Tuesday, 20 Jun 2017

Written Answers Nos 1008-1027

Long-Term Illness Scheme Coverage

Ceisteanna (1008, 1025, 1098, 1281)

John Brassil

Ceist:

1008. Deputy John Brassil asked the Minister for Health his plans to add congenital neutropenia to the long-term illness list; and if he will make a statement on the matter. [26526/17]

John Brassil

Ceist:

1025. Deputy John Brassil asked the Minister for Health his plans to add motor neuron disease to the long-term illness list; and if he will make a statement on the matter. [26585/17]

Bríd Smith

Ceist:

1098. Deputy Bríd Smith asked the Minister for Health the reason motor neuron disease is not covered under the long-term illness scheme; and if he will review this matter with the intention of adding motor neuron disease to the scheme [26862/17]

Noel Rock

Ceist:

1281. Deputy Noel Rock asked the Minister for Health his plans to make the long-term illness scheme available to persons who suffer from pulmonary fibrosis; and if persons that suffer from this condition could obtain medical cards; and if he will make a statement on the matter. [27751/17]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 1008, 1025, 1098 and 1281 together.

The LTI Scheme was established under Section 59(3) of the Health Act 1970 (as amended). The conditions covered by the LTI are: 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. Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.

There are no plans to extend the list of conditions covered by the Scheme.

Home Help Service Provision

Ceisteanna (1009)

Pat Breen

Ceist:

1009. Deputy Pat Breen asked the Minister for Health when a person (details supplied) will be facilitated; and if he will make a statement on the matter. [26536/17]

Freagraí scríofa

Minister of State at the Department of Health

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

Hospital Staff Data

Ceisteanna (1010)

Lisa Chambers

Ceist:

1010. Deputy Lisa Chambers asked the Minister for Health the number of staff employed at the maternity unit in Mayo University Hospital by job title; and if he will make a statement on the matter. [26539/17]

Freagraí scríofa

Minister for Health

In response to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.

Hospital Staff

Ceisteanna (1011)

Lisa Chambers

Ceist:

1011. Deputy Lisa Chambers asked the Minister for Health if there are vacancies in the maternity unit at Mayo University Hospital; if so, the number; when they will be filled; and if he will make a statement on the matter. [26540/17]

Freagraí scríofa

Minister for Health

In response to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.

Hospital Staff Data

Ceisteanna (1012)

Lisa Chambers

Ceist:

1012. Deputy Lisa Chambers asked the Minister for Health if staffing numbers in the maternity unit at Mayo University Hospital are at an adequate level to provide a safe service; and if he will make a statement on the matter. [26541/17]

Freagraí scríofa

Minister for Health

In response to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.

Hospital Staff Data

Ceisteanna (1013)

Lisa Chambers

Ceist:

1013. Deputy Lisa Chambers asked the Minister for Health the number of staff currently employed on a temporary contact at the maternity unit in Mayo University Hospital; and if he will make a statement on the matter. [26542/17]

Freagraí scríofa

Minister for Health

In response to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.

Hospital Staff Data

Ceisteanna (1014)

Lisa Chambers

Ceist:

1014. Deputy Lisa Chambers asked the Minister for Health the number of staff employed on a full-time contract at the maternity unit in Mayo University Hospital; and if he will make a statement on the matter. [26543/17]

Freagraí scríofa

Minister for Health

In response to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.

Medicinal Products Prices

Ceisteanna (1015)

Stephen Donnelly

Ceist:

1015. Deputy Stephen S. Donnelly asked the Minister for Health the pharmaceutical products used by the HSE exclusively available from UK manufacturers; the annual cost of these products; the risks to ongoing availability in the case of no agreement being reached in Brexit negotiations; if contingency planning is in place for these products; the expected timeline for accreditation of these products in this scenario; and if he will make a statement on the matter. [26556/17]

Freagraí scríofa

Minister for Health

I have asked the HSE to reply directly to the Deputy on the issues raised that relate to the agency. Please advise my private office if you do not receive a reply within ten working days.

The medicines regulator, the Health Products Regulatory Authority (HPRA), is currently working to identify the key risks to continued availability of medicines under different Brexit scenarios. In parallel with this work, the HPRA is examining the feasibility of a number of risk mitigation measures to avoid delays in medicines authorisation and to protect the availability of medicines on the Irish market.

