Written Answers Nos. 404-427
404. Deputy Charlie McConalogue asked the Minister for Health his plans to invest €55 million for mental health services in Budget 2018 (details supplied); and if he will make a statement on the matter. [43025/17]
Amharc ar fhreagraMental health is a priority for this Government. Since 2012, around €140 million has been added to the HSE Mental Health Budget, which now totals over €850 million. This is a significant increase, and the Programme for Partnership Government gives a clear commitment to further increasing our mental health budget annually, as resources allow, to expand existing services. Further investment in the Mental Health Services will be announced in Budget 2018.
405. Deputy Louise O'Reilly asked the Minister for Health his plans for a review of the illnesses constituted as long-term illnesses; and if not, the reason therefor. [43027/17]
Amharc ar fhreagraThe 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.
406. Deputy Éamon Ó Cuív asked the Minister for Health if, in assessing home care packages for persons being discharged from hospitals, there is an assessment carried out of the home situation; if there is a visit to the person's home to assess the help available, the physical conditions of the person's home and the suitability of the person's home; and if he will make a statement on the matter. [42198/17]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
407. Deputy Bobby Aylward asked the Minister for Health when FreeStyle Libre will be made available on the GMS and long-term illness card; if that availability will not be restricted only to persons with type 1 diabetes but will be made available to all persons on multi-daily insulin injections based on clinical need; and if he will make a statement on the matter. [42206/17]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.
408. Deputy Clare Daly asked the Minister for Health further to the refusal by the HSE to provide a person diagnosed with narcolepsy after receiving the pandemrix vaccine (details supplied) with a medical card, his views on whether it is appropriate that the HSE is refusing to accept a diagnosis of narcolepsy from an English hospital and is requesting that the person be diagnosed at enormous cost by one of two private Irish medical practitioners who do not hold public clinics; and the steps he will take to remedy this situation [42210/17]
Amharc ar fhreagraThe Department of Health, the HSE and the Department of Education and Skills continue to work together to provide a wide range of services and supports for those affected. The HSE's Advocacy Unit acts as liaison with service and support providers and other Government Departments to facilitate access to required services. It is in regular contact with individuals affected. Regional co-ordinators have been appointed to assist individuals by providing advice, information and access to local services.
The ex-gratia health supports include clinical care pathways to ensure access to rapid diagnosis and treatment, multi-disciplinary assessments led by clinical experts, counselling services for both the individuals and their families, discretionary medical cards for those who have been diagnosed have been provided to allow unlimited access to GP care and any prescribed medication, physiotherapy and occupational therapy assessments. Diagnosis of narcolepsy involves a specialised sleep study system which is currently only available in the Mater Private. It is intended that diagnoses will be carried out in the planned Centre of Excellence for Narcolepsy in St. James Hospital which has been prioritised by my Department in the 2018 Estimates process. This service will combine a new patient referral system with access to expert consultant and advanced nursing expertise for clinical diagnosis, access to the latest neurophysiological diagnostic techniques with overnight and daytime monitoring for both inpatients and outpatients, laboratory testing, brain imaging and genetic testing. The HSE will continue to pay for access to the services, such as dietician and psychology services, that would have been provided in the Centre of Excellence from private providers to so that none of the affected individuals miss out on receiving these supports.
The Deputy has raised a query regarding an individual case. The HSE has responsibility for the administration of treatment and delivery of services in this case. The matter has therefore been referred to the HSE for direct reply to the Deputy.
409. Deputy Joan Collins asked the Minister for Health the reason a person (details supplied) has not received medical equipment that has been requested by a consultant in St. James' Hospital. [42211/17]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.
410. Deputy Billy Kelleher asked the Minister for Health the number of persons who have received treatment to date in 2017 under the funding provided to the National Treatment Purchase Fund separately from HSE waiting list initiatives. [42217/17]
Amharc ar fhreagraI 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. Of this 2017 allocation, €15 million has been set aside for the treatment of those patients waiting longest for inpatient and day case procedures.
The first tranche of €5 million was dedicated to a Daycase Waiting List Initiative with a view to ensuring that in excess of 2,000 patients waiting longest for a day case procedure.
The second tranche of €5 million is being used for an insourcing initiative, whereby approximately 3,000 patients are receiving inpatient and day case treatment in a public hospital.
