Written Answers Nos. 438-467
438. Deputy Gerry Adams asked the Minister for Health the proposed changes to the tuberculosis, BCG, vaccination programme, following the Health Information and Quality Authority health technology assessment, and subsequent public consultation on proposed changes to the programme; and if he will make a statement on the matter. [5480/16]
Amharc ar fhreagraThe National Immunisation Advisory Committee (NIAC) and the National TB Advisory Committee have recommended stopping routine BCG vaccination of newborn babies and instead provide selective vaccination of babies in high-risk groups. The Department of Health requested the Health Information and Quality Authority (HIQA) to conduct a Health Technology Assessment (HTA) to review the implications of this change.
The HTA was published by HIQA on 8 December 2015. It recommended that sufficient resources for enhanced TB control and public awareness efforts must be provided before there is any change in national vaccination policy and strategy. However, HIQA has recommended that any change in strategy must be supported by a clear commitment to enhanced systematic and comprehensive tuberculosis (TB) control measures.
Tuberculosis (TB) is a notifiable disease under the Infectious Diseases (Amendment) Regulations 2011 (S.I. No. 452 of 2011). In 2015, 318 cases of TB were notified to the Health Protection Surveillance Centre, giving a national TB notification rate of 6.9 per 100,000, the lowest rate reported since surveillance commenced. According to the World Health Organisation, the definition of a low incidence TB country is one with a national TB notification rate of less than 10 cases per 100,000, Ireland is in this category.
In Ireland the number of cases of TB has been falling. Most European countries, including the UK, Sweden, Norway, Denmark and Iceland do not give BCG vaccine to all babies. Babies are not at risk of TB because of the delay in getting BCG vaccine in Ireland.
440. Deputy Brendan Griffin asked the Minister for Health if it is standard practice for parents of babies under six weeks old to be charged for general practitioner services in cases where they have not applied for free general practitioner care for children under six years of age; if and from whom there is a refund due in such cases; and if he will make a statement on the matter. [5485/16]
Amharc ar fhreagraThe Maternity and Infant Care Scheme provides an agreed programme of care free of charge to an expectant mother arising out of her pregnancy and to her new-born baby for six weeks after birth. Before the birth of the child the Scheme offers a system of combined care by a general practitioner who is a participant and is chosen by the expectant mother and the maternity unit/ hospital of choice. A schedule of antenatal visits to the general practitioner and the Maternity unit is recommended starting as soon after conception as possible. The schedule of visits may be varied by the general practitioner and/or obstetrician depending on the individual circumstances of the expectant mother.
After the mother and child leave hospital a visit is made by a Public Health Nurse to the new mother and baby at home. During this visit the mother is given advice and support in the care of herself and of the baby. Two designated visits to the General Practitioner are allowed for in the Scheme the first should be at 2 weeks after the Birth and this visit is especially for examination of the baby. The second visit is at 6 weeks after birth and is both for the mother and the baby. If additional visits are required by patients suffering from major conditions, the patient may avail of a maximum of 5 visits free of charge.
A child must be registered with the HSE for the Under 6's GP visit card in order to access GP services without fees. The child's eligibility will not commence until confirmation is received that the GP of choice has confirmed that they have accepted the child onto their panel.
441. Deputy Pearse Doherty asked the Minister for Health the details of the contract in place between the Health Service Executive and the company responsible for operating and implementing car parking charges at Letterkenny University Hospital in County Donegal; when this agreement expires; the amount of money which this agreement generated for the hospital in each of the years from 2010 to 2016 to date; if he plans to return the management of this service to public ownership; and if he will make a statement on the matter. [5491/16]
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.
442. Deputy Thomas Byrne asked the Minister for Health to provide a date for an appointment for surgery in Cappagh Hospital, Dublin 11, for a person (details supplied) in County Meath. [5498/16]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, 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 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.
