Tuesday, 10 Oct 2017

Written Answers Nos. 332-354

Cannabis for Medicinal Use

Ceisteanna (332, 333)

Jonathan O'Brien

Ceist:

332. Deputy Jonathan O'Brien asked the Minister for Health the date on which the compassionate access programme for medicinal cannabis will come into operation. [42648/17]

Jonathan O'Brien

Ceist:

333. Deputy Jonathan O'Brien asked the Minister for Health the number of times the expert group charged with developing the operational, clinical and practice guidelines for the compassionate access programme for medicinal cannabis has met; the dates on which it has met; and the names of those on this expert group. [42649/17]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 332 and 333 together.

As the Deputy will be aware, in March 2017, on foot of the conclusions from the Health Products Regulatory Authority’s report, "Cannabis for Medical Use – A Scientific Review", I established an Expert Reference Group to advise on the development of a Cannabis for Medical Use Access Programme.

The Expert Group is chaired by Dr. Mairín Ryan, Director of Health Technology Assessment at the Health Information and Quality Authority, HIQA, and comprises representation from the areas of oncology, palliative care, anaesthesiology, general practice, adult neurology, paediatric neurology, multiple sclerosis, psychiatry, pharmacy, patients, and ethics as well as representatives from HIQA, the HPRA, the National Medicines Information Centre and the Department of Health. To date, this group has met seven times.

The Expert Group is tasked with the development of clinical guidance for healthcare professionals treating patients through the Access Programme. A critical requirement for the successful establishment of the Access Programme is meaningful engagement with representative bodies, clinicians, patients, and pharmacists so that these groups are integral to the drafting of operational clinical guidance. This has involved continuous ongoing dialogue between the Experts and third parties throughout this initiative. The Group conducted a targeted consultation on the draft guidance, which will be finalised shortly. The Expert Group are also considering other operational aspects for the implementation of the Access Programme.

Officials in my Department are working on secondary legislation to underpin the programme and on the logistics of sourcing suitable cannabis-based product supplies for the Irish market place. This work will take a number of months to complete.

As I have previously advised, pending implementation of the Cannabis Access Programme, and for medical conditions that are not included in the Access Programme, under existing legislation it is open to me as Minister to consider granting a licence to an Irish registered medical practitioner, under the Misuse of Drugs Acts, for access to medical cannabis for named patients. The Chief Medical Officer has advised that the granting of such a licence must be premised on an appropriate application being submitted to the Department of Health, which is endorsed by a consultant who is responsible for the management of the patient and who is prepared to monitor the effects of the treatment over time. The decision to prescribe cannabis for medical use rests with the clinician, in consultation with their patient. As Minister for Health, I have no role in this clinical decision-making process.

Where a consultant requires information or clarification in relation to the licence application process, he or she should contact my Department directly.

The Cannabis Reference Group has met on the following dates:

- 30 March 2017;

- 11 April 2017;

- 9 May 2017;

- 23 May 2017;

- 16 June 2017;

- 27 June 2017; and

- 10 October 2017.

The membership of the group is as follows:

CRG Member	Representing
Dr. Mairín Ryan	HIQA and Chairperson
Dr. Seamus O’Reilly	RCPI - Medical Oncologist
Prof Tony O’Brien	RCPI – Consultant physician in palliative medicine
Dr. Peter Widdess-Walsh	RCPI – Consultant Neurologist
Dr. Chris McGuigan	RCPI - Consultant Neurologist
Dr. Bryan Lynch	RCPI – Paediatric Neurologist
Dr. Mike Scully	Consultant Psychiatrist – College of Psychiatrists
Dr. Brendan Conroy	Pain Specialist & Anaesthetist - The College of Anaesthetists of Ireland
Dr. Des Crowley	General Practitioner - Irish College of General Practitioners
Dr. Cora Nestor	Pharmaceutical Society of Ireland
Keith O'Hourihane	Pharmacist - Community Pharmacy representative
Professor David Smith	Ethicist - Royal College of Surgeons Ireland
Joan Jordan	Patient representative - European Patients Academy on Therapeutic Innovation
Aileen Tierney	Patient representative
Elaine Breslin	Health Products Regulatory Authority
Dr. Patricia Harrington	HIQA
Eugene Lennon	Principal Officer, Department of Health
Maria Egan	Pharmacist - Department of Health
Vanessa Lyons	Health Products Regulatory Authority
Niamh O’Rourke	National Clinical Effectiveness Committee, Department of Health
Eamonn Quinn	Pharmacist - Department of Health
Claudine Hughes	Chief Pharmacist - National Medicines Information Service

Nursing Staff Provision

Ceisteanna (334)

Brian Stanley

Ceist:

334. Deputy Brian Stanley asked the Minister for Health the steps which will be taken to replace eight front-line hospital and community based nurses in counties Laois and Offaly who are due to go on maternity leave over the coming months. [42651/17]

Freagraí scríofa

Minister of State at the Department of Health

As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

HSE Staff Recruitment

Ceisteanna (335)

Brian Stanley

Ceist:

335. Deputy Brian Stanley asked the Minister for Health the steps being taken to fill a post (details supplied) in community health services in County Laois. [42652/17]

Freagraí scríofa

Minister for Health

I have asked the HSE to respond to the Deputy directly on this matter.

