Written Answers Nos. 141-160
141. Deputy Fiona O'Loughlin asked the Minister for Health the number of school leaver places available to young persons with intellectual disabilities from September 2018; the number available in September 2016 and September 2017, respectively; and if he will make a statement on the matter. [8899/18]
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 an individual case, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
142. Deputy Brendan Smith asked the Minister for Health the homecare budget, including home care packages and home help services in counties Cavan and Monaghan in 2017; the provision for such services in 2018; and if he will make a statement on the matter. [8906/18]
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.
143. Deputy Maurice Quinlivan asked the Minister for Health the reason there is no child psychologist in the County Limerick early intervention service since May 2017. [8912/18]
Amharc ar fhreagra144. Deputy Maurice Quinlivan asked the Minister for Health the number of persons waiting to see a child psychologist in County Limerick. [8913/18]
Amharc ar fhreagra145. Deputy Maurice Quinlivan asked the Minister for Health the number of persons waiting to see a child psychologist in County Limerick, by the number of months waiting. [8914/18]
Amharc ar fhreagraI propose to take Questions Nos. 143 to 145, inclusive, together.
The 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.
146. Deputy Billy Kelleher asked the Minister for Health the number of persons offered an opportunity to attend an assessment with a person (details supplied); the number that responded; the number that attended on the day; the number that have been subsequently put forward for surgery; and if he will make a statement on the matter. [8915/18]
Amharc ar fhreagra147. Deputy Billy Kelleher asked the Minister for Health if children with scoliosis attending from Temple Street Children's University Hospital have been offered access to assessment and surgery through a mechanism (details supplied); and if he will make a statement on the matter. [8916/18]
Amharc ar fhreagraI propose to take Questions Nos. 146 and 147 together.
As this is a service matter, I have asked the HSE to respond to you directly.
148. Deputy Kevin O'Keeffe asked the Minister for Health if a public health nurse will visit a person (details supplied) in County Cork. [8932/18]
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.
149. Deputy Jackie Cahill asked the Minister for Health if he will request the HSE to consider the use of a site (details supplied); and if he will make a statement on the matter. [8933/18]
Amharc ar fhreagraThe Deputy's question has been referred to the Health Service Executive for direct reply as the management of the healthcare property estate is a service matter.
150. Deputy Mary Butler asked the Minister for Health when the details of the inquest of a person (details supplied) will be received; and if he will make a statement on the matter. [8937/18]
Amharc ar fhreagraUnder the Coroners Act 1962, a Coroner is an independent office holder with responsibility under the law for the medico-legal investigation of the circumstances of sudden, unexplained, violent and unnatural deaths. Any details in relation to an inquest into a death and when the details of such an inquest will be received is a matter for the Coroner.
151. Deputy Robert Troy asked the Minister for Health the reason a person (details supplied) who attended an appointment was told to return home in view of the fact that there was no consultant on site to carry out the assessment; and if he will make a statement on the matter. [8938/18]
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 the Deputy directly.
152. Deputy Brendan Howlin asked the Minister for Health his plans to include chiropractors as a regulated profession; if his attention has been drawn to the way in which the Euratom directive is being implemented in other EU states; if he has had discussions with the Minister for Communications, Climate Action and Environment on the matter; and if he will make a statement on the matter. [8939/18]
Amharc ar fhreagraThis questions relates to the transposition of the medical provisions of the Basic Safety Standards Directive (BSSD) by my Department and whether chiropractors will be designated as referrers and practitioners in the transposing regulations. The previous regulations did not designate chiropractors as referrers or practitioners.
Ionising radiation has many beneficial applications however as the use of ionising radiation increases, so does the potential for health hazards if not properly used or contained. The BSSD is an essential piece of legislation which protects the public, patients, workers and others from all forms of ionising radiation.
The statutory instrument transposing the BSSD will designate those who may refer for radiological tests, those who may carry them out and other functions and in this regard I propose to designate nurses, doctors, dentists and radiographers as appropriate. The proposed designation of relevant professionals is based on patient safety and public health considerations reflected in the advice of the Chief Medical Officer.
Information available to my Department suggests that a number of EU Member States do not propose to designate chiropractors for the purpose of the BSSD.
The Department of Communications, Climate Action and Environment has overall responsibility for the transposition of the BSSD and officials from my Department are in regular contact with that Department regarding the transposition.
My Department will finalise the medical provisions of the BSSD in the coming weeks.
153. Deputy Louise O'Reilly asked the Minister for Health the reason HSE performance reports since July 2016 suggest that no community intervention team service is available for the CHO1 area; and if he will make a statement on the matter. [8946/18]
Amharc ar fhreagra154. Deputy Louise O'Reilly asked the Minister for Health the community intervention team staffing levels by CHO area, in tabular form; and if he will make a statement on the matter. [8947/18]
Amharc ar fhreagra155. Deputy Louise O'Reilly asked the Minister for Health the community intervention teams which are outsourced; the CHO areas they are in; the way in which outsourced staffing levels compare to directly employed HSE CIT staff by CHO area; and if he will make a statement on the matter. [8948/18]
Amharc ar fhreagraI propose to take Questions Nos. 153 to 155, inclusive, together.
As these questions relates to service matters, I have arranged for the questions to be referred to the Health Service Executive (HSE) for direct reply.
