Written Answers Nos. 270-294
270. Deputy Gerry Adams asked the Minister for Health further to Parliamentary Question No. 330 of 6 February 2018, the funding the HSE is providing in respect of a home care package for a person (details supplied). [10899/18]
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.
271. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question Nos. 920 of 13 July 2017 and 415 of 6 February 2018, his plans to include a Garda vetting process in cases of previous malpractice or criminality by such therapists when the registration boards are being set up; and if he will make a statement on the matter. [10902/18]
Amharc ar fhreagraFurther to my response to Parliamentary Questions 920 of 2017 and 415 of 2018, there are no plans for the statutory regulation of complementary therapists, including hypnotherapists, in Ireland. Although not subject to professional statutory regulation, complementary therapists are subject to a range of legislation and regulation similar to other practitioners, including consumer legislation, competition, contract and criminal law.
As previously advised, Department policy has been informed by the National Working Group on the Regulation of Complementary Therapists that was published in 2005. In addition to considering this report, the Department of Health has supported greater voluntary self-regulation of complementary therapy.
The immediate priority for the Department is the establishment of the boards of the remaining professions designated under the Health and Social Care Professionals Act 2005. The draft Regulations to designate the professions of counsellor and psychotherapist and to establish a registration board for these professions have now, in accordance with the provisions of the Act, been laid before each House of the Oireachtas and resolutions approving the drafts have been submitted to each House for consideration.
Subject to the approval of the Houses, the next steps will be to make the regulations and appoint the 13 members of the registration board following the submission of suitable candidates for my consideration by the Public Appointments Service. When the registration board has been established and its members appointed its primary tasks will be to commence drafting the various bye-laws to allow it to establish its registers.
All applicants for registration with a Registration Board maintained by the Health and Social Care Professionals Council are required to undergo vetting with the National Vetting Bureau.
272. Deputy Danny Healy-Rae asked the Minister for Health the reason high blood pressure is not considered for the long-term illness scheme; and if he will make a statement on the matter. [10903/18]
Amharc ar fhreagraThe LTI Scheme was established under Section 59(3) of the Health Act 1970 (as amended). The conditions covered by the LTI are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide. Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
There are no plans to extend the list of conditions covered by the Scheme.
273. Deputy Robert Troy asked the Minister for Health if an appointment for a person (details supplied) will be expedited [10904/18]
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.
274. Deputy Maurice Quinlivan asked the Minister for Health his plans to pilot a reimbursement system that gives persons with primary progressive MS access to the drug Ocrevus while the price of this drug is being decided; and if he will make a statement on the matter. [10905/18]
Amharc ar fhreagra275. Deputy Maurice Quinlivan asked the Minister for Health his plans to meet a group (details supplied) to discuss the possibility of piloting a reimbursement system that gives persons with primary progressive MS access to Ocrevus while the price of this drug is being decided; and if he will make a statement on the matter. [10906/18]
Amharc ar fhreagraI propose to take Questions Nos. 274 and 275 together.
The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
This Act gives full statutory powers to the HSE to assess and make decisions on reimbursement, taking account of expert opinion as appropriate. The HSE follows the process set out in the Act for the assessment of all drugs, including hospital drugs.
This process ensures that only treatments that are clinical and cost effective are reimbursed.
As Minister for Health I do not have any statutory power or function in relation to the reimbursement of medicines.
I am keen, if possible, to explore ways in which new medicines might be more easily introduced in Ireland. However, any innovative approaches that may be tabled must be compatible with the principles and statutory provisions which are in place. These derive in large part from the legislation passed by the Oireachtas in 2013. I am currently considering the best way to process a dialogue with stakeholders in this regard.
276. Deputy James Browne asked the Minister for Health the name, title, level and division of each person who works within the HSE’s management structure of CHO5; and if he will make a statement on the matter. [10907/18]
Amharc ar fhreagraThis question has been referred to the HSE for direct response to the Deputy.
277. Deputy Louise O'Reilly asked the Minister for Health the reimbursement costs of the drugs payment scheme in each of the years 2007 to 2017, in tabular form; and if he will make a statement on the matter. [10911/18]
Amharc ar fhreagra278. Deputy Louise O'Reilly asked the Minister for Health the average gross costs of the drugs payment scheme by person in each of the years 2007 to 2017, in tabular form; and if he will make a statement on the matter. [10912/18]
Amharc ar fhreagra279. Deputy Louise O'Reilly asked the Minister for Health the average gross costs of the drugs payment scheme by item in each of the years 2007 to 2017, in tabular form; and if he will make a statement on the matter. [10913/18]
Amharc ar fhreagraI propose to take Questions Nos. 277 to 279, inclusive, together.
