Tuesday, 17 Apr 2018

Written Answers Nos. 979-996

Hospital Appointments Status

Ceisteanna (980)

Seán Sherlock

Ceist:

980. Deputy Sean Sherlock asked the Minister for Health when a person (details supplied) in County Kildare will be called for a medical procedure. [16468/18]

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.

Disease Management

Ceisteanna (981, 986, 1029)

Niamh Smyth

Ceist:

981. Deputy Niamh Smyth asked the Minister for Health his plans to implement a similar practice to that in Germany for the detection and treatment of Lyme disease; his further plans to improve follow up care for persons following diagnosis; his views on whether current training for doctors is adequate; and if he will make a statement on the matter. [16503/18]

Peadar Tóibín

Ceist:

986. Deputy Peadar Tóibín asked the Minister for Health his plans to implement a similar practice to that in Germany for the detection and treatment of Lyme disease; his plans to improve follow up care for persons following diagnosis; his views on whether current training for doctors is adequate; and if he will make a statement on the matter. [16520/18]

Pat Deering

Ceist:

1029. Deputy Pat Deering asked the Minister for Health his plans to implement a similar practice to that in Germany for the detection and treatment of Lyme disease; his plans to improve follow up care for persons following diagnosis; his views on whether current training for doctors is adequate; and if he will make a statement on the matter. [16760/18]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 981, 986 and 1029 together.

Lyme disease (also known as Lyme borreliosis) is an infection caused by a spiral-shaped bacterium called Borrelia burgdorferi. It is transmitted to humans by bites from ticks infected with the bacteria. The infection is generally mild affecting only the skin but can occasionally be more severe and highly debilitating. Lyme disease is diagnosed by medical history and physical examination. The infection is confirmed by blood tests which look for antibodies produced by an infected person's body in response to the infection. These normally take several weeks to develop and may not be present in the early stages of the disease. The standard laboratory approach to Lyme diagnostics is a two-stage approach and has been agreed by experts from the Scientific Advisory Committee of the Health Protection Surveillance Centre and other Irish and international experts. This testing is available in Ireland.

Laboratories in Ireland generally follow the laboratory testing recommendations of the US Centres for Disease Control and Prevention, the Infectious Disease Society of America, the European Federation of Neurological Societies, and the British Infection Association. Irish laboratories have their own quality assurance methods to make sure the tests are working correctly as well as being accredited by the Irish National Accreditation Body to perform the test correctly. In undertaking Lyme testing, it is essential that the results are interpreted in the light of the clinical condition of the patient. If the result of this initial screen is equivocal, the patient's samples are referred to the U.K.'s Rare and Imported Pathogens Laboratory. This laboratory uses a two-tier system recommended by American and European authorities which involves a screening test followed by a confirmatory test.

Testing which is performed abroad may be performed in laboratories which have not met National or International Accreditation (Quality Standards). These tests may be more likely to give a “false positive” result.

Lyme disease can be very successfully treated using common antibiotics by General Practitioners. These antibiotics are effective at clearing the rash and helping to prevent the development of complications. Antibiotics are generally given for up to three weeks. If complications develop, intravenous antibiotics may be considered.

The HSE Health Protection Surveillance Centre website (www.hpsc.ie) gives extensive information on Lyme disease diagnosis, treatment and how to avoid tick bites. A Lyme Disease Subcommittee of the Scientific Advisory Committee of HPSC with professional clinical, entomological, scientific and environmental health expert representation (including a representative of the Lyme Support Group, Tick-Talk Ireland) has been established to explore all possible ways of raising awareness about Lyme disease. This Subcommittee is expected to meet shortly with a view to finalising it report. This report will cover a number of areas, including initiatives undertaken to date, summary advice relating to awareness, preventive advice for the general public, preventive advice and material for those responsible for sites or locations known to have or suspected as having higher densities of ticks, and summary advice relating to GP management of the condition. Any person who is suffering ill health is eligible to seek medical attention, and to access appropriate health and social care services, irrespective of the cause of their symptoms.

