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Tuesday, 12 Mar 2013

Written Answers Nos. 569 - 588

Prescription Charges

Ceisteanna (569)

Andrew Doyle

Ceist:

569. Deputy Andrew Doyle asked the Minister for Health if a person (details supplied) in County Wicklow, who is in receipt of the disability allowance is exempt from paying the increased prescription charges; and if he will make a statement on the matter. [12524/13]

Amharc ar fhreagra

Freagraí scríofa

Medical card holders are required to pay a €1.50 charge per item for medicines and other prescription items supplied to them by community pharmacists, subject to a cap of €19.50 per month for each person or family. Prescription charges do not apply to children in the care of the HSE or to methadone supplied to patients participating in the Methadone Treatment Scheme.

Medicinal Products Expenditure

Ceisteanna (570, 612)

Pearse Doherty

Ceist:

570. Deputy Pearse Doherty asked the Minister for Health further to a report in a Sunday newspaper which suggested that generic drugs and medicines here cost as much as 24 times more than the same medicines in Britain, the research undertaken by his Department or by the Competition Authority in this area; and the steps he will take to ensure that drugs and medicines are sold at reasonable prices here. [12634/13]

Amharc ar fhreagra

Pearse Doherty

Ceist:

612. Deputy Pearse Doherty asked the Minister for Health further to a report in a Sunday newspaper which suggested that generic drugs and medicines here cost as much as 24 times more than the same medicines in Britain, the research he had undertaken in this area and the steps he will take to ensure that drugs and medicines are acquired at reasonable prices here. [12633/13]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 570 and 612 together.

The prices of drugs vary between countries for a number of reasons, including different prices set by manufacturers, different wholesale and pharmacy mark-ups, different dispensing fees and different rates of VAT. In recent years, a number of changes to the pricing and reimbursement system have been successfully introduced in Ireland. These have resulted in reductions in the prices of thousands of medicines.

The Department and the HSE have successfully finalised discussions with the Association of Pharmaceutical Manufacturers in Ireland (APMI), which represents the generic industry, on a new agreement to deliver further savings in the cost of generic drugs. Under this Agreement, from 1 November 2012, the HSE will only reimburse generic products which have been priced at 50% or less of the initial price of an originator medicine. In the event that an originator medicine is priced at less than 50% of its initial price the HSE will require a generic price to be priced below the originator price. This represents a significant structural change in generic drug pricing and should lead to an increase in the generic prescribing rate.

In addition, the Health (Pricing and Supply of Medical Goods) Bill 2012, which is currently before the House, provides for the introduction of a system of generic substitution and reference pricing for prescribed drugs and medicines. These reforms will promote price competition among suppliers and ensure that lower prices are paid for these medicines resulting in further savings for taxpayers and patients.

Water Fluoridation

Ceisteanna (571)

Seán Kenny

Ceist:

571. Deputy Seán Kenny asked the Minister for Health his views on acceptable levels of fluoride in water; and if he will make a statement on the matter. [12852/13]

Amharc ar fhreagra

Freagraí scríofa

The Forum on Fluoridation, which reported in 2002, advised that the fluoridation of piped public water supplies should continue as a public health measure. One of the recommendations of the Forum was to amend the Regulations regarding fluoridation of public water supplies to redefine the optimal level of fluoride in drinking water from 0.8 to 1.0 parts per million (ppm) to between 0.6 and 0.8 ppm. Regulations were introduced in 2007 to give legal effect to this change. The Irish Expert Body on Fluorides and Health, established in 2004, advises that the balance of scientific evidence worldwide confirms that water fluoridation, at the optimal level, does not cause any ill effects and continues to be safe and effective in protecting the oral health of all age groups.