Disease Management

Ceisteanna (1016, 1017, 1136, 1141, 1144, 1555, 1560)

Catherine Connolly

Ceist:

1016. Deputy Catherine Connolly asked the Minister for Health the system for identifying Lyme disease; the treatment options; and if he will make a statement on the matter. [26573/17]

Catherine Connolly

Ceist:

1017. Deputy Catherine Connolly asked the Minister for Health if his attention has been drawn to a method (details supplied) of detecting Lyme disease; if consideration will be given to introducing a similar system here; and if he will make a statement on the matter. [26574/17]

Richard Boyd Barrett

Ceist:

1136. Deputy Richard Boyd Barrett asked the Minister for Health the adequate tests which are done to diagnose Lyme disease; if Lyme disease is diagnosed, the supports and treatments offered to those who are suffering from the disease; and if he will make a statement on the matter. [26994/17]

Seán Sherlock

Ceist:

1141. Deputy Sean Sherlock asked the Minister for Health if the HSE will consider recognition of the ELISPOT test on Lyme disease completed by an organisation (details supplied) in Germany, which holds ISO15189:2014 certification to carry out examinations in this area. [27000/17]

Jan O'Sullivan

Ceist:

1144. Deputy Jan O'Sullivan asked the Minister for Health if he will develop a strategy on Lyme disease in co-operation with stakeholders including the areas of education for health workers, testing and diagnosis and treatment protocols; and if he will make a statement on the matter. [27004/17]

Robert Troy

Ceist:

1555. Deputy Robert Troy asked the Minister for Health his views on a matter (details supplied) in relation to Lyme disease. [28917/17]

Eugene Murphy

Ceist:

1560. Deputy Eugene Murphy asked the Minister for Health the steps he will take regarding the lack of adequate testing for the diagnosis of Lyme disease in view of the fact that many persons are forced to travel abroad to receive a diagnosis; and if he will make a statement on the matter. [28923/17]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 1016, 1017, 1136, 1141, 1144, 1555 and 1560 together.

Lyme disease is diagnosed by medical history and physical examination. The infection is confirmed by blood tests which look for antibodies produced by an infected person's body in response to the infection. These normally take several weeks to develop and may not be present in the early stages of the disease. The standard approach to Lyme diagnostics is a two-stage approach and involves using a sensitive enzyme immunoassay (EIA) as an initial, screening step. Screening EIAs can be insufficiently specific, giving false-positive reactions in the presence of other similar bacteria, and certain other viral infections, including glandular fever. In addition, blood samples from patients with autoimmune disorders and other inflammatory conditions can also lead to false-positive results. Samples giving positive or equivocal results in screening tests are further investigated in a second-stage immunoblot (Western blot) tests. Use of immunoblot testing greatly increases specificity. Using this two stage approach will give a great degree of certainty around the diagnosis of Lyme.

All clinical (and other) laboratories in Ireland must undergo continuous quality assurance to ensure that the quality of the diagnostics they provide is maintained at the highest international level for human diagnostics. Some laboratories abroad do not use antibody tests like the EIA (screening ELISA test) and Western Blot and instead will use other types of tests, for example, testing for levels of a specific white blood cell (CD-57) or lymphocyte transformation tests (tests to measure how specific cells in a person's immune system respond when exposed to antigens against Borrelia burgdorferi - the bacterium responsible for Lyme disease). These types of tests are not currently recommended by international groups such as the CDC, Infectious Diseases Society of America (IDSA) or BIA for a number of reasons:

I. There is not enough scientific evidence that they are suitable tests to diagnose Lyme disease;

II. There is no standard method to perform and interpret these kind of tests; and

III. Positive results in these kinds of tests may be due to other illnesses or conditions and not just Borrelia infection.

Lyme disease can be very successfully treated using common antibiotics. These antibiotics are effective at clearing the rash and helping to prevent the development of complications. Antibiotics are generally given for up to three weeks. If complications develop, intravenous antibiotics may be considered.

In Ireland, treatment by most clinicians is based on that laid out in evidence-based guidelines for the management of patients with Lyme disease, human granulocytic anaplasmosis (formerly known as human granulocytic ehrlichiosis), and babesiosis published by the Infectious Diseases Society of America (IDSA) in 2006. This pharmacological regime can be summarised thus:

- Doxycycline, amoxicillin or cefuroxime for the treatment of adults with early localized or early disseminated Lyme disease associated with erythema migrans, in the absence of specific neurologic manifestations (ceftriaxone in early Lyme disease for adults with acute neurologic disease manifested by meningitis or radiculopathy);

- Doxycycline, amoxicillin, or cefuroxime for adults with Lyme arthritis but without clinical evidence of neurologic disease;

- For late neurological disease in adults - intravenous ceftriaxone, cefotaxime or Penicillin G.

The Scientific Advisory Committee of the Health Protection Surveillance Centre (HPSC) has established a Lyme Borreliosis Sub-Committee, the aim of which is to develop strategies to undertake primary prevention in order to minimise the harm caused by Lyme Borreliosis in Ireland. In addition to staff from the HPSC, the membership of the Sub-Committee includes specialists in Public Health Medicine, Consultants in Infectious Diseases, Clinical Microbiology, Occupational Health an Entomologist from the Parks and Wildlife Service, a representative from the Local Government Management Agency, an Environmental Health Officer and, very importantly, a representative from Tick Talk Ireland, the primary Support Group for Lyme disease in Ireland.

