Written Answers Nos 1-30
10. Deputy Billy Timmins asked the Minister for Health the measures that have been taken to tackle the number of patients on trolleys in St. Vincent's University Hospital, Dublin; the impact of these measures; and if he will make a statement on the matter. [14312/13]
Amharc ar fhreagraImmediately following my appointment, I set out to address the issues which have been causing unacceptable delays in patients being treated in our hospitals. I established the Special Delivery Unit, (SDU), as set out in the Programme for Government. The SDU is working to unblock access to acute services by improving the flow of patients through the system. Since its establishment there has been significant improvements in the waiting times for unscheduled care against a background of reduced funding for health, reconfiguration of services and a challenging socio-economic climate.
Hospitals across the country have experienced a surge in presentations to Emergency Departments, as would be expected in the winter months, resulting in high demand for admissions and a consequent rise in trolley waits. Recent outbreaks of influenza have created additional logistical difficulties in relation to the admission, movement and discharge of patients in some hospitals. Those hospitals have released media messages advising non-attendance and restrictions on visiting. The SDU continues to monitor Emergency Department activity closely, engaging with key hospitals via teleconference and on-site meetings, collaborating in putting in place a range of measures to assist with patient flow and reviewing the available data for trends in relation to the reported levels of high activity.
Despite these pressures the year on year improvements continue nationally. Numbers recorded on trolleys at the end of 2012 showed a marked improvement of 23.6% less than 2011 which equates to 20,386 less people. From 1st January to 15th March, there has been a total of 15,220 patients on trolleys: this is a reduction of 2,258 patients or 12.9% on the equivalent period last year. Priority now is to reduce long waiters (over 9 hours) as we move to a six hour patient journey target. The SDU and the Patient Safety & Quality Directorate in HSE are in communication to agree a mechanism of capturing and responding in instances where a hospital reports one or more patients breaching the targets.
In relation to St. Vincent’s University Hospital, it is the largest hospital in Dublin South East region dealing with all trauma and serious cases and providing support for such patients presenting to St. Michael’s Hospital, Dun Laoghaire and St. Columcille’s Hospital. The hospital has advised that over the past few weeks the number of patients requiring admission has averaged between a low of 10 to a high of 30. The hospital is working closely with the SDU and the Acute Medicine Programme in order to enhance patient care pathways and patient flow.
The hospitals discharge process has been reviewed in detail and additional emphasis has been placed on the early identification of potential discharges. All members of the multi-disciplinary team have been engaged in this process. All consultants and their teams are required to identify potential “weekend discharges” for review by the consultant on call. Consultants and their teams are also required to prepare a list of “next day discharges” on a daily basis with a view to effecting discharges by 11.00 am the following day. The hospital has also introduced the following initiatives in relation to dealing with Emergency Department pressures:
- Introduction of an Acute Medicine Unit (AMU)
- Acute Assessment Unit (AAU)
- Clinical Decision Unit (CDU)
- Chest Pain Evaluation Unit (CPEU)
- Rapid access triage (Doctor/Nurse triaging patients)
- Specialty Specific targets for Length of Stay
The hospital is also in daily consultation with their community based colleagues to ensure that all necessary supports are in place to facilitate discharge from the acute setting, to facilities more appropriate to the patients needs.
It is envisaged that these developments will lead to shorter lengths of stay in acute hospital care which will in turn improve waiting times and patient experience in the Emergency Department.
