Written Answers Nos. 196-208
196. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide, in tabular form, the total State spend on medicines in each of the years 2011 to 2014; and a breakdown of same by scheme and by generic and patented medicines. [25633/15]
Amharc ar fhreagraUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the Health Service Executive (HSE) has statutory responsibility for the administration of the primary care schemes; therefore the matter has been referred to the HSE for attention and direct reply to you.
If you have not received a reply from the HSE within 15 working days, please contact my Private Office and they will follow up the matter with them.
197. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the measures introduced to promote the increased use of generic medicines; the practical implication of same; the amount saved to date; the estimated savings which would be realised by extending this scheme to the next ten most common medicines; and if he will make a statement on the matter. [25634/15]
Amharc ar fhreagraThe Government has introduced a series of reforms in recent years to reduce the prices of drugs and medicines which are paid for by the HSE. One of those key reforms has been the introduction of generic drug substitution and reference pricing as provided for by The Health (Pricing and Supply of Medical Goods) Act 2013.
The Act permits pharmacists to substitute medicines prescribed, provided that they have been designated as safely interchangeable by the Health Products Regulatory Authority (HPRA). Generic substitution is being introduced incrementally, with the HPRA prioritising those medicines which will achieve the greatest saving for patients and the State. This process will continue until all medicinal products on the reimbursable list have been assessed.
The Act also allows the HSE to set a reference price for groups of interchangeable medicines. Reference pricing involves the setting of a common reimbursement price, or reference price, for a group of interchangeable medicines. It means that one reference price is set for each group or list of interchangeable medicines, and this is the maximum price that the HSE will reimburse to pharmacies for all medicines in the group, regardless of the individual medicine’s prices. By the end of January 2015 the HSE had set reference prices for 110 interchangeable groups across 37 different medicines / combinations. Reference pricing has generated over €47 million in savings in 2014 and is expected to deliver a further €25 million in 2015. Reference prices will ensure that generic prices in Ireland will fall towards European norms.
Another measure to promote the use of generic medicines is the work being undertaken by the HSE's Medicines Management Programme. The programme actively engages with General Practitioners to reinforce the message around safe, effective and cost-effective prescribing including generic prescribing.
As part of our wider Troika commitments a target for generic penetration of the off-patent market by volume was set at 70% by the end of 2016. By end Q1 2015 generics accounted for over 70%, thus we have already met the 2016 target.
198. Deputy Caoimhghín Ó Caoláin asked the Minister for Health his views that the full implementation of the recommendations of the PA Consulting report, Addressing Weaknesses in Financial Management and Cost Containment within the Irish Health Service Executive - A Report and Action Plan September 2012, could deliver savings of 5% of total Health Service Executive budget; and if he will make a statement on the matter. [25635/15]
Amharc ar fhreagraIn 2012, my Department engaged with an expert from the UK NHS (Mark Ogden) to examine the financial management of the Health Service Executive and make recommendations regarding strengthening and improving the management of its finances. Subsequently, PA Consultancy was engaged to undertake a wide-ranging review of financial management and cost containment systems in the health service, including an assessment of the Ogden Report and the preparation of an action plan for the implementation of its recommendations.
Financial Reform is a key element of Future Health - A Strategic Framework for Reform of the Health Service 2012 – 2015. The HSE commenced the Finance Reform Programme in 2012. Central to the establishment of this programme was the recognition that successful implementation of Future Health and the wider reform agenda will require fundamental changes in the way financial management is delivered across the health system in Ireland.
One of the early outputs of the programme was the development of a new operating model for finance in health. The HSE has submitted a business case for the new operating model to the Department of Health and the Department of Public Expenditure and Reform. The Business Case defines the case for change and scope as well as providing an estimate of the resources required to deliver the new operating model and supporting technology.
Work is progressing on the Finance Reform Programme on a number of important work streams including securing agreement of the procurement approach for an Integrated Financial Management System.
The new financial operating model will greatly enhance the health sector's ability to effectively manage and monitor its budget at all levels.
