Written Answers Nos. 181-205
181. Deputy Billy Kelleher asked the Minister for Health the number of speech and language therapists employed in each CHO area; and the equivalent figures for the same date in 2015 and 2016 in tabular form. [45504/17]
Amharc ar fhreagra182. Deputy Billy Kelleher asked the Minister for Health the number of occupational therapists employed in each CHO area; and the equivalent figures for the same date in 2015 and 2016 in tabular form. [45505/17]
Amharc ar fhreagra183. Deputy Billy Kelleher asked the Minister for Health #the number of physiotherapists employed in each CHO area; and the equivalent figures for the same date in 2015 and 2016 in tabular form. [45506/17]
Amharc ar fhreagraI propose to take Questions Nos. 181 to 183, inclusive, together.
I have asked the HSE to respond to the Deputy directly on this matter.
184. Deputy Carol Nolan asked the Minister for Health the reason for the delay for a person (details supplied) to receive a hospital appointment; and if he will make a statement on the matter. [45512/17]
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 you directly.
185. Deputy Michael Healy-Rae asked the Minister for Health the status of a database (details supplied); and if he will make a statement on the matter. [45519/17]
Amharc ar fhreagraThere are no plans to develop a database along the lines referred to by the Deputy.
On the face of it, such an initiative would likely have significant data protection concerns.
186. Deputy Michael Moynihan asked the Minister for Health if the medical card scheme covers the cost of general practitioners completing application forms for persons who hold a medical card, such as driving licence applications and local authority grant applications; and if he will make a statement on the matter. [45527/17]
Amharc ar fhreagraThe GMS GP 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". The completion of forms required for local authority grant applications would also be outside the terms of the GMS contract.
Consultation fees charged by GPs outside the terms of the GMS or GP Visit Card contracts are a matter of private contract between clinicians and their patients. I have no role in relation to such fees.
187. Deputy Josepha Madigan asked the Minister for Health the stage of the Regulation of Assisted Human Reproduction Bill 1999; the work ongoing towards its enactment; and when it will come before Dáil Éireann. [45529/17]
Amharc ar fhreagraThe Regulation of Assisted Human Reproduction Bill 1999 was a Private Member's Bill proposed by Senator Mary Henry. This Bill was defeated at Second Stage in Seanad Éireann on 7 July 1999.
For the Deputy's information on Tuesday 3 October 2017 the Government approved the drafting of a Bill on assisted human reproduction (AHR) and associated areas of research. Officials in my Department are engaging with the Office of the Attorney General in relation to the process of drafting this Bill. The General Scheme is published on the Department's website and has been submitted to the Joint Oireachtas Committee on Health for review.
188. Deputy Clare Daly asked the Minister for Health if the Ireland east hospital group insisted that a full internal report on the death of a person (details supplied) be carried out before an inquest could be scheduled. [45530/17]
Amharc ar fhreagra189. Deputy Clare Daly asked the Minister for Health the timeframe for the report into the death of a person (details supplied) being carried out and delivered to the Ireland east hospital group. [45531/17]
Amharc ar fhreagraI propose to take Questions Nos. 188 and 189 together.
I can assure the Deputy that procedures are in place to record and review maternal deaths and to ensure that any learning is disseminated and applied to help improve our maternity services.
A maternal death is classified as a Serious Reportable Event and, as such, must be reported through the National Incident Management System within 24 hours. Investigations must be commenced within 48 hours of the organisation becoming aware of the incident and completed within four months of commencement. In addition, from now on, all maternal deaths will be subject to a review which is external to the Maternity Network/Hospital Group. I understand that maternal deaths are also reported to the Coroner as a 'rule of practice'.
With regard to the specific information sought by the Deputy, I have asked the HSE to reply to you directly.
190. Deputy Clare Daly asked the Minister for Health his views on and the reason for the conflict of interest for a member of the UCC maternal death inquiry team (details supplied) being involved in providing direct testimony in the inquest of a person concluded on 13 October 2017 in the Kilkenny Coroners Court, in view of the fact that the maternal death inquiry remit states specifically that all data it reviews on maternal deaths here must be anonymised. [45532/17]
Amharc ar fhreagraAs the issue raised by the Deputy is an operational matter, I have asked the HSE to respond to you directly.
