Written Replies Nos. 834 to 853
834. Deputy Anne Rabbitte asked the Minister for Health the reason for a change of policy by the HSE west (details supplied) to convalescent care discharge from UCHG and Portiuncula hospital; and if the HSE will revert to policy committed to in 2012 which respects a person's right to choose the location they receive care. [19384/17]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply.
835. Deputy John Brassil asked the Minister for Health the amount of money that has been paid to private care providers, such as (details supplied) for respite and residential care for persons with intellectual disabilities in each of the past three years; and if he will make a statement on the matter. [19397/17]
Amharc ar fhreagra839. Deputy John Brassil asked the Minister for Health the number of persons which have benefitted from HSE funded private home care such as that provided by companies (details supplied) for respite and residential care for persons with intellectual disabilities; his views on whether the costs to date have provided value for the moneys spent; and if he will make a statement on the matter. [19411/17]
Amharc ar fhreagraI propose to take Questions Nos. 835 and 839 together.
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.
The Programme for Partnership Government states that the Government wishes to provide more accessible respite care to facilitate full support for people with a disability.
As the Deputy's questions relate to service matters, I have arranged for the questions to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
836. Deputy Gino Kenny asked the Minister for Health the data collected on trends in the prescribing of psychoactive psychotropic drugs here, especially to children, over the past 20 years; if the collected data indicates an overall rise in problems associated with prescribed medications, especially with opioids, stimulants, anti-depressants and anti-psychotic drugs in terms of tolerance, withdrawal and dependency; the measures being taken to address any rise in prescription rates and associated problems regarding prescription medications; and if he will make a statement on the matter. [19402/17]
Amharc ar fhreagraMedication therapy is one of a number of tools available to health professionals for the treatment of children with mental health difficulties. It is however essential that the medicines in question are safe and that appropriate prescribing guidelines are followed by the health professional treating the child.
Before a medicine is made available to the public, it undergoes an authorisation process whereby the medicine’s safety, quality and efficacy is assessed, based on the results of clinical trials. All medicines have side effects so it is only when the risk benefit analysis is positive, i.e. that the potential benefits to the patient outweigh the potential risks that the medicine receives an authorisation.
Once available a medicine is then subject to ongoing monitoring and evaluation through a process of pharmacocovigilance which operates at EU wide level to monitor the use of medicines in large numbers of patients and manage and analyse information on suspected adverse reactions to medicines.
European reviews of certain antipsychotics, antidepressants, stimulants and opioids have resulted in updates to product information in order to support better informed prescribing and use of these medicines in various patient groups including children. Important safety updates are communicated by the Health Products Regulatory Authority (HPRA) to health professionals via their Drug Safety Newsletter. The HPRA, in conjunction with its European counterparts continues to review the safety of authorised medicines and take appropriate regulatory action when necessary.
In Ireland there are a number of sources of prescribing guidelines. More recent guidelines include a Consensus Statement issued by the College of Psychiatry on the use of benzodiazepines in specialist mental health services (2012), Guidance issued by the Irish College of General Practitioners on Child and Adolescent Mental Health: Diagnosis and Management (2013), and the Medical Council Guide to Professional Conduct and Ethics for Registered Medical Practitioners 2016. Section 42 of the Medical Council Guide states for example that doctors should keep up to date with developments in medication safety and seek independent, evidence-based sources of information on the benefits and risk of the medicine. It also states that doctors should be aware of the dangers of drug dependency when prescribing benzodiazepines, opiates and other drugs with addictive potential and should take reasonable steps to make sure they are not inappropriately obtaining drugs from multiple sources.
The Health Service Executive (HSE) has also been actively involved in ensuring appropriate prescribing of psychotropic drugs. Reports are sent to GPs on a regular basis setting out the number of benzodiazepine and ‘z’ drug prescriptions dispensed to their patients and these reports allow GPs to compare their prescribing patterns to that of their peers. The reports also highlight where patients are on these medications for longer than the recommended period.