Medical Card Eligibility

Ceisteanna (572)

Tony McLoughlin

Ceist:

572. Deputy Tony McLoughlin asked the Minister for Health on reaching the age of 23 years a full time dependant student (details supplied) in County Sligo with medical needs was automatically removed from the family drug payment card, they cannot apply for a medical card in their own right until they are 25 years; the action being taken to overcome this anomaly and the reason a full-time dependant student cannot remain on the family DPS after 23 years of age; and if he will make a statement on the matter. [12901/13]

Amharc ar fhreagra

Freagraí scríofa

Under the Medical Card Scheme, a person between the ages of 16 and 25 years, who is a dependant of a person who does not have a medical card, will only be provided with a medical card if the HSE assesses that it should be provided to avoid undue hardship to that person. This is set out in the Health Services (No 3) Regulations 1983 (S.I. No. 381 of 1983).

Under the Drugs Payment Scheme (DPS), an individual or family only has to pay €144 each month for approved prescribed drugs, medicines and certain appliances for use by that person or his or her family in that month. The definition of a family for this Scheme is an adult, their spouse, and any children under 18 years. Dependants over 18 years and under 23 years who are in full time education may also be included.

There are no plans to review the DPS age limit.

Thalidomide Victims Compensation

Ceisteanna (573, 642, 646, 647, 651, 660)

Finian McGrath

Ceist:

573. Deputy Finian McGrath asked the Minister for Health if he will support the Irish Thalidomide Association in 2013 and not take an adversarial approach to their plight (details supplied). [13312/13]

Amharc ar fhreagra

Brendan Smith

Ceist:

642. Deputy Brendan Smith asked the Minister for Health the proposals, if any, he has to address the concerns of the Irish Thalidomide Association (details supplied); and if he will make a statement on the matter. [12902/13]

Amharc ar fhreagra

Thomas P. Broughan

Ceist:

646. Deputy Thomas P. Broughan asked the Minister for Health if he will honour the programme for Government commitment in terms of a revised compensation scheme for thalidomide survivors in view of the additional entitlements recently awarded to citizens in Germany, Australia and the United Kingdom who are thalidomide survivors; and if he will make a statement on the matter. [12920/13]

Amharc ar fhreagra

Thomas P. Broughan

Ceist:

647. Deputy Thomas P. Broughan asked the Minister for Health the further action he is planning to take to resolve all outstanding financial, medical and legal issues for survivors of Thalidomide and the Irish Thalidomide Association in view of the alleged earlier flawed report from the State Claims Agency; and if he will make a statement on the matter. [12921/13]

Amharc ar fhreagra

Seán Ó Fearghaíl

Ceist:

651. Deputy Seán Ó Fearghaíl asked the Minister for Health if he will address the concerns raised in correspondence (details supplied) regarding thalidomide victims; and if he will make a statement on the matter. [13007/13]

Amharc ar fhreagra

Róisín Shortall

Ceist:

660. Deputy Róisín Shortall asked the Minister for Health the way he intends to honour the commitment in the programme for Government to continue to engage in discussions with the Irish Thalidomide Survivors Society; and if he will make a statement on the matter. [13112/13]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 573, 642, 646, 647, 651 and 660 together.

Given the challenges that persist for each individual, this Government's aim is to address the health and personal social care needs of thalidomide survivors living in Ireland. I have stated that I am willing to enter into discussions about a health care package on a non-statutory basis; an ex-gratia payment having regard to current financial circumstances; and a statement to the Dáil recognising the challenges faced by survivors.

There are two thalidomide representative organisations. The largest group, the Irish Thalidomide Association announced publicly in 2012 that it had ceased talks with the Government and their legal advisors have initiated personal injuries claims against the State.

The second organisation, the Irish Thalidomide Survivors Society, has sought an independent agency and a statutory health care package including other aspects of their needs such as housing, heating, transport and clothing, which are outside the remit of the health sector. My position remains unchanged from that outlined in my letter to the Irish Thalidomide Survivors Society in June last year in which I requested that the Society consider, in good faith, proceeding with a Health Care Protocol which envisaged appointing and training a multi-disciplinary team, arranging a multi-disciplinary health evaluation, identifying and documenting their healthcare needs/issues and developing plans to address those needs.

