Written Answers Nos. 381-398
381. Deputy Jackie Cahill asked the Minister for Health the number of persons that are currently in possession of a primary medical certificate, nationally and by county, in tabular form; and if he will make a statement on the matter. [5605/18]
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.
382. Deputy Billy Kelleher asked the Minister for Health if the necessity for a change of pessary will be included in the GMS to compensate general practitioners for carrying out this procedure in an effort to reduce the lengthening waiting list; if the pessary will be provided on the GMS in view of the fact that it is provided free at hospitals; and if he will make a statement on the matter. [5606/18]
Amharc ar fhreagraThe Deputy will be aware of the ongoing review of the GMS and other publicly funded contracts involving GPs, and that discussions to progress this work are underway.
Since 2015, negotiations have resulted in a number of service developments including the provision of free GP care to under 6's and over 70's, the introduction of a Diabetes Cycle of Care for adult GMS patients with Type 2 Diabetes and enhanced supports for rural GPs.
The agenda of issues to be addressed in future engagements with GP representatives is broad and it is not possible to specify each and every treatment or procedure which may need to be considered. It will however be important, in my view, that contractual arrangements are such as will accommodate evolving medical practice and enable care to be provided in the lowest-complexity setting possible.
There are a small number of pessaries on the Reimbursement List which release active ingredients to treat gynaecological conditions such as thrush and are time limited in nature. However, devices used as part of gynaecological procedures would not be encompassed by the Reimbursement List. In order for a product to be supplied on the community drugs schemes, the supplier must apply to the HSE for reimbursement approval and the product must meet published criteria.
383. Deputy Alan Farrell asked the Minister for Health his plans to improve service provision at Swords Health Centre; and if he will make a statement on the matter. [5634/18]
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.
384. Deputy James Browne asked the Minister for Health the annual funding provided to section 39 organisations each year since 2011; and the allocation to same for 2018. [5641/18]
Amharc ar fhreagraI have asked the HSE to respond to the Deputy directly on this matter.
385. Deputy Noel Rock asked the Minister for Health the status of an appointment for a person (details supplied). [5654/18]
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.
386. Deputy Maria Bailey asked the Minister for Health his plans to make the freestyle libre glucose monitoring system for persons with diabetes available under the general medical scheme; and if he will make a statement on the matter. [5656/18]
Amharc ar fhreagraUnder 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.
387. Deputy Niamh Smyth asked the Minister for Health the position of a person (details supplied) on the waiting list at Our Lady's Hospital, Navan; and if he will make a statement on the matter. [5687/18]
Amharc ar fhreagraThe 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.
388. Deputy Michael Fitzmaurice asked the Minister for Health when a replacement registered general nurse, RGN, will be put in place in a health centre (details supplied); if the centre will be employing another public health nurse, PHN; and if he will make a statement on the matter. [5706/18]
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.
389. Deputy Robert Troy asked the Minister for Health when a person (details supplied) will be called for orthodontic work. [5716/18]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.
390. Deputy Michael McGrath asked the Minister for Health the entitlement of a person (details supplied) to accessing morphine patches under the medical card scheme. [5720/18]
Amharc ar fhreagraMedicines 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-license 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.
391. Deputy James Browne asked the Minister for Health if he was consulted on the introduction of a digital age of consent; and if he will make a statement on the matter. [5721/18]
Amharc ar fhreagraI welcome the recent publication of the Data Protection Bill and consider the protection of personal data, especially data concerning health, as very important in building trust in how data can be used for patient care and treatment, health services management and health research. In 2017, following a consultative process, the Government approved a digital age of consent of 13 years for inclusion in the Data Protection Bill.
Section 29 of the Bill sets out the age of digital consent of 13 years for a child engaging with information society services. It would be important to ensure that the scope and interpretation of the terms "information system services" does not create any conflict with existing legislation, which stipulates older ages of consent in the context of medical treatment and care.
The Government is of the opinion that adopting a "digital age of consent" of 13 years represents an appropriate balancing of children’s rights, namely a child’s right to participation in the online environment and a child’s right to safety and protection, rights that are enshrined in the UN Convention on the Rights of the Child.
392. Deputy James Browne asked the Minister for Health the way in which young persons will be considered in the development and implementation of legislation, policy and services for youth as per recommendation one of the national youth mental health taskforce report 2017; and if he will make a statement on the matter. [5724/18]
Amharc ar fhreagraAn Expert Group Review of the Mental Health Act 2001 was published in 2015. This Review was carried out in consultation with service users, carers and other stakeholders, such as the Children's Rights Alliance, the Children's Mental Health Coalition and Barnardos, and was informed by human rights standards. The review contained 165 recommendations.
