Written Answers Nos. 320-344
320. Deputy Fergus O'Dowd asked the Minister for Health the status of the Versatis pain relief plasters under the long-term illness scheme; his plans to reintroduce the plasters on the scheme in view of the considerable number of persons that are adversely affected by the withdrawal of same; and if he will make a statement on the matter. [10996/18]
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
321. Deputy Catherine Murphy asked the Minister for Health if the HSE has an early alert system in place to notify persons to make contingency plans in situations in which there is an extreme weather warning in place; if his attention has been drawn to the fact that persons in need of PA hours may not receive ample notice that services may not be available during extreme weather events; and if he will make a statement on the matter. [10997/18]
Amharc ar fhreagra331. Deputy Catherine Murphy asked the Minister for Health if the HSE has an early alert system in place to notify persons to make contingency plans when there is an extreme weather warning in place; if his attention has been to the fact that persons in need of PA hours may not receive ample notice that services may not be available during extreme weather events; and if he will make a statement on the matter. [11131/18]
Amharc ar fhreagraI propose to take Questions Nos. 321 and 331 together.
The Department of Health and the Health Service Executive (HSE) are continuing to work with other agencies as part of the National Emergency Coordination Committee, to ensure that our vulnerable citizens are cared for.
The HSE will continue to maintain all essential services, particularly services to vulnerable people at home in the community.
With regard to the Deputy's reference to persons receiving ample notice that Personal Assistant services may not be available during extreme weather events, as this is a service matter, I have referred the question to the HSE for a direct reply to the Deputy.
322. Deputy Louise O'Reilly asked the Minister for Health the name and location of all primary care centres that are run by the HSE. [11033/18]
Amharc ar fhreagra323. Deputy Louise O'Reilly asked the Minister for Health the dates on which the primary care centres that are run by the HSE opened. [11034/18]
Amharc ar fhreagraI propose to take Questions Nos. 322 and 323 together.
As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.
324. Deputy Louise O'Reilly asked the Minister for Health the name and location of all primary care centres that are owned by the HSE. [11035/18]
Amharc ar fhreagraAs the management of the healthcare property estate is a service matter, your question has been referred to the Health Service Executive for direct reply.
325. Deputy Louise O'Reilly asked the Minister for Health the staff by occupation working in each primary care centre that is run by the HSE. [11036/18]
Amharc ar fhreagraAs the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.
326. Deputy Thomas Byrne asked the Minister for Health when a full home care support package will be put in place for a person (details supplied). [11050/18]
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 a 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.
327. Deputy Shane Cassells asked the Minister for Health if his attention has been drawn to the fact that hospitals are charging excessive amounts to health insurance providers for the venesections of persons with haemochromatosis (details supplied); and if he will make a statement on the matter. [11065/18]
Amharc ar fhreagraThe Health Act 1970 (as amended) provides that all people ordinarily resident in Ireland are entitled, subject to certain charges, to public in-patient hospital services including consultant services and to public out-patient hospital services. Under Section 52 of the Health Act 1970, as amended by Section 12 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.
However, on admission to a public hospital, all patients have the option of being treated as a public or private patient. Patients opting to be treated privately choose to pay the consultant and the hospital in respect of the services that each provides. On this basis, where a patient has opted to be a private patient and where venesection is classed as a day case procedure, the following statutory hospital charges under Section 55 apply.
|
Hospital Category |
Daily charge for day case in-patient services where overnight accommodation not provided |
|
Hospital Specified in Fifth Schedule |
€407 |
|
Hospital Specified in Sixth Schedule |
€329 |
The charges applied in respect of private care in a public hospital relate not only to accommodation costs but also costs associated with non-consultant hospital doctors, nursing staff, medicines, blood, medical and surgical supplies, radiology, diagnostics, operating theatres, laboratories, administration and support staff. It is also noted that patients opting to be treated privately must also pay the consultant fees associated with their treatment.
My Department is currently considering the issue of the application of the public in-patient charge of €80 for venesection in Acute Hospitals as well as broader issues in relation to the treatment of patients with Hereditary Haemochromatosis.
328. Deputy Billy Kelleher asked the Minister for Health when e-tendering will be open to those hoping to tender to become HSE providers; and if he will make a statement on the matter. [11082/18]
Amharc ar fhreagraAs this is a service matter, I have asked the HSE to reply directly to the Deputy.
329. Deputy Margaret Murphy O'Mahony asked the Minister for Health the number of persons awaiting drug rehabilitation in west County Cork; the length of time they have been waiting; and if he will make a statement on the matter. [11085/18]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
330. Deputy John Brassil asked the Minister for Health the status of the provision of a dedicated obstetrics theatre at University Hospital Kerry; and if he will make a statement on the matter. [11109/18]
Amharc ar fhreagraAs 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 as soon as possible.
332. Deputy Michael Healy-Rae asked the Minister for Health his views on a matter (details supplied) regarding electronic health records; and if he will make a statement on the matter. [11134/18]
Amharc ar fhreagraThe national eHealth Strategy has many elements with the development and integration of national ICT systems supporting health and social care at its centre. The Electronic Health Record (E.H.R.), along with the development of the Individual Health Identifier (I.H.I) are essential elements to ensure that patient data can be securely connected and shared between the various elements of our health services and providing safer, better care to patients.