On the matter of the timing of the withdrawal of the Thalidomide drug, I have been advised that no negligence or breach of duty could be established against the State on the basis of actions undertaken by the Department at the time. With regard to the fact that the payments made by the State to the survivors of Thalidomide and their families in 1975 were not referred to the High Court, I understand that the relevant rules of Court simply did not apply to the circumstances pertaining to the ex-gratia payment made on behalf of the Government. The payments made by the State in 1975 to the survivors of Thalidomide and their families were not made in settlement of any legal proceedings, either existing or threatened. The payment was not made in a legal context because the State had no liability. It was made because the State believed then that it was appropriate to make some provision for the survivors. The payments made were substantial and were designed to augment payments made to the survivors by the German Foundation.

There are currently 32 Irish Thalidomide survivors. Each survivor received lump sum payments from a German Foundation and the Irish Government in the early 1970s. In 1975 the lump-sums paid by the Irish Government ranged from €6,400 to €21,000. In addition, each survivor receives on-going monthly payments from both the German Foundation and the Irish Government. Combining the Irish and German payments, most individuals received €30,386 per annum or €2,572 per month, tax free. The German and Irish monthly allowance is not reckonable for State benefits and each individual is automatically entitled to a medical card.

In November 2012, officials in my Department forwarded to the Secretaries of both Thalidomide organisations, details regarding a scheme of support currently being provided to survivors of thalidomide worldwide, by the Contergan Foundation.

Health Services Staff Issues

Ceisteanna (574)

Billy Kelleher

Ceist:

574. Deputy Billy Kelleher asked the Minister for Health the reason two senior clinical leaders in nursing and medicine in north Galway mental health services have been relocated to west Galway; and if he will make a statement on the matter. [12295/13]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter this question has been referred to the HSE for direct reply.

Health Services Staff Issues

Ceisteanna (575)

Brendan Griffin

Ceist:

575. Deputy Brendan Griffin asked the Minister for Health if he will prioritise funding for old age psychiatry services in County Kerry in 2013; and if he will make a statement on the matter. [12298/13]

Amharc ar fhreagra

Freagraí scríofa

Budget 2013 provided an additional €35m for the continued development of mental health services across a range of headings including the further ongoing development of community mental health teams for adults, children, older persons and mental health intellectual disability and to the recruitment of over 470 additional staff to implement these measures. In relation to old age psychiatry services in County Kerry, as this is a service matter the question has been referred to the HSE for direct reply.

Medical Card Applications

Ceisteanna (576)

Tom Fleming

Ceist:

576. Deputy Tom Fleming asked the Minister for Health if he will expedite a medical card application in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [12307/13]

Amharc ar fhreagra

Freagraí scríofa

The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

Hospital Staff Issues

Ceisteanna (577, 578, 579)

Billy Kelleher

Ceist:

577. Deputy Billy Kelleher asked the Minister for Health if he will identify, by name, hospitals in which management have implemented elements of the deal agreed between health service management and hospital consultants at the Labour Relations Commission in autumn 2012; the nature of the elements of the agreement that have been put in place in each acute hospital; and if he will make a statement on the matter. [12309/13]

Amharc ar fhreagra

Billy Kelleher

Ceist:

578. Deputy Billy Kelleher asked the Minister for Health if he will identify, by name, the hospitals in which management has introduced the rostering of hospital consultants on any five out of seven days under the terms of the agreement reached at the Labour Relations Commission in September 2012; and if he will make a statement on the matter. [12310/13]

Amharc ar fhreagra

Billy Kelleher

Ceist:

579. Deputy Billy Kelleher asked the Minister for Health if he will identify, by name, the hospitals in which management has put in place roster arrangements to have consultants on duty on a 24 hour basis in specialties such as emergency medicine, neonatology, intensive care and obstetrics as provided in the agreement on work practice reforms brokered at the Labour Relations Commission in September 2012; and if he will make a statement on the matter. [12311/13]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 577 to 579, inclusive, together.