Specifically in relation to children, the Group made 13 recommendations as to how our mental health legislation could be improved and this includes, for example, that a list of child appropriate guiding principles should be included and also that children aged 16/17 should be presumed to have capacity to consent/refuse admission and treatment.
Amendments to the Mental Health Act 2001 based on the recommendations of the Expert Group Review of the Act are currently being progressed. Government approved plans to proceed with the general scheme of a bill and officials are working on the heads of the amending bill which will legislate for the recommendations of the Review, including those relating to children.
The National Youth Mental Health Task Force were very much aware of the recommendations of the review and wanted to ensure that there priority was maintained to ensure that the voice of all children and young people is heard. The Task Force agreed that young people are to be consulted in a meaningful way about the drafting of policies and legislation and the design of services that may affect their mental health. A Youth Forum has already been established in DCYA and such a mechanism would work well to assist policy makers when drafting reports.
In the future it is intended that a new inter-departmental Pathfinder Team, will take a lead in formalising mechanisms to ensure that the voices of young people are fully considered in the development and implementation of legislation, policy and services for youth. The Pathfinder team would be in a position to develop mandatory protocols which will work to safeguard young people against potential changes in policy that could negatively impact on youth mental health. A process for youth consultation would also routinely be carried out when designing mental health and other support services and facilities for young people. Pathfinder is currently being considered by DPER.
393. Deputy James Browne asked the Minister for Health the timeframe for the transfer of medium and low support mental health residences here to local authorities to manage the rollout of the tenancy sustainment programme; and if he will make a statement on the matter. [5725/18]
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.
394. Deputy Clare Daly asked the Minister for Health further to Parliamentary Questions Nos. 341, 342, 346, 347 and 348 of 30 January 2018, if his attention has been drawn to a scientific study of 92,246 first time surgical mesh procedures (details supplied). [5742/18]
Amharc ar fhreagraAs previously indicated to the Deputy, at my request the Chief Medical Officer is preparing a report on the many clinical and technical issues involved in the use of mesh implants in urogynaecological procedures in Ireland. This work involves engagement with national and international bodies, the professional colleges and others. The work is underway and will take a number of months to complete.
The Health Products Regulatory Authority (HPRA) is aware of the information from the UK study referred to by the Deputy. The HPRA continues to liaise closely with European Competent Authorities, including the UK's Medicines and Healthcare Products Regulatory Agency (MHRA), the European Commission and with international regulatory agencies in relation to all international evidence relating to these devices.
The safety of surgical meshes used in urogynecological surgery was reviewed by the European Commission’s Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR). The Opinion of the SCENIHR is is available, together with a summary of the outcome, on the website of the European Commission http://ec.europa.eu/health/scientific_committees/consultations/public_consultations/scenihr_consultation_27_en. The SCENIHR summary outlines that "clinical outcome following mesh implantation is influenced by material properties, product design, overall mesh size, route of implantation, patient characteristics, associated procedures (e.g. hysterectomy) and the surgeon’s experience."
My Department strongly advises that any woman who experiences or suspects that she has experienced a complication associated with transvaginal mesh implant (TVMI) surgery should discuss this with her GP or with the hospital from which she received the implant. My Department also advises that women considering surgery involving TVMIs should thoroughly discuss with their doctors the indications, alternatives (surgical and non-surgical), benefits and risks involved in their personal circumstances.
395. Deputy Timmy Dooley asked the Minister for Health when a person (details supplied) will have ear surgery; and if he will make a statement on the matter. [5771/18]
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.
396. Deputy Aengus Ó Snodaigh asked the Minister for Health the reason a person (details supplied) has been attending hospital for treatment for three years for an issue with their ankle; and if there is a scheme that will allow for this to be carried out as a matter of urgency. [5772/18]
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.
397. Deputy Sean Fleming asked the Minister for Health the position regarding funding for a project (details supplied) for the purchase of a new building in County Carlow; and if he will make a statement on the matter. [5777/18]
Amharc ar fhreagraYour question has been referred to the Health Service Executive for direct reply as the management of the healthcare property estate is a service matter.
398. Deputy Hildegarde Naughton asked the Minister for Health when a person (details supplied) will receive an operation in University Hospital Galway; and if he will make a statement on the matter. [5780/18]
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.