11. Deputy Tony McLoughlin asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Sligo General Hospital; the impact of these measures; and if he will make a statement on the matter. [14301/13]
Amharc ar fhreagra43 patients were waiting over a year for an inpatient or day case procedure in Sligo Regional Hospital at the end of February 2011. Now, 6 patients are waiting this length of time. This waiting list has been reduced by 86%. 168 patients were waiting over 9 months for an inpatient or day case procedure in Sligo Regional Hospital at the end of February 2011. Now, 94 patients are waiting this length of time. This waiting list has been reduced by 44%. This improvement in waiting list numbers is mirrored throughout the country. There are 35 hospitals with data available for both the end of February 2013 and the end of February 2011. 1,925 patients were waiting longer than a year for an inpatient or day case procedure in these hospitals at the end of February 2011. 396 patients were waiting this length of time at the end of February 2013. This waiting list has been reduced by 79%. 4,992 patients were waiting longer than nine months for an inpatient or day case procedure in these hospitals at the end of February 2011. 2,136 patients were waiting this length of time at the end of February 2013. This waiting list has been reduced by 57%. 10,844 patients were waiting longer than six months for an inpatient or day case procedure in these hospitals at the end of February 2011. 8,649 were waiting this length of time at the end of February 2013. This waiting list has been reduced by 20%. Since the end of February 2011, waiting lists longer than a year for inpatient and day case procedures have been eliminated in 15 hospitals and waiting lists longer than 9 months for these procedures have been eliminated in 9 hospitals
I am determined that the progress made in 2012 be maintained and improved upon. For 2013, the target is that no adult should be waiting longer than 8 months for inpatient or daycase treatment. It is important to recognise that the progress made in 2012 does not mean the problem is solved, and 2013 will of course be extremely challenging. For example, winter pressures in Emergency Departments have impacted on scheduled care waiting times. However, in the coming months, as winter pressures ease, the SDU will work towards re-balancing scheduled care to maintain the improvements seen in 2012 and to achieve the new 2013 target.
Sligo Regional Hospital achieved the national adult waiting list targets of 9 months for inpatient and daycase surgery and 13 weeks for scopes by the end of December 2012. Whilst the seasonal challenges of winter have temporarily increased numbers, with 94 patients currently waiting over 9 months, the hospital continues to progress towards regaining compliance with the targets. .
12. Deputy Robert Troy asked the Minister for Health if he will provide for the inclusion of cancer patients among those entitled to a free general practitioner card for long-term illnesses; and if he will make a statement on the matter. [13852/13]
Amharc ar fhreagraThe Government's Programme for Government committed it to major reforms of the manner in which health services are delivered. As part of the reform programme, Universal Primary Care is to be introduced on a phased basis during its term of office. Primary legislation is being prepared to give effect to this commitment. The wording of this legislation, which will allow the Minister for Health to make regulations to extend access to GP services without fees to persons with prescribed illnesses, is currently being drafted by the Office of the Attorney General and the Department. As the legislation is still being drafted, I am not in a position to give a definite date for its publication. Details of an implementation timeframe, illnesses to be covered etc and application details will be announced in due course.
13. Deputy Róisín Shortall asked the Minister for Health the target date for the full commencement of new regulations under the Misuse of Drugs Act to deal with the trading of certain z-drugs; the dealing in and prescribing of benzodiazepines; his plans to deal with the sale of anabolic steroids; and if he will make a statement on the matter. [14345/13]
Amharc ar fhreagraThe Department is reviewing the Misuse of Drugs Regulations with a view to, amongst other issues, introducing additional controls on certain prescription drugs being traded illicitly, including benzodiazepine medicines and z-drugs. A consultation process has taken place with key stakeholders in relation to the proposed amendments, which include introducing import and export controls on benzodiazepines and z-drugs as well as an offence of possession, thereby assisting the law enforcement roles of Customs and of the Garda Siochána.
Anabolic steroids are currently subject to prescription control under the Medicinal Products (Prescription and Control of Supply) Regulations 2003 (S.I. 540 of 2003), which means they cannot be supplied except in accordance with a prescription. In view of their potential for abuse, it is proposed to place them under the control of the Misuse of Drugs Regulations by making it an offence to import anabolic steroids other than for medical purposes.
Draft Misuse of Drugs (Amendment) Regulations are currently being prepared and will be submitted for the Government's approval. Following this, it will be necessary to notify the proposed legislation to the EU Commission and Member States to complete the 3 month EU notification period under the Technical Standards Directive.
14. Deputy Mary Lou McDonald asked the Minister for Health if the announced decision to make the drug Kalydeco available to cystic fibrosis sufferers has been implemented; and if he will make a statement on the matter. [13780/13]
Amharc ar fhreagraDr James Reilly TD, Minister for Health announced, on the 1st February 2013, that Kalydeco, a new innovative medicine for the treatment of cystic fibrosis (CF) in patients who have the G551D mutation, would be made available for patients in Ireland from the 1st of March.
The HSE has circulated a detailed protocol to hospitals in relation to the administration of the medication.
