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Tuesday, 10 Oct 2017

Written Answers Nos. 306-331

Hospital Consultant Contracts

Ceisteanna (306)

Fergus O'Dowd

Ceist:

306. Deputy Fergus O'Dowd asked the Minister for Health the status of dedicated respiratory consultants for Our Lady of Lourdes Hospital, Drogheda; and if he will make a statement on the matter. [42548/17]

Amharc ar fhreagra

Freagraí scríofa

In response to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.

Hospital Admissions

Ceisteanna (307)

Fergus O'Dowd

Ceist:

307. Deputy Fergus O'Dowd asked the Minister for Health the number of chronic obstructive pulmonary disease, COPD, patients admitted into the RCSI hospital group in the years 2015 and 2016 and to date in 2017, by location; the number of days COPD patients spent admitted as inpatients during the same time period; and if he will make a statement on the matter. [42549/17]

Amharc ar fhreagra

Freagraí scríofa

In response to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.

Medical Aids and Appliances Provision

Ceisteanna (308)

Kevin O'Keeffe

Ceist:

308. Deputy Kevin O'Keeffe asked the Minister for Health if sufficient funding will be sought from his Department in the context of Budget 2018 to meet the cost of purchasing medical equipment for those on a waiting list for same (details supplied). [42550/17]

Amharc ar fhreagra

Freagraí scríofa

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

Hospital Consultant Recruitment

Ceisteanna (309)

Louise O'Reilly

Ceist:

309. Deputy Louise O'Reilly asked the Minister for Health the status of the appointment of an oncologist with a special interest in Sarcoma for St. Vincent's hospital; the actions undertaken to fill this post since the interview process; the name of the successful person; the anticipated start date of the person; the reason for the length of time it has taken to fill this post; and if he will make a statement on the matter. [42552/17]

Amharc ar fhreagra

Freagraí scríofa

The Deputy's questions relate to service delivery matters, and accordingly I have asked the HSE to respond directly to her.

Hospital Charges

Ceisteanna (310)

Róisín Shortall

Ceist:

310. Deputy Róisín Shortall asked the Minister for Health if his attention has been drawn to changes to ultrasound charges at a hospital (details supplied) in Dublin 1; the reason for the change to hospital policy in this regard; his views on whether the charging for a scan such as this is acceptable; and if he will make a statement on the matter. [42566/17]

Amharc ar fhreagra

Freagraí scríofa

In response to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.

Question No. 311 withdrawn.

General Medical Services Scheme

Ceisteanna (312)

Joan Collins

Ceist:

312. Deputy Joan Collins asked the Minister for Health the reason Versatis 5% medicated plaster has been taken off the medical card since 1 September 2017 (details supplied); if his attention has been drawn to the fact that persons will be forced into the day ward system as a result of same; and the pressure and estimated costs on hospitals. [42578/17]

Amharc ar fhreagra

Freagraí scríofa

Medicines play a vital role in improving the health of Irish patients. Securing access to existing and new and innovative medicines is a key objective of the health service. However, the challenge is to deliver this objective in an affordable and sustainable manner. The medicines bill for the community drugs schemes – primarily the GMS, Long-Term Illness and Drugs Payment, as well as the High-Tech Arrangement - is forecast at just over €1.7 billion in 2017.

To ensure patients receive the highest quality care, it is essential that the resources invested in medicines are used efficiently and effectively. This requires an integrated approach to secure best value for money for all treatments, greater efficiencies across the supply chain and also the use of the most cost-effective treatments.

In 2013, the HSE established the Medicines Management Programme, MMP. It is headed by the National Medicines Information Centre, NMIC and the National Centre for Pharmacoeconomics, NCPE, in collaboration with the HSE-Primary Care Reimbursement Service, HSE-PCRS, and provides sustained national leadership on issues such as medicines management, access to medicines and the cost effective provision of medicines in Ireland. The MMP has undertaken a number of initiatives to improve evidence-based and cost-effective prescribing nationally and the review of Versatis is an example of this.

Versatis 5% medicated plaster is licensed for the symptomatic relief of neuropathic pain associated with previous herpes zoster (shingles) infection, known as post-herpetic neuralgia, PHN, in adults. Following an MMP review of the evidence available for the use of Versatis, the HSE introduced a new system for reimbursement of Versatis from 1 September 2017. This process will support the appropriate use of Versatis, ensuring that PHN patients continue to have receive this treatment. The HSE estimates that this protocol will reduce expenditure on this product by approximately 90%.