In September 2012, following intensive engagement between health service management and the consultant representative bodies at the Labour Relations Commission, a comprehensive set of measures was agreed. The agreement encompasses a range of flexibilities to enhance productivity and efficiency and to maximise the availability of consultants, as key clinical decision-makers. In particular it provides for:

- Consultant availability for rostering for any five days out of seven as opposed to weekdays;

- Rostering of consultants on a 16/7 (8 a.m. to midnight) or 24/7 basis in services where this is required;

- Clinical Directors having a much strengthened management role in respect of consultants, with reporting relationship for all consultants to the Clinical Director;

- Consultant cooperation with a range of measures to support improved Community and Mental Health services;

- Consultant compliance with the contractual requirements regarding private practice;

- Expeditious processing and signing of claims by consultants for submission to private health insurers.

The HSE is responsible for ensuring that the measures agreed at the LRC are implemented in all hospitals in the public health service. In this regard I have asked the Executive to collate the data requested by the Deputy and to reply to him directly.

Mobility Allowance Decision

Ceisteanna (580)

Nicky McFadden

Ceist:

580. Deputy Nicky McFadden asked the Minister for Health the way an alternative scheme to the mobility allowance and motorised transport grant will be administered; if he will ensure that current funding levels will be maintained; the organisations he has met with in order to develop an alternative scheme; and if he will make a statement on the matter. [12317/13]

Amharc ar fhreagra

Freagraí scríofa

A special review group, which will be independently chaired, has been established to seek an alternative method to provide for the needs of people in a manner that does not run counter to the Equal Status Acts. Following the initial phase of the group's work, which will concentrate on issues around Mobility Allowance and the Motorised Transport Grant, a key concentration of the group will be to look at opportunities for the enhancement of the transport options provided to the relevant persons in need. As part of the review, the Health Service Executive (HSE) will examine the circumstances of all those currently benefiting from the schemes to ensure the identified solutions will encompass their priority mobility needs. In addition, the Minister for Health has instructed the HSE to contact each individual in receipt of the payments to notify them of this decision.

It is important to note that, although the Government's decision ends both schemes to new applicants with immediate effect, the payment of mobility allowance to those currently in receipt of it, will continue for another four months. It is also important to note that the decision is in no way intended to save costs and the funding involved in the two schemes (€10.6 million) remains committed to meeting the priority transport needs of people with a disability.

In advance of the establishment of the Project Group, Department of Health officials met with representatives of the National Federation of Voluntary Bodies, the Disability Federation of Ireland and the Irish Wheelchair Association at my request. In addition, membership of the Project Group, which is independently chaired, is drawn from both the statutory and non-statutory sectors. The work of the Project Group is being supported by the National Disability Authority and includes representatives from the Irish Wheelchair Association, the Disability Federation of Ireland, an independent service user and advocate for people with disabilities and a retired County Council Manager with relevant experience. Both Minister Reilly and myself have instructed the Project Group to seek solutions across the whole of Government, so that alongside representatives from the Department of Health and the HSE, membership also includes representatives from Pobal and from the Departments of Transport, Tourism & Sport, Environment, Community and Local Government, Social Protection and Finance.

The Project Group has already met twice and their next meeting is scheduled for 25th March. The Government decision includes a requirement that the results of the review will be presented to the Government before any final decisions are made on future arrangements.

Vaccination Programme

Ceisteanna (581)

Brian Walsh

Ceist:

581. Deputy Brian Walsh asked the Minister for Health his views on whether there is a potential health risk to residents in Connemara, County Galway in view of the recent outbreak of tuberculosis on Inis Oirr, Aran Islands; his plans to change the BCG vaccination programme in the west of Ireland; and if he will make a statement on the matter. [12318/13]

Amharc ar fhreagra

Freagraí scríofa

The HSE has been investigating cases of TB linked to the island of Inis Oirr since November 2012. Cases of active TB have been identified and are being treated. They no longer pose an infectious risk to others.