443. Deputy Michael Healy-Rae asked the Minister for Health his views on the concerns of pharmacy owners regarding the Health Service Executive policy when building primary care centres (details supplied). [5500/16]
Amharc ar fhreagraThe HSE has responsibility for the provision and operation of Primary Care Centres. Therefore, I have asked the HSE to respond directly to the Deputy on this issue. 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.
444. Deputy Tony McLoughlin asked the Minister for Health the status of his and the Health Service Executive's negotiations with pharmaceutical companies which aim to reduce the cost of particular medicines in the State; his plans to make the Orkambi drug available to persons living with cystic fibrosis here in the next 12 months; and if he will make a statement on the matter. [5506/16]
Amharc ar fhreagraThe Department of Health, the HSE, the Department of Public Expenditure and Reform and the Office of Government Procurement commenced negotiations with the Irish Pharmaceutical Healthcare Association on a new pricing and supply Agreement on 24 March 2016. As negotiations are ongoing, it would not be in the best interests of the State to provide further comment at this time.
I am aware that there is a lot of concern and worry among cystic fibrosis (CF) sufferers and parents and families of children who have CF about the current debate on the cost and availability of this medicine. I met with Cystic Fibrosis Ireland on Monday 25 January to discuss the matter.
Orkambi is a combination drug for the treatment of CF in patients with two copies of a specific CF gene mutation. The drug was licensed by the U.S. Food and Drug Administration in July 2015 and by the European Medicines Agency on 19 November 2015. In other words, Orkambi has only been licensed for use in the European Union within the last few months. To date, it has not been approved for reimbursement by any public health service in Europe.
Each country has its own process for approval. The Irish process is laid down in law in the Health (Pricing and Supply of Medical Goods) Act 2013. Under this law, the 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 law. It is appropriate that these should not be political decisions and that a scientific and evidence based approach is taken to determine the extent to which patients would benefit from treatment with expensive new drugs.
Prior to reimbursing any medicine, the HSE considers a range of statutory criteria, including clinical need, cost-effectiveness, and the resources available to the HSE. The process for approval of high-tech new drugs in Ireland involves three steps. The first step involves a Rapid Review, which has been done. The second involves a full Health Technology Assessment by the National Centre for Pharmacoeconomics (NCPE). This expert assessment is scientific and objective and will evaluate whether the claims being made about the benefits of a new drug are valid, and to what extent, in terms of its impact on life expectancy, quality of life, reducing hospital admissions, reduced need for transplants etc. The NCPE will also consider which patient groups might benefit, how the drug compares with existing treatments and if it is cost-effective at the price being quoted by the manufacturer. This usually takes about 90 days. Orkambi's manufacturer, Vertex Pharmaceuticals, submitted an application to the HSE on 3 February 2016. I have requested the NCPE to expedite this part of the process to less than 90 days, and the Director has confirmed that he believes this can be achieved.
Once the assessment is complete, a recommendation is made to the HSE, which may then engage in price negotiations with the manufacturer.
A similar process is carried out in England by the National Institute for Health and Care Excellence (NICE), which does not expect to make a recommendation until July.
The process being followed is the same as that for other CF drugs like Kalydeco, new drugs to treat cancer and other rare diseases. Orkambi will be treated in the same way as these were, and has to be, under the law. This process is designed to secure the best value for the HSE, and the savings that accrue from this process can be used to fund other health service developments, for example isolation rooms for CF and cancer patients, better ambulance services, home supports for the elderly and safer maternity services.
I hope that it will be possible for Orkambi to be approved for patients who will benefit from it, and at a fair price, but it must go through the normal approval procedure first, like all other high-tech medicines.
445. Deputy Timmy Dooley asked the Minister for Health if the Health Service Executive in County Clare is processing and awarding home care packages; the number of applications which were awarded in March 2016; and if he will make a statement on the matter. [5510/16]
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.
