Written Answers Nos. 457-478
457. Deputy Pádraig Mac Lochlainn asked the Minister for Health the details of the inpatient and outpatient waiting list for orthopaedic surgery and procedures at Letterkenny University Hospital in County Donegal; and the steps being taken by management to deal with these waiting lists [42866/15]
Amharc ar fhreagraThe National Treatment Purchase Fund (NTPF) is responsible for the collection, collation and publication of Inpatient and Day Case waiting lists. Waiting list information is published on the NTPF website at the end of each month. The information is presented in different report formats, i.e. by National/Trend, by Hospital/Group, and by Specialty.
The most recent Inpatient/Day Case waiting list data for Letterkenny General Hospital, for end of October 2015, may be found at http://www.ntpf.ie/home/pdf//2015/10/hospitals/in-patient/0500.pdf and the most recent Outpatient Waiting List may be found at http://www.ntpf.ie/home/pdf//2015/10/hospitals/out-patient/0500.pdf.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.
458. Deputy Brendan Griffin asked the Minister for Health the measures that have been agreed to date to support rural general practitioners; his plans to provide further assistance to protect their viability; the level of ongoing negotiation between his Department and representatives of general practitioners; and if he will make a statement on the matter. [42892/15]
Amharc ar fhreagraUnder the General Medical Services (GMS) Scheme, where the doctor lives or practises in a centre with a population of less than 500 and where there is not a town with a population of 1,500 or more within a 4.83 kilometre radius of that centre, the doctor is entitled to special rural practice concessions, including a Rural Practice Allowance. The current annual Rural Practice Allowance is €16,216.07.
As a result of satisfying the criteria for payment of this allowance, the GP is also entitled to claim practice support subsidies towards the employment of a Practice Nurse, Practice Secretary and/or Practice Manager at the maximum applicable rate which the doctor would otherwise only be entitled to claim if he or she had a panel size of 1,200 and over. The GP would also be entitled to claim the maximum applicable contribution towards locum costs for periods of leave.
Where a GP currently holds the Rural Practice Allowance but the circumstances underpinning this have changed, the GP retains the allowance while they continue to practise in this location. However, an application for the allowance is considered afresh by the HSE when a new GP commences in the area.
The HSE has recently reviewed its guidelines for dealing with applications for a Rural Practice Allowance. The purpose of the new guidance is to ensure consistency, transparency and fairness in decision-making in respect of the relevant discretionary provisions of the GMS contract pertaining to the granting or otherwise of the allowance to new applicants. The new guidance does not affect existing holders of the allowance.
The HSE, Department of Health and Irish Medical Organisation are currently engaged in a comprehensive review of the GMS and other publicly funded health sector contracts involving GPs. Among the many topics being looked at by this review process is the issue of supports for General Practice in remote rural areas.
459. Deputy Tom Fleming asked the Minister for Health to provide essential physiotherapy treatment for a person (details supplied) in County Kerry; and if he will make a statement on the matter. [42926/15]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy. 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.
460. Deputy Pearse Doherty asked the Minister for Health the details of inpatient and outpatient care services provided at Lifford Community Hospital in County Donegal, for each year from 2005 to 2015 to date, in tabular form; and if he will make a statement on the matter. [42932/15]
Amharc ar fhreagra461. Deputy Pearse Doherty asked the Minister for Health the details of the number of inpatient beds at Lifford Community Hospital in County Donegal, for each year from 2005 to 2015 to date, in tabular form; and if he will make a statement on the matter. [42933/15]
Amharc ar fhreagraI propose to take Questions Nos. 460 and 461 together.
As these are service matters they have 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.
