Thursday, 8 Mar 2018

Written Answers Nos. 345-369

HSE Funding

Ceisteanna (345)

Pearse Doherty

Ceist:

345. Deputy Pearse Doherty asked the Minister for Health the funding provided to section 39 bodies in each of the past ten years in tabular form; and if he will make a statement on the matter. [11209/18]

Freagraí scríofa

Minister for Health

This question has been referred to the HSE for direct response to the Deputy.

Autism Support Services

Ceisteanna (346)

Peter Fitzpatrick

Ceist:

346. Deputy Peter Fitzpatrick asked the Minister for Health if funding is available for a person (details supplied) who has to take their child privately to be assessed for autism; and if he will make a statement on the matter. [11244/18]

Freagraí scríofa

Minister of State at the Department of Health

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.

Hospital Appointments Status

Ceisteanna (347)

Barry Cowen

Ceist:

347. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) can expect an appointment. [11247/18]

Freagraí scríofa

Minister for Health

Under 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.

Hospital Appointments Status

Ceisteanna (348)

Barry Cowen

Ceist:

348. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) can expect an appointment. [11248/18]

Freagraí scríofa

Minister for Health

Under 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.

Services for People with Disabilities

Ceisteanna (349, 350, 351)

James Browne

Ceist:

349. Deputy James Browne asked the Minister for Health the funding which has been set aside in each of the past five years to address the issue of loneliness and social isolation; if his Department or agencies under the remit of his Department have funded research on the topic of loneliness and social isolation; if his Department or agencies under the remit of his Department have projects planned which would address the issues of loneliness or social isolation; and if he will make a statement on the matter. [11250/18]

James Browne

Ceist:

350. Deputy James Browne asked the Minister for Health his views on whether loneliness and social isolation are some of the greatest public health risks; the steps he plans to take to combat this issue; and if he will make a statement on the matter. [11251/18]

James Browne

Ceist:

351. Deputy James Browne asked the Minister for Health the funding which has been set aside in each of the past five years to address the issue of loneliness and social isolation in particular amongst those with disabilities; if his Department or agencies under the remit of his Department have funded research on the topic of loneliness and social isolation; if his Department or agencies under the remit of his Department have projects planned which would address the issues of loneliness or social isolation; and if he will make a statement on the matter. [11255/18]

Freagraí scríofa

Minister of State at the Department of Health

I propose to take Questions Nos. 349 to 351, 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.

The department of Health is also responsible for the development of policy on, and oversight of, the provisions of specialist health and personal social services for people with disability, including the reform programme for health funded specialist disability services.

Transforming Lives is the programme to implement the recommendations of the Value for Money and Policy Review of Disability Services. The Review is a multi-year project which is resulting in very significant changes to the way in which services and supports for people with disabilities are delivered in moving away from institutional models of care and service delivery to community based, person centred, models of service. The implementation of the recommendations in the VFM Review continues to be a priority in the HSE’s National Service Plan for 2018.

The Report “Time to Move on from Congregated Settings – A Strategy for Community Inclusion” proposes a new model of support in the community moving people from Congregated settings to the community in line with Government policy.

The Programme for Partnership Government contains a commitment to continue to move people with disabilities out of congregated settings, to enable them to live independently and to be included in the community.  The objective is to reduce this figure by one-third by 2021 and ultimately, to eliminate all congregated settings.

At the end of December 2017, there were less than 2,400 people with a disability living in congregated settings. The HSE has prioritised the transition of 170 people from congregated settings in 2018 under its Service Plan. The HSE has established a subgroup, under the Value for Money Steering Group, which is developing an implementation plan for moving people from institutions that will be rolled out at a regional and local level, in full consultation with residents and their families.

To ensure that the needs of people transitioning from congregated settings are fully taken into account during the process, the model of care for individuals will be based on a person centred plan (PCP). The PCP may change over time in line with an individual’s needs and circumstances and the model of service delivery applicable at a particular time.

I am acutely aware of the degree of social isolation experienced by people with a disability.

The Deputy will be interested to know that in my portfolio as Minister of State at the Department of Employment Affairs and Social Protection, yesterday, together with my colleague Regina Doherty, I launched an extensive consultation process in relation to how our Department can support people with disabilities to obtain and retain employment. I firmly believe that securing employment can play a fundamental part in helping with the difficulties of social isolation experienced by many people with a disability.