The scale of the task to implement a national E.H.R. programme is considerable with a ten year programme of work to support it. Support for eHealth and the E.H.R. programme is a key recommendation in the SláinteCare Report which advocated “continued strong support of the e-health strategy - particularly ensuring the necessary funding for timely roll-out of the EHR system". eHealth deployment also forms part of the recently published National Development Plan where Project Ireland 2040 states that "The National Development Plan will support the provision of digital health services, including the development of electronic health records in many health care settings such as the New Children’s Hospital over the 10-year implementation timescale and reflects what was envisaged in the eHealth strategy for Ireland." Details of the eHealth elements of the implementation plan for Sláintecare will be announced shortly.
Significant progress is being made with the implementation of the Health Identifiers Act 2014, which provides for a system of unique identification for patients, professionals and providers. On 30 May 2017, a Commencement Order and Regulations under the Health Identifiers Act 2014 were signed, allowing for the implementation of the I.H.I. for patients. The technical implementation project of the IHI has begun with a roll-out for the integration of the identifier into various ICT systems nationally on a phased basis across health services.
In addition to the I.H.I., other national ICT systems are being introduced or standardised. For example, the Maternal and New-born system (MN-CMS) which is effectively our first national electronic patient record, has been phased-in to the Maternity Units in Kerry, Cork University Hospital, the Rotunda and the National Maternity Hospital in Dublin. It continues to be further deployed nationally on a phased basis. Other systems such as the national laboratory system (MedLIS), the national oncology management system (MOCIS) and other systems such as eReferrals are being implemented.
The HSE are currently progressing with a health portal initiative which will provide patients with access to their information. The initial focus of the health portal will be on maternity service users and will allow patients access to medical reports and upcoming appointments. The range of services available will expand as the National E.H.R. Programme progresses.
Ensuring patients and health professionals have access to the right information, in the right place, at the right time, supports more effective decision-making on the part of clinicians, improves administrative efficiency and can also empower patients to be more informed and involved in their own care or treatment. However, there must be a balance between using and sharing personal health information appropriately while continuing to protect rights to privacy and confidentiality. Patients must be assured at all times that their personal health information is handled legally, securely, efficiently and effectively in order to deliver the best possible care. The EU’s General Data Protection Regulation, which comes into effect in all member states in May, involves a single set of data protection and privacy rules and establishes a legal basis for the processing of personal data based on clear and uniform principles. The GDPR will replace the current data protection rules on the protection of individuals with regard to the processing of their personal data.
Details of the national eHealth programme of work are available at www.ehealthireland.ie.
333. Deputy Gerry Adams asked the Minister for Health the number of intermediate care vehicles deployed to 999 calls in the north east ambulance sub region in each of the years 2015 to 2018; and if he will make a statement on the matter. [11144/18]
Amharc ar fhreagraAs this is a service issue, I have asked the HSE to respond to you directly.
334. Deputy Gerry Adams asked the Minister for Health the number of persons waiting on home help hours in CHO Area 8; the number of persons waiting in County Louth; and the length of time these persons have been waiting for home help hours. [11147/18]
Amharc ar fhreagra335. Deputy Gerry Adams asked the Minister for Health the number of home help hours which were allocated to persons in CHO Area 8 in each of the years 2011 to 2017, and to date in 2018; and the number which were allocated to County Louth for the same period. [11148/18]
Amharc ar fhreagra336. Deputy Gerry Adams asked the Minister for Health the amount of which funding was allocated to provide home help hours in CHO Area 8 in each of the years 2011 to 2018; the amount of which was allocated to home help hours in County Louth; and if he will make a statement on the matter. [11149/18]
Amharc ar fhreagraI propose to take Questions Nos. 334 to 336, inclusive, together.
As these are service matters I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
337. Deputy Billy Kelleher asked the Minister for Health the way in which and the reason the decision was made to allow the continuous glucose monitoring system for diabetes patients under 21 years of age; and if he will make a statement on the matter. [11152/18]
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.
338. Deputy Billy Kelleher asked the Minister for Health when the proposed review of the continuous glucose monitoring system will take place; the measures the review would need to find in order to roll out the programme to all diabetic patients; and if he will make a statement on the matter. [11153/18]
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.
339. Deputy Billy Kelleher asked the Minister for Health if he has received a date for the approval of the model of care for rheumatic and musculoskeletal disorders from the acute hospital division of the HSE; and if he will make a statement on the matter. [11165/18]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
340. Deputy Billy Kelleher asked the Minister for Health the reason there has been such a delay in the model of care for rheumatic and musculoskeletal disorders which was clinically approved by the clinical advisory group of the national clinical programme for rheumatology in July 2016 (details supplied); and if he will make a statement on the matter. [11166/18]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
341. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the cost of providing home care services on an annual basis from 2013 to 2017 and to date in 2018 by CHO area; the division of funding provided by the HSE on a public versus private basis; and if he will make a statement on the matter. [11174/18]
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.
342. Deputy Stephen S. Donnelly asked the Minister for Health if his attention has been drawn to the fact that no progress has been made in the case of a person (details supplied); and if he will make a statement on the matter. [11184/18]
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 a service issue, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
343. Deputy Niamh Smyth asked the Minister for Health the status of plans to amend the fair deal scheme for farming families; and if he will make a statement on the matter. [11203/18]
Amharc ar fhreagraFollowing my reply to your PQ7918 of the 15 February 2018 the position remains similar. I hope to bring a memo to government in the coming weeks seeking government approval to amend the provisions of the Nursing Homes Support Scheme, to introduce the proposed changes. Primary legislation would then be required to give effect to the changes.
344. Deputy James Browne asked the Minister for Health the position regarding a proposed development of an extension to Wexford General Hospital; and if he will make a statement on the matter. [11208/18]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to you directly as soon as possible.