In terms of research data, the Drug Use in Ireland and Northern Ireland Drugs Prevalence Survey 2014/2015, commissioned by the National Advisory Committee on Drugs and Alcohol (NACDA) in Ireland and the Department of Health in Northern Ireland contains data on prevalence rates for sedatives/tranquillisers and anti-depressants. For young adults aged 15 to 34 and over lifetime prevalence (ever used) for sedatives/tranquillisers was 8.9% (down from 10.1%, the prevalence rate reported in the last survey in 2010/2011). The lifetime prevalence of anti-depressant use for the same age group was 8.3% (an increase from 6.8%, the prevalence rate reported in 2010/2011).
The Prevalence Study do not provide information on the number of children prescribed sedatives/tranquillisers and anti-depressants. The Health Service Executive (HSE) has some limited data on prescribing tends for children on the General Medical Services (GMS) scheme pharmacy claims database. A 2015 research study on benzodiazepine prescribing in children carried out an analysis of GMS data over a 9 year period (2002 -2011). The study found that prescription rates decreased slightly during the 9 year period and that prescription rates follow a similar pattern to those in other European countries. However the data is limited insofar as it only relates to medicines reimbursed under the GMS schemes and does not include prescriptions paid for by patients privately.
837. Deputy John Brassil asked the Minister for Health further to Parliamentary Questions Nos. 239 and 240 of 8 March 2017, and in view of the recent reply (details supplied) if he will address the matter; and if he will make a statement on the matter. [19406/17]
Amharc ar fhreagraActivity Based Funding (ABF) is a new model for funding public hospital care which was introduced in 2016. It involves moving away from inefficient block grant budgets to a new system where hospitals are paid for the volume and quality of care provided, subject to a budgetary limit. Each Hospital in the Programme is allocated an ABF budget and a set of activity targets. These can be altered by the Hospital Group subject to agreement with the Acute Hospitals and Finance Divisions within the HSE. A system of transition payments is in place to assist the less efficient hospitals to adjust. These payments will be phased out over time. The ABF system is currently applied to in-patient and day case services with other services still being funded through the block grant system.
It is important to note that while the new funding model is encouraging hospitals to use resources at their disposal more efficiently, it does not seek to reduce overall expenditure in the acute hospital system. Instead it provides a more transparent funding mechanism and it more fairly rewards hospitals for the activity that they undertake.
In relation to your specific queries regarding University Hospital Kerry, as this is a service matter, I have asked the HSE to respond to you directly.
838. Deputy Kevin O'Keeffe asked the Minister for Health the status of an appointment for a person (details supplied). [19408/17]
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.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
840. Deputy Kevin O'Keeffe asked the Minister for Health the status of a review for a person (details supplied) in County Cork. [19414/17]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for reply to the Deputy.
841. Deputy Sean Sherlock asked the Minister for Health the position regarding the National Obesity Policy and Action Plan 2016 – 2025; the actions undertaken to date in relation to an agreement on food reformulation targets with the food industry (details supplied); the estimated impact this will have on Exchequer funding; and if he will make a statement on the matter. [19417/17]
Amharc ar fhreagraA Healthy Weight for Ireland – Obesity Policy and Action Plan, 2016 – 2025 was launched in September 2016. The Policy sets out a 10 Steps Forward, 20 priorities and 60 actions to be undertaken during its life time.
Of the priority actions the following has been achieved:
1. Publication of Healthy Eating Guidelines and Food Pyramid;
2. Production of a paper on taxing Sugar Sweetened Drink; and
3. The Department provided leadership and collaborated with international organisations including World Health Organisation, EU (High Level Group on the prevention of childhood obesity and reformulation of food ) as well as North –South cooperation.
The following has commenced:
1. The development of legislation for calorie posting on menus;
2. Development of a Code of Practice for food and drink promotion, marketing and sponsorship;
3. Appointment of a clinical lead within the health service;
4. Inclusion of obesity prevention and care in the GP contract;
5. Implementation of the National Physical Activity Plan;
6. Development of obesity research.
The Code of Practice is in its final stage of development and will be launched very shortly.
In relation to reformulation of food to reduce fat, sugar and salt, my Department is in the process of establishing a national food product improvement Working Group and is working with the EU Commission on the Working Group on food improvement. This work will be used as a guide for Member States.
842. Deputy Barry Cowen asked the Minister for Health if hearing tests are carried out by public health nurses within the HSE for children aged 18 to 24 months and three to four years. [19418/17]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for reply to the Deputy.
