Written Answers Nos. 222 - 230
222. Deputy Robert Troy asked the Minister for Health his plans regarding the independence of dental hygienists; his plans to introduce a new Bill to amend or replace the Dentists Act 1985; and if he will make a statement on the matter. [8000/18]
Amharc ar fhreagraWork is continuing in relation to the development of new legislation to replace the Dentist Act 1985. The regulation and role of dental hygienists is being examined in the context of this new legislation.
A Regulatory Impact Analysis is currently underway, and the drafting of the Scheme of Bill, which is the next step in the process to develop the new legislation, has commenced, but it is at an early stage. It is therefore too early to give an indication as to when the Bill will be published and debated. Department officials are currently committed to drafting a priority Regulated Health Professions (Amendment) Bill, the primary purpose of which is to amend all health professional regulatory Acts as a consequence of the transposition of the Modernised Professional Qualifications Directive (2013/55/EU), and to address a number of other issues.
While the development of new dental legislation is a priority for me, work on the preparation of the Dental Bill will be progressed in line with competing legislative priorities.
223. Deputy Bríd Smith asked the Minister for Health the reason audits (details supplied) have not been published; if he will provide copies of these audits; and when the audit will be made publicly available. [8014/18]
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.
224. Deputy Pearse Doherty asked the Minister for Health the reason for service disruptions to speech and language services provided at a facility (details supplied) in County Donegal; when services will resume as normal; the alternative arrangements which have been put in place to ensure that service users may continue to access services in a timely manner; and if he will make a statement on the matter. [8021/18]
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.
225. Deputy Willie Penrose asked the Minister for Health if correspondence from a person (details supplied) has been received; if same will be given consideration; and if he will make a statement on the matter. [8034/18]
Amharc ar fhreagraThe provision of radiation oncology services in Ireland is governed by the National Plan for Radiation Oncology. The National Plan set out the projected infrastructure and equipment required to meet the needs for radiation oncology over a 20 year period.
Radiation oncology is available in five public hospitals: St. James's Hospital, Beaumont Hospital, St. Luke's Hospital Rathgar (which three together form the St. Luke's Radiation Oncology Network, Dublin), Cork University Hospital and University Hospital Galway. Radiation oncology services for public patients are also provided in two private facilities in Waterford and Limerick under the aegis of Cork University Hospital and University Hospital Galway respectively. Meanwhile, patients from the North West can receive radiation oncology treatment at the North West Cancer Centre in Altnagelvin Area Hospital, Derry.
The model of care for radiation oncology allows for the sufficient volume and concentration of activity and expertise to facilitate high quality radiation oncology treatments in line with best evidence and international best practice. Modern radiation oncology is increasingly complex. Delivery of such complex care requires several key components to ensure safe, high quality radiation therapy. These include appropriate physical infrastructure and equipment to meet the needs of both patients and staff, a highly trained multidisciplinary team including specialist doctors, nurses, radiation therapists, physicists and other health and social care professionals and a system of quality assurance that can ensure that radiation oncology services are safe, effective, equitable, efficient, timely and centred on the patients needs.
Future planned developments for radiation oncology services include the construction of new and upgraded facilities in Galway and Cork and the expansion of the facility in Beaumont. In line with the National Cancer Strategy 2017-2026 and the National Plan for Radiation Oncology, it is not intended to establish a centre for radiation oncology in the Midlands Regional Hospital, Tullamore.
226. Deputy Micheál Martin asked the Minister for Health if the HSE medicines management programme decision on Versatis patches will be reviewed in view of the distress caused to persons since the changes came into effect. [8050/18]
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 trebled between 2012 and 2016, from €9.4 million to over €30 million, 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 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 automatically 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 250 appeals to date, the HSE advises that over 60% 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.
227. Deputy Martin Kenny asked the Minister for Agriculture, Food and the Marine the number of unlicensed aquaculture enterprises in operation nationally; the number of aquaculture licences issued in 2016; if his attention has been drawn to the unlicensed aquaculture on the Inishowen shore of Lough Foyle; if there is progress on jurisdictional issues regarding aquaculture in Lough Foyle; and his views on whether the unlicensed aquaculture along Lough Foyle constitutes an offence under Article 6 of the Fisheries (Amendment) Act 1997. [7828/18]
Amharc ar fhreagraApplications for Aquaculture licences are considered by my Department under the provisions of the 1997 Fisheries (Amendment) Act, the 1933 Foreshore Act, and applicable EU Legislation.
In 2016, 122 Aquaculture licence determinations were made.
In the case of Lough Foyle, Section 2 of the 1997 Fisheries (Amendment) Act disapplies the Act to the Moville Area, as it is defined in the Foyle Fisheries Act, 1952.
