Written Answers Nos. 740-763
740. Deputy Róisín Shortall asked the Minister for Health the amount of funding the Government contributes to medicines research and development annually; and if he will make a statement on the matter. [46479/17]
Amharc ar fhreagraMy Department supports health research through the Health Research Board (HRB). The HRB is the lead agency in Ireland supporting and funding health research and generating information and evidence to inform health policy and practice. The HRB’s budget is in the region of €40m per annum.
Medicines research and development, which is funded by the HRB, encompasses a wide range of research projects, including in respect of the research and development aspects of both therapeutics and diagnostics. It involves research on existing therapies and on potential diagnostic or therapeutic targets, including medicinal, stem cell, immunological, vaccines and bioactives research.
HRB funded researchers are interested in potential therapeutic targets and early stage therapies for a range of diseases, or in discovering and validating biomarkers of disease or stratifying patients according to therapeutic response. This research explores potential therapeutics or therapeutic approaches across a broad range of diseases. In relation to development research, the HRB fund principal investigator led clinical trials of medicinal products for a smaller range of diseases through Cancer Trials Ireland (CTI), and within the HRB Clinical Trials Facilities which are supported by the Trials Methodology Research Network and the Statistics and Data Management Office, both located at NUI Galway. These initiatives also conduct industry-led clinical trials. The HRB Clinical Research Coordination Ireland acts as a sign-posting service to industry sponsors seeking to recruit Irish patients to multi-centre trials.
The HRB has informed my Department that between 2007 and to date in 2017 it has provided over €91m in active award commitments in this overall context. The table gives a breakdown for each year since 2007.
Health research projects in Ireland can also take place in other fora such as universities and hospitals. Information on these research projects and their expenditure levels would not be routinely collected by my Department. The Department of Business, Enterprise and Innovation may fund research relevant to the Deputy's question through its agencies - Science Foundation Ireland and Enterprise Ireland.
Finally, clinical trials of medicines in Ireland are also sponsored by the pharmaceutical industry.
Type of therapy or potential therapy - HRB Active award commitments
|
YEAR OF AWARD AND AWARD VALUE (€) Type of therapy or potential therapy |
2007 |
2010 |
2011 |
2012 |
2013 |
2014 |
2015 |
2016 |
2017 |
Total |
|
Bioactive |
312,290 |
1,296,942 |
127,136 |
1,736,368 |
||||||
|
Blood therapy |
799,045 |
799,045 |
||||||||
|
Clinical trials and interventions |
11,094,036 |
6,800,000 |
10,561,253 |
10,903,130 |
9,562,700 |
48,921,119 |
||||
|
Diagnostics - Biomarkers |
4,317,022 |
1,315,220 |
639,008 |
1,517,791 |
717,809 |
2,893,849 |
11,400,699 |
|||
|
Drug therapy |
1,263,494 |
308,855 |
647,331 |
3,118,537 |
2,907,952 |
808,832 |
2,822,937 |
11,877,938 |
||
|
Gene therapy |
292,541 |
327,462 |
620,003 |
|||||||
|
Immune therapy |
329,995 |
195,225 |
111,890 |
158,285 |
795,395 |
|||||
|
Personalised medicine |
1,726,906 |
482,345 |
969,888 |
386,762 |
2,848,382 |
6,414,283 |
||||
|
Regenerative therapy |
887,361 |
369,916 |
1,257,277 |
|||||||
|
Stem cell therapy |
595,091 |
858,348 |
329,559 |
1,782,998 |
||||||
|
Therapeutic target |
1,989,386 |
562,934 |
446,365 |
884,574 |
760,903 |
1,097,050 |
5,741,212 |
|||
|
Grand Total |
11,094,036 |
1,263,494 |
1,482,453 |
13,415,263 |
4,857,222 |
18,531,838 |
18,035,581 |
12,476,032 |
10,190,419 |
91,346,337 |
741. Deputy Charlie McConalogue asked the Minister for Health if he will review the points raised in correspondence (details supplied); and if he will make a statement on the matter. [46482/17]
Amharc ar fhreagraThe Health and Social Care Professions (Amendment) Bill 2017 passed Committee stage in Dáil Éireann on 11 July without amendment.
