Written Answers Nos 220-239
220. Deputy Maureen O'Sullivan asked the Minister for Health his views on some hospital groups charging €80 to haemochromatosis patients requiring venesection; and the steps he will take on behalf of persons receiving this life saving treatment. [6289/18]
Amharc ar fhreagraThe Health Act 1970 (as amended) provides that all people ordinarily resident in the country are entitled, subject to certain charges, to public in-patient hospital services including consultant services and to public out-patient hospital services. Under s52 of the Health Act 1970, as amended by s12 of the Health (Amendment) Act 2013, a person who has been referred to a hospital for an in-patient service, including that provided on a day case basis, will have to pay the statutory daily charge, currently €80 per day, up to a maximum of €800 per year. On this 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.
My Department is currently considering the issue of the application of the public in-patient charge of €80 for venesection in Acute Hospitals and an early meeting with the HSE in this regard is envisaged.
221. Deputy Brendan Howlin asked the Minister for Health if his Department has commissioned economic or regulatory impact assessments of the risks to sectors under the purview of his Department following the decision of the UK to exit the EU and the various types of future relationships that might result; if he will provide a copy of such studies conducted; the persons or body commissioned to conduct this research; the cost of same; and if he will make a statement on the matter. [6307/18]
Amharc ar fhreagra222. Deputy Brendan Howlin asked the Minister for Health the additional budget for 2018 or other years, provided to his Department and all agencies and bodies within his remit to plan or prepare for Brexit; the number of additional staff who have been recruited to work on this policy area in each body, agency and his Department; the number of dedicated staff planning and working on Brexit matters in each; and if he will make a statement on the matter. [6324/18]
Amharc ar fhreagraI propose to take Questions Nos. 221 and 222 together.
The Department of Foreign Affairs and Trade has responsibility for coordinating the whole-of-Government response to Brexit. In this capacity, the Department of Health is working closely with the Department of Foreign Affairs and Trade to address the many challenges resulting from Brexit. This co-operation also involves the relevant State Agencies. Contingency planning at both a domestic and an EU level is focused on three areas: preparing for a no-deal scenario or so-called “disorderly Brexit”; preparing for a transition period based on the “status quo”; and preparing for the future EU-UK relationship.
While the outcome of the December European Council and the move on to Phase 2 has lessened the likelihood of a disorderly Brexit, very detailed work on a no-deal or worst-case-scenario is advancing intensively through the cross-Departmental coordination structures chaired by the Department for Foreign Affairs and Trade . This work is also informed by ongoing stakeholder engagement. Separately, a new preparedness unit in the Commission is considering EU-level responses.
All this work provides a baseline scenario for the policies and sectors impacted, which can then be adapted as appropriate in light of developments in the EU-UK negotiations. In this regard, it is welcome that the direction of travel is now firmly towards achieving a “status quo” transition period. Agreement on a “status quo” transition will provide certainty to individuals and businesses while also aiming to avoid any cliff edge effects between the UK leaving the EU and a future relationship agreement coming into force. The period will provide time for businesses and citizenship to prepare for the UK’s withdrawal from the EU based on the outcome of the negotiations on the framework for the EU’s future relationship with the UK. In this respect, the expectation is that the European Council will adopt additional Guidelines at its meeting on 22-23 March 2018 on the framework for the future EU-UK relationship. These guidelines – as well as further clarity on the UK position, which has been sought by the European Council – will provide a clearer picture of the direction of travel in the negotiations.
The Department of Health and its agencies have been conducting detailed analysis on the impacts of Brexit in the area of health. A number of issues are being examined and contingency planning for a range of eventualities is under way. A key issue will be to ensure that there is minimum disruption to health services and that essential services are maintained on a cross-Border, all-island and Ireland-UK basis. The health sector has a highly mobile workforce and free movement issues and the mutual recognition and assurance of professional qualifications are being considered. On regulatory issues, it is clear that having a single set of rules across the European Union is enormously helpful – to protect human health, to ensure consumer protection and to provide a level playing field for industry. Ensuring continuity in the supply of medicines and medical devices following the UK’s departure from the EU is a priority. The issue of customs is of relevance as it relates to additional food safety controls and medicines. The implications of Brexit for networks and organisations such as the EU Rapid Alert System for Food and Feed, the European Reference Networks on rare diseases and the European Centre for Disease Prevention and Control are also under consideration.
