAs the Deputy's question relates to service matters I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
247. Deputy Mary Lou McDonald asked the Minister for Health the annual saving to the Exchequer if current public hospital consultants pay was capped at €150,000. [47018/12]
Amharc ar fhreagraIt is not possible to calculate a precise figure in this regard, as the Deputy has not specified what salary scale or other contractual remuneration arrangements she has in mind. Under the existing contracts, the total cost in 2012 of consultant remuneration, including payment for additional attendance and allowances for extra responsibilities but excluding employers' PRSI, will be approximately €476m. If all consultants (who number approximately 2,570) were subject to an absolute cap on public earnings of €150,000, the total cost would amount to approximately €386m.