191. Deputy Billy Kelleher asked the Minister for Health if he is considering charging a nominal fee of €5 per visit for free general practitioner care for those under 12 years of age. [45535/17]
Amharc ar fhreagraThe introduction of GP care without fees to all people over 70 and all children under 6 years of age in 2015 represents a major step forward in improving access, quality and affordability of health care in Ireland. The Programme for Government commits to the phased introduction of free GP care for all under-18s, subject to negotiations with GPs and noting the need for additional GPs to support the additional workload.
The Deputy will also be aware that the Report of the Committee on the Future of Healthcare which was published on 30 May 2017 recommended the phased introduction of universal GP care over the next five years.
Legislative changes will be required for any extension of GP care without fees to further cohorts of the population and the timetable will be subject to the outcome of discussions with GP representatives on this and other contractual matters currently being discussed. The Government’s wish is that progress on the extension of free GP care to children under 12 can be made in 2018. However, the timetable will be subject to the outcome of discussions with GP representatives on this and other contractual matters currently being discussed. No decisions have yet been made in relation to the precise terms and conditions connected to the extension of GP access to children under 12.
192. Deputy Catherine Murphy asked the Minister for Health the date he plans to make a drug (details supplied) available to phenylketonuria sufferers under the long-term illness scheme. [45536/17]
Amharc ar fhreagraThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
In reaching a decision, the HSE examines all the evidence which may be relevant in its view for the decision and will take into account such expert opinions and recommendations which may have been sought by the HSE, including, for example, advice from the National Centre for Pharmacoeconomics (NCPE).
Sapropterin (Kuvan) was previously considered under the national pricing and reimbursement processes in 2009. At that time, insufficient evidence was available to support the pricing and reimbursement application submitted by Merck Serono.
In December 2015, Merck Serono advised the HSE that the market authorisation for sapropterin was transferring to Biomarin in 2016. The HSE met with the new market authorisation holder in May 2016 and was advised that it would be submitting a health technology assessment dossier in relation to sapropterin.
The NCPE assessment of the new dossier was completed on the 15 September 2017 and the NCPE did not recommend sapropterin for reimbursement as it was not deemed cost effective.
The HSE assessment process is ongoing and the HSE will take into account any relevant expert advice when making its decision, in line with the Health (Pricing and Supply of Medical Goods) Act 2013.
193. Deputy Billy Kelleher asked the Minister for Health the work of the expert reference group established to draft guidelines to facilitate the use of cannabis treatments under an access programme; when the guidelines will be published; and if he will make a statement on the matter. [45537/17]
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 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.
The Deputy will be aware that under the Misuse of Drugs legislation it is open to the Minister for Health to grant a license to an Irish registered medical practitioner for access to medical cannabis for a named patient. The granting of a licence is based on submission of an application to the Minister which is endorsed by a consultant who is responsible for the management of the patient and who is prepared to monitor the effects of treatment over time. To date two such applications have been successful.
Ultimately it is the decision of the prescribing clinician, in consultation with their patient, to prescribe or not prescribe any particular treatment, including cannabis, for a patient under their care.
Applications received by the Department of Health are assessed without delay. Any consultant who requires further information or clarification in relation to the licence application process may contact the Department of Health directly.
194. Deputy Billy Kelleher asked the Minister for Health the number of beds and wards in all public and voluntary acute hospitals that were closed on 20 October 2017 or the latest date on which data for validated bed closures at hospital and ward level are available, in tabular form [45542/17]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to reply directly to the Deputy.
195. Deputy Billy Kelleher asked the Minister for Health the number of delayed discharges in all public and voluntary acute hospitals at the end of September 2017 or the latest date available; and the number of which have been delayed by time band (details supplied), in tabular form. [45543/17]
Amharc ar fhreagraIn relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
196. Deputy Billy Kelleher asked the Minister for Health if persons aged 75 years of age or over have experienced an emergency department wait time more than 24 hours to date in 2017; and if so, the hospital in which the wait occurred. [45544/17]
Amharc ar fhreagraIn relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
197. Deputy Billy Kelleher asked the Minister for Health the number of additional beds that will be provided during winter 2017 to help ease hospital overcrowding; and if he will make a statement on the matter. [45545/17]
Amharc ar fhreagraTackling overcrowding in Emergency Departments is a key commitment of this Government and I am delighted that €40 million in additional funding in 2017 has been made available as part of the 2018 Budget to address winter pressures and waiting lists over the rest of this year.