462. Deputy Pearse Doherty asked the Minister for Health the number of children waiting for appointments for physiotherapy, occupational therapy, and speech and language therapy in County Cavan and in County Monaghan for six months, 12 months, 18 months, 24 months, and 24 months plus, in tabular form; and if he will make a statement on the matter. [42934/15]
Amharc ar fhreagra463. Deputy Pearse Doherty asked the Minister for Health the status of the Cavan and Monaghan implementation plan for progressing disability services for children and young people, and the accessibility of therapy services and assessments for children in these counties; and if he will make a statement on the matter. [42935/15]
Amharc ar fhreagra464. Deputy Pearse Doherty asked the Minister for Health the time frame for the services that are being restructured and proposed under the Cavan and Monaghan implementation plan for progressing disability services for children and young people; how this will help those children on waiting lists of over 29 months to get access to critical therapies in the short to medium term; and if he will make a statement on the matter. [42936/15]
Amharc ar fhreagra465. Deputy Pearse Doherty asked the Minister for Health the status of the additional posts that have been allocated to the specific services that are being restructured and proposed under the Cavan and Monaghan implementation plan for progressing disability services for children and young people in County Cavan and in County Monaghan; how these will be filled; how the network teams are being developed; and if he will make a statement on the matter. [42937/15]
Amharc ar fhreagraI propose to take Questions Nos. 462 to 465, inclusive, together.
The Government is committed to the provision and development of services for children with special needs, including early intervention services, and to improving access by these children to assessments and therapeutic interventions insofar as possible within available resources. Health related therapy supports and interventions for children, such as speech and language therapy, can be accessed through both the HSE’s primary care services and its disability services, depending on the level of need. Significant additional resources have been invested in recent years in the State’s primary care and disability services with a view to enhancing therapy service provision.
Additional funding of €20m was allocated in 2013 to strengthen primary care services and to support the recruitment of prioritised front-line posts, including over 260 additional posts for Primary Care Teams. In addition, the HSE has introduced a number of initiatives specifically in relation to speech and language therapy services that are aimed at improving access to these services, such as therapists increasing clinic based work and providing family centred interventions in a group, as opposed to a one-to-one setting, whenever possible.
The HSE is also currently engaged in a major reconfiguration of its existing therapy resources for children with disabilities into multi-disciplinary geographically based teams, as part of its National Programme on Progressing Disability Services for Children and Young People (0-18 years). The key objective of this Programme is to bring about equity of access to disability services and consistency of service delivery, with a clear pathway for children with disabilities and their families to services, regardless of where they live, what school they go to or the nature of the individual child’s difficulties. An additional €4 million was allocated in 2014 to assist in implementing the Progressing Disability Services Programme, equating to approximately 80 additional therapy posts. Further investment of €4 million (equating to €6 million in a full year) has been provided this year to support its ongoing implementation.
Improving access to therapy services for children in primary care and in disability services is a particular priority for the Government. Within this context, funding of €8 million is being provided in 2016 to expand the provision of speech and language therapy through primary care services and to support the reorganisation and expansion of speech and language and other therapies under the Progressing Disability Services Programme. Full implementation of the Progressing Disability Services Programme is expected before the end of 2016.
I have asked the HSE to reply directly to the Deputy in respect of the specific operational matters he has raised. 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.
466. Deputy Michael McGrath asked the Minister for Health when a decision on an appeal under the home care package scheme by a person (details supplied) in County Cork will be made. [42942/15]
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.
467. Deputy Maureen O'Sullivan asked the Minister for Health given the report published by Action Ireland sampling 700 schoolchildren from Dublin, Galway and Cork, and the findings that girls are now more likely to consume alcohol than boys, if he will commit to a multi-pronged approach, along with the Department of Education and Skills, to tackle the problem of under-age drinking; if he will follow the example of Finland and regulate online marketing aimed at this demographic, to improve general health of young persons and Ireland's bad relationship with alcohol. [42952/15]
Amharc ar fhreagraIreland has a significant alcohol problem which needs decisive and innovative action to address it. A broad range of complementary measures is required to successfully reduce consumption of and the harms associated with alcohol misuse especially amongst young people. The Steering Group Report on a National Substance Misuse Strategy, 2012 contains recommendations which take a multi-pronged approach to tackling the misuse of alcohol, focusing on supply, prevention, treatment and rehabilitation and research. The Government has approved an extensive package of measures to deal with alcohol misuse, based on the Report's recommendations, to be incorporated in a Public Health (Alcohol) Bill. The General Scheme of the Public Health (Alcohol) Bill was approved by Government on the 3 February 2015. The Scheme includes provisions for minimum unit pricing, health labelling on products that contain alcohol, restrictions on the advertising and marketing of alcohol and the regulation of sponsorship. The Department of Health is continuing to work on the preparation of the legislation. It is expected that the Bill will be published shortly.
