Written Answers Nos. 1146-1167
1146. Deputy Michael McCarthy asked the Minister for Health if he will provide an outline of his position on water fluoridation, address concerns that the practice may be detrimental to a person's health; and if he will make a statement on the matter. [16214/13]
Amharc ar fhreagraWater fluoridation and the use of appropriate fluorides is a major plank of public health policy in Ireland in the prevention and management of tooth decay. In 2002 the Forum on Fluoridation, which was established to review this policy, concluded that the fluoridation of public piped water supplies should continue as a public health measure.
The effects of fluoridation on health and related matters are kept under constant review. The Irish Expert Body on Fluorides and Health, established in 2004, monitors new and emerging issues on fluoride and its effects. It advises that the balance of scientific evidence worldwide confirms that water fluoridation, at the optimal level, does not cause any ill effects and is the safest and most cost effective method of protecting the oral health of the population. The opinion of the Expert Body is supported by the World Health Organisation; the Centre for Disease Control and Prevention, the Public Health Service and the Surgeon General of the United States; the World Dental Federation; the International Association for Dental Research; the Royal College of Physicians of England and by major international scientifically validated reviews in many countries.
1147. Deputy Joe O'Reilly asked the Minister for Health when it was decided to remove access to phlebotomy services at Cavan General Hospital for diabetics attending consultants but not referred specifically as a result of an appointment at the diabetic day centre; the reason for the decision; and if he will make a statement on the matter. [16221/13]
Amharc ar fhreagraIn relation to the particular query raised by the Deputy, as this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy in this matter.
1148. Deputy Jack Wall asked the Minister for Health the reason medication (details supplied) is not covered by the GMS service; and if he will make a statement on the matter. [16224/13]
Amharc ar fhreagraThe HSE is responsible for the administration of the General Medical Services (GMS) Scheme, therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
1149. Deputy Finian McGrath asked the Minister for Health if he has a policy in place when local authorities are providing new playground facilities that they would provide playground equipment, which is, at least in part, accessible for children with disabilities, including children in wheelchairs; and if he will make a statement on the matter. [16267/13]
Amharc ar fhreagraThe Department of Health has no responsibility for playground facilities. Under the National Disability Strategy, responsibility for the accessibility of facilities to children and adults with disabilities lies with the Government Department or public body with general responsibility for the provision of the facilities in question to all citizens.
Question No. 1150 answered with Question No. 1129.
Question No. 1151 answered with Question No. 1118.
1152. Deputy Pearse Doherty asked the Minister for Health when the board of the Food Safety Authority of Ireland will have sufficient directors so as to enable it to lawfully meet. [16298/13]
Amharc ar fhreagraI presume that the Deputy is referring to Board members of the Food Safety Authority of Ireland rather than directors. The board of the Food Safety Authority of Ireland currently has 8 members. This is above the quorum of 4 necessary for it to meet lawfully. The Board most recently met on the 15 March 2013.
1153. Deputy Michael Healy-Rae asked the Minister for Health the position regarding a medical card appeal in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [16307/13]
Amharc ar fhreagraThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible. The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information has recently reissued to Oireachtas members.
1154. Deputy Charlie McConalogue asked the Minister for Health if he or his Department are aware of a funding deficit for St Catherine's Association, County Wicklow; if they have been contacted by the association in regard to it and a possible 40% reduction in front-line staff; and if he will make a statement on the matter. [16313/13]
Amharc ar fhreagraAs the Deputy may be aware, the HSE has been working for some time with this provider of services in relation to the sustainability of this organisation.
St. Catherine’s is a very valued service in Co. Wicklow, but has grown significantly over a very short timeframe in an unsustainable way.
The HSE has assured me that it is anxious to help St. Catherine's to return to sustainability and is working very closely with them to ensure that this valuable service can continue on a sustainable footing. I understand that St. Catherine’s is also engaging with the Department of Education and Skills on education related issues.
In relation to the specific queries raised by the Deputy, as these are service issues they have been referred to the HSE for direct reply.