In the course of the Committee Stage debate I indicated that my Department would, in advance of Report Stage, engage further with the two professional bodies involved, the Irish Society of Chartered Physiotherapists and the Irish Association of Physical Therapists, on the areas of concern to them. These relate to the designated professions’ codes of professional conduct and ethics and the proposed assessment of professional competence to be set for existing users of the title of physical therapist who do not hold the specified professional qualifications. These concerns had prompted a number of proposed amendments to the Bill at Committee Stage. While unable to accept these amendments I undertook to look at the possibility of addressing the concerns of both professional bodies in Ministerial amendments that could be tabled at the Bill’s Report Stage.
My Department's officials have since met with and corresponded with representatives of the two professional bodies on the matter and I intend to table amendments to the Bill at Report Stage.
742. Deputy Michael McGrath asked the Minister for Health the details of the HSE and other agencies under the remit of his Department for the recruitment of staff in the area of health promotion; and if he will make a statement on the matter. [46485/17]
Amharc ar fhreagraAs the Deputy is aware, operational responsibility for delivery of the health services is a matter for the HSE, including the promotion of health and wellbeing. Therefore, this question has been referred to the Health Service Executive with a request that they respond directly to the Deputy with any relevant information with regard to staff recruitment relating to health promotion.
Details for other agencies under the remit of the Department are operational matters for the agencies concerned and the Deputy should contact the relevant Director/CEO/Registrar directly.
743. Deputy Bobby Aylward asked the Minister for Health if he will request the Health Service Executive to provide a comprehensive status report on plans for refurbishment, renovation and new building works at a hospital (details supplied), as committed to in the capital plan; and if he will make a statement on the matter. [46486/17]
Amharc ar fhreagraThe Capital Programme announced in January 2016 provides for the replacement and refurbishment of 90 public nursing homes across the country over the next five years including St. Columba's Hospital, Cloghabrody, Thomastown, Co. Kilkenny. Under this Programme it is proposed to deliver a new build community nursing home by means of a Public Private Partnership (PPP) mechanism by the end of 2021.
This project is currently at appraisal stage and is proceeding according to capital planning guidelines. As the project is being delivered by means of a PPP mechanism, which is at an early stage of the development, it is not possible to give a detailed timeline for the delivery of each stage of the project. Assuming that there are no construction related issues encountered, it is expected that the facility will be operational by Q3-Q4 2021.
744. Deputy John Brassil asked the Minister for Health the savings per treatment area which have been derived from an agreement (details supplied) to date and in respect of the 30% automatic reduction pertaining to biological medicines when a biosimilar medicine comes to market to date, in tabular form; the unit in his Department responsible for tracking this information; if these data will be published; and if he will make a statement on the matter. [46487/17]
Amharc ar fhreagraAs the HSE has responsibility for this matter, I have asked the HSE to respond directly to the Deputy on this issue.
745. Deputy John Brassil asked the Minister for Health his views on the need to amend the Health (Pricing and Supply of Medical Goods) Act 2013 to remove biosimilars from the non-interchangeable list of medicines in circumstances where the presence of biosimilars on this list unfairly undermines confidence in biosimilar medicines, notwithstanding the fact that they adhere to the same safety, quality and efficacy standards which apply to all medicines approved for use; and if he will make a statement on the matter. [46489/17]
Amharc ar fhreagraThe Health (Pricing and Supply of Medical Goods) Act 2013 contains provision for the establishment of a List of Interchangeable Medicinal Products whereby items can be substituted at pharmacy level. Biological medicines are not permitted to be added to this list.
The existence of this clause does not affect physician-led interchangeability of biological and biosimilar medicines. The Health Products Regulatory Authority (HPRA) guidelines on biosimilar medicines clearly support physician led switching advising that, any change should be made in consultation with the patient. Thus there is currently no need for legislative change in this area.
