Written Answers Nos. 575-592
575. Deputy Sean Fleming asked the Minister for Health if he will call on the Health Service Executive to reverse its decision on financial grounds not to approve eculizumab, which is required by approximately 75 persons who suffer from paroxysmal nocturnal haemoglobinuria, under the community drugs scheme; and if he will make a statement on the matter. [6226/14]
Amharc ar fhreagraThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drug schemes in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013.
The HSE received an application for the inclusion of Eculizumab (Brand: Soliris) in the community drugs schemes. The application was considered in line with the procedures and timescales agreed in 2012 by my Department and the HSE with the Irish Pharmaceutical Healthcare Association (IPHA).
In accordance with these procedures, the National Centre for Pharmacoeconomics (NCPE) conducted a pharmacoeconomic evaluation of Eculizumab and concluded that, at a total cost per patient per year of €437,247 and a cumulative gross budget impact over 5 years estimated at €33 million, the therapy did not represent value for money for the treatment of patients in the Irish healthcare setting. In addition, the manufacturer did not include an economic model as part of their submission and failed to demonstrate the cost-effectiveness of this therapy. Consequently, the NCPE was unable to recommend reimbursement of the product under the community drug schemes. The report is available on the NCPE's website (www.ncpe.ie).
The NCPE report is an important input to assist the HSE in its decision making process and informs further discussions between the HSE and the manufacturer of the drug. The HSE assessment process is intended to arrive at a decision on the funding of high cost new medicines that is clinically appropriate, fair, consistent and sustainable. The HSE is now carefully considering all the issues which arise in relation to the proposed benefits and costs of this medicine and expects to reach a decision in the near future.
576. Deputy John McGuinness asked the Minister for Health when a person (details supplied) in County Kilkenny will receive a hospital appointment. [6232/14]
Amharc ar fhreagraThe National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2013, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the Health Service Executive, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to this particular query raised by the Deputy, I have asked the HSE to respond directly to the Deputy in this matter.
577. Deputy Maureen O'Sullivan asked the Minister for Health in view of the fact that Judge Quirke was explicit in recommending that health care should apply to each of the women who were admitted to and worked in a designated Magdalen laundry, the way he envisages bringing this about in order that women are entitled to health services equivalent to those provided with a Health (Amendment) Act card; and if he will make a statement on the matter. [6261/14]
Amharc ar fhreagraThe Minister for Justice and Equality is bringing forward in one Bill, on behalf of the relevant Departments, measures to deal with the provision of medical and other services and other matters to women who were admitted to and worked in the Magdalen Laundries. I am currently examining the health related provisions for inclusion in the legislation and expect to revert shortly to my colleague, the Minister for Justice and Equality.
578. Deputy Colm Keaveney asked the Minister for Health if he will provide a county breakdown of the number of children currently on waiting lists for speech and language therapies; the numbers waiting six months or less; the numbers waiting six months to 12 months; the numbers waiting 12 months to 24 months; and the numbers waiting more than 24 months. [6287/14]
Amharc ar fhreagraHealth related supports and interventions for children can be accessed through HSE Primary Care Teams and HSE Disability Services. The HSE’s National Service Plan 2013 provided for additional funding of €20m to strengthen primary care services (€18.525m for the recruitment of 264.5 primary care team posts and €1.475m to support Community Intervention Team development). Of the additional 264.5 posts allocated, 47 whole-time equivalent Speech and Language Therapy posts were approved. The recruitment process is ongoing in relation to these posts, with the majority of the posts filled or offered with start dates to be agreed. The HSE is striving to have the remainder of the posts filled as soon as possible in 2014.
I understand that each individual presenting to the HSE's speech and language service has an initial assessment to determine their individual need for therapy. The therapist, in conjunction with the parent(s) or carer, will determine the severity of the individual’s difficulties and prioritise for therapy accordingly. The level of intervention is in line with clinic policy, age and severity of the diagnosis. The waiting period for intervention is dependent on the nature and severity of the disorder following assessment. In an effort to address the issue of waiting lists and ensure that services are delivered in as equitable a manner as possible within available resources, the HSE has introduced a number of initiatives such as therapists increasing clinic based work instead of domiciliary work and providing family centred interventions in a group as opposed to a one-to-one setting, whenever possible.