The final €5 million is being used for a second outsourcing initiative, in which a further 2,000 patients are currently being scheduled for inpatient and day case treatment in the private hospital system.
The NTPF has advised that, to date, 6,906 patients have been authorised for treatment in private hospitals under its outsourcing initiatives, 2,683 patients have accepted an offer of treatment in a private hospital, and 1,309 patients have received their procedure so far.
The NTPF has also indicated that 3,161 patients have been authorised for treatment in public hospitals under insourcing initiatives, 1,106 offers of treatment have been accepted and 436 patients have been treated so far.
411. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 535 of 20 September 2017, if his attention has been drawn to the impact that the changes of the prescribing of Lidocaine has had on persons with chronic neuropathic pain; if the HSE medicines management programme has investigated the impact that changes to the prescription of pain medication has on persons with chronic neuropathic pain; and if he will make a statement on the matter. [42219/17]
Amharc ar fhreagraAs outlined in Parliamentary Question No. 535 of 20 September 2017, following a review by the Medicines Management Programme, MMP, of the evidence available to support the use of Versatis 5% medicated plaster, the HSE introduced a system for its reimbursement from 1 September 2017. This process provides for the use of Versatis for symptomatic relief of neuropathic pain associated with previous herpes zoster (shingles) infection, known as post-herpetic neuralgia, PHN, in adults.
All patients who currently use Versatis, for both licensed and unlicensed indications, 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. From 1 December 2017, in line with the MMP clinical review, 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. For example, in the situation outlined by the Deputy and other circumstances, a GP may make an application for reimbursement for unlicensed indications for new and existing patients through the online system. The application 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.
412. Deputy Anne Rabbitte asked the Minister for Health when a case (details supplied) will be fully assessed in view of the fact it has been awaiting assessment since 8 September 2017. [42220/17]
Amharc ar fhreagraThe 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.
413. Deputy Billy Kelleher asked the Minister for Health if persons with haemochromatosis are to be charged €80 for outpatient attendance to have their blood drawn off; if so, if this applies just to private patients; if this charge will be imposed on medical card patients also; the justification for imposing fees on this treatment; and if he will make a statement on the matter. [42221/17]
Amharc ar fhreagraOutpatient charges are set by S. I. No. 45/2013 - Health (Out-Patient Charges) Regulations 2013. Currently, the only charge for an outpatient service is at an Emergency Department, ED. Medical Card holders are exempt from this ED charge.
The €80 charged referred to by the Deputy is the statutory daily charge, up to a maximum of €800, where a person has been referred to a hospital for an inpatient service, including that provided on a day-case basis. Medical card holders are also exempt from this charge. On this basis, where venesection is classed as a day case procedure and is not carried out in an out patient setting, the public inpatient charge applies. There are no plans at present to exclude haemochromatosis patients from this charge.
414. Deputy Robert Troy asked the Minister for Health if financial assistance will be given to a person (details supplied) to assist with respite care bills; and if he will make a statement on the matter. [42228/17]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
415. Deputy Niamh Smyth asked the Minister for Health if a hospital appointment will be expedited for a person (details supplied); and if he will make a statement on the matter. [42243/17]
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.
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 the Deputy directly.
416. Deputy Martin Kenny asked the Minister for Health the number of staff who have been recruited by the national ambulance service in regions (details supplied) in each of the years 2015 and 2016 and to date in 2017, in tabular form. [42245/17]
Amharc ar fhreagraI have asked the HSE to respond to the Deputy directly on this matter.
417. Deputy Catherine Connolly asked the Minister for Health further to the roll-out of the national integrated medical imaging system, NIMIS, the number, name and location of HSE hospitals in which this system has been installed; the number, name and location of HSE hospitals in which this system is in operation; the number, name and location of the HSE hospitals operating under a different system; the provisions within the NIMIS to allow for co-operation within the non-NIMIS, for example, the sharing of images and reports; and if he will make a statement on the matter. [42247/17]
Amharc ar fhreagraBoth the roll-out and operation of NIMIS are being managed by the Health Service Executive and I have asked them to respond to the Deputy directly.
418. Deputy Fergus O'Dowd asked the Minister for Health if urgent and emergency funding for existing respite service proposals that are in the possession of the HSE will be provided in view of the respite crisis in County Louth; and if he will make a statement on the matter. [42248/17]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
419. Deputy Michael Healy-Rae asked the Minister for Health the status of a plastic surgery appointment for a person (details supplied); and if he will make a statement on the matter. [42249/17]
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.