15. Deputy Ray Butler asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Children's University Hospital, Temple Street, Dublin; the impact of these measures; and if he will make a statement on the matter. [14317/13]
Amharc ar fhreagraIn 2011, I established the Special Delivery Unit in my Department as set out in the Programme for Government. The aim of the SDU is to unblock access to acute services by improving the flow of patients through the system. The SDU's Scheduled Care Team focused initially on waiting times for in-patient and daycase elective surgery. For 2012, a target was set that no child should wait longer than 20 weeks for inpatient or daycase treatment. By the end of December 2012, the number of children nationally having to wait more than 20 weeks was down to 89, a drop of 95% on the 1,759 children waiting longer than the target in December 2011.
I am determined that the progress made in 2012 be maintained and improved upon and the 20-week target remains in place for 2013. It is important to recognise that the progress made in 2012 does not mean the problem is solved, and 2013 will of course be extremely challenging. For example, winter pressures have impacted on scheduled care waiting times for children. However, in the coming months, as winter pressures ease, the SDU will work towards re-balancing scheduled care to maintain the improvements seen in 2012.
With regard to the Children's University Hospital Temple Street, as set out in the HSE's Performance Report for December, no child at Temple Street was waiting longer than 20 weeks at the end of last year. As set out above, winter pressures have impacted on waiting times in the early part of this year and February data show the number of children waiting longer than 20 weeks at Temple Street at 53. As set out in the HSE's Regional Service Plan for Dublin Mid-Leinster, which has the remit for Children's University Hospital Temple Street, the hospital will continue to work with the Special Delivery Unit to achieve the 2013 target of no child waiting longer than 20 weeks for in-patient or day-case treatment.
16. Deputy Sandra McLellan asked the Minister for Health if he will restore home help hours in 2013 to at least their 2011 level; and if he will make a statement on the matter. [13792/13]
Amharc ar fhreagraI have already indicated that care provision in 2013 for the Home Help Service, will be restored to 2012 levels.
As is the case with all aspects of HSE service plans, the Home Help services are reviewed on a regular basis, in the context of achieving agreed targets or taking account of evolving circumstances over the course of 2013.
17. Deputy Michelle Mulherin asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists nationally; the impact of these measures; and if he will make a statement on the matter. [14260/13]
Amharc ar fhreagra22. Deputy Áine Collins asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Mercy University Hospital, Cork; the impact of these measures; and if he will make a statement on the matter. [14276/13]
Amharc ar fhreagra29. Deputy Peter Fitzpatrick asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Louth County Hospital; the impact of these measures; and if he will make a statement on the matter. [14275/13]
Amharc ar fhreagra52. Deputy Patrick O'Donovan asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Mid Western Regional Hospital, Croom, County Limerick; the impact of these measures; and if he will make a statement on the matter. [14279/13]
Amharc ar fhreagra53. Deputy Dara Murphy asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Cork University Hospital; the impact of these measures; and if he will make a statement on the matter. [14270/13]
Amharc ar fhreagra59. Deputy Charles Flanagan asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Midland Regional Hospital, Portlaoise, County Laois; the impact of these measures; and if he will make a statement on the matter. [14286/13]
Amharc ar fhreagra74. Deputy Simon Harris asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Tallaght Hospital, Dublin 24; the impact of these measures; and if he will make a statement on the matter. [14313/13]
Amharc ar fhreagra89. Deputy Pat Deering asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in St Luke’s General Hospital, County Kilkenny; the impact of these measures; and if he will make a statement on the matter. [14308/13]
Amharc ar fhreagra97. Deputy Eoghan Murphy asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in St Vincent’s University Hospital, Elm Park, Dublin 4; the impact of these measures; and if he will make a statement on the matter. [14310/13]
Amharc ar fhreagra106. Deputy Paul J. Connaughton asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Merlin Park Hospital, Galway; the impact of these measures; and if he will make a statement on the matter. [14278/13]
Amharc ar fhreagra112. Deputy Michael Creed asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in South Infirmary Victoria University Hospital, County Cork; the impact of these measures; and if he will make a statement on the matter. [14305/13]