199. Deputy Caoimhghín Ó Caoláin asked the Minister for Health in view of the fact that the Economic and Social Research Institute report, Delivery of Pharmaceuticals in Ireland – Getting a Bigger Bang for the Buck, published in January 2012, stated that prices of new pharmaceuticals, subject to patent protection, could be reduced further by setting the ex-factory price with reference to the lowest priced comparator member state, and that an examination of data for the past number of years suggests that prices would decline by 20% to 25%, if such an approach were adopted, if he will quantify the savings which could be made by introducing this measure with immediate effect; and if he will make a statement on the matter. [25636/15]
Amharc ar fhreagra209. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the full-year savings that would be made by introducing, with immediate effect, a measure setting the ex-factory price for new pharmaceuticals, subject to patent protection, with reference to the lowest priced comparator European Union member state. [25665/15]
Amharc ar fhreagraI propose to take Questions Nos. 199 and 209 together.
In 2012, the State entered into a new three-year price reduction Agreement with the Irish Pharmaceutical Healthcare Association. Under this Agreement, prices are set by reference to the average of the approved prices across a basket of 9 EU Member States. This Agreement remains in place until 31st October this year.
As the end of the current Agreement approaches consideration is being given to a range of options available to the State in seeking to deliver further savings on the cost of drugs. Such options include entering into a new Agreement with the Irish Pharmaceutical Healthcare Association as well as the possibility of using the legislative powers afforded to the HSE under the Health (Pricing and Supply of Medical Goods) Act 2013 to review and alter prices.
An important objective in any new arrangement will be to secure significant savings on the projected cost of drugs, as well as continued access to cost effective treatments. Since such savings may be the subject of negotiations with industry, I do not wish to place the State's detailed position or estimated savings into the public domain in advance.
200. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide, in tabular form, the total amount of moneys collected in each of the years 2011 to 2014 and in 2015 to date from private patients using public hospital services, providing this as a percentage of total income and as a percentage of actual cost of services used; and if he will make a statement on the matter. [25637/15]
Amharc ar fhreagraThe information sought by the Deputy is not readily available. However, the Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible. If the Deputy has not received a reply from the HSE within 15 working days, please contact my Private Office who will follow up the matter with them.
202. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the total State spend on suicide prevention and awareness projects, including on the National Office of Suicide Prevention in each of the years 2012 to 2014 and in 2015 to date; if he will provide a breakdown of same by year and by scheme-project; and if he will make a statement on the matter. [25639/15]
Amharc ar fhreagraFunding for suicide prevention is primarily provided by the National Office of Suicide Prevention, under the HSE.
In addition, my Department has, in the past, provided relevant organisations with National Lottery funding for the years in question. Details of this are as follows:
|
Year |
Organisation |
Purpose |
Grant Paid |
|
2012 |
Waterford & South East Branch of Samaritans |
Renovating Premises |
€34,000 |
|
Console |
Refurbishment of premises. |
€75,000 |
|
|
2013 |
Cork Counselling Services ltd |
Programme for Defeating Depression |
€50,000 |
|
Fingal Suicide Network |
Office Equipment |
€1,000 |
|
|
2014 |
Grow in Ireland – Southern Region |
Establishment of New Office |
€5,954 |
|
Cork Counselling Services Ltd. |
Adolescent mental health and suicide prevention programme |
€50,000 |
The Department of Health is processing various National Lottery applications for this year in respect of mental health and suicide prevention, and successful applicants will be informed in the normal way in due course.
I have referred the Deputy's question to the HSE for direct reply in respect of detailed information sought relating to the NOSP, or any other funding source used by the Executive for the purposes indicated by the Deputy.
203. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the total State spend on Health Service Executive disability services for each of the years 2012 to 2014 and for 2015 to date; if he will provide a breakdown of same by year and by scheme-project; and if he will make a statement on the matter. [25640/15]
Amharc ar fhreagraAs the Deputy's question relates to service matters, it has been referred to the Health Service Executive (HSE) for direct reply. If the Deputy has not received a reply from the HSE within 15 working days, he can contact my Private Office and they will follow up the matter with the HSE.
204. Deputy Frank Feighan asked the Minister for Health when a home care package will be made available to a person (details supplied) in County Roscommon. [25643/15]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply. If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up the matter with them.
205. Deputy Billy Kelleher asked the Minister for Health with regard to the European working time directive, and the April 2015 Health Service Executive performance report which states that compliance with a maximum 48-hour week was at 70%, as of end April 2015, and given that the rate of improvement in this area since the start of 2014 slowed significantly in September 2014, and given the general assumption that further meaningful improvements are dependent on acute service reconfiguration, if he will outline the acute service reconfiguration that is envisaged to improve compliance. [25652/15]
Amharc ar fhreagraThe HSE National Service Plan 2015 outlines the arrangements envisaged to progress EWTD compliance. It states: "In 2015 the focus will be on achieving full EWTD compliance by reallocation of clinical tasks to the most appropriate member of staff, introduction of electronic time and attendance systems and reorganisation of acute services, supported by new management structures for hospitals services being progressed under Hospital Groups. In some settings, large-scale changes to existing acute hospital services are required to achieve full compliance."