Hospital Appointments Delays

Ceisteanna (336)

Robert Troy

Ceist:

336. Deputy Robert Troy asked the Minister for Health if an appointment for a person (details supplied) will be scheduled; and if he will make a statement on the matter. [42672/17]

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 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.

HSE Funding

Ceisteanna (337)

Robert Troy

Ceist:

337. Deputy Robert Troy asked the Minister for Health the status of funding within the HSE to carry out valve-replacement surgery and the purchase of replacement valves; and if he will make a statement on the matter. [42673/17]

Freagraí scríofa

Minister for Health

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 Waiting Lists Data

Ceisteanna (338)

Fergus O'Dowd

Ceist:

338. Deputy Fergus O'Dowd asked the Minister for Health the waiting list for joint replacement operations in the Royal College of Surgeons hospital group, by individual hospital, for each of the past three years; the number of such replacement joint operations carried out in the hospitals; the locations in which they were carried out for the same period; if persons were sent to other hospitals outside this region during this period; if so, the locations to which they were sent; the cost of these operations; if a cap on the number of replacement operations per annum has been introduced; if so, the reason therefor; the date it was introduced; and if he will make a statement on the matter. [42676/17]

Freagraí scríofa

Minister for Health

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

Home Help Service Provision

Ceisteanna (339)

Michael Healy-Rae

Ceist:

339. Deputy Michael Healy-Rae asked the Minister for Health if additional home help hours on the weekend will be provided in the case of a person (details supplied); and if he will make a statement on the matter. [42692/17]

Freagraí scríofa

Minister of State at the Department of Health

As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Infectious Diseases

Ceisteanna (340, 371)

Kevin O'Keeffe

Ceist:

340. Deputy Kevin O'Keeffe asked the Minister for Health if his attention has been drawn to the increasing number of persons contracting Lyme disease; if he will instruct the HSE to be more supportive in recognising this illness; if he will request the HSE to provide and install diagnostic treatment units throughout the country, for example, equipment for blood testing for this particular disease; if he will put a programme in place in order that general practitioners can be fully familiarised with the symptoms that arise from a person being bitten by a tick; and if persons who are affected by this disease will be given consideration for approval when applying for a medical card. [42696/17]

Fiona O'Loughlin

Ceist:

371. Deputy Fiona O'Loughlin asked the Minister for Health the supports in place for persons with Lyme disease; and if he will make a statement on the matter. [42833/17]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 340 and 371 together.

Lyme disease (also known as Lyme borreliosis) is an infection caused by a spiral-shaped bacterium called Borrelia burgdorferi. It is transmitted to humans by bites from ticks infected with the bacteria. The Health Protection Surveillance Centre, HPSC, of the HSE has published extensive information concerning Lyme disease on its website. This contains information for the public on protection measures as well as information for healthcare professionals on diagnostics measures and clinical management. The website address is: www.hpsc.ie/a-z/vectorborne/lymedisease/.

Lyme borelliosis was made statutorily notifiable in Ireland by the Infectious Diseases (Amendment Regulations) Regulations 2011 (S.I. no 452 of 2011). The number of annual neuroborreliosis notifications over the last few years is as follows: 2012 - eight cases; 2013 - 13 cases; 2014 - 18 cases; 2015 - 12 cases; and 2016 - 21 cases (provisional). However, recent estimates suggest that, due to underreporting of mild cases, there may be up to 50-100 cases in Ireland per year. The Weekly Infectious Disease Report, published by the HPSC on 4 October 2017, indicated that for week 39-2017 (24/9/17-30/9/17) there have been ten cases notified so far in 2017 – a decrease of four on the same period last year.