Versatis has been reimbursed in the community drugs schemes since 2010. Initially, the projected budget impact was low due to the specific licensed indication. However, total expenditure has increased significantly, from €9.4 million in 2012 to over €30 million in 2016, due to off-licence use as a general treatment for pain not associated with shingles. Currently, over 25,000 patients are in receipt of this item. The MMP report highlighted that the clinical evidence for Versatis in PHN is limited due to lack of comparative data and its value is uncertain for all other types of pain. The NCPE estimates that, in Ireland, between 5-10% of the prescribing of this product is for the licensed indication of PHN.

All patients who currently receive antivirals for shingles, or patients who are prescribed antivirals for shingles in the future, will automatically be approved for Versatis for three months. No action is required by GPs and the patient’s pharmacy will be notified of his or her approval status.

All patients who currently use Versatis have been identified and automatically registered on the HSE-PCRS system for three months and will continue to receive the treatment from their pharmacy until 30 November 2017. However, from 1 December 2017, non-shingles patients will no longer be dispensed Versatis under the community drugs schemes. The HSE has produced patient information leaflets and advised GPs on treatment alternatives.

In exceptional circumstances, the product may be dispensed for unlicensed indications. GPs will make an application for reimbursement for unlicensed indications for new and existing patients through the online system. Applications will be reviewed by the MMP before a decision is made and communicated to the GP.

Full details of the review of Versatis are available on the HSE website at: http://hse.ie/eng/about/Who/clinical/natclinprog/medicinemanagementprogramme/yourmedicines/lidocaine-plaster/lidocaine-medicated-plaster.html.

As this is a matter for the HSE, I have no role in this decision in relation to individual treatments. However, I fully support the objectives of the HSE Medicines Management Programme.

Hospital Appointments Status

Ceisteanna (313)

Fiona O'Loughlin

Ceist:

313. Deputy Fiona O'Loughlin asked the Minister for Health the status of an operation (details supplied); and if he will make a statement on the matter. [42583/17]

Amharc ar fhreagra

Freagraí scríofa

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 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 the Deputy directly.

Civil Marriages Data

Ceisteanna (314)

Seán Fleming

Ceist:

314. Deputy Sean Fleming asked the Minister for Health the waiting time for each civil registration office for persons who are seeking an appointment to notify the civil registration office of their intention to marry; and if he will make a statement on the matter. [42591/17]

Amharc ar fhreagra

Freagraí scríofa

The Civil Registration Service is operated by the Health Service Executive on behalf of the General Register Office under the aegis of the Department of Employment Affairs and Social Protection. I have referred the Deputy's question to the Health Service Executive to address the specific issue raised and for direct reply to the Deputy.

Occupational Therapy

Ceisteanna (315)

Dara Calleary

Ceist:

315. Deputy Dara Calleary asked the Minister for Health if his attention has been drawn to the fact that occupational therapists in County Mayo are not carrying out risk assessments on pre-school-going children with special needs under the newly introduced access inclusion model; the reason occupational therapist services are not carrying out these assessments; the steps he has taken to resolve this issue; if he will consider reverting back to the previous system (details supplied) in order that pre-school-going children with special needs can avail of necessary supports to assist in their attendance at school; and if he will make a statement on the matter. [42595/17]

Amharc ar fhreagra

Freagraí scríofa

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.

Occupational Therapy Waiting Lists

Ceisteanna (316)

Dara Calleary

Ceist:

316. Deputy Dara Calleary asked the Minister for Health when a person (details supplied) in County Mayo can expect to have their next occupational therapy appointment; his views on whether it is unfair that this person has had no appointment since February 2017; the steps that he is taking to alleviate waiting times in County Mayo; and if he will make a statement on the matter. [42596/17]

Amharc ar fhreagra

Freagraí scríofa

As this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive, HSE, for direct reply.

Medical Card Eligibility

Ceisteanna (317)

Dara Calleary

Ceist:

317. Deputy Dara Calleary asked the Minister for Health the reason a person (details supplied) in County Mayo is now being asked to apply for the renewal of their card under regular regulations; the reason their card has not automatically been renewed under the EU Regulation 1408/71 as per the original application; and if he will make a statement on the matter. [42597/17]

Amharc ar fhreagra

Freagraí scríofa

The 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 was issued to Oireachtas members.

Hospital Waiting Lists Data

Ceisteanna (318)

Charlie McConalogue

Ceist:

318. Deputy Charlie McConalogue asked the Minister for Health the number of persons waiting to see a consultant neurologist in County Donegal; the length of time these persons have been waiting; if a second neurologist has been appointed; the way in which the appointment will impact on waiting lists; and if he will make a statement on the matter. [42599/17]

Amharc ar fhreagra

Freagraí scríofa

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

General Medical Services Scheme

Ceisteanna (319)

Robert Troy

Ceist:

319. Deputy Robert Troy asked the Minister for Health the status of the general practitioner blood tests under the medical card scheme (details supplied); the general practitioner functions that are not covered under the medical card scheme; and if he will make a statement on the matter. [42607/17]