1155. Deputy Billy Kelleher asked the Minister for Health if his attention has been drawn to the Health Service Executive warning within its National Operational Plan 2013 (details supplied); the planning he is undertaking for the significant growth in requirement for long-term residential care; and if he will make a statement on the matter. [16319/13]
Amharc ar fhreagra1158. Deputy Billy Kelleher asked the Minister for Health if he will provide a timeframe in respect of the finalisation and publication of the Health Service Executive Review of Public Nursing Home Units; in the interest of openness and transparency, if he will commit to publishing the review; and if he will make a statement on the matter. [16322/13]
Amharc ar fhreagraI propose to take Questions Nos. 1155 and 1158 together.
Under the Health Act 2004, the Health Service Executive must prepare a service plan and submit it to the Minister for Health for approval. The National Service Plan 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 Minister Reilly approved the Plan and laid a copy before both Houses of the Oireachtas on 9th January this year. Subsequently, the Executive prepared and published its Operational Plan and Regional Service Plans which underpin the National Service Plan.
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 demand for these services will continue to grow with changing demographics, and the associated complex needs of an ageing population. At the last Census, there were over 535,000 people over the age of 65 in Ireland. This was an increase of 14.4% since the 2011 Census. It is estimated that by 2041, there will be between 1.3m and 1.4m people over the age of 65 in Ireland, with the greatest increases in the over 80 age group.
As the Deputy is aware, the Department is working closely with the HSE to develop an overall plan regarding future public nursing home provision for the Minister’s consideration. The plan will reflect regional need and have regard to the current severe financial constraints, restrictions on public sector staffing and recruitment and the on-going need to meet service and safety standards; all of which pose challenges for community nursing units across the country. Additional work is needed before this exercise can be completed and a set of proposals presented to the Minister for consideration.
The Nursing Homes Support Scheme, A Fair Deal, is a demand-led, resource capped system of financial support for people assessed as needing long-term nursing home care. Funding is currently being released on a weekly basis. At end of January it was taking an average of 34 days for funding to issue, from the date that the person's application was determined.
The 2013 Service Plan sets a target of 22,761 people to be in receipt of financial support at end-2013, compared to 22,065 at end-2012. Approvals will continue to be granted and the position will be kept under constant weekly review. The HSE is monitoring the Scheme on a weekly basis and has demonstrated its ability to manage this process effectively.
Work on the review of the Nursing Homes Support Scheme is ongoing. The review will include an examination of the on-going sustainability of the Scheme. It is expected that the review will be completed in 2013.
1156. Deputy Billy Kelleher asked the Minister for Health if he will provide a specific timeframe and commitment in respect of when updated cost of care figures for public nursing home units will be published; and if he will make a statement on the matter. [16320/13]
Amharc ar fhreagra1157. Deputy Billy Kelleher asked the Minister for Health the reason there is a lack of transparency in respect of the cost of care under the nursing home support scheme in respect of public nursing homes; and if he will make a statement on the matter. [16321/13]
Amharc ar fhreagraI propose to take Questions Nos. 1156 and 1157 together.
The Nursing Homes Support Scheme Act 2009 requires the Minister to lay details of the goods and services which constitute long-term residential care services in public nursing home before the Houses of the Oireachtas. The full list of goods and services which was laid before the Houses is available on the Department's website at:
http://www.dohc.ie/issues/fair_deal/cost_components.pdf?direct=1
The list of goods and services set out in the Deed of Agreement between the National Treatment Purchase Fund (NTPF) and each private nursing home that is approved for the purposes of the Nursing Homes Support Scheme is consistent with the list of goods and services which was laid before the Houses.
Revised public nursing home cost of care figures will be published shortly.
Question No. 1158 answered with Question No. 1155.