Amharc ar fhreagra113. Deputy Patrick O'Donovan asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Mid Western Regional Hospital, Dooradoyle, County Limerick; the impact of these measures; and if he will make a statement on the matter. [14280/13]
Amharc ar fhreagra116. Deputy Seán Kyne asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in University College Hospital, County Galway; the impact of these measures; and if he will make a statement on the matter. [14318/13]
Amharc ar fhreagra126. Deputy John Paul Phelan asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Lourdes Orthopaedic Hospital, Kilcreene, Kilkenny; the impact of these measures; and if he will make a statement on the matter. [14274/13]
Amharc ar fhreagra132. Deputy Damien English asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Our Lady’s Hospital, Navan, County Meath; the impact of these measures; and if he will make a statement on the matter. [14297/13]
Amharc ar fhreagra135. Deputy Marcella Corcoran Kennedy asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Midland Regional Hospital, Tullamore, County Offaly; the impact of these measures; and if he will make a statement on the matter. [14289/13]
Amharc ar fhreagra138. Deputy Terence Flanagan asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Beaumont Hospital, Dublin; the impact of these measures; and if he will make a statement on the matter. [14263/13]
Amharc ar fhreagra142. Deputy Kieran O'Donnell asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Mid Western Regional Hospital, Limerick; the impact of these measures; and if he will make a statement on the matter. [14282/13]
Amharc ar fhreagra147. Deputy Joe O'Reilly asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Cavan General Hospital; the impact of these measures; and if he will make a statement on the matter. [14267/13]
Amharc ar fhreagra154. Deputy Paudie Coffey asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Waterford Regional Hospital; the impact of these measures; and if he will make a statement on the matter. [14321/13]
Amharc ar fhreagra156. Deputy Liam Twomey asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Wexford Hospital; the impact of these measures; and if he will make a statement on the matter. [14324/13]
Amharc ar fhreagraI propose to take Questions Nos. 17, 22, 29, 52, 53, 59, 74, 89, 97, 106, 112, 113, 116, 126, 132, 135, 138, 142, 147, 154 and 156 together.
In 2011, I established the Special Delivery Unit in my Department as set out in the Programme for Government. The aim of the SDU is to unblock access to acute services by improving the flow of patients through the system. The SDU's Scheduled Care Team focused initially on waiting times for in-patient and daycase elective surgery. For 2012, a target was set that no adult should wait longer than 9 months for inpatient or daycase treatment. By the end of December 2012, the number of adults having to wait more than 9 months for inpatient and day case surgery nationally had fallen to 86. This was down from 3,706 in December 2011, representing a 98% decrease
I am determined that the progress made in 2012 be maintained and improved upon. For 2013, the target is that no adult should be waiting longer than 8 months for inpatient or daycase treatment. It is important to recognise that the progress made in 2012 does not mean the problem is solved, and 2013 will of course be extremely challenging. For example, winter pressures in Emergency Departments have impacted on scheduled care waiting times. However, in the coming months, as winter pressures ease, the SDU will work towards re-balancing scheduled care to maintain the improvements seen in 2012 and to achieve the new 2013 target.
With regard to the specific hospitals referred to, I have asked the HSE to respond directly to the Deputies concerned.
18. Deputy Seamus Kirk asked the Minister for Health when BreastCheck will be extended to women over 65 years; and if he will make a statement on the matter. [13860/13]
Amharc ar fhreagra83. Deputy Éamon Ó Cuív asked the Minister for Health his plans to expand the BreastCheck programme; and if he will make a statement on the matter. [13866/13]
Amharc ar fhreagraI propose to take Questions Nos. 18 and 83 together.
The BreastCheck Programme provides free mammograms to all women aged 50-64. The Programme for Government includes the extension of BreastCheck to women in the 65-69 age group, in keeping with EU Guidelines on effective screening for breast cancer.
The main priority for the HSE's National Cancer Screening Service (NCSS) at present is to maximise national uptake in the 50-64 year age cohort and it aims to extend the upper age range from 65 - 69 in 2014 in keeping with the Programme for Government.
In the meantime women of any age who have concerns about breast cancer should seek the advice of their GP who will, if appropriate, refer them to the symptomatic breast services in one of the eight designated specialist cancer centres.