These issues are currently being examined by my Department and its agencies and this work will continue over the period ahead. The key priorities for my Department are to ensure continuity in the provision of health services and to avoid, or mitigate changes to the current situation that would have a negative impact on human health. These are also key factors in considering the prioritisation of risks.
In terms of allocation of resources, the Deputy Secretary, Policy and Strategy Division, and the Assistant Secretary, R and D and Health Analytics Division are the lead officials in my Department for planning and coordination in respect of Brexit. The Department of Health participates fully in the Senior Officials Group on EU Affairs, the Interdepartmental Group on EU and Brexit and its workgroups as appropriate.
The Department established a Management Board subcommittee on Brexit in advance of the UK referendum, to examine the implications of a decision to leave the EU. The Subcommittee is chaired at senior level and made up of representatives from across the Department, as well as from the HSE, which is represented at National Director level.
Brexit raises many issues across a wide range of areas that need to be addressed. Work on each specific issue involves line Units with policy responsibility. In this way, work on Brexit-related issues is being mainstreamed throughout the Department.
Within my Department, the International and Research Policy Unit provides a co-ordinating function in relation to Brexit just as it does for other international matters and North-South cooperation. The Department has a full-time EU health attaché assigned to the Permanent Representation in Brussels, who is in regular contact with International and Research Policy Unit and other Units throughout the Department. Staffing and resources allocated to Brexit in my Department are kept under ongoing review.
Brexit has been identified as a specific priority in the HSE National Service Plan. The HSE has established a Steering Group to examine and assess the issues and risks associated with Brexit and the implications for the Executive. The group consists of representatives from across Directorates and is examining a number of priority areas. Other agencies including the HPRA are also prioritising actions on Brexit including engagement with the EMA and stakeholders in Ireland.
223. Deputy Joan Burton asked the Minister for Health the involvement his Department has had in respect of contracts with a company (details supplied) that provides public private partnership contracts; the nature of the contract; if it was for capital construction or service supply; the duration of each contract; the value of fee commitments; the alternative arrangements he has made; and if he will make a statement on the matter. [6341/18]
Amharc ar fhreagraA payment was made to the company in question in July 2017 following a procurement exercise through the Office of Government Procurement's Framework for the Provision of Security Software and Associated Reseller Services, in respect of maintenance and three year licensing for Sophos Anti Virus protection in the amount of €40,811.40.
224. Deputy John Brassil asked the Minister for Health his plans to reinstate the Millstreet ambulance service; and if he will make a statement on the matter. [6392/18]
Amharc ar fhreagraAs the question raised by the Deputy relates to a service issue, I have asked the HSE to respond to you directly.
225. Deputy Billy Kelleher asked the Minister for Health the amount that has been allocated for gaymen's health services in 2018; the way in which this budget will be spent; and if he will make a statement on the matter. [6393/18]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to you.
226. Deputy Billy Kelleher asked the Minister for Health the position regarding an application by an organisation (details supplied) to the HSE seeking further funding; and if he will make a statement on the matter. [6451/18]
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.
227. Deputy Louise O'Reilly asked the Minister for Health the reason praxilene and naftidrofuryl oxalate medications are no longer available; and if he will make a statement on the matter. [6454/18]
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.
228. Deputy Peadar Tóibín asked the Minister for Health the persons on State boards under the aegis of his Department who also serve on other State boards; the persons on State boards under the aegis of his Department who have previously served on other State boards; and if he will make a statement on the matter. [6465/18]
Amharc ar fhreagraThe nomination and appointment process for boards of bodies under the aegis of my Department is set out in legislation. In line with Government Decision SI80/20/10/1617 of 2014 and Guidelines set out by the Department of Public Expenditure and Reform relating to the advertising for expressions of interest in vacancies on State Boards, my Department in conjunction with the Public Appointments Service (PAS) currently advertises for board vacancies as they arise, where I, as Minister for Health, have nominating rights under relevant legislation. I also appoint members on the nomination of various bodies, again in accordance with relevant legislation.