It is recognised therefore that reorganisation and reconfiguration of acute services is required to achieve full EWTD compliance. Any changes to services will be undertaken in a planned and orderly manner and will take account of existing patient flows, the level of demand in hospitals and the new Group Hospital structures. Service provision, achievement of EWTD compliance and patient safety and outcomes will be priorities of the HSE in the development of the plan to support the attainment of compliance. The specific details of the plan will also be subject to the Court of Justice ruling on EWTD due on the 9th July 2015, in particular the extent, if any, to which protected training time constitutes working time. Currently the HSE and IMO have a collective agreement that excludes such time.
206. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the full-year saving that would be realised by reducing the spend on branded medicines by 2%; and if he will make a statement on the matter. [25662/15]
Amharc ar fhreagraUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the Health Service Executive (HSE) has statutory responsibility for the administration of the primary care schemes; therefore the matter has been referred to the HSE for attention and direct reply to you.
If you have not received a reply from the HSE within 15 working days, please contact my Private Office and they will follow up the matter with them.
207. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he has investigated the introduction of diagnostic related groupings and case-mix based payment in strategic purchasing; if this would give potential savings; and if he will make a statement on the matter. [25663/15]
Amharc ar fhreagraDiagnosis Related Group (DRG) systems classify patients into distinct groupings which are clinically similar and consume similar health resources. A DRG system has been operational in Irish hospitals for over 20 years with the AR-DRG grouping system used to group each hospital’s inpatient and daycase workload into approximately 1,050 DRGs. Until the end of 2013, the main use of the DRG system was to adjust the budget allocations of acute public hospitals by up to 3% in line with the complexity of their casemix and their relative performance under the Casemix System. DRGs have also been used as a tool to assist with planning as well as monitoring and assessing performance within the acute hospital sector.
Since January, 2014 the DRG system has been used to facilitate the introduction of a new prospective, case-based funding model for public hospital care called Activity Based Funding (ABF). ABF is also referred to as Money Follows the Patient. The new model involves moving away from inefficient block grant budgets to a new system where hospitals are paid for the actual level of activity undertaken. As such, hospitals will be funded based on the quantity and quality of the services they deliver to patients. They will be liberated, subject to overall budgetary ceilings, to pursue the most cost-effective means of achieving this standard of performance. Budgetary discipline will be delivered through the use of fixed budgets for ABF activity.
As outlined in the recently published “ABF Implementation Plan”, the new model is being rolled-out on a phased basis in public hospitals and full implementation will take a number of years. January 2016 will be an important milestone in the process when block budgets for inpatient and daycase activity will be converted into ABF allocations for the first time. It is intended that the payment system will extend over time to cover other hospital activity and eventually evolve so that money can follow the patient out of the hospital setting to primary care.
The introduction of ABF is an important step towards implementation of a commissioning or strategic purchasing model. My Department has commenced the process of developing policy on a commissioning model in the Irish context that is aimed at improving the way the health system plans and arranges for the delivery of services.
These reforms are designed to introduce a greater level of efficiency to the health service, and create a specific link between spending and activity. They do not seek to reduce overall spending. Instead, the changes provide a more transparent funding mechanism that rewards hospitals more fairly for activity. The experience of other jurisdictions that have implemented ABF suggests that the funding model can deliver improved performance in important measures of system efficiency such as significantly reduced average lengths of stay, increased numbers of day surgery admissions, and an increase in the number of discharges at the weekend. However, it is important to note that ABF and commissioning will play an important role in driving improvements in quality and patient safety as well as efficiency. The work of the National Clinical Programmes and the National Clinical Effectiveness Committee will be central to the future developments in this regard.
208. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if the World Health Organisation safe surgery checklist has been implemented in full in Irish hospitals; and if he will make a statement on the matter. [25664/15]
Amharc ar fhreagraAs this is a service matter the question has been referred to the Health Service Executive for attention and direct reply to the Deputy.
If no reply has been received from the HSE within 15 working days please contact my Private Office and they will follow up the matter with the Executive.