In the context of the Deputy’s specific questions on the issues of loneliness and social isolation, in particular among people with a disability, he may wish to access the research conducted by IDS TILDA. This is a longitudinal study researching ageing in Ireland among people with an intellectual disability aged 40 and over, funded by the Department of Health, through the Health Research Board. Their website is http://www.idstilda.tcd.ie/.

National Development Plan

Ceisteanna (352)

Micheál Martin

Ceist:

352. Deputy Micheál Martin asked the Minister for Health if meetings have been held in his Department regarding the new hospitals announced in the NDP and NPF; when the process will begin; and if he will make a statement on the matter. [11288/18]

Freagraí scríofa

Minister for Health

The National Development Plan provides €10.9 billion to invest in infrastructure, equipment and additional service capacity for the public health sector. This represents an increase of 165% in capital funding over the previous decade.

It is important to recognise that this is a long-term plan which provides for a large number of Health developments across the country, including both national programmes and individual projects, across acute, primary and social care. We must ensure that we carefully plan the use of this capital funding so as to meet the population needs and achieve value for money. Health capital projects currently underway will continue including the new Children's Hospital, the new National Rehabilitation Hospital and the new National Forensic Mental Health Service Hospital.

As is to be expected with a ten year plan, many proposals, including new elective-only hospitals in Dublin, Cork and Galway, are at an early stage and will require to progress through appraisal, planning, design and tender before a firm location, timeline or funding required can be established.

These matters are the subject of ongoing meetings in my Department.

Motorised Transport Grant

Ceisteanna (353, 374)

Jim O'Callaghan

Ceist:

353. Deputy Jim O'Callaghan asked the Minister for Health when he plans to provide a scheme to replace the motorised transport grant for persons with disabilities which ended in 2013. [11340/18]

Niall Collins

Ceist:

374. Deputy Niall Collins asked the Minister for Health when an alternative scheme will be devised to replace the motorised transport grant which was closed to new applicants in 2013; and if he will make a statement on the matter. [11441/18]

Freagraí scríofa

Minister of State at the Department of Health

I propose to take Questions Nos. 353 and 374 together.

The Deputies will be familiar with the background to the closure of both the Mobility Allowance and Motorised Transport Grant schemes in February 2013. 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.

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.

With regard to the Motorised Transport Grant, this scheme operated as a means-tested grant to assist persons with severe disabilities with the purchase or adaptation of a car, where that car was essential to retain employment. The maximum Motorised Transport Grant, which was payable once in any three-year period, was €5,020. Following closure of the 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.

Autism Support Services

Ceisteanna (354, 355)

James Browne

Ceist:

354. Deputy James Browne asked the Minister for Health the number of children in CHO5 awaiting autism spectrum disorder diagnostic assessment for more than three, six, nine, 12, 18, 24 and 36 months; and if he will make a statement on the matter. [11344/18]

James Browne

Ceist:

355. Deputy James Browne asked the Minister for Health the number of children in County Wexford awaiting autism spectrum disorder diagnostic assessment for more than three, six, nine, 12, 18, 24 and 36 months; and if he will make a statement on the matter. [11345/18]

Freagraí scríofa

Minister of State at the Department of Health

I propose to take Questions Nos. 354 and 355 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.

Cross-Border Health Initiatives

Ceisteanna (356)

Niamh Smyth

Ceist:

356. Deputy Niamh Smyth asked the Minister for Health if a person (details supplied) can access a drug for his condition; if so, if he will be reimbursed for same; if it can be accessed under the cross-border health directive; and if he will make a statement on the matter. [11363/18]

Freagraí scríofa

Minister for Health

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.

The HSE received separate applications for the reimbursement of Nivolumab (Opdivo) for eight separate indications, including for use as a combination therapy in 2017.

In October 2017, Nivolumab was approved by the HSE for the treatment of:

- melanoma (monotherapy);

- renal cell carcinoma, and

- Hodgkins Lymphoma.

The HSE decided not to support the use of Nivolumab in the treatment of locally advanced or metastatic non-small cell lung cancer. The HSE Drugs Group did not consider the evidence for clinical benefit to be sufficiently robust in the context of the proposed price and budget impact.

The company is welcome to submit a new reimbursement application which will be assessed in line with the 2013 Act.

The EU Directive 2011/24/EU on Patients’ Rights in Cross Border Healthcare aims to ensure EU citizens may access safe and good quality healthcare services across EU borders. The Directive establishes a framework for cross border healthcare between EU/EEA states to facilitate patients to access care in another Member State in accordance with their entitlements in their own country. Under the Directive, known as the Cross Border Healthcare Directive (CBD), insured patients are entitled to have the costs of cross-border healthcare services reimbursed if the healthcare service in question is among the benefits to which they are entitled in their Member State of affiliation. As such, it allows Irish residents to avail of healthcare in other EU or EEA (excluding Switzerland) Member States that they would be entitled to within the public health system in Ireland, which is not contrary to Irish legislation.