The National Biosimilar Medicines Policy is currently being drafted by my Department. The National Biosimilar Medicines Policy will aim to better position Ireland to benefit from current and future biosimilar medicines. The primary objective of the policy will be to increase biosimilar use in Ireland, by creating a robust framework in which biologicals and biosimilars can be safely, cost-effectively and confidently used in the health service.
Having performed research on international best practice as part of the policy development process, my Department will now begin developing an appropriate policy framework to increase the usage of biosimilar medicines in Ireland.
I expect this policy to be published in early 2018.
746. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the accommodation options available to adults with an intellectual disability in County Cavan and its wider hinterland; and if he will make a statement on the matter. [46491/17]
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 service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
747. Deputy Tom Neville asked the Minister for Health the budget for 2016 for children's mental health services; and if he will make a statement on the matter. [46499/17]
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.
749. Deputy Charlie McConalogue asked the Minister for Health if a decision has been made by the HSE regarding a funding request by a hospital (details supplied); and if he will make a statement on the matter. [46527/17]
Amharc ar fhreagraAs this is a service matter, I ask the HSE to contact you with regard to the project.
750. Deputy Kevin O'Keeffe asked the Minister for Health if a long-stay bed for a person (details supplied) in County Cork will be expedited. [46529/17]
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.
751. 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. [46530/17]
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.
752. 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. [46531/17]
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 you directly.
753. Deputy Niamh Smyth asked the Minister for Health the supports in place for those with epidermolysis bullosa, EB; the efforts being made to highlight the need for additional permanent EB outreach nurses; and if he will make a statement on the matter. [46544/17]
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.
754. Deputy Margaret Murphy O'Mahony asked the Minister for Health the estimated additional number of occupational therapists required to deal with a projected increase in the demand for public occupational therapy visits of between 33% and 38% by 2030 from a level of 0.35 million in 2015. [46548/17]
Amharc ar fhreagraAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
755. Deputy Jack Chambers asked the Minister for Health the medicines that will be discontinued from the medical card scheme in the coming months; the reason Lidocaine patches are being removed from cover under the scheme; and if he will make a statement on the matter. [46549/17]
Amharc ar fhreagra761. Deputy Michael Healy-Rae asked the Minister for Health the status of a product (details supplied) no longer available on the medical card; and if he will make a statement on the matter. [46575/17]
Amharc ar fhreagraI propose to take Questions Nos. 755 and 761 together.
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 do this in an affordable and sustainable manner. The medicines bill for the community drugs schemes – primarily the GMS, Long Term Illness and Drugs Payment schemes and the High Tech Arrangement – is forecast at just over €1.7 billion in 2017.
To ensure patients receive the highest quality care, resources invested in medicines must be used efficiently and effectively. This requires an integrated approach to secure best value for money for all treatments, greater efficiencies in the supply chain and the use of the most cost-effective treatments.
Lidocaine 5% medicated plaster (Versatis) is licensed for the symptomatic relief of neuropathic pain associated with previous herpes zoster (shingles) infection, known as post-herpetic neuralgia (PHN), in adults. It was reimbursed in the community drugs schemes from 2010. The projected budget impact was low due to the specific licensed indication but total expenditure has increased significantly, from €9.4 million in 2012 to over €30 million in 2016, mainly from off-license use for pain not associated with shingles. Currently, over 25,000 patients receive this item.
An HSE Medicines Management Programme (MMP) review of Versatis highlighted that the clinical evidence for its use in PHN is limited due to lack of comparative data and its value is uncertain for all other types of pain. The National Centre for Pharmacoeconomics estimated that, in Ireland, between 5-10% of prescribing of this product is for the licensed indication of PHN.
Following the MMP review, the HSE introduced a new reimbursement system for Versatis from 1 September 2017. This process supports the appropriate use of Versatis, ensuring that PHN patients continue to receive this treatment. The HSE estimates that this protocol will reduce expenditure on this product by approximately 90%.
Under the protocol, all patients who receive antivirals for shingles are automatically approved for Versatis for three months. No action is required by GPs and the patient’s pharmacy is 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 get Versatis under the community drugs schemes. The HSE has produced information leaflets for patients and advised GPs on treatment alternatives.