Lyme borreliosis can be asymptomatic or have a range of clinical presentations. Current best advice is that diagnosis should be made only after careful consideration of the patient's clinical history, physical findings, laboratory evidence and exposure risk. The diverse nature of these symptoms, which can have both physical and psychological causes, are shared by many conditions which has implications for both diagnostic and treatment services. Exposure to ticks prior to disease manifestations is necessary for the diagnosis of Lyme borreliosis. Since an awareness or recollection of a tick-bite is not always present, however, this should not exclude the diagnosis of Lyme borreliosis. Later stages require the use of antibody detection tests (or advanced DNA detection techniques). Testing for Lyme Disease is provided routinely by all major, regional hospitals in Ireland. In undertaking Lyme testing, it is essential that the results are interpreted in the light of the clinical condition of the patient. If the result of this initial screen is equivocal, the patient's samples are referred to the U.K.'s Rare and Imported Pathogens Laboratory Service of Public Health England in the Porton Down facility which uses a two-tier system recommended by American and European authorities. This involves a screening serological test followed by a confirmatory serological test. All laboratories 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.

Testing and treatment for Lyme borreliosis is widely available in Ireland in all major hospitals. 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, then management of patients can be undertaken by infectious disease consultants in regional hospitals when intravenous antibiotics may be considered as a method of treatment.

Primary Care Centres

Ceisteanna (341)

Bernard Durkan

Ceist:

341. Deputy Bernard J. Durkan asked the Minister for Health the opening hours for the Derrinturn and Johnstownbridge health centres; and if he will make a statement on the matter. [42701/17]

Freagraí scríofa

Minister for Health

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.

Autism Support Services

Ceisteanna (342, 343, 344)

Thomas P. Broughan

Ceist:

342. Deputy Thomas P. Broughan asked the Minister for Health the waiting list times for occupational therapists assessments in the regional autism services, Dublin; and if he will make a statement on the matter. [42708/17]

Thomas P. Broughan

Ceist:

343. Deputy Thomas P. Broughan asked the Minister for Health if he will be seeking more funding for autism services in Budget 2018 (details supplied); and if he will make a statement on the matter. [42709/17]

Thomas P. Broughan

Ceist:

344. Deputy Thomas P. Broughan asked the Minister for Health the average waiting time for children on the autism spectrum looking to access preschool services; and if he will make a statement on the matter. [42710/17]

Freagraí scríofa

Minister of State at the Department of Health

I propose to take Questions Nos. 342 to 344, inclusive, 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.

Health Services Funding

Ceisteanna (345)

Brendan Howlin

Ceist:

345. Deputy Brendan Howlin asked the Minister for Health if funding for a further podiatrist in County Wexford will be made available to support persons with diabetes; if his attention has been drawn to the recent data released which indicates that County Wexford has the largest year-on-year increase in the incidence of diabetes related foot ulcers and amputations; and if he will make a statement on the matter. [42712/17]

Freagraí scríofa

Minister for Health

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

Hospital Appointments Status

Ceisteanna (346)

Michael Healy-Rae

Ceist:

346. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for an MRI scan for a person (details supplied); and if he will make a statement on the matter. [42717/17]

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 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 (347)

Timmy Dooley

Ceist:

347. Deputy Timmy Dooley asked the Minister for Health the status of a medical assessment for a person (details supplied); and if he will make a statement on the matter. [42726/17]

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 scheduling of appointments is a matter for the hospital to which the patient has been referred. Should a patient’s general practitioner consider 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.

Mental Health Services Staff

Ceisteanna (348)

Pearse Doherty

Ceist:

348. Deputy Pearse Doherty asked the Minister for Health the number of staff vacancies which have occurred at the psychiatric unit at Letterkenny University Hospital in 2015 and 2016 and to date in 2017, in tabular form; the dates on which each such vacancy was filled; and if he will make a statement on the matter. [42727/17]

Freagraí scríofa

Minister for Health

I have asked the HSE to respond to the Deputy directly on this matter.

Hospitals Data

Ceisteanna (349)

Éamon Ó Cuív

Ceist:

349. Deputy Éamon Ó Cuív asked the Minister for Health the number of operating theatres for orthopaedic surgery available in Galway University Hospital; if these theatres are on the Merlin Park campus; if not, the reason the theatres that were on this campus are not available; and if he will make a statement on the matter. [42731/17]

Freagraí scríofa

Minister for Health

The Saolta University Healthcare Group advises that Galway University Hospitals currently have four orthopaedic surgical theatres. Two of these theatres are located on the University Hospital Galway campus and provide trauma surgical services. The remaining two theatres are located on the Merlin Park campus and provide elective orthopaedic surgical services.

My Department was advised by Saolta that a leak developed in the roof of a building in the Merlin Park hospital campus that houses the hospital's two orthopaedic theatres on 4 September. At this time, hospital management temporarily suspended operations for a week to facilitate the Galway University Hospital Buildings and Maintenance Unit to effect repairs.