As Nivolumab is not currently available within the public health system in Ireland for use for people with lung cancer, it would not be possible to avail of it abroad under the Cross Border Directive.

Hospital Waiting Lists Data

Ceisteanna (357)

Eugene Murphy

Ceist:

357. Deputy Eugene Murphy asked the Minister for Health the number of persons waiting for an ENT appointment in each CHO area in tabular form; and the number waiting zero to six, six to 12 and more than 12 months respectively. [11364/18]

Freagraí scríofa

Minister for Health

The National Treatment Purchase Fund (NTPF) publishes the Inpatient/Daycase and Outpatient waiting list figures by specialty for each hospital on its website each month. This information is available at www.NTPF.ie.

The attached document sets out the number of persons waiting for an ENT appointment in each Hospital Group at the end of January 2018; and the number waiting 0 to 6, 6 to 12 and more than 12 months respectively.

Inpatient/Day Case Otolaryngology (ENT) waiting list by Hospital Group

Group	0–6 Months	6–12 Months	12+ Months	Total
Dublin Midlands Hospital Group	651	234	512	1397
Ireland East Hospital Group	376	159	91	626
RCSI Hospitals Group	482	224	29	735
Saolta Hospital Group	786	484	569	1839
South/South West Hospital Group	623	207	185	1015
The Children’s Hospital Group	119	42	90	251
University Limerick Hospitals Group	331	149	125	605
Small Volume Hospitals	1	1		2
Total	3369	1500	1601	6470

From NTPF Inpatient / Day Case Active Waiting List published data for January 2018

Hospital Appointments Status

Ceisteanna (358)

Willie Penrose

Ceist:

358. Deputy Willie Penrose asked the Minister for Health the steps which will be taken to have a person (details supplied) admitted to hospital; and if he will make a statement on the matter. [11379/18]

Freagraí scríofa

Minister for Health

Under 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.

Hospital Appointments Status

Ceisteanna (359)

Timmy Dooley

Ceist:

359. Deputy Timmy Dooley asked the Minister for Health when a person (details supplied) in County Clare will have a knee replacement; and if he will make a statement on the matter. [11395/18]

Freagraí scríofa

Minister for Health

Under 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.

Speech and Language Therapy Provision

Ceisteanna (360)

Michael McGrath

Ceist:

360. Deputy Michael McGrath asked the Minister for Health when a child (details supplied) in County Cork will receive further speech and language therapy. [11396/18]

Freagraí scríofa

Minister of State at the Department of Health

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.

Health Services Provision

Ceisteanna (361)

Michael McGrath

Ceist:

361. Deputy Michael McGrath asked the Minister for Health the details of the intervention services occupational therapy, speech and language therapy and physiotherapy that will be provided for a child (details supplied) in County Cork. [11401/18]

Freagraí scríofa

Minister of State at the Department of Health

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.

Treatment Abroad Scheme

Ceisteanna (362)

James Browne

Ceist:

362. Deputy James Browne asked the Minister for Health the number of occasions on which persons under 18 years of age received treatment in the United Kingdom in each of the past four years; and if he will make a statement on the matter. [11402/18]

Freagraí scríofa

Minister for 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 Policy

Ceisteanna (363)

Róisín Shortall

Ceist:

363. Deputy Róisín Shortall asked the Minister for Health the bodies or person that were invited by the independent review group on the removal of private practice from public hospitals to make a submission. [11411/18]

Freagraí scríofa

Minister for Health

I established an independent review group, led by Dr Donal de Buitléir, to examine the separation of private activity from public hospitals.

The consultation process to be followed is a matter for the independent review group.

I understand that the group undertook a public consultation exercise - advertised in the national media, on the Department's website and on social media - and also wrote to relevant organisations, in order to receive written input from members of the public and interested stakeholders.

I expect that the review group will continue to engage with all relevant stakeholders, prior to reporting back to me with their recommendations.

National Maternity Hospital Status

Ceisteanna (364)

Róisín Shortall

Ceist:

364. Deputy Róisín Shortall asked the Minister for Health the status of the new national maternity hospital; and when a legal agreement on retaining this hospital in public ownership will be reached. [11412/18]

Freagraí scríofa

Minister for Health

Following the grant of planning permission for the new National Maternity Hospital (NMH) on the St. Vincent's University Hospital campus, the Design Team is continuing to work on the detailed design of the hospital and the preparation of tender documents.