In addition, my Department commissioned an Efficiency Review of the BreastCheck Screening Programme in order to prepare for the age extension of BreastCheck to women up to the age of 69. The review makes a number of recommendations on how the screening process could be enhanced to increase the number screened. My Department will continue to work with the HSE to ensure that national priorities and Programme for Government commitments are met.
19. Deputy Derek Keating asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists including day care waiting lists for children in Cappagh Orthopaedic Hospital; the impact of these measures; and if he will make a statement on the matter. [14266/13]
Amharc ar fhreagraIn 2011, I established the Special Delivery Unit in my Department as set out in the Programme for Government. The aim of the SDU is to unblock access to acute services by improving the flow of patients through the system. The SDU's Scheduled Care Team focused initially onwaiting times for in-patient and daycase elective surgery.For 2012, a target was set that no child should wait longer than 20 weeks for inpatient or daycase treatment. By the end of December 2012, the number of children nationally having to wait more than 20 weeks was down to 89, a drop of 95% on the 1,759 children waiting longer than the target in December 2011.
I am determined that the progress made in 2012 be maintained and improved upon and the 20-week target remains in place for 2013. It is important to recognise that the progress made in 2012 does not mean the problem is solved, and 2013 will of course be extremely challenging. For example, winter pressures have impacted on scheduled care waiting times for children. However, in the coming months, as winter pressures ease, the SDU will work towards re-balancing scheduled careto maintain the improvements seen in 2012. Cappagh National Orthopaedic Hospital is actively managing all patient waiting lists.As per the Health Service Executive December 2012 Performance Report, there were no children waiting more than 20 weeks on the elective inpatient/daycase waiting list for Cappagh Hospital. I understand that currently there are no children waiting in breach of inpatient/daycase waiting list targets (i.e. 20 weeks) as issued by the Special Delivery Unit.
20. Deputy Michael Moynihan asked the Minister for Health his plans to train and recruit more public health nurses; and if he will make a statement on the matter. [13848/13]
Amharc ar fhreagraThe Public Health Nurse is responsible for the delivery of the public health nursing service for specific geographic areas. The scope and range of public health nursing services are aligned to the health service demand that emerges from the population demographics and epidemiology. This demand varies depending on the complexity of health service requirements in geographic areas such as deprivation, cohort of frail older adults, extent of child health interventions, prevalence of chronic diseases etc.
The future planning of public health nursing posts will be based on identified service need and undertaken within the context of available resources to the HSE.
PHN training is delivered at post graduate level and numbers are determined by the HSE according to service need, including retirements and workforce planning. There are currently 40 PHNs in training, scheduled to graduate this year and work within the public health system when vacancies arise. The HSE has yet to determine the number of training places to be offered this year for graduation in 2014.
In 2013, Primary Care funding of €20m, nationally, will be invested to support the recruitment of prioritised front-line primary care team posts and enhance the capacity of the primary care sector. The HSE's 2013 National Service Plan has identified approximately 250 Primary Care posts (including Public Health Nurses (PHNs), Registered General Nurses (RGNs), Occupational Therapists, Physiotherapists and Speech and Language Therapists). These posts will be filled using the Resource Allocation model, based on deprivation and need, which was developed by the HSE's National Primary Care Office and Health Intelligence Unit.
Using this model, the HSE completed a detailed analysis of the numbers and distribution of the above health care professionals. The analysis revealed considerable variation across the 17 Integrated Service Areas in ratios of health care professionals to population, and to population numbers in areas of high deprivation. Based on this analysis, it proposed that of the approximate 250 posts, 70 Public Health Nurses and 37 Registered General Nurses will be recruited to Primary Care Teams. It is my firm intention, along with my colleague Minister of State Alex White, to have these posts filled as soon as possible in 2013.
I am confident that these additional posts will have a positive impact on the ongoing development of services in the community, giving people direct access to integrated multi-disciplinary teams of health professionals.
21. Deputy Catherine Byrne asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Our Lady’s Hospital for Sick Children, Crumlin, Dublin; the impact of these measures; and if he will make a statement on the matter. [14295/13]
Amharc ar fhreagraIn 2011, I established the Special Delivery Unit in my Department as set out in the Programme for Government. The aim of the SDU is to unblock access to acute services by improving the flow of patients through the system. The SDU's Scheduled Care Team focused initially on waiting times for in-patient and daycase elective surgery. For 2012, a target was set that no child should wait longer than 20 weeks for inpatient or daycase treatment. By the end of December 2012, the number of children nationally having to wait more than 20 weeks was down to 89, a drop of 95% on the 1,759 children waiting longer than the target in December 2011.