Medicinal Products Availability

Ceisteanna (982)

Robert Troy

Ceist:

982. Deputy Robert Troy asked the Minister for Health if the drug Ocrelizumeb will be approved for MS sufferers here (details supplied). [16504/18]

Freagraí scríofa

Minister for Health

The HSE has statutory responsibility for medicine pricing and reimbursement decisions, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. The Act specifies the criteria for decisions on the reimbursement of medicines.

The 2013 Act does not give the Minister for Health any powers in this regard.  The HSE does not require approval or consent from the Minister or Government when making a reimbursement decision.

HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).

The NCPE conducts health technology assessments (HTAs) for the HSE, and makes recommendations on reimbursement to assist HSE decisions. The NCPE uses a decision framework to systematically assess whether a drug is cost-effective as a health intervention

As outlined in the IPHA agreement, and in line with the 2013 Act,  the HSE will decide, within 180 days of receiving the application (or a longer period if further information is sought from the company), to either:

1. add the medicine to the reimbursement list or agree to reimburse it as a hospital medicine,

2. refuse to reimburse the medicine.

The HSE strives to reach a decision in as timely a manner as possible and within the 180 days. However, because of the significant monies involved, it must ensure that the best price is achieved, as these commitments are often multi-million euro investments on an on-going basis. Successful price negotiations also allow for further drugs to be approved within the finite budget available.

I have been informed that the NCPE are currently conducting health technology assessments for Ocrelizumab for the treatment of adult patients with early primary progressive multiple sclerosis (PPMS) and for the treatment of adult patients with relapsing forms of multiple sclerosis (RMS).

Hospital Waiting Lists

Ceisteanna (983, 1017, 1037)

John Deasy

Ceist:

983. Deputy John Deasy asked the Minister for Health if his attention has been drawn to the fact that more than 900 children are on the waiting list for three years in Crumlin children’s hospital to be seen, diagnosed and treated for juvenile arthritis; if his attention has been further drawn to the fact that the World Health Organization recommends a country of Ireland’s population should have a minimum of six paediatric rheumatologists with a treatment waiting time of no more than six weeks; and the steps being taken to ensure more timely treatment is provided in these cases. [16505/18]

Brendan Howlin

Ceist:

1017. Deputy Brendan Howlin asked the Minister for Health the actions the HSE has taken to date to deal with the increasing waiting lists for children seeking paediatric rheumatology treatment; the number of children on the waiting list; the waiting period involved; if this number is compliant with the World Health Organization standards; if not, his plans or those of the HSE to deal with this matter; and if he will make a statement on the matter. [16709/18]

Jim O'Callaghan

Ceist:

1037. Deputy Jim O'Callaghan asked the Minister for Health the steps being taken to reduce the waiting list in Our Lady's Children's Hospital, Crumlin for children to be seen, diagnosed and treated for juvenile arthritis; and if he will make a statement on the matter. [16779/18]

Freagraí scríofa

Minister for Health (Deputy Simon Harris)

I propose to take Questions Nos. 983, 1017 and 1037 together.

I am aware that there are challenges in meeting the growing demand for rheumatology services, and that the Health Service Executive is working towards improving access to such services.  In relation to rheumatology service provision, as this is a service matter, I have asked the Health Service Executive to respond to you directly as soon as possible.

Paediatric Services

Ceisteanna (984, 985)

Clare Daly

Ceist:

984. Deputy Clare Daly asked the Minister for Health his plans to amend or abolish the terms of loco parentis in paediatric home care packages; and if he will make a statement on the matter. [16517/18]

Clare Daly

Ceist:

985. Deputy Clare Daly asked the Minister for Health his plans to request that the HSE take on board the recommendation for a parent representative to be included on the Primary Care Steering Group in view of a motion of support for same passed by Seanad Éireann earlier in 2018. [16518/18]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 984 and 985 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.

Question No. 986 answered with Question No. 981.

