Tuesday, 24 May 2016

Written Answers Nos. 446-466

Cross-Border Health Services Provision

Ceisteanna (446)

Pearse Doherty

Ceist:

446. Deputy Pearse Doherty asked the Minister for Health regarding the cross-border directive, CBD, if he will outline the way the total cost of comparable treatment in another jurisdiction versus the costs incurred of having the treatment provided here is communicated to persons applying to access the scheme; the way in which persons are informed of the fact that reimbursement rates are set at whichever cost is the lesser; and if he will make a statement on the matter. [11390/16]

Freagraí scríofa

Minister for Health

The Health Service Executive operates the EU Directive on Patients' Rights in Cross Border Healthcare in Ireland. In line with practice in other EU Member States, the HSE, through the National Contact Point (NCP) office, provides information for patients on the Cross-Border Directive on its website and also by phone. The principal function of the NCP (which is the mechanism specified under the Directive for the dissemination of information on the Directive by Member States) is to facilitate exchange of information for patients concerning their rights and entitlements relating to receiving healthcare in another Member State, in particular the terms and conditions for reimbursement of cost and the procedures for accessing and determining those entitlements.

Under the Directive, insured patients are entitled to have costs of cross-border healthcare service reimbursed if the healthcare service in question is among the benefits to which they are entitled in their Member State of affiliation. The HSE is proactive in advising potential users of the Scheme that reimbursement will be at the cost of the treatment availed of abroad or the cost of providing the healthcare in Ireland whichever is the lesser. The patient is notified of this by the HSE in numerous ways: via the HSE website or in response to phone queries; on the Pro-forma invoice to be used for cases where an overnight in-patient stay is not required; and the letters issued in response to prior authorisation applications for cases involving an overnight in-patient stay will advise the actual amount to be reimbursed, based on the treatment code/s provided by the treating/referring consultant in the application form.

The HSE also advises where a patient is in any doubt as to the need to seek prior authorization before availing of a consultation or treatment abroad to contact the NCP. The NCP is happy at that stage to advise patients of the reimbursement rate that will apply to the assessment/treatment being accessed.

The HSE endeavours to reimburse the cost of treatment incurred or the cost of providing such healthcare in the State, which ever is the lesser, to the applicant within 30 days of receipt of a claim for reimbursement, in line with Prompt Payment Legislation.

Medical Products

Ceisteanna (447)

Louise O'Reilly

Ceist:

447. Deputy Louise O'Reilly asked the Minister for Health the savings to the Exchequer from a 2% reduction in branded medicines; and if he will make a statement on the matter. [11391/16]

Freagraí scríofa

Minister for Health

According to the HSE, the Primary Care Reimbursement Service spent approximately €1 billion in ingredient costs on medicines from monopoly suppliers in the year ending November 2014.

Therefore, a 2 percent reduction in these costs would save the Exchequer approximately €20 million.

Medical Products

Ceisteanna (448)

Louise O'Reilly

Ceist:

448. Deputy Louise O'Reilly asked the Minister for Health to provide an update on Irish Pharmaceutical Healthcare Association negotiations; and if he will make a statement on the matter. [11392/16]

Freagraí scríofa

Minister for Health

The Department of Health, the HSE, the Department of Public Expenditure and Reform and the Office of Government Procurement entered negotiations with the Irish Pharmaceutical Healthcare Association (IPHA) in recent months, with a view to securing an agreement that:

- significantly reduced the price of medicines to the Irish taxpayer;

- reduced the growth in the drugs and medicines bill to an affordable level; and, as result,

- put the HSE in a position to invest in new and innovative medicines over the next four years.

My colleague, the Minister for Public Expenditure and Reform, and I formally briefed Government on the position with regard to these negotiations, in particular that the State team had concluded that the potential of the current negotiation process had been exhausted and that the value of the best offer of the IPHA fell substantially short of what would satisfy the State's strategic requirements.

In the absence of an agreement with IPHA, the Health (Pricing and Supply of Medical Goods) Act 2013 is available to the HSE to determine the reimbursement prices paid.

Medicinal Products Licensing

Ceisteanna (449)

Louise O'Reilly

Ceist:

449. Deputy Louise O'Reilly asked the Minister for Health if he has considered a scheme of compulsory licensing for medicines; if not, if he will consider compulsory licensing; and if he will make a statement on the matter. [11393/16]

Freagraí scríofa

Minister for Health

The Health Products Regulatory Authority is the state agency responsible for licensing and regulating medicines, medical devices and other health products.