I am determined that the progress made in 2012 be maintained and improved upon and the 20-week target remains in place for 2013. It is important to recognise that the progress made in 2012 does not mean the problem is solved, and 2013 will of course be extremely challenging. For example, winter pressures have impacted on scheduled care waiting times for children. However, in the coming months, as winter pressures ease, the SDU will work towards re-balancing scheduled care to maintain the improvements seen in 2012.
I have asked the HSE to reply directly to the Deputy in relation to the specific query raised.
23. Deputy Brian Stanley asked the Minister for Health the additional measures he will undertake to address the high price of medicines, both generic and branded, in this State, as compared to other jurisdictions; and if he will make a statement on the matter. [13788/13]
Amharc ar fhreagra88. Deputy Seán Crowe asked the Minister for Health the measures he is taking to reduce the cost of generic drugs in view of reports that the Health Service Executive pays up to 24 times more than the National Health Service for some generic drugs; if he will outline a timeframe for same; and if he will make a statement on the matter. [13770/13]
Amharc ar fhreagraI propose to take Questions Nos. 23 and 88 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.
Following intensive negotiations involving the Irish Pharmaceutical Healthcare Association (IPHA), the HSE and the Department of Health, a major new deal on the cost of drugs in the State was concluded in October last. It will deliver a number of important benefits, including
- significant reductions for patients in the cost of drugs,
- a lowering of the drugs bill to the State,
- timely access for patients to new cutting-edge drugs for certain conditions, and
- reducing the cost base of the health system into the future.
The gross savings arising from this deal will be in excess of €400m over 3 years. €210 million from the gross savings will make available new drugs to patients over 3 years. Thus, the deal will result in a net reduction in the HSE expenditure on drugs of about €190m.
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. It is estimated that the combined gross savings from the IPHA and APMI deals will be in excess of €120 million in 2013.
The IPHA agreement provides that prices are referenced to the currency adjusted average price to wholesaler in the nominated EU member states in which the medicine is then available. The prices of a range of medicines were reduced on 1 January 2013 in accordance with the agreement.
The Health (Pricing and Supply of Medical Goods) Bill 2012, which was passed at Committee Stage yesterday, provides for the introduction of a system of generic substitution and reference pricing. The Bill provides that when the HSE is setting a reference price for, or reviewing a reference price set for, a relevant group of interchangeable medicinal products it shall take into account the following criteria:
- the ability of suppliers to meet patient demand for the relevant item;
- the value for money afforded by the relevant item;
- the equivalent prices of the relevant item in all other Member States where the product is marketed;
- the prices of therapeutically similar items; and
- the resources available to the HSE.
It is important to balance achieving best value for money for the taxpayer with assuring continuity of supply for critical medical products, particularly in a small market like Ireland. Consequently, the Bill aims to achieve value for money while avoiding disruption in the availability of medicines on the Irish market. This legislation will promote price competition among suppliers and ensure that lower prices are paid for these medicines resulting in further savings for both taxpayers and patients.
24. Deputy Mary Mitchell O'Connor asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in Royal Victoria Eye and Ear Hospital; the impact of these measures; and if he will make a statement on the matter. [14299/13]
Amharc ar fhreagraIn 2011, I established the Special Delivery Unit in my Department as set out in the Programme for Government. The aim of the SDU is to unblock access to acute services by improving the flow of patients through the system. The SDU's Scheduled Care Team focused initially on waiting times for in-patient and daycase elective surgery. For 2012, a target was set that no adult should wait longer than 9 months for inpatient or daycase treatment. By the end of December 2012, the number of adults having to wait more than 9 months for inpatient and day case surgery nationally had fallen to 86. This was down from 3,706 in December 2011, representing a 98% decrease
I am determined that the progress made in 2012 be maintained and improved upon. For 2013, the target is that no adult should be waiting longer than 8 months for inpatient or daycase treatment. It is important to recognise that the progress made in 2012 does not mean the problem is solved, and 2013 will of course be extremely challenging. For example, winter pressures in Emergency Departments have impacted on scheduled care waiting times. However, in the coming months, as winter pressures ease, the SDU will work towards re-balancing scheduled care to maintain the improvements seen in 2012 and to achieve the new 2013 target.