The reconfiguration of children’s disability services into geographically-based multi-disciplinary teams as part of the Progressing Disability Services for Children and Young People Programme will ensure an equitable delivery of services. The purpose of the reconfiguration of existing therapy resources is to ensure that the resources available are used to best effect, in order to provide health supports and ongoing therapy to all children (0-18 years) in line with their prioritised needs. In particular, it will mean that all children, regardless of where they receive their education services will have equitable access to services based on their needs.
The 2014 budget for Disability Services is being maintained broadly in line with 2013, with targeted investment of €14m for a number of developments, including the roll out of the Progressing Disability Services for Children and Young People (0-18) Programme, which will entail the provision of 80 additional therapy posts, to increase services for children with all disabilities. A proportion of these will be Speech and Language Therapy posts.
My Department has requested the HSE for the detailed information concerning speech and language therapy waiting lists at county level that he has requested and I will be in further communication with him in this regard as soon as possible.
579. Deputy Gerald Nash asked the Minister for Health the monetary value of a contract awarded to a company (details supplied) for a particular piece of work; the daily rate paid for this work; the amount spent to date; the overall value of the contract; when it is expected to be completed; if a full public tendering process was utilised for the selection process; and if he will make a statement on the matter. [6289/14]
Amharc ar fhreagraThe review undertaken by Mr Tom Beegan, Consultant, at the request of Ernst & Young and on behalf of the HSE, was entitled A Plan to Integrate and Improve Disability Services, and was separate to the Value for Money and Policy Review of Disability Services in Ireland report which I published in 2012.
The HSE have informed me that Ernst & Young was awarded the contract in January 2013 to conduct the review, following the relevant public procurement process in November 2012 under the HSE's Framework Agreement for the Provision of Personnel Placement & Supply Services. Mr Tom Beegan was the lead consultant nominated by the company to carry out the work.
The daily rate charged by Ernst & Young for work on the review was €1,107 per day including VAT. The review was completed in April 2013 and involved 68 working days. The total cost incurred was €75,276.00 including VAT.
580. Deputy Thomas P. Broughan asked the Minister for Health if cohabiting couples are assessed in the same manner as married couples when a person in a cohabiting relationship makes a medical card application; if both persons in a cohabiting relationship are assessed on the same basis as a married couple; and if he will provide details of the legislative basis for this type of assessment. [6296/14]
Amharc ar fhreagraUnder the Health Act 1970, as amended, persons who are married or live together as husband and wife or are civil partners as respects each other within the meaning of the Civil Partnership and Certain Rights and Obligations of Cohabitants Act 2010, are assessed in the same manner.
581. Deputy John Deasy asked the Minister for Health to set out the funding programmes that are available from his Department to assist projects involved in youth diversion and rehabilitation; and to whom applications for State support should be directed in each instance. [6328/14]
Amharc ar fhreagraLocal and Regional Drugs Task Forces receive annual funding from the Drugs Initiative of my Department to allocate to community based drugs initiatives in their areas. Organisations involved in providing youth diversion and rehabilitation may apply to their local Drugs Task Force for funding. A list of the Drugs Task Forces can be found on www.health.gov.ie.
582. Deputy Catherine Murphy asked the Minister for Health if, after awarding a medical card for a young child (details supplied) suffering from acute quadriplegic cerebral palsy until 2015, he expected a major change in the family's circumstances in the first seven months of the issuance of the card; and if he will make a statement on the matter. [6336/14]
Amharc ar fhreagraThe Health Service Executive operates under the legislative framework of the Health Act of 1970, as subsequently amended. The assessment for a medical card is determined primarily by reference to the means, including the income and reasonable expenditure, of the applicant and his or her partner and dependants. In the interest of probity, the HSE is obliged to ensure that a person’s eligibility is correctly recorded in line with the eligibility legislation and the national guidelines.
There is no legal basis for the HSE to award a medical card/GP visit card to persons with serious medical conditions on the basis of their medical condition alone, irrespective of their income/means or in the case of a child, their parents’ income/means.
The standard procedure for the review of medical cards for persons aged 66 years or older is that their medical card will be reviewed every 4 years. For persons under the age of 66 years, the length of validity of a medical card is 3 years. Depending on the individual's circumstances, it may be issued for a shorter period. If an individual's circumstances change, he/she must inform the HSE, as he/she may no longer be eligible. In addition to the standard assessment and review processes above, random audits of eligibility are being undertaken by the HSE on an on-going basis. If selected for review under this process, the Medical Card holder will be informed and requested to submit up to date income details.