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.
420. Deputy Fergus O'Dowd asked the Minister for Health the status of the medical cannabis compassionate programme; the timeframe for this programme to become more widely used by medical professionals; and if he will make a statement on the matter. [42250/17]
Amharc ar fhreagraAs 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.
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 an 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. The Expert Group conducted a targeted consultation on the draft guidance and is due to finalise this guide 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.
Pending implementation of the Cannabis Access Programme, and for medical conditions that are not included in the Cannabis 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.
Ultimately it is the decision of the clinician, in consultation with their patient, to prescribe or not prescribe a particular treatment for a patient under their care. 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.
421. Deputy Eugene Murphy asked the Minister for Health the number of hip and knee replacements that have taken place in Castlebar Hospital, County Mayo, in the past year; and if he will make a statement on the matter. [42258/17]
Amharc ar fhreagraIn response to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
422. Deputy Eugene Murphy asked the Minister for Health the number of post-operation wash out procedures following knee and hip replacements in the past year in Castlebar Hospital, County Mayo; and if he will make a statement on the matter. [42259/17]
Amharc ar fhreagraIn response to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
423. Deputy Eugene Murphy asked the Minister for Health the number of persons who contracted the MRSA virus in Castlebar Hospital post-operation procedures in the hospital in the past three years; and if he will make a statement on the matter. [42261/17]
Amharc ar fhreagraIn response to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
424. Deputy Billy Kelleher asked the Minister for Health the timeframe to publish an antimicrobial resistance plan; and if he will make a statement on the matter. [42262/17]
Amharc ar fhreagraI am pleased to advise the Deputy that Ireland's National Action Plan on Antimicrobial Resistance 2017-2020, iNAP, will be published on Wednesday 25 October next. The plan will be launched by Minister Michael Creed, T.D., and I as the development of iNAP has been a cross-Departmental initiative, requiring a cross sectoral and whole of Government approach to addressing the world wide threat of antimicrobial resistance, AMR.
Ireland's first National Action Plan on AMR 2017-2020 was developed following the WHO Global Action Plan on Antimicrobial Resistance 2015, which required all countries to have in place a national action plan by mid-2017, and by the European Commission, which also required Member States to develop a national action plan by mid-2017. The plan has been prepared by both the Department of Health and the Department of Agriculture, Food and the Marine, DAFM, with the guidance of the Interdepartmental AMR Consultative Committee. This ambitious three-year plan has been developed in collaboration with all relevant stakeholders and covers the use of antimicrobial medicines in animal health and agriculture, as well as human health - taking a "One Health" approach to tackling AMR, encompassing all sectors.
The iNAP lists Strategic Interventions and Activities, responsible bodies and priority rankings of timelines for implementation. An implementation plan will be developed separately which will address means of tackling AMR as appropriate to each sector. The National Patient Safety Office, NPSO, will discuss arrangements for progressing this body of work with the HSE's HCAI National Lead and relevant others; DAFM are establishing an AMR implementation plan team to oversee its body of work in addressing the interventions and activities listed proper to the agriculture and environment sectors.
The iNAP aims to ensure the development and implementation of multifaceted interventions which will safeguard against inappropriate prescribing, dispensing and consumption of medicines, while simultaneously promoting rational use in patients and animals that are expected to benefit from treatment.
425. Deputy Peter Burke asked the Minister for Health the reason the HSE has cut an information and advice programme (details supplied); and if he will make a statement on the matter. [42263/17]
Amharc ar fhreagraThe Department of Health and the Health Service Executive, HSE, is totally committed to increasing breastfeeding rates in Ireland.
National health policy, including the Healthy Ireland Framework, the National Maternity Strategy 2016-2026, the National Obesity Policy and Action Plan 2016-2025 and the recently published National Cancer Strategy 2017-2026, all emphasise the importance of supporting mothers who breastfeed as well as taking action to increase breastfeeding rates in Ireland.
The recent National Strategy for Women and Girls 2017-2020 re-affirmed the commitment to advance public support of breastfeeding and includes an action to extend provision for breastfeeding breaks under employment legislation (currently available to mothers of children under six months).