The Good Friday Agreement provided for the establishment of the Foyle, Carlingford and Irish Lights Commission (FCILC). This body is one of the six North South Implementation Bodies created under the Agreement. The Loughs Agency, as part of the FCILC, has been given responsibility for fisheries related matters in respect of both Lough Foyle and Carlingford Lough and the legislation envisages that the Agency will enter into a management agreement with the relevant authorities in both jurisdictions with a view to assuming responsibility for aquaculture licensing within the loughs. Discussions in respect of the management agreement are ongoing.
The management of aquaculture and associated foreshore licensing functions in Lough Foyle gives rise to legal and jurisdictional complexities. Negotiations regarding the jurisdiction of the Lough Foyle area are, in the first instance, a matter for the Department of Foreign Affairs and Trade.
My Department organises and participates in an inter-departmental working group which is pursuing a way forward in terms of the future management of aquaculture and associated foreshore activities on Lough Foyle, in parallel with a workable resolution of the complex jurisdictional issues involved.
In view of the multi dimensional and cross jurisdictional nature of the issues involved it would not be appropriate for me to comment further at this time.
228. Deputy Patrick O'Donovan asked the Minister for Agriculture, Food and the Marine the reason for the delay in responding to an appeal by a person (details supplied); and if he will make a statement on the matter. [7832/18]
Amharc ar fhreagraThe person named was approved into GLAS 1 with a contract commencement date of 1 October 2015 and has received payments in respect of 2015 and the 2016 advance payment. The GLAS plus advance payment for 2016 was also processed.
Following an inspection a penalty has been applied to the holding, meaning a reduced 2016 balancing payment issued to the applicant. Further validation checks must now be undertaken to ensure that the 2016 GLAS plus payment is processed correctly.
The Department has not received any notification of the applicant's intention to request a review of the inspection result.
229. Deputy Michael Healy-Rae 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. [7841/18]
Amharc ar fhreagraAll GLAS payments are up to date in this case.
230. Deputy Martin Kenny asked the Minister for Agriculture, Food and the Marine the number of Sitka spruce forest plantations over 30 years old, by county; the age and size of each; and if he will make a statement on the matter. [7846/18]
Amharc ar fhreagraDuring the 1930s and 1940s a range of conifer species were planted in Ireland, including Norway spruce, Scots pine and larch, along with Sitka spruce and Lodgepole pine. This reflected the untested nature of the North American species being planted at the time. From the 1950s onwards confidence in Sitka spruce and Lodgepole pine grew, leading to their dominance in afforestation up to the mid-90s, after which the role of Lodgepole pine declined, reflecting primarily the improved land quality available for afforestation after this period and the generally poor form of the species.
From 2006 to 2010 the species composition of afforestation remained largely stable. However the finding of Phytophthora ramorum in Japanese larch in 2010, led to its withdrawal from the afforestation programme. From the mid-90s onwards a wider range of tree species has been planted, with ash and oak dominating broadleaf planting. However, more recently, the fungal disease Chalara fraxinea was found in ash in 2012, resulting in the cessation of grant aid for this species. Sitka spruce remains the predominant species used in Irish forestry. It has proven to be one of the most productive conifers in Ireland and as such has become the mainstay in roundwood processing. According to the National Forest Inventory 2012 Sitka spruce is the most common tree species in Ireland, occupying 52.4% of the total forest area.
The information sought is not currently prepared in the format requested. However, it is possible to provide similar data that will give an indication of the composition of Ireland’s forests as regards Sitka spruce. The total area of Sitka spruce in each county is presented in the following table.
Sitka spruce
|
County |
Area (ha) |
|
Carlow |
3,494 |
|
Cavan |
6,946 |
|
Clare |
26,919 |
|
Cork |
47,078 |
|
Donegal |
31,102 |
|
Dublin |
2,243 |
|
Galway |
27,593 |
|
Kerry |
27,070 |
|
Kildare |
1,023 |
|
Kilkenny |
8,989 |
|
Laois |
12,013 |
|
Leitrim |
14,138 |
|
Limerick |
16,322 |
|
Longford |
1,470 |
|
Louth |
405 |
|
Mayo |
19,413 |
|
Meath |
439 |
|
Monaghan |
1,931 |
|
Offaly |
5,554 |
|
Roscommon |
12,573 |
|
Sligo |
10,837 |
|
Tipperary |
20,290 |
|
Waterford |
12,584 |
|
Westmeath |
1,739 |
|
Wexford |
4,714 |
|
Wicklow |
17,683 |
|
Total |
334,564 |
According to the National Forest Inventory (NFI) 2012, the following table represents the total area of Sitka spruce above the age of 30.
Sitka spruce
|
Age Class |
Area (ha) |
|
31-40 |
42,480 |
|
41-50 |
16,060 |
|
51+ |
2,150 |