Any medical card holder undergoing a review to renew a medical card, who genuinely engages with the HSE in that review, will not have their entitlement withdrawn before the review is complete, regardless of the expiry date shown on their medical card. In cases where a decision is made not to grant a medical card, the applicant is informed of the decision and is notified of their right to appeal this decision. Contact details for the appeals office are provided to them. Where a person submits an appeal to a decision not to renew a medical card within 21 days of that decision, he/she retains the medical card or GP visit card until the appeal is decided.
I am advised by the HSE that a Medical Card was issued for Moya Nason and a GP Visit Card was issued for the other Nason family members on 2 May 2012. These were valid until 30 April 2015. The family were chosen for review, under the random review procedure and were notified of this on 19 December 2013. Following this review, the HSE altered the expiry date to 31 March 2014.
583. Deputy Caoimhghín Ó Caoláin asked the Minister for Health to provide details of the supports available to patients suffering from narcolepsy; if he will update the long-term illness scheme and ensure the inclusion of narcolepsy; and if he will make a statement on the matter. [6362/14]
Amharc ar fhreagraI note that early indications from scientific and medical research into narcolepsy suggest that the prognosis for children may be better that previously indicated and that they should, with appropriate medication and supports, be able to reach their potential.
The HSE and the Department of Education and Skills continue to provide a range of services and supports to individuals diagnosed with narcolepsy following pandemic vaccination regardless of age, on an ex-gratia basis. These services and supports which are co-ordinated by the HSE National Advocacy Unit are intended to provide that individuals receive tailored assistance to address their specific requirements, where appropriate. It is acknowledged that treatment and individual medical needs may need to be reassessed over time to take account of changes in their condition or circumstances.
The ex-gratia health supports include clinical care pathways to ensure access to rapid diagnosis and treatment, multi-disciplinary assessments led by clinical experts, counselling services for both the individuals and their families, discretionary medical cards for those who have been diagnosed have been provided to allow unlimited access to GP care and any prescribed medication, ex-gratia reimbursement of vouched expenses incurred in the process of diagnosis and treatment, including travel expenses for attending medical appointments; physiotherapy, occupational therapy assessments, dental assessments and dietary services all on a needs basis. Regional co-ordinators have been appointed to assist individuals to provide advice, information and access to local services.
On the education side, the National Educational Psychological Services (NEPS) engaged with all of the schools being attended by children with narcolepsy to provide guidance and assistance on the condition and the supports available. These include special education home tuition, the provision of supplemental learning support/resource teaching support on a needs basis and the provision of Special Needs Assistants (SNA) support if required. Furthermore, reasonable accommodations, including special examination centres and rest breaks were provided for students who sat state exams in last June. Similar arrangements will be available on a needs basis to students sitting state exams in future years. The Department of Education and Skills issued circulars providing information to schools on the nature, likely symptoms, possible effect of the condition of narcolepsy on students and the supports available for students.
With regard to third level, students diagnosed with narcolepsy following pandemic vaccination can access the Disability Access Route to Education (DARE) scheme, which is a college/university scheme which offers enhanced access routes to third level education.
All health and educational services and supports will continue to be provided on an ex-gratia basis. Those services and supports will be reassessed on an ongoing basis to take account of the individual's condition and circumstances.
In relation to the Long Term Illness scheme there are no plans to extend the list of conditions covered.
584. Deputy Tom Fleming asked the Minister for Health If he will expedite a medical card appeal in respect of persons (details supplied) in County Kerry; and if he will make a statement on the matter. [6371/14]
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 issued to Oireachtas members.
585. Deputy Tom Fleming asked the Minister for Health if he will expedite a medical card in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [6372/14]
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 issued to Oireachtas members.
586. Deputy Caoimhghín Ó Caoláin asked the Minister for Health to outline the current provision of ambulance and pre-emergency care in Cashel, County Tipperary; if this service has been reduced in the past 12 months or if there are plans to reduce it in the time ahead, including a possible reduction in staff members and the loss of a second ambulance; if he will immediately review this situation; and if he will make a statement on the matter. [6374/14]
Amharc ar fhreagraAs this is a service matter, I have asked the HSE to respond directly to the Deputy.
587. Deputy Michael Healy-Rae asked the Minister for Health his views on correspondence (details supplied) regarding Neknomination. [6378/14]
Amharc ar fhreagraThis latest craze and recent tragic events highlight our excessive patterns of alcohol consumption. Ireland has a significant alcohol problem which needs decisive and innovative action to address it. Last October the Government approved an extensive package of measures to deal with alcohol misuse to be incorporated in a Public Health (Alcohol) Bill. These measures are based on the recommendations contained in the Steering Group Report on a National Substance Misuse Strategy.