With regard to the specific hospital referred to, I have asked the HSE to respond directly to the Deputies concerned.
25. Deputy Brendan Smith asked the Minister for Health if he intends to being forward a new National Cancer Strategy; the timeline for same; and if he will make a statement on the matter. [13851/13]
Amharc ar fhreagra129. Deputy Seamus Kirk asked the Minister for Health if he has commenced work on a new national cancer strategy; the timeline for same; and if he will make a statement on the matter. [13843/13]
Amharc ar fhreagraI propose to take Questions Nos. 25 and 129 together.
The second national cancer strategy, “A Strategy for Cancer Control in Ireland, 2006", addressed the rising burden of cancer in the Irish population. The Strategy was developed by the second National Cancer Forum, an advisory body to the Minister for Health and Children at that time. The Strategy’s vision was that “Ireland will have a system of cancer control which will reduce our cancer incidence, morbidity and mortality rates relative to other EU countries by 2015.” To date, significant progress has been made on implementing the Strategy's recommendations but more work is needed on reducing the burden of cancer associated with lifestyle related behaviours.
The HSE established the National Cancer Control Programme (NCCP) in 2007 to implement the 2006 Strategy. The role of the NCCP is to provide a comprehensive programme of cancer control in Ireland, to transform how cancer care is delivered, and ensure that cancer services meet the highest standards.
Recently, I published Future Health: A Strategic Framework for Reform of the Health Service 2012-2015. This sets out the main healthcare reforms that will be introduced in the coming years, as key building blocks for the introduction of Universal Health Insurance in 2016. Future Health is about prioritising the needs of patients even as difficult decisions on health financing are made.
Future Health will deliver a major reshaping of the health system by restructuring our service delivery, and improving our organisational, financial, governance and accountability systems across the board – in the primary, community and hospital sectors. Any changes that are deemed necessary in relation to cancer control will be considered in the context of Future Health.
26. Deputy Seán Crowe asked the Minister for Health if he will supply details of which of the 15 candidate screening units have been accredited as part of the National Colorectal Screening Programme and which units are providing screening colonoscopies; and if he will make a statement on the matter. [13774/13]
Amharc ar fhreagraThe HSE’s national colorectal screening programme, BowelScreen, commenced in November 2012 and is being introduced on a phased basis to men and women between the ages of 60-69 years. When fully implemented the programme will offer free screening to men and women aged 55-74 every two years.
The screening test, known as a Faecal Immunochemical Test (FIT), is a home based test and approximately 94 to 95 per cent of people will receive a normal result and will be invited for routine screening again in two years time. A small number, in the region of five to six per cent, will receive a not normal result and will require an additional test. They will be referred for a colonoscopy to a Screening Colonoscopy Unit within a hospital contracted by the HSE’s National Cancer Screening Service (NCSS) for provision of this service.
Over half of the initially selected fifteen candidate screening colonoscopy units have been accredited to date, and the remainder of units continue to work to achieve this benchmark. Also a number of additional units are pursuing NHS Joint Advisory Group (JAG) accreditation and will come into the programme in time.
The units accredited to date are St. Vincent’s University Hospital; St. James’s Hospital; Connolly Hospital, Blanchardstown; Louth County Hospital; Sligo General Hospital; Midland Regional Hospital, Tullamore; Ennis General Hospital; Mercy Hospital, Cork and Wexford General Hospital.
The NCSS continues to work closely with the remaining initially selected screening colonoscopy units to support them achieving accreditation; these are Cavan General Hospital; Kerry General Hospital, Tralee; Letterkenny General Hospital; Mayo General Hospital, Castlebar; South Tipperary General Hospital, Clonmel and Tallaght.
The accredited screening colonoscopy units provide good geographic coverage and are appropriate for the invited population to date. The programme is being rolled-out on a phased basis and is providing screening colonoscopies as required.