Regarding the Baby Friendly Hospital Initiative, BFHI, issue, in 2016 the HSE commissioned a research team at TCD to undertake a review of the Baby Friendly Hospital Initiative. One of the key findings of the review was that there was no difference in breastfeeding rates in hospitals that had achieved the Baby Friendly designation and those that hadn’t achieved designation. In fact, while the initiative has been in place for 20 years, only nine of the 19 maternity hospitals have achieved the Baby Friendly designation. This review highlighted the need for a revised model of the Baby Friendly Hospital Initiative.
Following completion of the review, the HSE initiated engagement with the Baby Friendly Hospital Initiative and other stakeholders on developing a revised model. The HSE has made the decision to pause the existing initiative, and it is not being funded for 2017.
The HSE is currently progressing the development of a revised model, working with the National Women and Infants Programme, the HSE Health and Well-being Division, the HSE Lead Midwife and other key stakeholders. The revised model will continue to support the implementation of the WHO/UNICEF 10 Steps to Successful Breastfeeding, which is the basis of the Baby Friendly Hospital Initiative. The revised model is expected by the end of the year and will be rolled out in 2018.
A wide range of other actions are underway in implementing the HSE National Breastfeeding Action Plan 2016-2020. These include:
- Improved Governance and health service structures;
- Breastfeeding training and skills development;
- Health service policies and practices;
- Support at all stages of the breastfeeding continuum; and
- Research, monitoring and evaluation.
Details of specific actions can be seen in the HSE National Breastfeeding Action Plan 2016-2020 on the HSE website, breastfeeding.ie, and at the following link: https://www.breastfeeding.ie/Uploads/breastfeeding-in-a-healthy-ireland.pdf.
426. Deputy Joan Collins asked the Minister for Health if home help hours will be provided for a person (details supplied); if funding will be provided in order that extra staff and support for home help services in Crumlin will be provided for persons leaving hospital; and if he will make a statement on the matter. [42264/17]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
427. Deputy Róisín Shortall asked the Minister for Health the status of the development of a national women's health action plan as committed to in the national strategy for women and girls; the number of persons in his Department working on this action plan; the dates of their meetings; and if he will make a statement on the matter. [42271/17]
Amharc ar fhreagraThe National Strategy for Women and Girls, 2017-2020, NSWG, was published in April, 2017, and is the framework through which the Government is pursuing actions to advance the rights of women and girls and to enable their full participation in Irish society.
Implementation is co-ordinated by the Department of Justice and Equality. The Department of Health was represented on the Strategy Committee that developed the NSWG and is also represented on the Committee overseeing its implementation, which has met on two occasions since the NSWG launch, on 13 July and 26 September, 2017.
The Department of Health is principally involved with implementation of Objective Two of the NSWG: "Advance the Physical and Mental Health and Wellbeing of Women and Girls ".
Action 2.1 of the NSWG commits to, "Strengthen partnership work with the National Women's Council of Ireland, NWCI, in identifying and implementing key actions to address the particular physical and mental health needs of women and girls in order to advance the integration of their needs into existing and emerging health strategies, policies and programmes through an action plan for women's health".
Under this Action, the Department and the HSE will work with the NWCI and potentially additional relevant organisations, including others in receipt of funding from the HSE, such that an advanced partnership approach can be developed to support the implementation of existing actions and needs outlined in the NSWG. Progress on this Action will be supported by the Health and Well-being Programme within the Department and by the Health and Well-being Division within the HSE.
The Healthy Ireland Framework provides the overarching context for progressing actions with regard to the health and well-being of women and girls. Healthy Ireland takes a whole-of-Government and whole-of-society approach to improving health and well-being, with a focus on prevention, reducing health inequalities and keeping people healthier for longer.
Within the context of Healthy Ireland, there are currently a number of issues where improvements in the health and well-being of women and girls could have significant impacts; these are set out in the NSWG.
These include improving awareness and supporting healthier choices in terms of smoking cessation, safer alcohol consumption, improving uptake of the HPV vaccine, increasing physical activity participation rates in younger women and improving rates of folic acid consumption and breastfeeding.
The Healthy Ireland approach is that many organisations have a role to play in achieving the goals of Healthy Ireland and in implementing the various strategies and plans under the Healthy Ireland aegis. Hence, the Department of Health and the HSE will continue to work in partnership with the NWCI and other relevant organisations to support women and girls in improving their health and well-being. An initial meeting between the HSE and NWCI has been scheduled for early October, in order to progress implementation of these aims.