Surveillance and Control measures have been implemented in accordance with national guidelines. Contacts of the active cases both on Inis Oirr and the mainland have been screened. As there is a lot of social contact in a small island community, screening was offered to the entire resident population of the island. A large majority of people accepted this offer. People who have evidence of exposure to TB but no active infection are also being treated and monitored as appropriate.

The incidence of TB in the west of Ireland has been lower than in other parts of the country for the last number of years. The risk to people in Connemara should not be any higher than in the west generally.

BCG in the West of Ireland has historically been offered to primary school leaving age children as the incidence of TB peaked in the teenage years in the west in the past. Childhood TB has not been a feature of the outbreak linked to Inis Oirr.

WHO describes countries with an incidence of less than 10 cases per 100,000 population as a low incidence country. The annual notification rate of TB has declined in Ireland since 2007 when the rate was 11.3 per 100,000 (480 cases). In 2010 and 2011, the annual TB notification rates were 9.2 per 100,000 (420 cases in 2010 and 424 cases in 2011) which is the lowest rate recorded since surveillance of TB began in the 1950s and now categorise Ireland as a low incidence country. TB cases notified in 2013 to date, correspond to a provisional crude incidence rate of 8.1 per 100,000 population.

The BCG vaccination programme in Ireland is under review which will inform future policy.

Departmental Expenditure

Ceisteanna (582)

Robert Troy

Ceist:

582. Deputy Robert Troy asked the Minister for Health the costs of providing hardware and software to his home and the homes of Ministers of State in his Department; and if he will make a statement on the matter. [12369/13]

Amharc ar fhreagra

Freagraí scríofa

My Department has not supplied IT hardware or software either to my home or the homes of the Ministers of State in my Department.

Departmental Expenditure

Ceisteanna (583, 585, 586, 587)

Robert Troy

Ceist:

583. Deputy Robert Troy asked the Minister for Health the costs of providing telephone in the homes of Ministers and Ministers of State in his Department; and if he will make a statement on the matter. [12387/13]

Amharc ar fhreagra

Robert Troy

Ceist:

585. Deputy Robert Troy asked the Minister for Health the cost of telephones and ICT provided to the constituency offices including monthly telephone bills of Ministers and Ministers of State in his Department since March 2011; and if he will make a statement on the matter. [12406/13]

Amharc ar fhreagra

Robert Troy

Ceist:

586. Deputy Robert Troy asked the Minister for Health if any additional costs other than telephones, ICT and monthly telephone bills are being paid to constituency office by his Department; and if he will make a statement on the matter. [12424/13]

Amharc ar fhreagra

Robert Troy

Ceist:

587. Deputy Robert Troy asked the Minister for Health the number of mobile phones in use by him and Junior Minister and politically appointed staff; the total costs of the mobile phones since March 2011; and if he will make a statement on the matter. [12442/13]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 583, 585, 586 and 587 together.

The information requested by the Deputy is outlined below.

No telephones were provided in my home or the homes of the Ministers of State in my Department.

The Houses of the Oireachtas Service offers a managed IT support service for the constituency-based offices of Ministers and Ministers of State whereby ICT equipment is supplied to Ministers and the assets so supplied are retained by the Oireachtas.

In addition to this, two of my constituency staff were supplied with laptops by my Department to a total value of €1850.15. These devices are retained on my Department’s asset register.

A Constituency function operates as an adjunct to Minister of State White’s Office, as it has done for a number of his predecessors. As the office is in Hawkins House, my Department equips it. Since March 2011, two PCs were provided to the office, as part of the normal departmental upgrade of its infrastructure, at a total cost of €852.40. These assets are retained on my Department’s asset register.

Additional software licences, to a total value of €640 approximately, were supplied by my Department to Minister of State Shortall’s Constituency staff, while she was in office.

The information requested by the Deputy regarding the cost of telephones bills in constituency offices is set out in tabular statement.

Name

Date (from March, 2011)

Amount

Minister James Reilly

Bills from March, 2011 to December, 2011 paid directly by Constituency Office. This amount was refunded by Department.

