Written Answers Nos 218-228
218. Deputy Thomas P. Broughan asked the Minister for Health if the Pre-Hospital Emergency Care Council has established a fitness to practise committee; if the committee has lay member appointees; the number of members; the number of lay members; and if he will make a statement on the matter. [13468/18]
Amharc ar fhreagraThe Pre-Hospital Emergency Care Council (PHECC) is an independent statutory body with responsibility for professional regulation in the area of pre-hospital emergency care including the recognition of professional qualifications.
Accordingly, the Deputy's query has been referred to PHECC for direct response.
219. Deputy Niamh Smyth asked the Minister for Health if there is assistance or exemptions for persons (details supplied) struggling to pay prescription charges for their medication; and if he will make a statement on the matter. [13498/18]
Amharc ar fhreagraAll medical card holders are required to pay a prescription charge of €2 per item for medicines and other prescription items supplied to them by community pharmacies under the General Medical Services scheme. This charge is subject to a monthly cap of €20 for each person or family. This ensures that no person or family pays more than €20 per month.
Any future change to the prescription charge is a matter which I intend to consider in the context of the implementation of the health commitments in the Programme for Government and having regard to the funding available.
220. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [13499/18]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for direct reply to the Deputy.
221. Deputy Tom Neville asked the Minister for Health if non-premium phone numbers will be made available to persons who need to contact out-of-hours doctors services (details supplied); and if he will make a statement on the matter. [13506/18]
Amharc ar fhreagraAs this question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive for direct reply.
222. Deputy Michael Healy-Rae asked the Minister for Health the position regarding the future for cardiology patients (details supplied) in County Kerry; and if he will make a statement on the matter. [13509/18]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to you directly as soon as possible.
223. Deputy Robert Troy asked the Minister for Health the reason Versatis plasters and patches are no longer being prescribed (details supplied). [13510/18]
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 16 March 2018, there have been 5,504 online applications from GPs requesting the reimbursement of Versatis. Of these applications, 1,059 patients (over 19%) have been approved.
Some 526 online appeals have been made, and over 69% of these patients have been approved. The MMP has sought further information on 38 appeals before a recommendation on reimbursement can be made.
Since 1 September 2017, some 1,421 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 recently, 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 reimbursement decision is a matter for the HSE. However, I fully support the objectives of the HSE Medicines Management Programme.
224. Deputy Darragh O'Brien asked the Minister for Agriculture, Food and the Marine the regulatory framework in place with respect to animal welfare and lionising of exotic animals and pets; and if he will make a statement on the matter. [13333/18]
Amharc ar fhreagraThe Animal Health and Welfare Act 2013 provides for the welfare, including during a sale, of all animals.
EU Directive 92/65/EEC (the "Balai Directive") provides for the authorisation of organisations such as zoos that move certain animals between EU Member States.
TRACES (TRAde Control and Expert System) monitors intra-EU trade and the importation of animals, and therefore serves as a record of movements of animals between EU Member States.
There are a number of legislative acts under the remit of the Minister for Culture, Heritage and the Gaeltacht that provide for the protection of animals. These include the Wildlife Acts 1976 to 2012, and legislation on habitats and on CITES.
The European Communities (Birds & Natural Habitats) Regulation 2011 restricts the importation, distribution, sale or release of approximately 70 species of plants and animals considered to be harmful invasive alien species of national concern. It is an offence to breed, reproduce or release an animal listed as an invasive alien species.
Animals covered by the EU Habitats Directive, such as otters and bats, are afforded strict protection and may not be sold in pet shops.
The Convention on International Trade in Endangered Species of Flora and Fauna (CITES) regulates international trade in close to 35,000 species of plants and animals. It seeks to ensure that international trade in listed species is sustainable, legal and traceable.
Dog licences are under the remit of the local authorities.