In exceptional circumstances, the product may be approved for supply through the community schemes for unlicensed indications. GPs apply for reimbursement for unlicensed indications through the online system. The MMP reviews applications before a decision is made and communicated to the GP.
Full details of the Versatis review are available on the HSE website at http://hse.ie/eng/about/Who/clinical/natclinprog/medicinemanagementprogramme/yourmedicines/lidocaine-plaster/lidocaine-medicated-plaster.html.
This decision is a matter for the HSE. However, I fully support the objectives of the HSE Medicines Management Programme.
756. Deputy Peter Burke asked the Minister for Health the status of an appointment for a person (details supplied). [46565/17]
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.
757. Deputy Róisín Shortall asked the Minister for Health the position regarding the introduction of the new transport support scheme to replace the mobility allowance; the timeframe for the provision of same; and if he will make a statement on the matter. [46567/17]
Amharc ar fhreagra822. Deputy Jack Chambers asked the Minister for Health the status of the legislation for the new transport support scheme; and if he will make a statement on the matter. [46879/17]
Amharc ar fhreagraI propose to take Questions Nos. 757 and 822 together.
I was pleased to have the opportunity to discuss the proposed Health (Transport Support) Bill with the Joint Committee on Public Petitions on Wednesday 11 October. The Deputies may be familiar with the background to the closure of both the Mobility Allowance and Motorised Transport Grant schemes in February 2013. Since the closure of the Mobility Allowance, the Government has directed that the Health Service Executive should continue to pay an equivalent monthly payment of up to €208.50 per month to the 4,700 people in receipt of the Mobility Allowance, on an interim basis, pending the establishment of a new Transport Support Scheme.
The Government decided that the detailed preparatory work required for a new Transport Support Scheme and associated statutory provisions should be progressed by the Minister for Health. The Programme for a Partnership Government acknowledges the ongoing drafting of primary legislation for a new Transport Support Scheme to assist those with a disability to meet their mobility costs. The Government's legislative programme for 2017 includes the Health (Transport Support) Bill. I can confirm that work on the policy proposals for the new Scheme is at an advanced stage. The proposals seek to ensure that:
- There is a firm statutory basis to the Scheme's operation;
- There is transparency and equity in the eligibility criteria attaching to the Scheme;
- Resources are targeted at those with greatest needs; and
- The Scheme is capable of being costed and is affordable on its introduction and on an ongoing basis.
The draft General Scheme and Heads of Bill were circulated to other government Departments and have been the subject of consultation between the Department of Health and the Department of Public Expenditure and Reform. When the consultation with other relevant Departments has been completed, the next step will be to seek Government approval to the drafting of a Bill for the new Scheme.
It is important to note that the Disabled Drivers and Disabled Passengers scheme operated by the Revenue Commissioners, remains in place. This scheme provides VRT and VAT relief, an exemption from road tax and a fuel grant to drivers and passengers with a disability, who qualify under the relevant criteria set out in governing regulations made by the Minister for Finance.
Specifically adapted vehicles driven by disabled persons are also exempt from payment of tolls on national toll roads and toll bridges. Transport Infrastructure Ireland has responsibility for this particular Scheme.
758. Deputy Seán Haughey asked the Minister for Health the arrangements he has made for replacement mental health services to replace a facility (details supplied) for persons with mental health issues in Dublin; the community mental health services available to these persons; and if he will make a statement on the matter. [46569/17]
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.
759. Deputy Seán Haughey asked the Minister for Health the future status of a health centre (details supplied); the services currently provided by the health centre; the population which is served by the centre; the changes to the current services planned; his plans for changes; and if he will make a statement on the matter. [46570/17]
Amharc ar fhreagraAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
760. Deputy Billy Kelleher asked the Minister for Health if he will report on the new information technology strategy for the health system as a whole published in 2014 by eHealth Ireland; the progress made on its implementation; and if he will make a statement on the matter. [46573/17]
Amharc ar fhreagraThe Government approved and published the eHealth strategy in 2013 for realising the potential of eHealth in the Irish health service. This strategy sets out a number of objectives and a road map for the delivery and implementation of eHealth for the benefit of patients. The Knowledge & Information strategy, published in 2014 by the Office of the Chief Information Officer in the HSE, builds upon the eHealth strategy and outlines how integrated information and enabling technology will support the delivery of innovative, safe and high quality patient care to meet the needs of our population across all patient pathways and care settings.