The Public (Health) Alcohol Bill will make it illegal to market or advertise alcohol in a manner that is appealing to children. It provides for the making of regulations regarding the marketing and advertising of alcohol and includes provisions, inter alia, for restrictions on broadcast marketing and advertising, cinema advertising, outdoor advertising, print media and the regulation of sponsorship by alcohol companies. The provisions in relation to marketing and advertising will be reviewed after three years to gauge their effectiveness.
The other measures set out in the Steering Group Report on a National Substance Misuse Strategy, 2012, were endorsed by Government and are to be progressed by the relevant Departments and organisations. The Report recommends that the Social Personal and Health Education Programme (SPHE) in schools and Youthreach centres is continued and developed. The Department of Edcuation and Science is responsible for implementing this recommendation. The Department of Education and Science conducted a thematic evaluation of teaching and learning in SPHE. They reported that 98% of the schools visited had a substance misuse policy (Looking at Social Personal and Health Education Teaching and Learning in Post Primary Schools, 2013). SPHE is mandatory in all primary schools and will also form part of the new mandatory 'Wellbeing' component of junior cycle in post primary schools.
The First Annual Report on the National Substance Misuse Strategy is due by the end of 2015. The report, which will be laid before the Houses of the Oireachtas, will outline progress on the implementation of the recommendations in the Steering Group Report on the National Substance Misuse Strategy, the target for reduction in annual per capita consumption of pure alcohol, and the key performance indicators recommended in the Steering Group report.
468. Deputy Maureen O'Sullivan asked the Minister for Health if he will commit to meeting the group Regret to address its members' concerns about their daughters' health in relation to the human papilloma virus vaccine; given that he has previously expressed his confidence in the vaccine, if he will address the parents' concerns that the one common denominator in the emergence of some very serious health issues is the vaccine; if he will offer care plans or compensation given the hardships faced by these families; and if he will make a statement on the matter. [42953/15]
Amharc ar fhreagraAs Minister for Health I consider meeting any organisation in the health area that requests to do so. However due to scheduling commitments and other diary events such as Cabinet and Dáil business I am not always available to meet all who request a meeting.
In Ireland, the Health Products Regulatory Authority (HPRA) is the regulatory authority for medicines in Ireland. There are 2 licensed HPV vaccines available in Ireland (Gardasil® and Cervarix®). Gardasil® is the vaccine used by the HSE in the School Immunisation Programme and over 100,000 girls have received this vaccine since its introduction. The vaccine protects against two high risk types of HPV (16 and 18) that cause 73% of all cervical cancers. Vaccinated women and girls will still be at risk from other high risk types of HPV that can cause cervical cancer and will therefore need to continue to have regular cervical smear tests.
Gardasil® is a fully tested vaccine which was licensed by the European Medicines Agency (EMA) in 2006. No medicine, including vaccines, is entirely without risk, there is therefore on-going pharmacovigilance and monitoring of medicinal products once they are authorised for use. The safety profile of Gardasil® has been continuously monitored since it was first authorised. The introduction of new vaccines is based on the expert advice of the National Immunisation Advisory Committee. Decisions on the supply of vaccines into the market are undertaken by specific expert agencies rather than being the responsibility of the Minister of the day.
The EMA has recently completed a review of the HPV vaccine. The review which the HPRA participated in specifically focused on rare reports of two conditions, complex regional pain syndrome and postural orthostatic tachycardia syndrome associated with heart rate increase. The outcome of the review which was carried out by the EMA Pharmacovigilance and Risk Assessment Committee (PRAC) found no evidence of a causal link between the vaccine and the two conditions examined.
As part of its monitoring of the safety of medicines, the HPRA operates an adverse reaction reporting system, where healthcare professionals and patients are encouraged to report adverse reactions they consider may be associated with their treatment, through the range of options in place for reporting. All reports received are evaluated and considered in the context of the safety profile of the product concerned, with reports followed up as necessary for further information, that may assist in the assessment of the case.