446. Deputy Tony McLoughlin asked the Minister for Health the status of the establishment of the new follow-up mammography service at Sligo University Hospital; the expected date of the first screening; the way in which the service will operate; and if he will make a statement on the matter. [5512/16]
Amharc ar fhreagraThe contract has been placed for the provision of a follow-up mobile mammography service for women from the Sligo/Leitrim area who have already received treatment for breast cancer. The service will operate periodically from Sligo University Hospital. It will of a comparable standard and quality to that provided in the Symptomatic Breast Disease Unit at Galway University Hospital and it will be linked electronically to the imaging system in that hospital. The date on which the mammography service will commence in Sligo has not yet been finalised.
447. Deputy Tony McLoughlin asked the Minister for Health if the Health Service Executive has issued a public tender for the provision of a fixed cardiac catheterisation laboratory at Sligo University Hospital; and if he will make a statement on the matter. [5514/16]
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.
448. Deputy Tony McLoughlin asked the Minister for Health the date the new neurologist consultant position at Sligo University Hospital will commence; and if he will make a statement on the matter. [5516/16]
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.
449. Deputy Kevin O'Keeffe asked the Minister for Health the status of a hospital appointment for a person (details supplied) in County Cork. [5519/16]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, 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 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.
450. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) in County Offaly will receive a hospital appointment. [5520/16]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, 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.
451. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) in County Offaly will receive a hospital appointment. [5521/16]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, 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.
452. Deputy Michael Healy-Rae asked the Minister for Health the status of an application for a primary care certificate by a person (details supplied) in County Kerry; and if he will make a statement on the matter. [5525/16]
Amharc ar fhreagraAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy. 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 the matter up with the HSE.
453. Deputy Robert Troy asked the Minister for Health to ensure a person (details supplied) is provided with a medical appointment as a matter of priority, given the person's age and circumstances. [5531/16]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, 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 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.
454. Deputy Thomas P. Broughan asked the Minister for Health the availability of dialectical behavioural therapy within the child and adolescent mental health services; and if he will make a statement on the matter. [5543/16]
Amharc ar fhreagraAs this is a service issue this question has been referred to the HSE for direct reply. If you have not received a reply within 15 working days, please contact my Private Office and they will follow up the matter with them.
455. Deputy Thomas P. Broughan asked the Minister for Health the supports within mental health services available to adults who have been diagnosed with a personality disorder; and if he will make a statement on the matter. [5544/16]
Amharc ar fhreagraAs this is a service issue this question has been referred to the HSE for direct reply. If you have not received a reply within 15 working days, please contact my Private Office and they will follow up the matter with them.
456. Deputy Kevin O'Keeffe asked the Minister for Health the reason for the delay in finalising an application under the fair deal nursing home scheme by a person (details supplied) in County Cork. [5550/16]
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.
458. Deputy Kevin O'Keeffe asked the Minister for Health to re-instate specific dietary and medical products for medical card holders. [5552/16]
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 faces a continuing challenge to deliver services in a way that will minimise any adverse impact on patients and continue to protect, as far as possible, the most vulnerable citizens. Unfortunately, as a result it has become necessary for the HSE to suspend certain products from its list of items reimbursable under the GMS and other community drug schemes. This includes gluten-free products.
Gluten-free products have become more widely available in supermarkets in recent years and tend to be significantly cheaper than products sold through community pharmacies. Coeliac patients can also claim medical expenses tax relief on expenditure incurred on gluten-free products manufactured specifically for coeliacs. There are no plans to reinstate these products on the list of reimbursable items under the GMS and other community drug schemes.
459. Deputy Michael Creed asked the Minister for Health the status of legalisation concerning a drug (details supplied) for medical uses; the experience in this regard of clinical trials being held in other jurisdictions that he is aware of; the process involved in approving new drug treatments; and if he will make a statement on the matter. [5554/16]
Amharc ar fhreagraCannabis oil is not a definitive term and could contain cannabis or any number of cannabis-related compounds. Cannabis and certain cannabis-related compounds are controlled under the Misuse of Drugs Acts 1977 to 2015 and are listed in schedule 1 of the Misuse of Drugs Regulations 1988, as amended.