1159. Deputy Clare Daly asked the Minister for Health with regard to the draft national consent policy in relation to refusal of treatment in pregnancy, if the guideline which says that a woman's refusal of treatment which may impact on the life of the foetus must require a legal opinion to be sought and if this is not a serious breach of the woman's human rights regarding her own decision making with regard to giving birth. [16324/13]
Amharc ar fhreagraAn adult with capacity can refuse all forms of treatment (including life-sustaining treatment) even where such a refusal may be considered unwise and/or conflict with prevailing medical advice and could lead to his/her death. The case [In the matter of a Ward of Court (withholding medical treatment) (No. 2) [1996] 2 IR 79] established that an adult with capacity has the right to refuse medical treatment to facilitate a natural death.
A number of subsequent court cases have reinforced the rulings from the Ward of Court case, in particular JM v The Board of Management of St Vincent’s Hospital [2002] 1 IR 321 and Fitzpatrick v FK (No.2) [2008] IEHC 104.
However, this situation becomes more complex in the case of pregnancy given that the rights of both parties (i.e. the mother and unborn) need to be considered. As the HSE's Consent Policy remains in draft form it would be inappropriate for me to comment on it at this stage. I expect the policy to be finalised shortly.
1160. Deputy Pearse Doherty asked the Minister for Health the total number of staff employed by the specialist services for children within the multidisciplinary autism team in County Donegal; if he will provide in tabular form the number of staff employed in the specialist services for children within the multidisciplinary autism team in County Donegal for 2008, 2009, 2010, 2011 and 2012; the number of staff employed by the specialist services for children within the multidisciplinary autism team in County Donegal that are currently on maternity leave; the number of staff that have been employed on temporary contracts to replace those on maternity leave; and if he will make a statement on the matter. [16336/13]
Amharc ar fhreagraMy Department will look into the matter and I will respond to you directly.
1161. Deputy Pearse Doherty asked the Minister for Health the amount of funding that has been allocated to the Donegal Autism Service specifically for the support of children diagnosed as being on the autistic spectrum in County Donegal for 2008, 2009, 2010, 2011 and 2012; the total amount that has been allocated under the Health Service Executive care plan for 2013 for the support of children diagnosed as being on the autistic spectrum in County Donegal for 2013; and if he will make a statement on the matter. [16337/13]
Amharc ar fhreagraMy Department will look into the matter and I will respond to you directly.
1162. Deputy Pearse Doherty asked the Minister for Health the current waiting times for an initial appointment with the relevant children’s specialists on the autism team in County Donegal; the average length of time from when a child is initially referred to the autism team and a full assessment or diagnosis is made; the number of children in County Donegal who are awaiting an initial appointment with a relevant specialist within the autism team; the number of children who have been referred to the autism team in County Donegal who are undergoing assessment or awaiting final diagnosis; the percentage of children referred to the autism team in each of the past five years who have been diagnosed as having autistic spectrum disorder; and if he will make a statement on the matter. [16338/13]
Amharc ar fhreagraMy Department will look into the matter and I will respond to you directly.
1163. Deputy Pearse Doherty asked the Minister for Health if he has considered correspondence sent to him outlining the situation whereby two Departments (details supplied) in Sligo Regional Hospital have taken the decision to suspend referrals from general practitioners in County Donegal due to a backlog of waiting lists and increasing workload; the steps being taken by him to resolve this matter; and if he will make a statement on the matter. [16339/13]
Amharc ar fhreagraI have made inquiries and my officials are not aware of the correspondence referred to by the Deputy, however, as this is a service issue I have asked the HSE to reply directly to the Deputy in relation to this matter.
1164. Deputy Pearse Doherty asked the Minister for Health the current waiting times for an appointment with a dermatology specialist in both Letterkenny General Hospital and Sligo Regional Hospital; and if he will make a statement on the matter. [16340/13]
Amharc ar fhreagraIn relation to the particular query raised by the Deputy, as this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy in this matter.
1165. Deputy Pearse Doherty asked the Minister for Health his views on whether it is acceptable that a person (details supplied) in County Donegal, who was referred by their general practitioner in June 2012 as an urgent case for a surgical procedure due to their pain levels is still awaiting the procedure; and if he will make a statement on the matter. [16341/13]
Amharc ar fhreagraThe management of in-patient and daycase waiting lists for patients awaiting public health care is based on the principle that after urgent and cancer patients are treated, then clinically assessed routine patients should be seen in chronological order (i.e. longest waiter first).