The initial work of the Lyme Borreliosis Sub-committee involved a survey of laboratory methods for the diagnosis of Lyme borreliosis in Ireland, the development of Lyme borreliosis guidance for general practitioners, the publication of medical media articles to highlight diagnostics and laboratory methods relating to Lyme borreliosis available in Ireland. Material has been produced which is aimed both at the general public and General Practitioners. The Sub-Committee first met on 6 May 2015 and it is expected to report in 2017.

There is significant support and extensive information for health professionals and the public on the HPSC website. These supports include a fact sheet on tick borne diseases, including Lyme Disease. This fact sheet gives information on clinical features, the disease, transmission routes, prevention measures, diagnosis, and management and treatment. There is also an erythema migrans (EM) diagnostic tool to aid health professionals in the diagnosis of EM, which is frequently the earliest clinical manifestation of Lyme borreliosis. Information for the public includes:

- Lyme Disease Frequently Asked Questions;

- Laboratory testing for Lyme Disease: FAQs for general public;

- Lyme Disease Illustrations; and

- CDC's instructions on how to remove a tick.

As testing and treatment for Lyme borreliosis is widely available in Ireland there is no requirement for people to travel to other EU Member States to access these services.

Disease Management

Ceisteanna (1018)

Catherine Connolly

Ceist:

1018. Deputy Catherine Connolly asked the Minister for Health if German results in respect of Lyme disease detection for persons (details supplied) will be accepted here; and if he will make a statement on the matter. [26575/17]

Freagraí scríofa

Minister for Health

As testing and treatment for Lyme borreliosis is widely available in Ireland there is no requirement for people to travel to other EU Member States to access these services. The question that the Deputy raises relates to an individual case, therefore it has been referred to the Health Service Executive for a direct reply.

Disease Management

Ceisteanna (1019, 1188)

Catherine Connolly

Ceist:

1019. Deputy Catherine Connolly asked the Minister for Health if his attention has been drawn to the fact that persons who have tested positive for Lyme disease in another jurisdiction are permitted to donate blood here; and if he will make a statement on the matter. [26576/17]

Kevin O'Keeffe

Ceist:

1188. Deputy Kevin O'Keeffe asked the Minister for Health if persons suffering from Lyme disease can receive treatment outside the State (details supplied); if his attention has been drawn to the fact that some persons with this disease are blood donors; and if he will make a statement on the matter. [27220/17]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 1019 and 1188 together.

I refer the Deputy to my reply to question number 181 on 10 May 2017 which sets out the position concerning Lyme disease and blood donation.

Services for People with Disabilities

Ceisteanna (1020, 1021)

Robert Troy

Ceist:

1020. Deputy Robert Troy asked the Minister for Health the appropriate length of time a child should be waiting for an early-years assessment in County Westmeath. [26577/17]

Robert Troy

Ceist:

1021. Deputy Robert Troy asked the Minister for Health the appropriate length of time a child should be waiting for a school-years assessment in County Westmeath. [26578/17]

Freagraí scríofa

Minister of State at the Department of Health

I propose to take Questions Nos. 1020 and 1021 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.

As 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.

Services for People with Disabilities

Ceisteanna (1022)

Robert Troy

Ceist:

1022. Deputy Robert Troy asked the Minister for Health the appropriate length of time an adult should be waiting for an adult assessment in County Westmeath. [26579/17]

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.

The particular issue raised by the Deputy is a service matter for the HSE. Accordingly I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Respite Care Services Provision

Ceisteanna (1023)

Robert Troy

Ceist:

1023. Deputy Robert Troy asked the Minister for Health the status of the provision of respite care beds in counties Longford and Westmeath; and the length of the waiting list for each county. [26580/17]

Freagraí scríofa

Minister of State at the Department of Health

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

Medicinal Products Availability

Ceisteanna (1024)

Michael McGrath

Ceist:

1024. Deputy Michael McGrath asked the Minister for Health further to Parliamentary Question No. 805 of 21 March 2017, if he will arrange for a reply to be issued by the HSE. [26584/17]

Freagraí scríofa

Minister for Health

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for reply to the Deputy. I have asked the HSE to reply to you as a matter of urgency.

Question No. 1025 answered with Question No. 1008.

Ambulance Service Staff

Ceisteanna (1026)

Pearse Doherty

Ceist:

1026. Deputy Pearse Doherty asked the Minister for Health further to Parliamentary Question No. 205 of 18 May 2017, if there is policy or regulation in existence which prohibits paramedics deployed from Northern Ireland providing treatment according to their qualified skill set to persons when dispatched to attend calls here; and if he will make a statement on the matter. [26587/17]

Freagraí scríofa

Minister for Health

As this is a service matter, I have asked the HSE to respond to you directly.

Services for People with Disabilities

Ceisteanna (1027)

Niall Collins

Ceist:

1027. Deputy Niall Collins asked the Minister for Health if he will advise a person (details supplied); and if he will make a statement on the matter. [26588/17]

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, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.