A number of initiatives are in place or in development to reduce the cost of medicines in Ireland. It is not proposed, at this point, to change the current system for licensing medicines in Ireland.

Hospital Services

Ceisteanna (450)

Aengus Ó Snodaigh

Ceist:

450. Deputy Aengus Ó Snodaigh asked the Minister for Health if a person (details supplied) will be given a date to have a medical procedure scheduled. [11399/16]

Freagraí scríofa

Minister for Health

Under 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 HSE, 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.

Early Childhood Care and Education

Ceisteanna (451)

Charlie McConalogue

Ceist:

451. Deputy Charlie McConalogue asked the Minister for Health if funding will be provided for a special needs assistant for a person (details supplied); and if he will make a statement on the matter. [11400/16]

Freagraí scríofa

Minister of State at the Department of Health

The Early Childhood Care and Education (ECCE) Programme, is the responsibility of the Minister for Children and Youth Affairs. The Department of Children and Youth Affairs has brought forward a new model of supports to facilitate the full participation of children with a disability in the ECCE Programme. The new model will provide supports including enhanced continuing professional development for early years practitioners; grants for equipment, appliances and minor alterations; and access to therapeutic intervention. Funding of €15m has been provided to phase these supports in during 2016. Full year costs for these supports are estimated to be €33 from 2017 onwards. This model of supports was launched on 18th November last by the Minister for Children and Youth Affairs with the full support of both the Department of Health and the Department of Education and Skills.

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

Improving access to therapy services for children in primary care and in disability services is a particular priority for the Government. Building on additional investment in recent years, funding of €8m is being provided to the HSE in 2016 to expand the provision of Speech and Language Therapy in primary care and the further development of early intervention therapy services under the Progressing Disabilities Programme to facilitate the inclusion of children with a disability in mainstream pre-school settings, as part of the roll out of the new inclusive pre-schools model.

It should be noted that while the Health Services executive has no statutory obligation to provide assistant supports for children with special needs wishing to avail of the ECCE scheme, it has, to date, worked at local level and in partnership with the relevant disability services to address individual needs as they arise. This has been done for example, by funding special pre-schools that cater specifically for children with disabilities. In some limited and specific cases at local level, disability services have in the past also facilitated children with a disability to attend mainstream pre-schools by providing additional supports where possible and where resources are available. The provision of such additional supports should not be confused with Special Needs Assistants, who are funded by the Department of Education and Skills to support children with special educational needs in primary and post primary school settings.

Within this context, I have asked the HSE to respond directly to the Deputy in relation to the individual case he 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.

Long-Term Illness Scheme Coverage

Ceisteanna (452)

John Brassil

Ceist:

452. Deputy John Brassil asked the Minister for Health to add motor neurone disease to the list of qualifying medical conditions for the long-term illness scheme; and if he will make a statement on the matter. [11406/16]

Freagraí scríofa

Minister for Health

The Long-Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act, 1970 (as amended). Regulations were made in 1971, 1973 and 1975 specifying the conditions covered by the LTI Scheme, which are as follows: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; Parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide. There are no plans to extend the list of conditions covered by the LTI Scheme.

Under the Drug Payment Scheme, no individual or family pays more than €144 per calendar month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals incurring ongoing expenditure on medicines.

Under the provisions of the Health Acts, medical cards are provided to persons who are, in the opinion of the HSE, unable without undue hardship to arrange GP services for themselves and their dependants. In the assessment process, the HSE can take into account medical costs incurred by an individual or a family.

Departmental Properties

Ceisteanna (453)

Peadar Tóibín

Ceist:

453. Deputy Peadar Tóibín asked the Minister for Health the annual rental value of each vacant property and land holding of his Department. [11422/16]

Freagraí scríofa

Minister for Health

My Department does not have any vacant properties or land holdings.

Disability Support Services

Ceisteanna (454)

Róisín Shortall

Ceist:

454. Deputy Róisín Shortall asked the Minister for Health his plans to reduce the unacceptable waiting list for children to access a service (details supplied); and if he will make a statement on the matter. [11444/16]

Freagraí scríofa

Minister of State at the Department of Health

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

Improving access to therapy services for children in primary care and in disability services is a particular priority for the Government. Building on additional investment in recent years, funding of €8m is being provided to the HSE in 2016 to expand the provision of Speech and Language Therapy in primary care and the further development of early intervention therapy services under the Progressing Disabilities Programme to facilitate the inclusion of children with a disability in mainstream pre-school settings, as part of the roll out of the new inclusive pre-schools model.

Within this context, I have asked the HSE to respond directly to the Deputy in relation to the specific area referred too. 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.