In the case of appointments to State Boards under my aegis candidates who express an interest in being a board member through PAS must confirm the details of any other State Boards on which they are serving on their application forms. This information is then available to the Assessment Panel, convened by PAS, which examines all applications for membership, prior to the final list being provided to me for selection of nominees.
The specific information sought by the Deputy particularly in regard to previous State Board membership is not readily available. Details of the current membership of all applicable state boards are published on the www.stateboards.ie website.
229. Deputy Bobby Aylward asked the Minister for Health if there will be an expansion of supports for victims of Lyme disease in 2018; and if he will make a statement on the matter. [6434/18]
Amharc ar fhreagraLyme disease (also known as Lyme borelliosis) is an infection caused by a spiral-shaped bacterium called Borrelia burgdorferi. It is transmitted to humans by bites from ticks infected with the bacteria. The infection is generally mild affecting only the skin but can occasionally be more severe and highly debilitating. Lyme disease is diagnosed by medical history and physical examination. The infection is confirmed by blood tests which look for antibodies produced by an infected person's body in response to the infection. These normally take several weeks to develop and may not be present in the early stages of the disease. The standard laboratory approach to Lyme diagnostics is a two-stage approach and has been agreed by experts from the Scientific Advisory Committee of the Health Protection Surveillance Centre and other Irish and international experts. This testing is available in Ireland.
Lyme disease can be very successfully treated using common antibiotics by General Practitioners. These antibiotics are effective at clearing the rash and helping to prevent the development of complications. Antibiotics are generally given for up to three weeks. If complications develop, intravenous antibiotics may be considered.
The HSE Health Protection Surveillance Centre website (www.hpsc.ie) gives extensive information on Lyme Disease diagnosis, treatment and how to avoid tick bites. A Lyme Disease Subcommittee of the Scientific Advisory Committee of HPSC with professional clinical, entomological, scientific and environmental health expert representation (including a representative of the Lyme Support Group, Tick-Talk Ireland) has been established to explore all possible ways of raising awareness about Lyme disease. This Subcommittee is expected to meet shortly with a view to finalising it report. This report will cover a number of areas, including initiatives undertaken to date, summary advice relating to awareness, preventive advice for the general public, preventive advice and material for those responsible for sites or locations known to have or suspected as having higher densities of ticks, and summary advice relating to GP management of the condition. Any person who is suffering ill health is eligible to seek medical attention, and to access appropriate health and social care services, irrespective of the cause of their symptoms.
230. Deputy Michael Moynihan asked the Minister for Health the reason the number of outpatients waiting more than 18 months for an appointment in Cork hospitals increased from 993 in December 2015 to 7,339 in December 2017; and if he will make a statement on the matter. [6432/18]
Amharc ar fhreagraReducing waiting times for patients is one of the Government's key priorities. In addition, all patients are prioritised according to clinical need.
The Outpatient Waiting List Action Plan 2017 contained a specific target to reduce by 50% the number of patients who would be waiting 15 months or more for outpatient appointments by removing over 95,000 patients from the Outpatient Waiting List by the end of October 2017. This target was met within the time-frame and performance up to the week ending 3 November 2017 saw nearly 100,000 patients come off the list.
Notwithstanding, the Outpatient Waiting List remains a significant challenge to be addressed in 2018. Outpatient activity has increased year-on-year, while the gap between referrals and appointment activity continues to widen, with 2017 data from the HSE indicating a gap of over 1,200 patients per week. Moreover, almost half a million (479,000) outpatients did not attend their outpatient appointment last year. This is an area that needs to be tackled.
