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Wednesday, 31 Jan 2018

Written Answers Nos. 204-212

Hospital Waiting Lists

Ceisteanna (204, 205)

Eugene Murphy

Ceist:

204. Deputy Eugene Murphy asked the Minister for Health the status of a person (details supplied) on a waiting list for a surgical procedure; and if he will make a statement on the matter. [4703/18]

Amharc ar fhreagra

Eugene Murphy

Ceist:

205. Deputy Eugene Murphy asked the Minister for Health if an appointment for a person (details supplied) will be expedited; and if he will make a statement on the matter. [4704/18]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 204 and 205 together.

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The 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.

Home Help Service Provision

Ceisteanna (206)

James Browne

Ceist:

206. Deputy James Browne asked the Minister for Health if increased home care in the morning and a hoist can be provided for a person (details supplied) in County Wexford; and if he will make a statement on the matter. [4714/18]

Amharc ar fhreagra

Freagraí scríofa

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

Hospital Appointments Status

Ceisteanna (207)

Peter Burke

Ceist:

207. Deputy Peter Burke asked the Minister for Health if an appointment will be expedited for a person (details supplied); and the status of same. [4721/18]

Amharc ar fhreagra

Freagraí scríofa

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

Medicinal Products Reimbursement

Ceisteanna (208)

Kevin O'Keeffe

Ceist:

208. Deputy Kevin O'Keeffe asked the Minister for Health if his attention has been drawn to the fact that specific medication has been withdrawn from medical card holders; if his attention has been further drawn to the fact that those using this medication were not notified of this; and if he will consider reinstating this medication to medical card holders (details supplied). [4723/18]

Amharc ar fhreagra

Freagraí scríofa

Medicines play a vital role in improving the health of Irish patients. Securing access to existing and new and innovative medicines is a key objective of the health service. However, the challenge is to 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 – was approximately €1.8 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 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 has been reimbursed in the community drugs schemes since 2010. The projected budget impact on introduction 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-licence use for pain not associated with shingles.

An HSE Medicines Management Programme (MMP) review of this product 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, only 5-10% of prescribing of this product has been for the licensed indication of PHN.

Following the MMP review, the HSE introduced a new reimbursement system for the product from 1 September 2017. This process supports its appropriate use, ensuring that PHN patients continue to receive this treatment. The HSE estimates that this protocol will reduce annual expenditure on this product by approximately 90%.

Under the protocol, all patients who were receiving antivirals for shingles were automatically approved for the lidocaine medicated plaster for three months. No action was required by GPs and the patient’s pharmacy was notified of his or her approval status.

These patients were identified and automatically registered on the HSE-PCRS system for three months and continued to receive the treatment from their pharmacy until 30 November 2017. However, since 1 December 2017, non-shingles patients no longer receive this item 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 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.

Long-Term Illness Scheme

Ceisteanna (209)

Dara Calleary

Ceist:

209. Deputy Dara Calleary asked the Minister for Health if his attention has been drawn to the recent decision of the NHS to make the FreeStyle Libre system available to persons with diabetes in the UK; the status of the assessment process to include the system in the LTI scheme here; and if he will make a statement on the matter. [4725/18]

Amharc ar fhreagra

Freagraí scríofa

Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

Diabetes Strategy

Ceisteanna (210)

Dara Calleary

Ceist:

210. Deputy Dara Calleary asked the Minister for Health if his attention has been drawn to the pressure and hardships suffered on a daily basis by persons with diabetes; the supports available for them; and his plans for enhancing those supports in the future. [4726/18]

Amharc ar fhreagra

Freagraí scríofa

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

Eating Disorders

Ceisteanna (211)

Tony McLoughlin

Ceist:

211. Deputy Tony McLoughlin asked the Minister for Health if the same high quality of care that is provided by eating disorder teams will be assured at the proposed mini hub eating disorder treatment locations in counties Sligo, Cavan, Kilkenny, Limerick and Waterford as in the hub locations in counties Galway, Cork and Dublin [4738/18]

Amharc ar fhreagra

Freagraí scríofa

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

Home Help Service

Ceisteanna (212)

Niamh Smyth

Ceist:

212. Deputy Niamh Smyth asked the Minister for Health if more full-time carer positions for the provision of home help hours in counties Cavan and Monaghan by the HSE will be funded; and if he will make a statement on the matter. [4748/18]

Amharc ar fhreagra

Freagraí scríofa

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

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