Amharc ar fhreagra

Freagraí scríofa

Under the terms of the current GMS contract, GPs are required to provide eligible patients with, ''all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess". There is no provision under the GMS GP contract for persons who hold a medical card or GP visit card to be charged for routine phlebotomy services provided by their GP, or the Practice Nurse on behalf of the GP, which are required to either assist in the diagnosis of illness or the treatment of a condition. The HSE has advised GPs that where a blood test forms part of the investigation or necessary treatment of a patient’s symptoms or conditions, this should be free of charge for patients who hold a medical card or GP visit card. Notwithstanding this, I am aware that in recent times some GPs have begun to charge GMS patients for phlebotomy services in some circumstances.

This is a matter of concern for me as it has long been the position of the Government and the Oireachtas that no user charges should apply to GP services provided to GMS and GP visit card patients. If a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for routine phlebotomy services by his or her GP, then that patient may make a complaint to the HSE Local Health Office, who will deal with the matter in accordance with the HSE's Complaints Policy. In order to achieve clarity on this issue, I have asked that any difference of perspective in relation to the provision of phlebotomy services be addressed in the GP contractual review process, which is currently under way. The aim is to develop a contract which has a population health focus, providing in particular for health promotion and disease prevention and for the structured ongoing care of chronic conditions. I look forward to constructive and positive engagements with a view to achieving a satisfactory outcome.

The GMS contract stipulates that fees are not paid to GPs by the HSE in respect of certain medical certificates which may be required, for example, "under the Social Welfare Acts or for the purposes of insurance or assurance policies or for the issue of driving licences". Consultation fees charged by GPs outside the terms of the GMS or GP Visit Card contracts are a matter of private contract between the clinicians and their patients.

Hospital Appointments Status

Ceisteanna (320)

Pat Deering

Ceist:

320. Deputy Pat Deering asked the Minister for Health when a person (details supplied) will be called for a procedure. [42617/17]

Amharc ar fhreagra

Freagraí scríofa

The Deputy's questions relate to service delivery matters and accordingly I have asked the HSE to respond directly to him.

Hospital Appointments Status

Ceisteanna (321)

Barry Cowen

Ceist:

321. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) can expect an appointment with a consultant. [42619/17]

Amharc ar fhreagra

Freagraí scríofa

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 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 the Deputy directly.

Question No. 322 answered with Question No. 284.

Protected Disclosures

Ceisteanna (323)

John McGuinness

Ceist:

323. Deputy John McGuinness asked the Minister for Health if a protected disclosure submitted to his Department by a person (detailed supplied) has been processed. [42622/17]

Amharc ar fhreagra

Freagraí scríofa

All protected disclosures submitted to my Department are given due attention in keeping with my Department's protected disclosures policy and procedures and in accordance with the requirements under the Protected Disclosures Act 2014. Given that all protected disclosures must be treated as confidential, it would not be appropriate for me to comment on a specific case.

Hospital Appointments Status

Ceisteanna (324)

Peter Burke

Ceist:

324. Deputy Peter Burke asked the Minister for Health when a person (details supplied) in County Westmeath will receive two operations which have been triaged as urgent; and if he will make a statement on the matter. [42625/17]

Amharc ar fhreagra

Freagraí scríofa

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 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 the Deputy directly.

Hospital Appointments Status

Ceisteanna (325)

James Browne

Ceist:

325. Deputy James Browne asked the Minister for Health the status of an appointment for a person (details supplied). [42631/17]

Amharc ar fhreagra

Freagraí scríofa

As this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive, HSE, for direct reply.

Occupational Therapy Waiting Lists

Ceisteanna (326)

James Browne

Ceist:

326. Deputy James Browne asked the Minister for Health the number of persons awaiting occupational therapy services in County Wexford; the number of those waiting who are under 18 years of age; and the average waiting time for those awaiting these services. [42632/17]

Amharc ar fhreagra

Freagraí scríofa

As this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive, HSE, for direct reply.

Questions Nos. 327 and 328 answered with Question No. 276.

Hospital Appointments Status

Ceisteanna (329, 330, 331)

James Browne

Ceist:

329. Deputy James Browne asked the Minister for Health if a person (details supplied) will receive urgent prioritisation for scoliosis treatment here. [42636/17]

Amharc ar fhreagra

James Browne

Ceist:

330. Deputy James Browne asked the Minister for Health the way in which his Department and the HSE have assisted a person (details supplied). [42637/17]

Amharc ar fhreagra

James Browne

Ceist:

331. Deputy James Browne asked the Minister for Health the way in which his Department and the HSE plan to assist a person (details supplied). [42638/17]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 329 to 331, inclusive, together.

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 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 the Deputy directly.

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