Recent experience in relation to waiting list initiatives, including outsourcing, suggests that there are opportunities for further improvements and a number of steps including the commencement of a national waiting list validation project by the HSE, are being taken to ensure the lists are accurate. These efforts are to intensify in the coming months. My Department has also requested the HSE to develop an Outpatient Waiting List Action Plan for 2018, building on progress achieved last year.
In relation to the particular query raised, I have asked the HSE to respond to the Deputy directly.
231. Deputy John Lahart asked the Minister for Health the extra support that will be provided to Tallaght hospital in 2018 to reduce waiting times for a first-time appointment to see a neurologist in view of the fact that there are 1,123 persons waiting more than 18 months at the end of 2017. [6402/18]
Amharc ar fhreagraReducing waiting times for patients is one of the Government's key priorities. In addition, all patients are prioritised according to clinical need.
The HSE Outpatient Waiting List Action Plan 2017 contained a specific target to reduce by 50% the number of patients who would be waiting 15 months or more for outpatient appointments by the end of October 2017. The Plan aimed to remove over 95,000 patients from the Outpatient Waiting List. This target was met with almost 100,000 patients coming off the Waiting List by the week ending 3 November.
Notwithstanding, the Outpatient Waiting List remains a significant challenge to be addressed in 2018. Outpatient activity has increased year-on-year, while the gap between referrals and appointment activity continues to widen, with 2017 data from the HSE indicating a gap of over 1,200 patients per week. Moreover, almost half a million (479,000) outpatients did not attend their outpatient appointment last year. This is an area that needs to be tackled.
Recent experience in relation to waiting list initiatives, including outsourcing, suggests that there are opportunities for further improvements and a number of steps including the commencement of a national waiting list validation project by the HSE, are being taken to ensure the lists are accurate. These efforts are to intensify in the coming months. My Department has also requested the HSE to develop an Outpatient Waiting List Action Plan for 2018, building on progress achieved last year.
In relation to the particular query raised, I have asked the HSE to respond to the Deputy directly.
232. Deputy Eamon Scanlon asked the Minister for Health the facilities that will now be provided for Alzheimer's patients in County Sligo; and if he will make a statement on the matter. [6427/18]
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.
233. Deputy John Curran asked the Minister for Health the level of current and capital funding that would be required to implement Sláintecare proposals in view of the recent hospital bed capacity review which found that if the proposals in the Sláintecare report are implemented an additional 2,500 hospital beds would be required; the annual timeframe for the full delivery of these 2,500 additional hospital beds; and if he will make a statement on the matter. [2117/18]
Amharc ar fhreagraThe Terms of Reference and the scope of the Capacity Review did not include the costing of additional capacity. The Review was tasked with outlining the potential effects of reform scenarios on the demand for health and social care services. It was not tasked with modelling the potential impact of the Sláintecare proposals on future demand and capacity, although the reform scenarios outlined in the Review align with the principles underlying Sláintecare. Further, the Capacity Review recognised that Sláintecare provides the direction of travel for reform of healthcare delivery. My Department is developing an implementation plan for the Sláintecare Report and I expect to bring proposals to Government shortly.
The Review has established two extremes that define the indicative range and scale of potential capacity needs up to 2031 and the level of reforms involved. The review recognised that further work would be needed to assess the optimum reform strategy that takes account of workforce, the whole life cost of services, eligibility arrangements and their impact on implementing reforms, the feasibility of delivering infrastructure and impact on operational services in the timeframe. As the Deputy will appreciate, costing is an important and complex process in its own right. For example, it is important to state that there is no one cost for a hospital bed. The cost is dependent on the nature of the bed (such as Inpatient, Daycase, critical care), the specialty and where the bed will be delivered (for example, an existing hospital, an extension, or a new development). Following from this, the findings of the report have been the subject of discussions with the Minister for Public Expenditure in the context of the forthcoming National Development Plan.
As a final point, I would like to reiterate what I have stated previously, that adding additional capacity can't be the only answer. In tandem, we need fundamental reform of our health system - with significant development of the primary and community care system, and Sláintecare provides the blueprint for this.