Home Help Service Provision

Ceisteanna (455)

Willie O'Dea

Ceist:

455. Deputy Willie O'Dea asked the Minister for Health the number of home help hours provided to persons in County Clare in each of the years 2010 to 2015; and if he will make a statement on the matter. [11454/16]

Freagraí scríofa

Minister for Health

As 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.

Psychological Assessments

Ceisteanna (456)

Pearse Doherty

Ceist:

456. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) may expect to have an assessment carried out by a child psychologist; and if he will make a statement on the matter. [11464/16]

Freagraí scríofa

Minister of State at the Department of Health

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

As the Deputy's question relates to an individual case, this is a service matter for the Health Service Executive (HSE). I have asked the HSE to look into the particular matter raised and to reply directly 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.

Hospital Waiting Lists

Ceisteanna (457)

Róisín Shortall

Ceist:

457. Deputy Róisín Shortall asked the Minister for Health the current waiting times for a for a procedure (details supplied) in a hospital in Dublin 1; the steps are being taken to reduce the waiting times; and if he will make a statement on the matter. [11471/16]

Freagraí scríofa

Minister for Health

The 2016 HSE Service Plan undertakes to maintain 2015 levels of service in respect of scheduled care and continues to address waiting times with Hospital Groups as part of the regular performance and accountability process. The HSE has established a Scheduled Care Governance Group to coordinate key initiatives to reduce waiting list numbers. In 2016, the HSE is focussing on key activities including:

- ensuring that chronological scheduling is adhered to;

- putting in place administrative and clinical validation procedures to ensure that patients are available for treatment;

- relocating high-volume low complexity surgeries to smaller hospitals; and

- designating an improvement lead for each hospital group, to provide support in meeting national targets for appointment and treatment.

In line with the NTPF Strategic Plan 2016, the NTPF is undertaking the following key deliverables in 2016:

- supporting the HSE in the delivery of improved waiting list for scheduled care, particularly in relation to the management of in-patient, day case and outpatient waiting lists;

- working with the HSE to assist hospitals in the development of local demand and capacity planning tools and mechanisms; and

- developing technical guidance materials for hospitals to ensure the highest standard of data quality and practice.

In addition, the Department is currently engaging with the NTPF and the HSE in planning a dedicated waiting list initiative, which will be rolled out in 2016. Also, the Programme for Government contains a commitment to provide €15m to the NTPF in 2017 to address waiting lists and the Department will engage with the NTPF and the HSE regarding the development of this initiative.

In relation to the particular query on waiting times for cataract operations in the Mater hospital, 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.

Tobacco Control Measures

Ceisteanna (458)

Joan Burton

Ceist:

458. Deputy Joan Burton asked the Minister for Health when the legislation to introduce plain packaging on tobacco products will be brought before the House; and if he will make a statement on the matter. [11479/16]

Freagraí scríofa

Minister for Health

The Public Health (Standardised Packaging of Tobacco) Act 2015 (“the 2015 Act”) was enacted in March last year.

As well as providing for the standardised packaging of tobacco products, the 2015 Act also gives effect in part to Directive 2014/40/EU of the European Parliament and of the Council of 3rd April 2014 on the approximation of the laws, regulations and administrative provisions of the Member States concerning the manufacture, presentation and sale of tobacco and related products. The provisions of the 2015 Act which give effect to the Directive came into force on 20th May, 2016, as required by the Directive.

Part 5 of the Health (Miscellaneous Provisions) Bill 2016 seeks to amend certain sections of the 2015 Act as they pertain to Regulations made under the 2015 Act. The legislative process for this Bill has been initiated in the Houses of the Oireachtas. However, due to the unforeseen and unusual delay in the formation of the Government, the legislative process for this Bill has not progressed to date, we are currently awaiting dates to bring the Bill before the House.

Psychological Assessments Waiting Times

Ceisteanna (459)

Pearse Doherty

Ceist:

459. Deputy Pearse Doherty asked the Minister for Health the current waiting times for children to be assessed by a child psychologist in County Donegal; the total number of persons waiting for up to three months, six months, nine months, one year, 15 months, 18 months, 21 months, 24 months, and for more than 24 months; and if he will make a statement on the matter. [11481/16]

Freagraí scríofa

Minister for Health

As 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.

HSE Staff

Ceisteanna (460)

Thomas Byrne

Ceist:

460. Deputy Thomas Byrne asked the Minister for Health the number of staff members of the Health Service Executive currently on extended leave, not including holiday or sick leave, with full or partial pay. [11490/16]

Freagraí scríofa

Minister for Health

I have asked the HSE to respond to the Deputy directly on this matter. If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up on the matter with them.