Should the patient's general practitioner consider that the patient's condition warrants an earlier appointment, he/she would be in the best position to take the matter up with the consultant and hospital involved.
In relation to the specific query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.
1166. Deputy Michael McCarthy asked the Minister for Health if his attention has been drawn to the alleged use of an allegedly defective hip product in a hospital (details supplied) for a defined period of time; if he will explain the delay between the surgeons raising concerns and the patients being notified; the date on which the Health Service Executive Serious Incident Management Team, that was appointed to investigate the issue, will make their findings public and to explain the delay in reporting back on an issue that was first raised in 2008; if he will confirm the reasons given by the manufacturer for the withdrawal of the product from the market; and if he will make a statement on the matter. [16344/13]
Amharc ar fhreagraI am advised by the Health Service Executive (HSE) that the Executive stopped using the product combination referred to by the Deputy in 2008 when the Executive discovered unexpected early joint replacement failure in a small number of patients. The product had been in use in two hospitals in Cork between 2005 and August 2008. A management plan and incident management team was put in place at the time to oversee the review/recall process. All the individuals potentially affected were identified and seen. The HSE have confirmed that all patients who required revision surgery have had revision surgery - others will be monitored via out-patient appointments.
The incident was notified to the HSE Serious Incident Management Team in June 2010 and a report has now been completed and conveyed to the HSE.
I have arranged to have the Deputy's question referred to the Health Service Executive for attention and a more detailed response.
1167. Deputy Michael Healy-Rae asked the Minister for Health the action he will take regarding Health Pricing and Supply of Medical Goods Bill 2012 whereby there was concerns at the Bill's failure to exempt anti-epileptic drugs from the new system of generic substitution as recommended in the Morning Report 2010 as is the standard practice internationally (details supplied); and if he will make a statement on the matter. [16347/13]
Amharc ar fhreagraAs the Deputy will be aware, the Health (Pricing and Supply of Medical Goods) Bill, passed Committee Stage on the 19th of March. Under the Bill, the Irish Medicines Board has statutory responsibility for establishing and publishing a List of Interchangeable Medicinal Products.
In deciding whether to add a group of medicinal products to the List of Interchangeable Medicinal Products, the Board must be satisfied that each medicinal product which falls within the group:
(a) has the same qualitative and quantitative composition in each of its active substances as each of the other medicinal products which fall within the group;
(b) is in the same pharmaceutical form as, or in a pharmaceutical form that is appropriate for substitution for, each of the other products in the group; and
(c) has the same route of administration as each of the other medicinal products which fall within the group.
In addition, the Bill provides that the Board is not permitted to add a group of medicinal products to the List of Interchangeable Medicinal Products where:
- there is a difference in bioavailability between the medicinal products and the interchangeable medicinal products which currently fall within the group of interchangeable medicinal products which may lead to a clinically significant difference in efficacy between them, and
- any of the medicinal products cannot be safely substituted for any one or more of the other medicinal products in the group.
I would like to emphasise that in making a decision to add a medicinal product to a group of interchangeable medicinal products or a group of medicinal products to the List of Interchangeable Medicinal Products the Board is obliged to have regard to the criteria as set out in the Bill and that these criteria fully reflect the recommendations set out in the Joint Department of Health/HSE report 'Proposed Model of Reference Pricing and Generic Substitution' (the Moran Report, 2010) regarding criteria for interchangeability.
To further enhance the patient safety aspect of generic substitution, Section 13 of the Bill allows a prescriber to indicate on a prescription that a branded interchangeable medicinal product should, for clinical reasons, not be substituted.
I am satisfied that these provisions address the concerns raised by the Deputy. I met with the Irish Epilepsy Association in January and explained this position.
It is also important to point out that generic medicines must meet exactly the same standards of quality and safety and have the same effect as the originator medicine. All of the generic medicines on the Irish market are required to be properly licensed and meet the requirements of the Irish Medicines Board.