I can assure the Deputy that we are making progress on the draft legal framework which will ensure that the State's significant investment in the new maternity hospital will be protected. While completion of the detailed legal agreement will require further engagement between both hospitals, the HSE and my Department, I can confirm that a broad understanding has been reached on the way forward. This will protect the State's resources in investing in this important project and it will also further underpin the operational independence of the maternity hospital. The Deputy will, I hope, appreciate that pending finalisation of agreement between all stakeholders, it is premature for me to give any further information at this point.

Hospital Consultant Contracts

Ceisteanna (365)

Róisín Shortall

Ceist:

365. Deputy Róisín Shortall asked the Minister for Health if he will report on progress on responding to the issues raised in the media (details supplied); and if he will make a statement on the matter. [11413/18]

Freagraí scríofa

Minister for Health

My Department has been engaged with the HSE in relation to consultants complying with the private practice provisions of their contracts since last summer and, in particular, since the RTE Investigates programme of 21 November last.

I have made it very clear that consultants must deliver their work commitment to the public system. In that context, the Department has emphasised the need for robust measures to ensure compliance and that consultants deliver their work commitment to the public system.

The HSE has submitted details of measures it has implemented and proposals in train. On 12 February the Director General of the HSE confirmed to the Secretary General that all Hospital Groups have been directed to put in place a robust assurance process with each of their hospitals to confirm contract compliance, including a monthly monitoring process by hospitals of performance at individual consultant level.

A meeting has been arranged between officials of my Department and senior HSE Management on 22 March 2018 to discuss these proposals and any other measures that may be required to ensure that the arrangements in place are sufficiently robust to monitor consultants activity and to ensure compliance.

In the longer term I have established an independent group, chaired by Dr Donal de Buitléir, to examine the impact of separating private practice from the public hospital system given that this was one of the key recommendations of the Sláintecare Report.

General Practitioner Contracts

Ceisteanna (366)

Róisín Shortall

Ceist:

366. Deputy Róisín Shortall asked the Minister for Health the reason for the delay in negotiating a new general practitioner contract; and timeframe to complete these negotiations. [11414/18]

Freagraí scríofa

Minister for Health

The Government is committed to delivering more non-acute care within the primary care sector, so that better care close to home can be provided for communities around the country.

General Practitioners play an important role in the primary care system. It is generally accepted that there is a need to modernise the current GMS contract and ensure that general practice is a viable and rewarding career for medical graduates. My aim is to develop a contract which has a population health focus, providing in particular for health promotion and disease prevention and for the structured ongoing care of chronic conditions. A new contract must be flexible and be able to respond to the changing nature of the GP workforce. It must also include provisions in relation to service quality and standards, performance, accountability and transparency.

It is essential that engagement on GP contractual issues is aimed squarely at meeting the substantial challenges, current and future, the health service and general practice face. The latest phase of engagement with GP representatives commenced in January 2017, and discussions were progressed on a wide range of items throughout 2017.  Discussions are currently paused, and, at my request, officials of my Department are working with their counterparts in the Department of Public Expenditure and Reform and in the HSE to ensure that the overall approach is focused fully on the strategic challenges and on the Government’s health services reform agenda. It is important to ensure that any new contract will result in service improvements across general practice benefitting both patients and GPs.

I expect that engagement with GP representative bodies will recommence shortly. I look forward to further progress in the coming months on the GP contract.

Hospital Procedures

Ceisteanna (367)

Róisín Shortall

Ceist:

367. Deputy Róisín Shortall asked the Minister for Health if approval will be given to the provision of electronic leg prostheses to public patients in view of the better performance of same for persons compared to the type used currently; and if he will make a statement on the matter. [11415/18]

Freagraí scríofa

Minister for Health

As this is a service matter it has been referred to the HSE for direct reply to the Deputy.

Health Services Provision

Ceisteanna (368, 369)

Niamh Smyth

Ceist:

368. Deputy Niamh Smyth asked the Minister for Health if nursing support for a person (details supplied) will be provided; and if he will make a statement on the matter. [11422/18]

Niamh Smyth

Ceist:

369. Deputy Niamh Smyth asked the Minister for Health if nursing support for a person (details supplied) will be provided; and if he will make a statement on the matter. [11423/18]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 368 and 369 together.

As this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.