Medical Card Data

Ceisteanna (461)

Robert Troy

Ceist:

461. Deputy Robert Troy asked the Minister for Health why families where one person only in the household has a medical card have to pay the €25 prescription charges for the medical card holder, in addition to the €144 prescription charges under the drugs payment scheme, resulting in the monthly prescription charges for such families being €169. [11527/16]

Freagraí scríofa

Minister for Health

The General Medical Services (GMS) and Drugs Payment (DPS) Schemes are separate schemes with separate qualifying criteria and entitlements, which are not transferable.

Under the GMS, medical card holders pay a €2.50 charge per item for medicines and other prescription items supplied to them by community pharmacists. There is a cap of €25 per month for each person or family for items provided under this scheme.

There is no prescription charge for items dispensed under the DPS. Under this scheme an individual or family pays the first €144 for approved medicines and other prescription items each month, with any cost above that threshold paid by the State.

Prescription charges will be considered in the context of the implementation of the Health commitments in the Programme for Government and having regard to the funding available to facilitate such measures.

Drugs Payment Scheme

Ceisteanna (462)

Robert Troy

Ceist:

462. Deputy Robert Troy asked the Minister for Health why a medication (details supplied) which is available on prescription only does not have a code and is not covered under the drugs payment scheme. [11528/16]

Freagraí scríofa

Minister of State at the Department of Health

Where reimbursement is sought for a licensed product under the state drug schemes, the supplier must apply for reimbursement approval to the HSE. The HSE considers the application against a range of criteria set out in the Health (Pricing and Supply of Medical Goods) Act 2013, including cost effectiveness.

The product in question received market authorisation from the Health Products Regulatory Authority in 2015. The HSE has advised that it received a reimbursement application and that further documentation is awaited in relation to that application.

Nursing Homes Support Scheme Review

Ceisteanna (463)

Peter Burke

Ceist:

463. Deputy Peter Burke asked the Minister for Health to consider changing the fair deal scheme to ensure family farms are not eroded and rendered non-viable due to dilution of the farm asset scheme; and if he will make a statement on the matter. [11529/16]

Freagraí scríofa

Minister for Health

When the Nursing Homes Support Scheme commenced in 2009, a commitment was made that it would be reviewed after three years. This Review was published in July 2015. A number of key issues have been identified for more detailed consideration across Departments and Agencies, including the treatment of business and farm assets for the purposes of the financial assessment element of the Scheme.

An Interdepartmental/Agency Working Group has been established to progress the recommendations contained in the Review. This Group is chaired by the Department of Health and includes representatives from the Department of the Taoiseach, the Department of Public Expenditure and Reform, the HSE, the Revenue Commissioners and, when required, the National Treatment Purchase Fund. The Group will consider a submission already made in this context by the Irish Farmers' Association and will then consider whether an additional presentation by the IFA would be appropriate. Any significant changes ultimately deemed necessary to the Nursing Homes Support Scheme will require legislation and will accordingly be addressed together at the conclusion of the Review implementation process.

The Working Group is due to make a preliminary report on its progress to the Cabinet Committee on Health in June 2016.

Ambulance Service

Ceisteanna (464)

Danny Healy-Rae

Ceist:

464. Deputy Danny Healy-Rae asked the Minister for Health the reason emergency ambulances are disallowed from transporting patients from home to district or community hospitals, even when they are requested to do so by a local GP; the reason that in one case when the emergency ambulance arrived to take a patient to the local district hospital two miles away, the ambulance staff realised the patient was to be taken to a district hospital and said they were debarred from doing this and could only take the patient to a hospital with an accident and emergency department; and if he will make a statement on the matter. [11532/16]

Freagraí scríofa

Minister for Health

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.

Health Services

Ceisteanna (465)

Danny Healy-Rae

Ceist:

465. Deputy Danny Healy-Rae asked the Minister for Health why the intermediary care vehicles in County Kerry are not fully staffed; the number of these vehicles which are parked, because of the lack of paramedics to operate them; and if he will make a statement on the matter. [11533/16]

Freagraí scríofa

Minister for Health

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.

HSE Funding

Ceisteanna (466)

Eoin Ó Broin

Ceist:

466. Deputy Eoin Ó Broin asked the Minister for Health the funding provided by the Health Service Executive to homeless organisations for each year from 2008 to 2015 and to date in 2016 in tabular form. [11534/16]

Freagraí scríofa

Minister for Health

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and they will follow up the matter with them.