Hospital Consultant Recruitment

Ceisteanna (196)

Eamon Scanlon

Ceist:

196. Deputy Eamon Scanlon asked the Minister for Health if his attention has been drawn to the fact that two permanent specialist consultant posts remain unfilled for diabetes services at Sligo University Hospital; if the posts of paediatric consultant and adult endocrinologist at Sligo University Hospital have been advertised; if not, the reason therefor; if the positions advertised are in line with the recommendations of the HSE-approved national model of care for paediatric health care services in Ireland in that the posts would allow 2.5 days per week allocated to the care of children and adolescents requiring diabetes and-or endocrinology support; and if he will make a statement on the matter. [7755/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

In response to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.

Hospital Consultant Contracts

Ceisteanna (197)

Seán Fleming

Ceist:

197. Deputy Sean Fleming asked the Minister for Health the progress to date on the establishment of more robust measures to be put in place in 2018 to ensure consultants comply with all their contractual obligations in respect of the 2008 contract; the changes that have occurred since the beginning of 2018 to ensure this matter is dealt with; and if he will make a statement on the matter. [7758/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I have been very clear that consultants must deliver their work commitment to the public system.

For some time now my Department has been working closely with the HSE to find a solution to ensure more effective monitoring of compliance by consultants to their contracts and that compliance is achieved in respect of all consultants.

It is the responsibility of management to make sure these contracts are being enforced and I have asked the HSE to ensure that more robust measures are in place in 2018 to make sure consultants comply with their contractual obligations. I have been clear I will require absolute assurances on this point.

Section 20 of the 2008 Consultant Contract gives the employer of the consultant full authority to take all necessary steps to ensure a Consultant's practice shall not exceed the agreed ratio of public to private practice. Accordingly, I have referred this question in relation to measures to ensure consultant compliance to the HSE for direct reply.

Hospital Services

Ceisteanna (198)

Seán Fleming

Ceist:

198. Deputy Sean Fleming asked the Minister for Health the number of hours that were involved by his Department's staff and staff in the HSE in the course of drawing up the Dublin midlands hospital group plan for a new model of clinical service delivery in Portlaoise hospital; and if he will make a statement on the matter. [7762/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Dublin Midlands Hospital Group has been working for some time on a draft plan for a new model of clinical service delivery at Portlaoise Hospital. A draft plan was submitted to my Department in December 2016. This draft report was reviewed in detail and was the subject of detailed engagement between Department officials and the HSE over the course of a number of months. Significant additional work was also undertaken by the HSE on foot of this engagement resulting in a revised draft plan that was submitted to my Department in September 2017.

It remains the case, as outlined at my meeting with the Deputy and the other Laois Oireachtas members in December 2017, that no decision has been made yet on the draft Action Plan for Portlaoise Hospital. I have asked my Department to conduct a consultation process in this regard early this year involving local clinicians and the community.

Hospital Services

Ceisteanna (199)

Jackie Cahill

Ceist:

199. Deputy Jackie Cahill asked the Minister for Health the progress in respect of the upgrading of services to be offered at Our Lady's Hospital, Cashel, County Tipperary; the extra planned services that will be offered at the hospital; the timeframe for these services to be rolled out; the value of the investment that will be made to facilitate the upgrade; and if he will make a statement on the matter. [7774/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Hospitals Building Programme

Ceisteanna (200)

Jackie Cahill

Ceist:

200. Deputy Jackie Cahill asked the Minister for Health when patients and staff will move into the planned development at South Tipperary General Hospital, that is, to offer extra wards separate from but attached to the existing hospital; the position of the development in the planning process; the recruitment plan in place to ensure the proposed new development will be properly staffed; and if he will make a statement on the matter. [7775/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Increasing bed capacity in public acute hospitals has been and continues to be a priority in terms of addressing the causes and challenges of Emergency Department overcrowding.

I can confirm that funding has been allocated for the modular build programme to deliver capacity at South Tipperary General Hospital, which is targeted for completion in the latter quarter of 2018.

In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.

Hospitals Capital Programme

Question No. 202 answered with Question No. 163.

Ceisteanna (201)

Jackie Cahill

Ceist:

201. Deputy Jackie Cahill asked the Minister for Health the future capital investment planned for South Tipperary General Hospital that will complement the short-term plans for the hospital in order that the hospital is properly prepared to offer existing and enhanced acute services in the medium and longer term; and if he will make a statement on the matter. [7776/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Question No. 202 answered with Question No. 163.

Medical Card Drugs Availability

Ceisteanna (203)

John Curran

Ceist:

203. Deputy John Curran asked the Minister for Health if there is an appeals process in place for medical card holders who were previously receiving lidocaine patches but are now being refused these patches; if so, the details of the appeals process; and if he will make a statement on the matter. [7779/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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 trebled between 2012 and 2016, from €9.4 million to over €30 million, 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 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. No action was required by GPs and the patient’s pharmacy was notified of his or her approval status.

However, since 1 December 2017, non-shingles patients no longer receive this item under the community drugs schemes. In August 2017 the HSE advised GPs of the changes and of treatment alternatives.

It is possible for non-shingles patients to be approved for the patch through the community drug schemes. The patient's GP should apply to the Medicines Management Programme through the online system, and the MMP will review the application and inform the GP of its decision.

I am advised that the MMP has received over 4,500 applications from GPs, of which some 10% have been approved. For many of the conditions applied for, prescribing of the patch was inappropriate, for example for conditions such as deep venous thrombosis, angina, gout and endometriosis.

Where a GP’s application is rejected, it may be appealed. Of some 200 appeals to date, the HSE advises that over 50% have been accepted on clinical grounds.

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.