Cross-Border Health Services Provision

Ceisteanna (987)

Marc MacSharry

Ceist:

987. Deputy Marc MacSharry asked the Minister for Health when a person (details supplied) in County Donegal will receive a decision on their application to the Cross Border Directive for reimbursement of expenses for a medical procedure which was sent in January 2018; and if he will make a statement on the matter. [16521/18]

Freagraí scríofa

Minister for Health

Under the terms of the relevant legislation, Statutory Instruments 203 of 2014 and 65 of 2015, the Health Service Executive operates the EU Directive on Patients’ Rights in Cross Border Healthcare in Ireland, including the reimbursement of patients.

Accordingly the HSE has been asked to examine this matter and to reply to the Deputy as soon as possible.

Paediatric Services

Ceisteanna (988)

Catherine Murphy

Ceist:

988. Deputy Catherine Murphy asked the Minister for Health the status of the Primary Care Steering Group (details supplied); the status of the abolition of the loco parentis clause in paediatrics homecare packages; and if he will make a statement on the matter. [16587/18]

Freagraí scríofa

Minister for Health

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.

Disease Management

Ceisteanna (989)

Róisín Shortall

Ceist:

989. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Questions Nos. 174 of 14 December 2016 and 227 of 24 May 2017, the status of the work of the Lyme borreliosis subcommittee; his plans to update processes for the detection and treatment of Lyme disease; his further plans to improve follow up care for persons following diagnosis; his views on whether training for doctors is adequate in this regard; the screening processes in place to ensure that blood donations are screened for Lyme borreliosis; and if he will make a statement on the matter. [16588/18]

Freagraí scríofa

Minister for Health

As this PQ refers to the Lyme borreliosis subcommittee of the Health Protection Surveillance Centre, I have referred it to the Health Service Executive for attention and direct reply to the Deputy.

Protected Disclosures

Ceisteanna (990)

Bríd Smith

Ceist:

990. Deputy Bríd Smith asked the Minister for Health if his attention has been drawn to the refusal by the management at Our Lady's Hospice in Harold's Cross to accept a protected disclosure from members of its staff; the obligations on employers under this legislation; and if he will make a statement on the matter. [16591/18]

Freagraí scríofa

Minister for Health

As the question refers to a Section 38 Agency which is governed by the Health Service Executive, this is a matter for the HSE.

This question has been referred to the Executive for direct reply to the Deputy.

Home Help Service Provision

Ceisteanna (991)

Michael Healy-Rae

Ceist:

991. Deputy Michael Healy-Rae asked the Minister for Health if a person (details supplied) will be considered for additional hours of home help; and if he will make a statement on the matter. [16599/18]

Freagraí scríofa

Minister of State at the Department of Health

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Home Care Packages Provision

Ceisteanna (992)

Thomas Byrne

Ceist:

992. Deputy Thomas Byrne asked the Minister for Health when a home care package awarded to a person (details supplied) will be put in place. [16601/18]

Freagraí scríofa

Minister of State at the Department of Health

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Disabilities Assessments

Ceisteanna (993)

Jackie Cahill

Ceist:

993. Deputy Jackie Cahill asked the Minister for Health when a person (details supplied) will receive an appointment for an assessment of needs; and if he will make a statement on the matter. [16603/18]

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.

Question No. 994 answered with Question No. 727.

Mental Health Services Data

Ceisteanna (995)

Mary Butler

Ceist:

995. Deputy Mary Butler asked the Minister for Health the number of minors under 18 years of age in adult psychiatric units by CHO in January, February and March 2018, in tabular form; and if he will make a statement on the matter. [16613/18]

Freagraí scríofa

Minister of State at the Department of Health

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Hospital Beds Data

Ceisteanna (996)

Mary Butler

Ceist:

996. Deputy Mary Butler asked the Minister for Health the bed capacity numbers allocated for minors under 18 years of age by CHO in tabular form; and if he will make a statement on the matter. [16614/18]

Freagraí scríofa

Minister for Health

In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.