225. Deputy Mattie McGrath asked the Minister for Agriculture, Food and the Marine the number of horses slaughtered for human consumption in 2017 by studbooks (details supplied); and the age and gender of the 7,260 horses slaughtered for the food chain in 2017. [13338/18]
Amharc ar fhreagraThe following table provides details of the numbers of horses slaughtered for human consumption at Department-approved slaughter establishments over the past number of years. Records maintained by my Department do not indicate the age and gender of each animal:
|
Year |
Horses |
|
2012 |
24,362 |
|
2013 |
10,711 |
|
2014 |
7,602 |
|
2015 |
6,033 |
|
2016 |
7,618 |
|
2017 |
7,748 |
226. Deputy Mattie McGrath asked the Minister for Agriculture, Food and the Marine the equine industry cull rate (details supplied). [13339/18]
Amharc ar fhreagraDairy and beef culling rates are in general estimated from data stored in DAFM data bases for the bovine species. It is normally calculated from the numbers estimated as leaving the national herd compared to the total number of calvings in a year.
However this type of in-depth information on equines is not available at the moment. In addition, equines are bred for multiple purposes and on average have much longer life longevity compared to other farm species which would add to the complexity of such a calculation.
227. Deputy Mattie McGrath asked the Minister for Agriculture, Food and the Marine his views on whether the issue of equines being stamped out of the food chain is a contributory factor to the seizure of horses and ponies without the correct paperwork (details supplied) under the Control of Horses Act 1996 at a cost of €4.5 million in each of the years 2014 to 2017; his plans to review this system; and if the payment of such items will continue. [13340/18]
Amharc ar fhreagraEquines seized under the Control of Horses Act 1996 are generally done so on the basis that they are straying, causing a nuisance or posing a danger. In these circumstances they are unlikely to be under the care of their keepers. Accordingly, any identification document issued in respect of the animals will not be available immediately.
Where, at the point of seizure, a microchip cannot be detected in an equine, it is not possible to determine the identification status or food chain eligibility of that animal. The absence of a microchip does not necessarily render an equine unidentified as microchips are required only for equines identified with a passport from 1 July 2009 onwards.
EU legislation governing the identification of equines is Commission Implementing Regulation 262/2015 (CR 262/2015), as transposed into national law via S.I. 62 of 2016.
S.I. 62 of 2016 requires that an application for an equine passport must be made within 6 months of the recorded date of birth of the equine. CR 262/2015 provides that all equines must be issued with an identification document (passport) recording the number of the approved microchip implanted into the equine by a private veterinary practitioner, no later than 12 months from the date of birth of the animal. Identification documents issued after that time must be in the format of replacement/duplicate documents which must be stamped to irrevocably exclude the related equines from the food chain.
CR 262/2015 endeavours to protect the food chain and public health in ensuring that only those equines eligible for the food chain are slaughtered for human consumption. It is a binding legislative Act that must be applied in its entirety across the EU.
228. Deputy Mattie McGrath asked the Minister for Agriculture, Food and the Marine if data is gathered via microchips or DNA samples as to the breed categories of the 9,000 horses and ponies seized under the Control of Horses Act 1996 in each of the years 2014 to 2017, such as thoroughbred, warmbloods, sport horses, Connemara ponies, Kerry bog ponies and so on. [13341/18]
Amharc ar fhreagraThe Control of Horses Act 1996 details powers available to local authorities for the control and welfare of horses. Evidence from the local authorities indicates that the majority of horses seized under the Act are not microchipped and while owners of seized horses are given five days to reclaim their horses, very few are in fact reclaimed. The legislation governing equine identification provides that all equines must be identified with a passport no later than 12 months from the date of birth of the animal; there is no requirement for equines identified prior to 1 July 2009 to have a transponder implanted.
The Animal Health and Welfare Act 2013 places an obligation on all those in charge of an animal to meet the animal’s needs. Horses impounded under the Control of Horses Act are often in a very poor state and invariably have not been identified by their owners. Taking DNA samples from these animals for testing would be a prohibitive cost to the taxpayer and has limited value in the absence of an existing library of DNA samples against which to compare.
The Farm Animal Welfare Advisory Council (FAWAC) advises all horse owners to adhere to the legal requirement for all horses to be identified and in possession of a valid passport and reiterate that it is the responsibility of horse owners throughout the country to ensure the welfare of horses in their care. Cases of horse cruelty and abandonment should be forwarded to the Animal Welfare Helpline for investigation email animalwelfare@agriculture.gov.ie.