Under 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.
280. Deputy Louise O'Reilly asked the Minister for Health the details of primary care reimbursement service's expenditure by its various schemes in each of the years 2007 to 2017, in tabular form; and if he will make a statement on the matter. [10914/18]
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.
281. Deputy Louise O'Reilly asked the Minister for Health the number and percentage of the population that have neither private health insurance nor a medical card; and if he will make a statement on the matter. [10915/18]
Amharc ar fhreagraThe Healthy Ireland survey is a nationally representative sample survey of adults aged 15 and over. From this survey, it is possible to ascertain the proportion of adults in Ireland who have neither private health insurance or a Medical/GP Visit Card.
According to data from waves 1 and 2 of this survey, approximately 22% of adults aged 15 and over have neither private health insurance or a Medical/GP Visit Card. This equates to approximately 833 thousand adults.
282. Deputy Michael Healy-Rae asked the Minister for Health his views on a matter (details supplied) regarding the mobility allowance and motorised transport grant scheme; and if he will make a statement on the matter. [10916/18]
Amharc ar fhreagraThe Deputy will be familiar with the background to the closure of both the Mobility Allowance and Motorised Transport Grant schemes in February 2013.
The Government decided that the detailed preparatory work required for a new Transport Support Scheme and associated statutory provisions should be progressed by the Minister for Health. The Programme for a Partnership Government acknowledges the ongoing drafting of primary legislation for a new Transport Support Scheme to assist those with a disability to meet their mobility costs. The Health (Transport Support) Bill is on the list of priority legislation for publication in the Spring/Summer session 2018. I can confirm that work on the policy proposals for the new Scheme is at an advanced stage. The proposals seek to ensure that:
- There is a firm statutory basis to the Scheme's operation;
- There is transparency and equity in the eligibility criteria attaching to the Scheme;
- Resources are targeted at those with greatest needs; and
- The Scheme is capable of being costed and is affordable on its introduction and on an ongoing basis.
It is hoped to bring a General Scheme and Heads of Bill to Government shortly, seeking Government approval to the drafting of the Bill for the new Transport Support Payment.
Since the closure of the Mobility Allowance, the Government has directed that the Health Service Executive should continue to pay an equivalent monthly payment of up to €208.50 per month to the 4,133 people in receipt of the Mobility Allowance, on an interim basis, pending the establishment of a new Transport Support Scheme.
Following closure of the Motorised Transport Grant Scheme in February 2013, no further Motorised Transport Grants have been payable.
It is important to note that the Disabled Drivers and Disabled Passengers scheme operated by the Revenue Commissioners, remains in place. This scheme provides VRT and VAT relief, an exemption from road tax and a fuel grant to drivers and passengers with a disability, who qualify under the relevant criteria set out in governing regulations made by the Minister for Finance. Specifically adapted vehicles driven by disabled persons are also exempt from payment of tolls on national toll roads and toll bridges. Transport Infrastructure Ireland has responsibility for this particular Scheme.
Responsibility for the legislation governing the Road Traffic (Bus Lanes) (Exemption) Regulations rests with my colleague, the Minister for Transport, Tourism and Sport.
283. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [10921/18]
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.
284. Deputy Michael Healy-Rae asked the Minister for Health his views on a matter in relation to a person (details supplied); and if he will make a statement on the matter. [10924/18]
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.
285. Deputy Robert Troy asked the Minister for Health the status of a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [10925/18]
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.
286. Deputy Billy Kelleher asked the Minister for Health when the HSE will publish its operational plans for 2018 for each sector. [10940/18]
Amharc ar fhreagraThe HSE have advised that they expect to publish all Operational Plans by the end of March, 2018. These will be available on the HSE website (www.hse.ie).
287. Deputy Billy Kelleher asked the Minister for Health when each hospital group will publish its 2018 operational plans [10941/18]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to you directly.
288. Deputy Seán Haughey asked the Minister for Health the capital funding provided for Beaumont Hospital in 2017; and the capital funding allocated for projects (details supplied) during 2017, in tabular form [10942/18]
Amharc ar fhreagraAs the HSE is responsible for the delivery of health care infrastructure projects, the Executive has been requested to reply directly to you in relation to the capital funding incurred for Beaumont Hospital in 2017.
289. Deputy Micheál Martin asked the Minister for Health the status of an appeal by a person (details supplied); and if he will make a statement on the matter. [10947/18]
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 a safe and sustainable manner. Treatment must be appropriate and proportionate and clinical decision-making, such as prescribing, should be based on both patient needs and sound medical evidence.
Lidocaine 5% medicated plasters are licensed for the localised relief of post-shingles pain in adults. This is the only licensed use for the patch in Ireland. It has been reimbursed in the community drugs schemes since 2010.