156. Deputy Clare Daly asked the Minister for Health his views on the recent crisis in Temple Street Children's University Hospital (details supplied); the steps he has taken to ensure that this will not happen again; and if he will make a statement on the matter. [8952/18]
Amharc ar fhreagraTackling overcrowding in EDs is a key commitment of this Government and this year, as part of Budget 2018, an extra €30m was made available to respond to winter pressures in 2017, with a further €40m being provided in 2018.
I acknowledge that there continues to be an unacceptable number of patients waiting on trolleys throughout the system and I can assure the Deputy that this issue remains a priority for me and my Department.
In relation to Temple Street Children's Hospital, as this is a service matter, I have asked the HSE to respond to you directly on this matter.
157. Deputy Louise O'Reilly asked the Minister for Health when a report (details supplied) will be published; and if he will make a statement on the matter. [8953/18]
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.
158. Deputy Brian Stanley asked the Minister for Health his plans to review the HSE decision on access to the versatis patch pain medication which has been withdrawn; the legal powers he has in regard to such decisions; and if he will make a statement on the matter. [8956/18]
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.
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 and pharmacies 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 4,700 applications from GPs, of which some 14% 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. 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.
159. Deputy Billy Kelleher asked the Minister for Health if his attention has been drawn to the fact that the Health Service Executive shall not make the reimbursement of the costs of cross-border healthcare under EU regulations subject to prior authorisation except in circumstances in which it has been made subject to prior authorisation under regulation 12; the exceptions under regulation 12; the date the exceptions were made; the reason for the exceptions, in tabular form; and if he will make a statement on the matter. [8957/18]
Amharc ar fhreagra160. Deputy Billy Kelleher asked the Minister for Health his views on whether in the ordinary course of requiring medical treatments that the spirit of the cross border EU regulations not to require prior authorisation is being thwarted by the information on the HSE website; and if he will make a statement on the matter. [8958/18]
Amharc ar fhreagraI propose to take Questions Nos. 159 and 160 together.
The Cross Border Directive provides rules for the reimbursement of patients of the cost of receiving treatment abroad, where the patient would be entitled to such treatment in their home Member State and supplements the rights that patients already have at EU level through the legislation on the coordination of social security schemes (Regulation 883/04). The Directive seeks to ensure a clear and transparent framework for the provision of cross border healthcare within the EU, for those occasions where the care patients seek is provided in another Member State rather than in their home country.
The HSE, as the National Contact Point (NCP) for the Directive has the responsibility to ensure Irish patients who seek to have healthcare abroad under the terms of the Directive are assisted with access to the information they need to make an informed choice. The HSE advises where a patient is in any doubt as to the need to seek prior authorisation before availing of a consultation or treatment abroad to contact the NCP. The NCP will advise patients of the reimbursement rate that will apply to the assessment/treatment being accessed.
Regarding prior authorisation of healthcare, Article 8 of the Directive permits this in certain circumstances and was transposed into Irish law by Regulation 12 of S.I. 2013 of 2014 on 14 July 2014. Regulation 12 lists the circumstances where the HSE may specify particular cross-border healthcare as subject to prior authorisation. These circumstances are as follows:
(a) involves planning requirements relating to the object of ensuring sufficient and permanent access to a balanced range of high quality treatment in the State, or the wish to control costs or avoid, as far as possible, any waste of financial, technical and human resources, and -
(i) involves overnight hospital accommodation of the insured person for at least one night, or
(ii) requires the use of highly specialised and cost-intensive medical infrastructure or medical equipment,
(b) involves treatments presenting a particular risk for a patient, or,
(c) is provided by a healthcare provider that, on a case-by-case basis, could give rise to serious and specific concerns relating to the quality or safety of the care, with the exception of healthcare which is subject to European Union legislation ensuring a minimum level of safety and quality throughout the European Union.
However, the HSE may refuse to grant prior authorisation in the following circumstances:
(a) the patient will, according to a clinical evaluation, be exposed with reasonable certainty to a patient-safety risk that cannot be regarded as acceptable, taking into account the potential benefit for the person of the sought cross-border healthcare;
(b) the general public will be exposed with reasonable certainty to a substantial safety hazard as a result of the cross-border healthcare in question;
(c) the healthcare is to be provided by a healthcare provider that raises serious and specific concerns relating to the respect of standards and guidelines on quality of care and patient safety, including provisions on supervision, whether these standards and guidelines are laid down by laws and regulations or through accreditation systems established by the Member State of treatment; or
(d) the Health Service Executive can provide healthcare that is the same as, or equivalent to, the healthcare sought by the patient within a time limit which is medically justifiable, taking into account the patient’s current state of health at the time the decision under this Regulation is taken and the probable course of the medical condition to which the healthcare relates.
Nevertheless, a patient may, if they wish, request prior authorisation for any procedure regardless of whether or not this is required under Regulation 12. This has the advantage for the patient as they will receive an indication of the level of reimbursement to expect and also an assurance they are complying with any conditions necessary under the terms of the Directive.
As the HSE has responsibility for the administration of the Cross Border Directive I have asked the HSE to examine the issues raised concerning the information on the Cross Border Directive on its website and to reply to the Deputy as soon as possible.