This funding will be aimed at reducing overcrowding in our hospitals in this period through the provision of extra capacity and additional supports including the provision of social care measures such as additional home care packages and transitional care beds, funding to alleviate specific periods of ED overcrowding in hospitals by providing additional diagnostic services and surge capacity as required, support to drive public health campaigns including for the flu vaccine and additional funding for measures to reduce waiting times for the longest waiting patients. It is also envisage that this funding will be used to strengthen capacity in the system through the funding of additional beds.
My Department and the HSE is currently engaging intensively on agreeing the details of this funding, and any additional bed capacity to be provided, and I look forward to sharing with colleagues the outcome of these discussions in due course.
198. Deputy Billy Kelleher asked the Minister for Health the contingency plans in place for health services to cope with a greater 'flu outbreak than is normally experienced; and if he will make a statement on the matter. [45546/17]
Amharc ar fhreagraInfluenza can be a serious illness for people in ‘at risk’ groups which can lead to hospitalisation and death.
‘At-risk’ people include those aged 65 years and older, people with chronic illness requiring regular medical follow-up, those with lower immunity due to disease or treatment, pregnant women, and residents of nursing homes, and other long stay facilities.
The priority for this winter is to increase uptake of the influenza vaccine in ‘at risk’ groups and in health care workers to reduce and control the incidence of flu and outbreaks in the community and healthcare settings.
The Health Service Executive launched their influenza immunisation and ‘Under the Weather’ campaigns for the 2017-18 season earlier this month.
Reducing the incidence of influenza reduces the need for people to seek treatments, and consequently reduces the demands on health services.
The Health Service Executive has put in place significant measures to ensure it is prepared for influenza this winter:
- A national steering group is in place to coordinate the response;
- Each Hospital Group and Community Health Organisation has submitted a Flu plan based on the evidence of last year’s successes and areas of concern for the oncoming season;
- Each Long Term Care Facility and Private Nursing Home has received a detailed communication on how to prepare and deal with flu; and
- Additionally, each Hospital Group and associated Community Health Organisation to produce a Winter Plan which includes a specific section on Flu.
These plans were reviewed at a national meeting earlier this week. It is expected that these preparations will significantly reduce the impact of influenza on the health services.
199. Deputy Robert Troy asked the Minister for Health the reason tryptophan is banned here; and the number of other countries in which it is banned. [45548/17]
Amharc ar fhreagraThe Health Products Regulatory Authority (HPRA) is the competent authority responsible for the regulation of human medicines in Ireland. Medicines containing L-tryptophan are subject to prescription in Ireland, but the substance is not banned. Medicines containing L-tryptophan have not been authorised in Ireland since 2005, when Optimax was withdrawn by the marketing authorisation holder.
L-tryptophan is authorised in the UK, Austria and Spain as a prescription-only medicine; the HPRA does not have information on its status in other countries.
200. Deputy James Browne asked the Minister for Health his plans to examine the pay inequality that arises when public sector employees receive pay increases while employees section 39 organisations, such as an organisation (details supplied), remain on the same pay scale; and if he will make a statement on the matter. [45555/17]
Amharc ar fhreagraUnder section 39 of the Health Act 2004, the HSE has in place Service Level Agreements with voluntary providers which set out the level of service to be provided for the grant to the individual organisation. Any individuals employed by these section 39 organisations are not HSE employees, therefore neither the HSE nor the Minister have a role in determining the salaries or other terms and conditions applying to these staff.
The staff of these Section 39 organisations are not public servants and therefore were not subject to the FEMPI legislation which imposed pay reductions. It follows then that the staff of the section 39 bodies will not be eligible for any pay restoration which is provided for under the more recent Public Service Agreements. It is a matter for Section 39 organisations to negotiate salaries with their staff as part of their employment relationship and within the overall funding available for the delivery of agreed services.
201. Deputy James Browne asked the Minister for Health his plans to examine the pay and working conditions of HSE employed psychiatric nurses and consultant child psychiatrists to entice new staff; and if he will make a statement on the matter. [45558/17]
Amharc ar fhreagraI recognise that there are particular difficulties recruiting mental health staff at present and related workforce challenges. Psychiatry is a specialty where there are significant worldwide shortages and international competition for our doctors and nurses.