€1680.46

January 2012

€167.42

February, 2012

€163.12

March, 2012

€221.16

April, 2012

€108.77

May, 2012

€208.51

June, 2012

€47.15

July, 2012

€108.33

August, 2012

€52.26

September, 2012

€51.51

October, 2012

€108.33

November, 2012

€47.17

December, 2012

€52.34

January, 2013

€51.51

February, 2013

€51.47

March, 2013

€51.94

TOTAL

€3243.45

Name

Date (from March 2011)

Amount

Minister Kathleen Lynch

July, 2011 (inclusive of service connection charge of €545.61)

€1154.86

August, 2011

€439.99

September, 2011

€267.80

October, 2011

€371.82

November, 2011

€436.27

December, 2011

€425.73

January, 2012

€317.54

February, 2012

€435.62

March, 2012

€405.53

April, 2012

€349.09

May, 2012

€367.67

June, 2012

€343.55

July, 2012

€337.88

August, 2012

€308.07

September, 2012

€283.46

October, 2012

€322.26

November, 2012

€332.05

December, 2012

€345.99

January, 2013

€267.06

February, 2013

€347.49

March, 2013

€276.43

TOTAL

€8181.16

October, 2012

€75.39

Minister Alex White

Date (from March 2011)

Amount

November, 2012

€73.02

December, 2012

€73.35

January, 2013

€67.01

February, 2013

€73.35

March, 2013

€82.41

TOTAL

€371.18

The total number of mobile phones in use by myself, Ministers of State and politically appointed staff is nine. The total cost of mobile phone bills since March, 2011 is €19,381.44.

Health Services Staff Issues

Ceisteanna (584)

Brendan Griffin

Ceist:

584. Deputy Brendan Griffin asked the Minister for Health if his attention has been drawn to the difficulty faced by the Health Service Executive in recruiting consultant radiologists; the way he proposes to address this shortage; and if he will make a statement on the matter. [12394/13]

Amharc ar fhreagra

Freagraí scríofa

The recruitment of staff in the health sector is primarily a matter for the Health Service Executive. I have asked the Executive to reply directly to the Deputy in relation to the recruitment of consultant radiologists. Consultant posts in certain specialties have traditionally been difficult to fill, most notably in areas such as radiology, paediatric intensive care and histopathology. There are also geographical locations to which it is difficult to attract candidates. These are generally locations outside the major urban centres. Where necessary, locum arrangements are put in place to ensure service delivery.

Questions Nos. 585 to 587, inclusive, answered with Question No. 583.

Departmental Expenditure

Ceisteanna (588)

Robert Troy

Ceist:

588. Deputy Robert Troy asked the Minister for Health the cost of drivers of each vehicle assigned to him and Ministers of State in his Department since March 2011; the mileage and other costs claimed in respect of each since March 2011; the overall yearly costs of ministerial cars in 2010; and if he will make a statement on the matter. [12460/13]

Amharc ar fhreagra

Freagraí scríofa

The Minister for Health and the Ministers of State are all required to use their own cars and the salary costs for drivers and mileage expenses since March 2011 are broken down as follows:

Minister

Driver pay & Subsistence

Mileage & Other Costs

James Reilly, T.D.

€186,268

€27,861

Roisin Shorthall T.D.

Did not have driver

€8,149 (includes taxis)

Kathleen Lynch T.D.

€169,081

€28,977

Alex White T.D.

€27,321

€3,339

TOTAL

€382,670

€68,326

In addition a total sum of €6805 was paid in respect of tolls for all Ministers.

My Department was not responsible for paying the cost of Garda drivers and State Cars etc. under previous arrangements in place in 2010. However, on 25th April 2012 my colleague, Mr Noonan, T.D., Minister for Finance, in response to a Parliamentary Question, indicated that the average cost of transport for Ministers under that previous arrangement was €280,000 per annum per Minister. This appears to be significantly more expensive than current arrangements.

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