As of the 27 November, the HPRA has received 936 reports of suspected adverse reactions or events notified in association with the use of HPV vaccines. Of the 936 reports received, 933 were associated with use of Gardasil® and three were associated with Cervarix®. The vast majority have been consistent with the expected pattern of adverse effects for the vaccines, as described in the product information, such as gastrointestinal symptoms, malaise, headache, dizziness and injection site reactions. Parents of any child with a suspected adverse reaction following administration of a vaccine are advised to contact the HSE vaccination teams or their general practitioner for advice and are referred for further management if required.
The EMA has advised healthcare professionals that available data does not warrant any change to the use of HPV vaccines as there are no new safety concerns regarding HPV vaccines. Healthcare professionals should therefore continue using the vaccines in accordance with the current product information.
469. Deputy Maureen O'Sullivan asked the Minister for Health if he will extend the BreastCheck cut-off age from 65 to 70 years of age and increase health advertising on its importance, given the ageing population and the reduction in the number of women taking the check during the past year; and if he will make a statement on the matter. [42954/15]
Amharc ar fhreagraLast year I announced the extension of BreastCheck, the free breast screening service, to women aged 65-69 years, in keeping with EU Guidelines. Previously, this service was available to women aged 50-64 years. I am pleased to confirm that the first invitations to the extended age range have issued and that the screening of 500 women in this cohort will take place this year.
Earlier this year, BreastCheck launched a new advertising campaign. It highlights the benefits and convenience of participating in BreastCheck and aims to encourage women to attend their first appointment, while normalising regular breast screening among all eligible women. The campaign has been featured on TV, radio, print, outdoor, social and digital media throughout the year and most recently in October, in support of Breast Cancer Awareness Month. A similar level of advertising activity is planned for 2016.
470. Deputy Maureen O'Sullivan asked the Minister for Health the short-term plans in place to relieve the overcrowding in accident and emergency departments; if he will reform the nature of these departments, for instance, by allocating intellectual disability nurses for patients presenting with mental health problems, with a separate triage for those presenting with alcohol and addiction issues; if staff are under increasing pressure due to poor management of departments; and if he will make a statement on the matter. [42955/15]
Amharc ar fhreagraLast December I convened the ED Taskforce to assist in dealing with the challenges presented by ED overcrowding and significant progress has been made to date.
Additional funding of €117m has been provided in 2015 to relieve pressures on acute hospitals including reducing delayed discharges, lowering the waiting time for Fair Deal funding and providing additional transitional care beds and home care packages. The HSE began its winter planning process early this year. Funding has been made available to support the acute hospital system over the winter period by providing additional bed capacity and other initiatives to support access to care. 197 hospital beds have opened nationally since October with another 38 due to open in the next few weeks. While it is still extremely challenging, the number of people waiting for nine hours or more on a trolley has fallen to, on average, 112 in Quarter 4. This compares with 127 on average in June, and 173 in February.
All hospitals have escalation plans to manage not only patient flow but also patient safety in a responsive, controlled and planned way that supports and ensures the delivery of optimum patient care. Last week I co-signed the ED Congestion Escalation Directive to ensure that progress made to date on overcrowding is sustained and improved upon. The Directive requires hospitals to implement their Escalation Plan whenever the Emergency Department experiences overcrowding and it is expected that this will add to the progress made on overcrowding so far.
The National Clinical Programme for Emergency Medicine encourages, and hopes to ensure, that the diagnosis and treatment of patients in Emergency Departments (ED) is conducted in a way that potential underlying causes for a patient's symptoms including serious underlying injuries and illness are ruled out. For this reason caution must always be taken in streaming of patients to separate areas before they have undergone a medical examination. The ED is the safest environment for the assessment of these patients. Emergency Medicine clinical expertise is required to differentiate between physical injury and the effects of alcohol or other substances and advanced diagnostic imaging is frequently required for such assessment.
471. Deputy Maureen O'Sullivan asked the Minister for Health the supports in place for persons diagnosed with long-term degenerative diseases such as Parkinson's who do not qualify for a medical card; if there are significant financial demands on persons who are often on very modest incomes but are just above the threshold for a medical card; if State assistance is required for persons in this predicament. [42956/15]
Amharc ar fhreagraParkinsonism is one of 16 long-term illnesses or disabilities covered by the Long Term Illness Scheme, which was established under Section 59(3) of the Health Act, 1970 (as amended). This scheme is administered by the Health Service Executive (HSE), and provides free drugs, medicines, and medical and surgical appliances directly related to the treatment of the specific conditions covered.