The aim is to reduce alcohol consumption to the OECD average by 2020 (i.e. 9.1 litres of pure alcohol per capita per annum). In 2011 the average per-capita pure alcohol consumption for everyone over the age of 15 was 11.63 litres in Ireland.
A broad range of complementary measures is required to successfully reduce consumption of, and harms associated with, alcohol misuse. The package of measures to be implemented will include provision for minimum unit pricing, regulation of the marketing and advertising of alcohol, regulation of sports sponsorship, structural separation of alcohol from other products in mixed trading outlets and labelling of alcohol products.
Minimum unit pricing is a mechanism of imposing a statutory floor in price levels per gram of alcohol that must be legally observed by retailers in both the on and off trade sector. Its primary function would be thus to discourage at risk levels of alcohol consumption and is targeted in particular at harmful and hazardous drinking. The Government also agreed that new low risk limits for alcohol consumption be introduced based on Irish standard drink of 10 grams of alcohol i.e 11 standard drinks or 112 grams of pure alcohol per week for women and 17 standard drinks or 168 grams of pure alcohol per week for men.
Work on developing a framework for the necessary Department of Health legislation is continuing. A health impact assessment, in conjunction with Northern Ireland, was commissioned in 2013, as part of the process of developing a legislative basis for minimum unit pricing. The health impact assessment will study the impact of different minimum prices on a range of areas such as health, crime and likely economic impact. The study should be finalised by mid-2014.
My Department has also written to the Internet Content Governance Advisory Group, established by the Department of Communications, Energy and Natural Resources asking the Group to take into consideration the significant role the internet plays in alcohol advertising.
588. Deputy Michael McCarthy asked the Minister for Health the position regarding the establishment of the healthy Ireland council; the number of positions available; if he will provide a full job description of the roles available; when recruitment is likely to take place; and if he will make a statement on the matter. [6384/14]
Amharc ar fhreagraThe details requested by Deputy McCarthy are available on the Department of Health’s website at http://www.dohc.ie/press/releases/2014/20140122.html and on the Public Appointments website at http://www.publicjobs.ie/publicjobs/campaignAdvert/9960.htm. The deadline for submission of expressions of interest is Friday 14 February 2014.
589. Deputy Tom Fleming asked the Minister for Health if he will expedite a full medical card in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [6385/14]
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 issued to Oireachtas members.
590. Deputy Tom Fleming asked the Minister for Health if he will expedite a medical card application in respect of persons (details supplied) in County Kerry; and if he will make a statement on the matter. [6395/14]
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 issued to Oireachtas members.
591. Deputy Tom Fleming asked the Minister for Health if he will confirm the additional resources that are being made available for children and young adults with autism in County Kerry in the 2014 Health Service Executive service plan (details supplied); and if he will make a statement on the matter. [6406/14]
Amharc ar fhreagraAccountability for the management of services is a matter for the Health Service Executive to address within the ambit of its Vote (Vote 39). The level of health services to be delivered in 2014 within the available funding has been set out in the HSE’s National Service Plan, which was approved in December 2013.
The Health Service Executive has recognised the need to increase the level of consistency and standardisation in the way both early intervention services and services for school-aged children with disabilities, including autism, are delivered. It is currently engaged in a reconfiguration of existing therapy resources to geographic based teams for children (0-18 years) as part of the National Programme on Progressing Disability Services for Children and Young People (0-18 years).
The Programme is organised at national, regional and local level and includes representatives from the health and education sectors, service providers (both statutory and non-statutory) and parents. These stakeholders are working together to see how current services can be reorganised in line with agreed policy.
The purpose of the reconfiguration of existing therapy resources is to ensure that the resources available are used to best effect, in order to provide health supports and ongoing therapy to all children (0-18 years) in line with their prioritised needs.
My Department has asked the HSE to reply directly to the Deputy concerning the specific local issues and particular case that he has raised.
592. Deputy Brian Walsh asked the Minister for Health if the Health Service Executive has considered a proposal to make an existing 50-bed nursing facility available for use by a charitable organisation (details supplied) in County Galway; the decision reached following any such considerations; and the reasons for reaching that decision. [6408/14]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply.