A second leak was noted on 13 of September, and Saolta advises that a multi-disciplinary team, consisting of members of the hospital's management and infection control teams and the HSE's West Estates division, took the immediate decision in the interest of patient safety to suspend operations in the two theatres to allow a full assessment of the infrastructural damage and the development of a plan to effect a complete repair of the damage.

As a result, elective orthopaedic surgeries are now being deferred at Merlin Park and affected patients are being contacted by the Hospital. It should be noted however that no emergency patients have been affected.

Hospital Waiting Lists Data

Ceisteanna (350)

Éamon Ó Cuív

Ceist:

350. Deputy Éamon Ó Cuív asked the Minister for Health the number of persons on the waiting list for orthopaedic surgery at Galway University Hospital for more than two years and less than three years, for three years and less than four years and for four or more years; the steps being taken to reduce the waiting time for such operations; and if he will make a statement on the matter. [42732/17]

Freagraí scríofa

Minister for Health

I acknowledge that waiting times are often unacceptably long and I am conscious of the burden that this places on patients and their families.

Reducing waiting times for the longest waiting patients is one of this Government's key priorities. Consequently, Budget 2017 allocated €20 million to the NTPF, rising to €55 million in 2018.

In order to reduce the numbers of long-waiting patients, I asked the HSE to develop Waiting List Action Plans for 2017 in the areas of Inpatient/Daycase, Scoliosis and Outpatient Services. The Inpatient/Daycase Action Plan is being delivered through a combination of normal hospital activity, as well as insourcing and outsourcing initiatives utilising NTPF funding. Under the Inpatient/Daycase Plan, since early February, over 25,000 patients have come off the Inpatient/Daycase Waiting List.

The NTPF has advised that, to date, 6,906 patients have been authorised for treatment in private hospitals under its initiatives, 2,683 patients have accepted an offer of treatment in a private hospital, and 1,309 patients have received their procedure. The NTPF has also indicated that 3,161 patients have been authorised for treatment in public hospitals under the Plan’s insourcing initiatives, 1,106 offers of treatment have been accepted and 436 patients have been treated.

Under the Outpatient Plan, since early February, over 89,000 patients have come off the Outpatient Waiting List.

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

National Treatment Purchase Fund Data

Ceisteanna (351)

Éamon Ó Cuív

Ceist:

351. Deputy Éamon Ó Cuív asked the Minister for Health the number of persons referred under the treatment purchase fund in 2017 for orthopaedic operations in the Galway region; and if he will make a statement on the matter. [42733/17]

Freagraí scríofa

Minister for Health

I acknowledge that waiting times are often unacceptably long and I am conscious of the burden that this places on patients and their families.

Reducing waiting times for the longest waiting patients is one of this Government's key priorities. Consequently, Budget 2017 allocated €20 million to the NTPF, rising to €55 million in 2018.

In order to reduce the numbers of long-waiting patients, I asked the HSE to develop Waiting List Action Plans for 2017 in the areas of Inpatient/Daycase, Scoliosis and Outpatient Services. The Inpatient/Daycase Action Plan is being delivered through a combination of normal hospital activity, as well as insourcing and outsourcing initiatives utilising NTPF funding. Under the Inpatient/Daycase Plan, since early February, over 25,000 patients have come off the Inpatient/Daycase Waiting List.

The NTPF has advised that to date 6,906 patients have been authorised for treatment in private hospitals under its initiatives, 2,683 patients have accepted an offer of treatment in a private hospital, and 1,309 patients have received their procedure. The NTPF has also indicated that 3,161 patients have been authorised for treatment in public hospitals under the Plan’s insourcing initiatives,1,106 offers of treatment have been accepted and 436 patients have been treated. Under the Oupatient Plan, since early February, over 89,000 patients have come off the Outpatient Waiting List.

In response to the particular query raised, the NTPF have advised that 17 patients waiting 15 months or more for an orthopaedic procedure in County Galway have been offered treatment to date.

Primary Care Centres Provision

Ceisteanna (352, 353)

Darragh O'Brien

Ceist:

352. Deputy Darragh O'Brien asked the Minister for Health the progress with regard to the provision of a primary health care centre in Swords, County Dublin; and if he will make a statement on the matter. [42734/17]

Darragh O'Brien

Ceist:

353. Deputy Darragh O'Brien asked the Minister for Health the progress with regard to the provision of a primary health care centre in Malahide, County Dublin; and if he will make a statement on the matter. [42735/17]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 352 and 353 together.

As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.

Hospitals Building Programme

Ceisteanna (354)

Joe Carey

Ceist:

354. Deputy Joe Carey asked the Minister for Health the position regarding a project (details supplied) at the University Hospital Limerick; and if he will make a statement on the matter. [42747/17]

Freagraí scríofa

Minister for Health

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