234. Deputy John Deasy asked the Minister for Agriculture, Food and the Marine the reason for the delay in payment under the green low-carbon agri-environment scheme, GLAS, scheme for a person (details supplied); and when payment will issue. [6239/18]
Amharc ar fhreagraThe above named was approved into GLAS 1 with a contract commencement date of October 1 2015 and has received all payments in respect of 2015, 2016 and 2017.
All payments are up to date in this case.
235. Deputy Charlie McConalogue asked the Minister for Agriculture, Food and the Marine the number of applications received under the flood damage relief scheme for Inishowen; the number of applications that have been paid out under the scheme; the number of applications that are still pending under the scheme; and if he will make a statement on the matter. [6243/18]
Amharc ar fhreagraThe 2017 Flood Damage Relief Measure is being implemented in response to the localised severe flooding experienced in the Inishowen area on August 22 2017. The measure aims to provide financial assistance to farmers in approved cases for the direct costs arising from instances of
- Loss of livestock,
- Loss of/damage to conserved hay or silage
- Clean-up of damaged agricultural lands and
- repairs to damaged fencing
My Department received 315 applications. 292 of these applications have now been fully processed, with payments totalling €573,542 issuing to 238 eligible applicants. The remainder have been determined, during processing, not to have had eligible losses under any of the four headings outlined above.
Processing of the remaining 22 files, not fully processed, is still on going and further payments are expected to be made over the coming weeks as further cases are cleared.
236. Deputy Martin Kenny asked the Minister for Agriculture, Food and the Marine the future economic benefit to farmers, landowners and the local community in County Leitrim after the forestry premiums on the 28,000 ha of forest plantations in the county stop and the land is clear felled and replanted; if the next generation of forest owners will have to wait 30 years for a return on their investment; and if he will make a statement on the matter. [6253/18]
Amharc ar fhreagraThe annual premium payment for most forest owners in County Leitrim ends after 20 years at which point forest thinnings should begin to generate a financial return. The sale of timber at the clearfell stage in particular is significant for most forest owners. The decision on when to clearfell is an important one, the right decision will maximise potential returns to the owner.
The Department have recently developed an online Felling Decision Tool, which aims to provide owners with information on estimated timber revenues and forest characteristics (wood volumes per hectare, tree top height, and mean tree size in cubic metres) at different stages in the forest cycle. This tool may be used to assist in deciding when to clearfell, by providing financial information on the implication of felling earlier or later than when the financial returns are normally at their highest. This may enable landowners to get a better return from their investment in forestry, as well as providing the revenue needed to cover reforestation costs to continue the forest cycle.
The All Ireland Forecast shows that there is the potential to increase the private harvest by over 2.5 million cubic metres by the end of the next decade. Based on this forecast, the value of timber harvested in 2017 by private forest owners in County Leitrim can be estimated at €1.2 million. However, it is the continuous cycle of activity that takes place within the entire forest estate that delivers benefits for the wider economy. These activities begin in the forest nursery where the trees are grown, forests are then established which requires machines to prepare the site and people to plant and care for the trees. Forest roads are needed prior to first thinning, which could be followed by up to three further thinnings before the final clearfell. Haulage companies are then hired to transport the logs to processors. Once the trees are felled the forest is replanted and the cycle restarts from the beginning.
The network of companies established to service the forest industry within Leitrim and throughout the country is only possible because the national forest estate has achieved a scale that can support these businesses. While it is the case that forest owners do not receive a forest premium on the second and subsequent rotations, forests will start to generate an income at first thinning. However, when we look beyond the individual forests and look at the wide range of activities that take place throughout the 28,000 hectares of forestry in County Leitrim the wider benefits become apparent.
237. Deputy Charlie McConalogue asked the Minister for Agriculture, Food and the Marine when a GLAS payment for a person (details supplied) will be processed; and if he will make a statement on the matter. [6274/18]
Amharc ar fhreagraThe above named was approved into GLAS 1 and has received all payments in respect of scheme years 2015 and 2016.