The HSE has been focused on increasing the number of front-line staff over the past two years as the budgetary position has improved and progress has been made in growing the consultant, NCHD and nursing workforce. While there are difficulties in filling posts in certain specialties, including psychiatry, the number of consultants employed in the public health system continues to increase year on year. At the end of August 2017 there were 2,913 whole time equivalents consultants in the public health service, an increase of 101 compared with the end August 2016 and an increase of over 700 in the past decade. The number of NCHDs has also increased significantly. At the end of August 2017 there were 6,209 whole time equivalent NCHDs, an increase of 278 compared with the end of August 2016 number and an increase of over 1,100 in the past decade. The number of nursing and midwifery staff stood at 36,278 in August 2017; this is an increase of 739 whole time equivalents in the past 12 months, notwithstanding intense global competition for our nurses and midwives.
Recruitment of nurses and midwives is a key priority this year. The HSE have committed to offering permanent contracts to all graduate nurses, including mental health nurses. These contracts are being offered as part of the 2017 Nursing and Midwifery Agreement, reached with the INMO and SIPTU. This Agreement has a particular focus on addressing recruitment and retention of nursing and midwifery posts. It has committed to put in place an additional 1,224 nursing and midwifery posts across the public health service by the end of December 2017. This Agreement followed an agreement with the Psychiatric Nurses Association and SIPTU in summer 2016 that also includes a range of measures aimed at improving psychiatric nursing staffing levels. Very extensive and detailed work has been sustained throughout 2017 to implement these Agreements.
The Report of the Public Service Pay Commission identified problems in recruitment and retention in specific and specialist groups that are internationally in demand particularly in the health sector Following the ratification of the Public Service Stability Agreement, the Commission will now carry out a more comprehensive examination of underlying difficulties in recruitment and retention in those sectors and employment streams where difficulties are clearly evident, including psychiatry. The Commission is committed to reporting on medical and nursing grades in 2018. The outcome of its assessment will be subject to discussions between the relevant parties.
202. Deputy John Brassil asked the Minister for Health the number of response calls by the ambulance service for the Killarney area that took over 45 minutes to respond to, by month, in each of the years 2014 to 2016 and to date in 2017, in tabular form; and if he will make a statement on the matter. [45566/17]
Amharc ar fhreagraAs this is a service matter, I have asked the HSE to respond to you directly.
203. Deputy Bernard J. Durkan asked the Minister for Health when a person (details supplied) will be seen by their consultant; and if he will make a statement on the matter. [45581/17]
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 you directly.
204. Deputy Brendan Smith asked the Minister for Health if there is a higher instance of persons with haemochromatosis in specific parts of the country; if so, the variation between the different HSE regions; if there are standard procedures throughout the country for the treatment of such persons in view of the fact that there are substantial costs for persons attending hospitals as outpatients that do not have a medical card; and if he will make a statement on the matter. [45604/17]
Amharc ar fhreagraResearch indicates that approximately 1 in 83 people in Ireland are predisposed to develop hereditary haemochromatosis. The HSE does not hold a database of individuals with haemochromatosis and therefore is not in a position to provide information in relation to the prevalence of this condition across the country.
A statutory daily charge is levied where a person has been referred to a hospital for an in-patient service, including that provided on a day case basis. Where venesection is classed as a day case procedure, and is not carried out in an out-patient setting, the public in-patient charge applies. Medical card holders are exempt from this charge.
Also, the Irish Blood Transfusion Service (IBTS) operates a haemochromatosis clinic in the Stillorgan Blood Donation Clinic and sees approximately 600 patients there annually. The IBTS has also commenced provision of a programme for hereditary haemochromatosis patients in their D'Olier Street, Dublin and St. Finbar's Hospital, Cork clinics. These clinics provide phlebotomy free of charge to patients who have a prescription from their treating clinician.
205. Deputy Brendan Smith asked the Minister for Health the progress that will be made in 2018 in providing additional respite services (details supplied); if his attention has been drawn to the widespread concern about the inadequate services provided at present; and if he will make a statement on the matter. [45605/17]
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.