In the medical card assessment process, the HSE can take into account medical costs incurred by an individual or a family. Furthermore, the HSE may exercise discretion and grant a medical card even though an applicant's means exceed the prescribed threshold, where deemed appropriate.
The HSE has also taken steps to ensure greater interaction between the medical card central assessment office and the Local Health Office and/or Primary Care Team to see if there are further circumstances or needs that would support a medical card application, and to ensure that assistance is provided to meet the individual's needs as far as possible (where they do not have a medical card).
The Drugs Payment Scheme (DPS) provides assistance for people who are not eligible for either a medical card or the Long-Term Illness Scheme. Under the DPS, an individual or family pays a maximum of €144 each month for approved prescribed drugs, medicines and certain appliances for use by that person or his or her family.
472. Deputy Maureen O'Sullivan asked the Minister for Health if a waiting time, in many cases in excess of 14 months, is too long for public patients waiting to see a gynaecologist; and if he will make a statement on the matter. [42957/15]
Amharc ar fhreagraImproving waiting times for scheduled care for patients is a key priority for the Government. In January, taking into account current pressures on acute hospital services, I put in place maximum permissible waiting times for in-patient and day case treatment and outpatient appointments of 18 months by 30 June and 15 months by year end.
The HSE was provided with additional funding of €51m to ensure that these maximum waiting times would be achieved. The funding provided is intended to maximise capacity across public and voluntary hospitals as well as outsourcing activity where the capacity is not available to meet patient needs within the maximum allowable waiting time.
In June, the HSE reported a performance against the 18 month maxima of 99.6% for in-patient/day cases (IP/DC) and 92% for out-patients (OPD). The latest NTPF figures, published on Friday 6 November, continue to show improvements. There are reductions in the total In-patient/Daycase waiting list, and in the numbers of patients waiting between 15–18 months and waiting over 18 months. This is very positive, as it is the first time that we have seen reductions in all 3 key categories.
Concerted efforts have been made to reduce outpatient waiting lists by facilitating additional clinics outside conventional working hours and outsourcing where capacity is limited. Improvements are also evident with the end of October seeing a reduction of almost 5000 in the overall Outpatient waiting lists and of over 3000 in the number of people waiting between 15–18 months for appointments. The total number of people waiting for outpatient appointments has fallen below 400,000 for the first time this year.
The HSE is addressing the areas of underachievement of maximum waiting times with Hospital Groups as part of the regular performance and accountability process, as well as seeking the support of the National Clinical Programmes to ensure that the appropriate referral and clinical pathways are used at all times. The main priority is the patients affected by any delays in waiting lists and the HSE will ensure that these patients are prioritised for treatment.
473. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question No. 174 of 5 November 2015, why he has not introduced a statutory duty of candour rather than a purely voluntary open disclosure, as has been done in the United Kingdom. [42963/15]
Amharc ar fhreagra474. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question No. 174 of 5 November 2015 why he has not incorporated a statutory duty of candour into the contracts of medical staff that participate in reviews and investigations. [42964/15]
Amharc ar fhreagra475. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question No. 174 of 5 November 2015 and given the almost weekly medical negligence cases and the huge amount of money being spent on legal fees, if the failure to disclose should now be a criminal issue as well as an issue of professional misconduct. [42965/15]
Amharc ar fhreagraI propose to take Questions Nos. 473 to 475, inclusive, together.
The safety of service users is of paramount importance and steps need to be taken to anticipate and avoid things going wrong and to reduce the impact if they do. All employees including medical staff are required to disclose and report incidents in line with the HSE's Safety Incident Management Policy. Creating a culture of open disclosure and learning from the things that go wrong is the bedrock of making systems safer. Open Disclosure is defined as 'an open consistent approach to communicating with patients and their families when things go wrong in healthcare. This includes expressing regret for what has happened, keeping the patient informed, providing feedback on investigations and the steps taken to prevent a recurrence of the adverse event'.
I recently announced that the Government has given its approval to the drafting of provisions to support open disclosure of patient safety incidents. This will be included in the Department of Justice and Equality’s draft Bill on Periodic Payment Orders which is well advanced. The legislation is part of a broader package of reforms aimed at improving the experience of those who are affected by adverse events.