843. Deputy Thomas Pringle asked the Minister for Health his views on correspondence from an organisation (details supplied); if he will address the need for a second breast surgeon, a breast radiologist, radiographer support and the infrastructure and support needed within the breast clinic at Letterkenny hospital; and if he will make a statement on the matter. [19419/17]
Amharc ar fhreagraThe Breast Cancer Service at Letterkenny University Hospital operates as a satellite centre of University Hospital Galway. The service is run by a single consultant who also undertakes general surgery at the hospital, and it is augmented by locum consultants and by Galway-based Saolta consultants who travel to carry out clinics in Letterkenny to meet needs arising.
At present, efforts are being made to recruit a full-time locum consultant surgeon to deal with current demands on the service. Consideration continues to be given to longer-term measures to meet the future requirements of the service and staffing at consultant and other levels will be among the issues to be considered.
I recently met with cancer support groups from the area and I can confirm that the HSE's National Cancer Control Programme (NCCP), my Department and the Saolta Group are actively engaged in ensuring that a quality breast cancer service will be available in Letterkenny.
A radiologist post for Letterkenny University Hospital has been advertised, but attempts to fill this position have proved challenging. Radiography numbers in Letterkenny have increased, and the hospital will continue to develop its radiography service to meet the needs of patients. The possibility of further cooperation with health services in Northern Ireland is also being explored, with the hope of building on the level of co-operation achieved in relation to the North West Cancer Centre at Altnagelvin Hospital. This centre opened in November last year and it is providing access to radiotherapy services to people from both jurisdictions in the North West.
844. Deputy Marc MacSharry asked the Minister for Health the number of applications made to the HSE for drug reimbursement since 2012; the number of these applications that were for drugs with rare disease orphan designation; and if he will make a statement on the matter. [19423/17]
Amharc ar fhreagra845. Deputy Marc MacSharry asked the Minister for Health the number of drug reimbursement applications that have been reimbursed by the HSE for all medicines since 2012 in tabular form. [19424/17]
Amharc ar fhreagra846. Deputy Marc MacSharry asked the Minister for Health the number of drug reimbursement applications that have not been recommended for reimbursement by the HSE for all medicines since 2012 in tabular form. [19425/17]
Amharc ar fhreagra847. Deputy Marc MacSharry asked the Minister for Health the number of orphan drugs that have been reimbursed by the HSE for the treatment of rare disease since 2012 in tabular form. [19426/17]
Amharc ar fhreagra848. Deputy Marc MacSharry asked the Minister for Health the number of orphan drugs that have not been recommended for reimbursement by the HSE since 2012 in tabular form; and if he will make a statement on the matter. [19427/17]
Amharc ar fhreagra849. Deputy Marc MacSharry asked the Minister for Health the details of each drug currently reimbursed since 2012 in tabular form; the date each drug was submitted for approval; the date of its subsequent commercial entry date; and if he will make a statement on the matter. [19428/17]
Amharc ar fhreagra850. Deputy Marc MacSharry asked the Minister for Health the details of each orphan drug currently reimbursed since 2012 in tabular form; the date each drug was submitted for approval; the date of its subsequent commercial entry date; and if he will make a statement on the matter. [19429/17]
Amharc ar fhreagra851. Deputy Marc MacSharry asked the Minister for Health the number of orphan drug applications which, following rapid review assessment by the National Centre for Pharmacoeconomics, NCPE, were recommended for full pharmacoeconomic assessment since 2012, in tabular form; and if he will make a statement on the matter. [19430/17]
Amharc ar fhreagra852. Deputy Marc MacSharry asked the Minister for Health the number of orphan drug applications recommended for reimbursement based solely on the NCPE’s rapid review process since 2012 in tabular form. [19431/17]
Amharc ar fhreagra853. Deputy Marc MacSharry asked the Minister for Health the number of orphan drug applications not recommended for reimbursement by the NCPE at the original submitted price that were subsequently approved for reimbursement following confidential price negotiations in tabular form; and if he will make a statement on the matter. [19432/17]
Amharc ar fhreagraI propose to take Questions Nos. 844 to 853, inclusive, together.
As this is a service matter, I have forwarded your request to the HSE who will respond to the Deputy directly.