Significant progress has been made on both strategies since their publication. This includes the establishment of eHealth Ireland, the appointment of a Chief Information Officer for the HSE, the establishment of the eHealth Ireland Advisory Committee and the development of the Irish eHealth Ecosystem.
Progress has also been made in relation to the implementation of the Health Identifiers Act 2014, which provides for a system of unique identification for patients, professionals and providers, via an Individual Health Identifier (IHI). The Individual Health Identifier will enhance patient data security and confidentiality and support administrative efficiency. On 30 May 2017, a Commencement Order and Regulations under the Health Identifiers Act 2014 were signed, allowing for the implementation of the Individual Health Identifier.
The HSE have also developed a business case for the implementation of an electronic health care record (EHR) in Ireland. The business case sets out a number of investment scenarios including timescales for implementation and roll out. Progress has been achieved with the roll-out of the Maternity and Newborn Clinical Management System (MN-CMS), which is the design and implementation of an electronic health record for all women and babies in maternity services in Ireland, going live in Cork in December 2016 with Kerry following in March 2017. In both locations the new MN-CMS successfully replaced paper processes with efficient digital processes. Further implementations are planned for the Rotunda Hospital by year end and the National Maternity Hospital in early 2018.
eReferrals (National Electronic General GP Referrals), an initiative that has developed the infrastructure to electronically transmit referrals from GPs to Acute Hospitals, have now been rolled out to all six hospital groups.
Implementation of a new Financial Operating Model for the HSE is at an advanced stage and this will be underpinned by a single national technology platform which will be adopted by all health entities as it will provide the most cost effective and expedient approach to financial management.
The MedLIS project promotes patient safety and quality improvement of services being provided by Laboratory Services and is currently being closely monitored by the HSE project steering group and is anticipated to 'go-live' in St. James Hospital in Q2 2018.
My Department also participates in a number of international eHealth forums, including the EU eHealth Network, in the context of digital services in support of the Cross-Border Directive (Directive 2011/24/EU) on the application of patients’ rights in cross-border healthcare and is also aimed at furthering the eHealth agenda on issues such as interoperability and common standards for the exchange of information in support of patient care.
The delivery of digital health care services will require a robust legal framework to ensure confidentiality and security of patient data consistent with the new EU data protection regulation, Regulation (EU) 2016/679 (General Data Protection Regulation). The GDPR will have a significant effect on how and where data is gathered and the purpose for which it is used. My Department is currently examining the appropriate information framework that will provide the optimum environment to support future developments in eHealth. In this context, a public consultation is currently being carried out by my Department to seek views on the proposals to inform the drafting of a national health information policy in 2018.
Increases in capital spending and resources have been facilitated and the capacity and capability of HSE ICT to successfully undertake large scale ICT projects have been further developed, which will see continued progression on the area of ICT and eHealth.
Delivery of eHealth is also being examined in the context of the Sláintecare report, which advocates the “Continued strong support of the e-health strategy – particularly ensuring the necessary funding for timely roll-out of the EHR system”. The report is currently being reviewed by my Department in the context of its implementation and with a particular focus on further implementing the eHealth strategy and a National Electronic Health record.
762. Deputy Michael Healy-Rae asked the Minister for Health if he will address a matter (details supplied) concerning expenditure by the HSE on transport; and if he will make a statement on the matter. [46591/17]
Amharc ar fhreagraAs this is a service matter, I have referred your question the Health Service Executive for direct reply.
763. Deputy Niamh Smyth asked the Minister for Health the status of a centre (details supplied); and if he will make a statement on the matter. [46593/17]
Amharc ar fhreagraAs 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.