Cannabidiol, the substance referred to as CBD by the Deputy, is not subject to control under these Acts. However, CBD is derived from cannabis which is a controlled drug. Due to the manufacturing processes, CBD extracts may contain a number of other ingredients, some of which may be controlled. In order to elucidate and define the ingredients of a CBD oil product, a full certificate of analysis would be required for that product. If a CBD oil product does not contain an ingredient which is a controlled substance, it may be feasible to have that product imported and used in Ireland, in accordance with specific conditions.
Cannabis oil or CBD oil are not an authorised medicinal products in Ireland. Products for which medicinal claims are made, or which contain certain substances likely to have pharmacological actions on the body are considered as medicinal products. Under European and Irish legislation, before a medicine can be placed on the Irish market, the manufacturer must seek an authorisation from the Health Products Regulatory Authority (HPRA) or, in the case of certain medicinal products, the European Medicines Agency (EMA). A determination on an application for authorisation of a medicine is based on a rigorous scientific assessment of the application against the criteria of safety, quality, efficacy, legal and regulatory requirements. I have no role in the process of authorising medicinal products.
The HPRA is responsible for the assessment of clinical trials with medicinal products conducted in Ireland. Before a medicinal product can be authorised for use, it must go through the clinical trials process to ensure that it is safe and effective, and also that the quality of the product is sufficient. The publicly-accessible EU Clinical Trials Register of trials being conducted in the EU and European Economic Area currently lists 38 trials authorised using cannabis. These trials are mainly investigating the safety and efficacy of cannabis in neurological and psychiatric conditions. There are currently no clinical trials using cannabis taking place in Ireland.
460. Deputy Kevin O'Keeffe asked the Minister for Health for the appointment of a nurse or nurses to deal with, assist and advise patients who are currently living with neurological conditions in County Cork; and if he will make a statement on the matter. [5557/16]
Amharc ar fhreagraAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy. 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 the matter up with the HSE.
461. Deputy John Brassil asked the Minister for Health the number of emergency medical cards issued in County Kerry in the years 2013 to 2016 to date; and if he will make a statement on the matter. [5560/16]
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 issued to Oireachtas members.
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.
462. Deputy Gerry Adams asked the Minister for Health if the provision of laundry services at Our Lady of Lourdes Hospital in Drogheda, County Louth, will remain in-house and not be outsourced to a private company. [5563/16]
Amharc ar fhreagra463. Deputy Gerry Adams asked the Minister for Health to incorporate a new laundry facility within the upcoming phase 2 hospital extension at Our Lady of Lourdes Hospital in Drogheda, County Louth. [5564/16]
Amharc ar fhreagra464. Deputy Gerry Adams asked the Minister for Health to consult with the laundry manager at Our Lady of Lourdes Hospital in Drogheda, County Louth, regarding the upgrade of its facilities. [5565/16]
Amharc ar fhreagraI propose to take Questions Nos. 462 to 464, inclusive, together.
As these are service matters, 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.
465. Deputy Sean Fleming asked the Minister for Health when the Health Service Executive will apply for and approve a communication device for a person (details supplied) in County Laois; and if he will make a statement on the matter. [5587/16]
Amharc ar fhreagraAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy. 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 the matter up with the HSE.
466. Deputy Sean Fleming asked the Minister for Health when an appointment will be provided to a person (details supplied) in County Laois; and if he will make a statement on the matter. [5597/16]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, 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.
467. Deputy Michael Healy-Rae asked the Minister for Health the status of occupational therapy for a person (details supplied) in County Kerry; and if he will make a statement on the matter. [5601/16]
Amharc ar fhreagraAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy. 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 the matter up with the HSE.