28. Deputy Niall Collins asked the Minister for Health his assessment of the new Health Service Executive regional service plans; and if he will make a statement on the matter. [13838/13]
Amharc ar fhreagra64. Deputy Sean Fleming asked the Minister for Health in view of the staff cuts in a number of sectors, the way the new Health Service Executive regional service plans will deliver improved services; and if he will make a statement on the matter. [13858/13]
Amharc ar fhreagraI propose to take Questions Nos. 28 and 64 together.
Under the Health Act 2004, the Health Service Executive must prepare a service plan and submit it to me for my approval following publication of the Estimates. The National Service Plan which was submitted to me in December sets out the quantum and type of health services to be provided in 2013 within the overall level of funding provided. In accordance with the Act I approved the National Service Plan and laid a copy of the plan before both Houses of the Oireachtas on 9th January this year. Subsequently, the Executive prepared and published its the Operational Plan and Regional Service Plans which underpin the National Service Plan at the end of February. The HSE has responsibility for the delivery of services set out in these Regional Plans and to ensure that services are delivered within budget. The Director General Designate of the HSE, Tony O'Brien, has provided full briefing on the Regional Service Plans to the Regional Fora.
30. Deputy Robert Troy asked the Minister for Health the key measures in the recently published National Implementation Framework of the Value for Money and Policy Review of the Disability Services Programme; and if he will make a statement on the matter. [13869/13]
Amharc ar fhreagra148. Deputy Barry Cowen asked the Minister for Health the way the published National Implementation Framework of the Value for Money and Policy Review of the Disability Services Programme will improve matters for those with disability; and if he will make a statement on the matter. [13856/13]
Amharc ar fhreagraI propose to take Questions Nos. 30 and 148 together.
I recently approved the National Implementation Framework of the Value for Money (VFM) and Policy Review of the Disability Services Programme which was published on the Department's website (www.doh.ie) on 28th February last. The development of the Framework is one of the key actions identified in Future Health, the recently published Strategic Framework for Reform of the Health Service 2012 – 2015. It supports the message coming through from Future Health regarding the need to restructure service delivery, and improve organisational, financial, governance and accountability systems with the aim of providing a more effective and more accountable service.
The vision of the Disability Services Programme as set out in the VFM Review is "to contribute to the realisation of a society where people with disabilities are supported, as far as possible, to participate to their full potential in economic and social life, and have access to a range of quality personal social supports and services to enhance their quality of life and well-being". The recommendations in the Review describe how this vision is to be given tangible effect.
The National Implementation Framework determines how the recommendations from the VFM Review are translated into concrete actions. It assigns responsibilities for those actions, and specifies timelines for their completion. It also identifies priorities and key performance indicators. The Framework describes the project management and monitoring processes which are needed to make sure that the reform of the Disability Services Programme is achieved in a planned, timely and cost effective manner.
The implementation of the recommendations, in the manner set out in the National Implementation Framework will ultimately improve the lives of people with disabilities in the following ways:
- People with disabilities and their families will have more choice and flexibility in the services they receive and will have more control over how they access these services.
- Services and supports will be tailored to meet individual need and will support greater independence and social inclusion.
- The move to individualised budgeting will be underpinned by a standardised needs assessment to ensure fairness and transparency in the way in which funding is allocated.
- Supports and services will be delivered with greater equity, transparency and accountability and will be more cost effective.
A set of key measures necessary to implement the 7 strategic aims which are at the core of the recommendations of the VFM Review have been identified. Each key measure has been broken down into a set of key actions. These key measures are clustered under the following strategic aims
1. Establish a national disability function, within the framework of the Social Care Directorate, with a central directional role in funding, shaping and driving the Disability Services Programme.
2. Achieve optimal efficiency in the delivery of the Disability Services Programme.
3. Re-shape certain services and models of service delivery through a collaborative process based on a commissioning and procurement framework.
4. Develop a national resource allocation model, based on a standardised and appropriate assessment of need process, a methodology for associating standard costs with assessed needs and transparent protocols for determining the basis for allocating finite resources.
5. Develop and implement an information infrastructure to support the effective delivery of the Disability Services Programme.
6. Develop a strategic planning framework to support the re-configuration of the Disability Services Programme.
7. Drive migration towards a person-centred model of services and supports through the Service Level Arrangement (SLA) process by initiating and evaluating demonstration projects as proof of concept.
A full list of key measures is published in Appendix A of the Framework.