All GLAS claims must clear validation checks before payment can be made. My Department is working proactively to complete the checks to allow for the issue of payments. This case is expected to clear the validations required shortly and the 2017 advance payment to issue. GLAS payments are issuing on a weekly basis.
238. Deputy Charlie McConalogue asked the Minister for Agriculture, Food and the Marine the status of a GLAS payment for a person (details supplied); and if he will make a statement on the matter. [6275/18]
Amharc ar fhreagraThe above named was approved into GLAS 2 with a contract commencement date of January 1 2016 and has received all payments in respect of the 2016 scheme year.
All GLAS claims must clear validation checks before payment can be made. My Department is working proactively to complete the checks required to allow for the issue of payments. Once this case clears the validations the 2017 advance payment will be made. GLAS payments are issuing on a weekly basis.
239. Deputy Brendan Howlin asked the Minister for Agriculture, Food and the Marine if his Department has commissioned economic or regulatory impact assessments of the risks to sectors under the purview of his Department following the decision of the UK to exit the EU and the various types of future relationships that might result; if he will provide a copy of such studies conducted; the persons or body commissioned to conduct this research; the cost of same; and if he will make a statement on the matter. [6297/18]
Amharc ar fhreagraContingency planning at both a domestic and an EU level is focused on three areas: preparing for a no-deal scenario or so-called “disorderly Brexit”; preparing for a transition period based on the “status quo”; and preparing for the future EU-UK relationship.
While the outcome of the December European Council and the move on to Phase 2 has lessened the likelihood of a disorderly Brexit, very detailed work on a no-deal or worst-case-scenario is advancing intensively through the cross-Departmental coordination structures chaired by the Department for Foreign Affairs and Trade. This work is also informed by ongoing stakeholder engagement. Separately, a new preparedness unit in the Commission is considering EU-level responses.
All this work provides a baseline scenario for the policies and sectors impacted, which can then be adapted as appropriate in light of developments in the EU-UK negotiations. In this regard, it is welcome that the direction of travel is now firmly towards achieving a “status quo” transition period. Agreement on a “status quo” transition will provide certainty to individuals and businesses while also aiming to avoid any cliff edge effects between the UK leaving the EU and a future relationship agreement coming into force. The period will provide time for businesses and citizenship to prepare for the UK’s withdrawal from the EU based on the outcome of the negotiations on the framework for the EU’s future relationship with the UK. In this respect, the expectation is that the European Council will adopt additional Guidelines at its meeting on 22-23 March 2018 on the framework for the future EU-UK relationship. These guidelines – as well as further clarity on the UK position, which has been sought by the European Council – will provide a clearer picture of the direction of travel in the negotiations.
The Government’s contingency planning continues to be firmly grounded in the extensive work and outreach that has already been undertaken by individual Departments and agencies, as well as by stakeholder organisations, academics and others. Much of this is in the public domain.
My Department has conducted a range of analysis and research activities in relation to Brexit. This work is ongoing, and is primarily concerned with the implications of Brexit for agrifood trade with the UK across different sectors.
For example, both internally and in consultation with the relevant stakeholders through the Brexit Stakeholder Consultative Committee and the All-Island Civic Dialogue process, my Department has established the extent of sectoral exposure to the UK market, the potential implications of Brexit for each sector and the possible responses to the challenges presented. It has also been analysing the potential practical impact on the day-to-day functioning of trade flows, as well as potential tariffs that might be applied to Ireland's agrifood exports to the UK in the event of a 'hard' Brexit.
The agencies reporting to my Department have also undertaken important research in relation to Brexit, with Teagasc publishing reports on, for example, the potential implications for the Irish agrifood sector in overall terms and on the implications for family farm incomes, and Bord Bia conducting important work through its Brexit Barometer.
In addition, my Department is in ongoing contact with the relevant agencies and with other Departments in the context of reviewing research on the implications of Brexit for the agrifood industry, and with a view to identifying further potential areas of research.