When the plasters were first introduced, the budget impact was low, because of the specific indication for which they are licensed. It was therefore a cause of clinical concern that, from 2012 on, usage increased significantly, to the point where, as a nation, we were using more plasters than the entire UK National Health Service, with ten times our population.
When a treatment is intended for a small group of patients, and evidence suggests that it is being used for many times that number, it is important and appropriate for clinicians to review its use. In 2016, the HSE Medicines Management Programme reviewed the use of the plasters. The review estimated that only 5-10% of prescribing had been for the licensed indication.
Following the clinical review, and in the interest of ensuring appropriate patient care, the HSE introduced a new reimbursement approval system for the patches from 1 September 2017. This process supports their appropriate use, ensuring that post-shingles patients continue to receive this treatment.
Under the new arrangements, all patients receiving lidocaine plasters for the licensed indication, shingles, were automatically approved on the HSE system. All of these patients continue to receive the treatment under the community schemes.
Non-shingles patients were given a three month grace period, in which their GP could move them to other treatments or apply for continued reimbursement. However, from 1 December 2017, non-shingles patients were no longer automatically reimbursed under the community drugs schemes.
In order for non-shingles patients to receive the patch through the community schemes, their GP must apply online for continued reimbursement approval. If an application is refused, the GP may appeal, making a clinical case for the patient. The HSE advises that the turnaround time for applications is three working days and for appeals it is five days.
As of 5 March 2018, there have been 5,156 online applications from GPs requesting the reimbursement of Versatis. Of these applications, over 17%, or 896 patients, have been approved.
In addition, 437 online appeals have been made, and over 66% of these patients have been approved. The MMP has sought further information on 40 appeals before a recommendation on reimbursement can be made.
Since 1 September 2017, some 1,182 patients have been approved for the reimbursement of lidocaine plasters, based on the clinical case made by the GP.
It is clear that this new process supports appropriate use and prescribing and both post-shingles patients and other appropriate cases can continue to be treated with lidocaine plasters.
The introduction of the new approval system was flagged in August 2017, when details of the proposed changes were circulated by the HSE to prescribers and pharmacies. This advice has been re-issued in the last week, and information for patients and practitioners is on the HSE Medicines Management Programme website. (https://www.hse.ie/eng/about/who/cspd/ncps/medicines-management/lidocaine-plaster/).
This decision is a matter for the HSE. However, I fully support the objectives of the HSE Medicines Management Programme.
290. Deputy Louise O'Reilly asked the Minister for Health the legal position regarding medical card holders undertaking blood tests for the purposes of monitoring their health on a recurring basis [10954/18]
Amharc ar fhreagraI assume the Deputy is referring to reports of medical card holders being charged by their GPs for phlebotomy services.
Under the terms of the current GMS contract, GPs are required to provide eligible patients with ''all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess." There is no provision under the GMS GP contract for persons who hold a medical card or GP visit card to be charged for routine phlebotomy services provided by their GP which are required to either assist in the diagnosis of illness or the treatment of a condition. The HSE has advised GPs that where a blood test forms part of the investigation or necessary treatment of a patient’s symptoms or conditions, this should be free of charge for patients who hold a medical card or GP visit card. Notwithstanding this, I am aware that some GPs have begun to charge GMS patients for phlebotomy services in some circumstances.
This is a matter of concern for me as it has long been the position, under successive Governments, that no user charges should apply to GP services provided to GMS and GP visit card patients. If a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for routine phlebotomy services by his or her GP, then that patient may take the matter up with their HSE Local Health Office, who will investigate the complaint.
If the local office determines that the charge was inappropriate, it will inform the HSE Primary Care Reimbursement Service who will arrange to refund the cost of the blood test to patient and recoup this amount from the GP. The local office will inform the GP of the decision to deduct the payment.
291. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the position regarding the provision of funding by the HSE for the genomic sequencing machine in the next generation sequencing laboratory in the Mater Hospital; the status of the recruitment of a national clinical director who will have responsibility for developing the services envisaged; and if he will make a statement on the matter. [10956/18]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to you directly.
292. Deputy James Browne asked the Minister for Health if he will provide a copy of the HSE’s mental health division operational plan for 2018. [10960/18]
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.
293. Deputy James Browne asked the Minister for Health the number of psychiatric beds in University Hospital Waterford; and if he will make a statement on the matter. [10961/18]
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.
294. Deputy James Browne asked the Minister for Health the number of referrals of persons in County Wexford to the department of psychiatry in each of the years 2015 to 2017; and if he will make a statement on the matter. [10962/18]
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.