This legislation builds on the joint development by the HSE and State Claims Agency of the National Policy on Open Disclosure (2013). The HSE is progressing the implementation of the Policy across all health and social care services. We all know that when error or harm is experienced by a patient, the trust and confidence of that patient and their family are compromised. That is why honest, open disclosure and communication, which demonstrate empathy and sensitivity, are so essential. The intent of this legislation is to provide certain legal protections for healthcare staff for open disclosure, which is undertaken in good faith and in compliance with national standards. This will give further support to those staff in their communications with patients and family members if an adverse event occurs. The Ethical Code of Practice set out by the Medical Council also makes clear the responsibilities of doctors in relation to open disclosure.
Open disclosure is now HSE policy and therefore any unjustified breach of the policy (as with any HSE policy) will be managed in line with the HSE disciplinary procedures. Where potential deviations have been identified the Healthcare records must be reviewed to ascertain any documentation in relation to communication with the patient about the adverse event and to establish if any rationale for non-disclosure has been documented. Where there is no evidence that open disclosure has occurred the incident must be reviewed with the staff involved in the event. The patient must be informed of the event and the impact of the event explained and acknowledged. The patient should also be informed of the initial failure to disclose and an appropriate acknowledgement, explanation and apology provided.
From a patient safety perspective the key focus of open disclosure is on learning so that systems and processes can be improved in order to reduce potential future harms to patients. If a person is not satisfied that a health professional or administrator has fulfilled their obligations regarding open disclosure then that person has recourse to the HSE's complaints procedures. It is also open to a person to raise a complaint with the appropriate professional regulatory body or with the Ombudsman.
476. Deputy Mattie McGrath asked the Minister for Health if he will increase support for neonatal care and, in particular, for the roll-out of a retro-transport service to be run in conjunction with the neonatal transport programme; and if he will make a statement on the matter. [42966/15]
Amharc ar fhreagraAs this is a service matter, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.
477. Deputy Ruth Coppinger asked the Minister for Health his views on the letter signed by 838 doctors from 44 countries regarding the decriminalisation of abortion, that Amnesty International published recently (details supplied); and if he will make a statement on the matter. [42432/15]
Amharc ar fhreagraAs the Deputy is aware, Article 40.3.3 of the Irish Constitution states that: 'The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right.'
Article 40.3.3 of the Constitution, as interpreted by the Supreme Court in Attorney General v X, provides that it is lawful to terminate a pregnancy in Ireland if it is established as a matter of probability that there is a real and substantial risk to the life, as distinct from the health, of the mother, which can only avoided by a termination of the pregnancy.
The Protection of Life During Pregnancy Act 2013 was enacted on 30 July 2013 and commenced on 1 January 2014. It regulates access to lawful termination of pregnancy in accordance with the Xcase and the judgment of the European Court of Human Rights in the A, B and C v Ireland case.
The Government does not intend to propose any amendments to Article 40.3.3 of the Constitution at present.
478. Deputy Gerry Adams asked the Minister for Health if a doctor prescribes medication for a patient on a medical card that is available over the counter, does a pharmacist have to charge for that medicine; and if he will make a statement on the matter. [43014/15]
Amharc ar fhreagra480. Deputy Gerry Adams asked the Minister for Health the regulations for doctors and pharmacists in circumstances where the doctor prescribes medication for a patient on a medical card and that medication is also available without prescription over-the-counter; if it is within the pharmacist's discretion not to allow this medication to be covered by the medical card and to require the patient to incur the full cost of the over-the-counter medication; and if he will make a statement on the matter. [43041/15]
Amharc ar fhreagraI propose to take Questions Nos. 478 and 480 together.
Where a product prescribed for a patient with a Medical Card is the subject of an entry on the Reimbursement List, published pursuant to the Health (Pricing and Supply of Medical Goods) Act 2013, the pharmacist must dispense the product in accordance with the provisions of the Community Pharmacy Contractor Agreement.
Where a product is prescribed which does not appear on the Reimbursement List, but is available as an over-the-counter (OTC) item, the pharmacist could apply for authorisation under HSE Discretionary Hardship Arrangements. Alternatively, the pharmacist may indicate to the patient (or the patient’s carer) that the product can be purchased.
