Written Answers Nos. 54-73
54. Deputy Ruth Coppinger asked the Minister for Health if pre-exposure prophylaxis will be available at an affordable level through the health service; and if he will make a statement on the matter. [17121/18]
Amharc ar fhreagraThe 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.
The NCPE indicate that a HTA was commissioned by the HSE on Emtricitabine / tenofovir disoproxil fumarate (Truvada®) on 19 July 2017. The NCPE are currently awaiting a submission from the applicant to conduct this assessment.
Pre-exposure prophylaxis (PrEP) currently has marketing authorisation in the EU and as such is available from pharmacies with a private prescription.
The HIV PrEP group continues to work towards the goal of ensuring that everyone in Ireland has access to adequate and effective HIV prevention and remains focused on making recommendations in relation to PrEP in Ireland and developing the necessary guidance to inform implementation.
55. Deputy Timmy Dooley asked the Minister for Health when the national psychology placement office will be established; and if he will make a statement on the matter. [17032/18]
Amharc ar fhreagraThe requirements for the appointment and promotion of psychologists in the Psychological Services of the HSE have been the subject of a review. A Report of the Psychology Review Implementation Group recommended the establishment of a National Psychology Placement Office which should;
- identify appropriate health care placements
- assist with placement allocation
- maintain a single education and placement record for all trainees
- assist Garda Vetting procedures and
- examine any potential implication stemming from cited EU Directives
The HSE leadership team have accepted the recommendation and a process for implementation, including the establishment of a project team, is underway.
The HSE has advised that they are continuing to work towards the establishment of the National Psychology placement office as a matter of priority.
56. Deputy Louise O'Reilly asked the Minister for Health his views on the move towards primary care; if additional staff will be provided for new primary care centres; if not, the centres that will not receive additional new staff; the reason therefor; and if he will make a statement on the matter. [16977/18]
Amharc ar fhreagraThe expansion of healthcare delivery towards primary care remains a key priority for the Government and, indeed, is one of the key features of Sláintecare.
The case for the development of a more integrated, proactive and community-based care model is broadly accepted. Primary Care Centres (PCC) can facilitate such a model by offering a range of multi-disciplinary services that can provide "better care, closer to home" and so play a role in reducing the demand for hospital care.
I understand that, prior to the construction or procurement of any new PCC, extensive dialogue takes place between HSE Estates and HSE local management to ensure that provision is made for current and future staffing requirements. It is important to note that new centres are capable of accommodating the additional staff that may be required as the plans for further shifts of activity to primary care are implemented.
As the Deputy may be aware, specific funding has been provided in recent years to recruit additional staff to support service delivery in the primary care sector as set out below:
- Speech and Language Therapists - in 2016, funding of €4m was provided for the recruitment of up to 83 additional posts, almost all of which are now in place;
- Assistant and Staff Grade Psychologists – again in 2016, some €5m was provided for the recruitment of 114 assistant psychology posts and 20 staff grade psychology posts, with the recruitment process nearly complete; and
- Occupational Therapists - in Budget 2018, over €1m in additional funding was secured as part-year funding for the provision of 40 posts, with recruitment on track for the third quarter of this year.
57. Deputy Maureen O'Sullivan asked the Minister for Health if a request from a group (details supplied) that a separate sub-group for addiction be established to address the issue, beyond a criminal and legal approach, will be supported. [16982/18]
Amharc ar fhreagraThe group referred to by the Deputy does not come under the remit of the Minister.
58. Deputy Maureen O'Sullivan asked the Minister for Health the services that will be provided in the primary care centre, Summerhill, Dublin 1; and his plans for the health centres that will be made vacant by this new facility [16983/18]
Amharc ar fhreagraAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
59. Deputy Peter Burke asked the Minister for Health the status of plans to build a neurorehabilitation unit in County Longford; the progress that has been made on this matter in the past number of months; when business cases were received by the HSE on the establishment of such a unit; when a decision will issue; and if he will make a statement on the matter. [16740/18]
Amharc ar fhreagraPlans for individual service and capital developments are matters for the Health Services Executive. My Department has asked the Health Service Executive to reply directly to you in respect of the issues you raise in your question.
60. Deputy Paul Murphy asked the Minister for Health if his attention has been drawn to the case of a person (details supplied); his views on their treatment; and if he will make a statement on the matter. [16530/18]
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.
61. Deputy Sean Fleming asked the Minister for Health the number of additional appointments at national director, assistant national director, general manager or grade VIII level the HSE expects to make during the remainder of 2018; and if he will make a statement on the matter. [17057/18]
Amharc ar fhreagraI have asked the HSE to respond to you directly on this matter.
62. Deputy Gino Kenny asked the Minister for Health when parent representatives will be included in the primary care steering group in view of a motion agreed by Seanad Éireann; his views on whether parents of sick children should be represented on the steering group in view of the fact that the policies being discussed and decided will directly affect their children and that they have a unique insight and experience being full-time carers; and if he will make a statement on the matter. [16895/18]
Amharc ar fhreagraAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
63. Deputy Anne Rabbitte asked the Minister for Health the reason Galway local health office, LHO, experienced a reduction of 44,145 home help hours in 2017; and if he will make a statement on the matter. [17044/18]
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.
64. Deputy Marc MacSharry asked the Minister for Health if a fixed catheterisation laboratory will be provided at Sligo University Hospital; and if he will make a statement on the matter. [17075/18]
Amharc ar fhreagraAs this is a service issue, I have asked the HSE to reply to you directly.
65. Deputy Stephen S. Donnelly asked the Minister for Health his views on the finding of the health service capacity review that some 13,000 extra residential care beds are needed; the action being taken to address the issue; and if he will make a statement on the matter. [17087/18]
Amharc ar fhreagraThe recent publication of the Capacity Review report stated that if key reforms and productivity measures are implemented, the following additional capacity will be required by 2031 to meet the healthcare demands of our growing and ageing population:
- 13,000 extra residential care beds (older persons services)
- 120% increase in homecare
- 48% increase in Primary Care workforce, and
- nearly 2,600 extra acute hospital beds
The Review is clear that investment and reform across the health system, not just in acute hospitals but also in primary and social care, must happen in tandem and must be mutually supportive of each other.
The Government is committed to investing in new capacity and making tangible reforms to our model of healthcare delivery as outlined in this report. Its findings were considered in the context of the recently published National Development Plan which shows very significant increases in capital funding.
In that context, I am pleased to say that the National Development Plan provides capital funding over the next ten years for additional capacity requirements including 4,500 additional short-term and long-term beds across the public system in Community Nursing Units and other step-down facilities, as identified by the Health Service Capacity Review.
Appraisal and planning across all Community Healthcare Organisations in line with health strategies and demographic needs will inform the selection of projects for delivery of these new beds and additional capacity.
66. Deputy Martin Heydon asked the Minister for Health his plans to introduce the opt-out process for organ donation; the process involved in the implementation of same; and if he will make a statement on the matter. [17012/18]
Amharc ar fhreagraThe Government approved the preparation of a General Scheme and Heads of a Human Tissue Bill last year. The proposed legislation will include provisions for a soft opt-out organ donation system and the establishment of an Organ Donor Register to record the decision of individuals to opt-out of organ donation.
If an individual registers her/his wish to opt-out of organ donation, the family will not be approached to discuss organ donation following her/his death. If an individual is not on the register it will be presumed that she/he had no objection to donating her/his organs. However, it is proposed that the next-of-kin will always be consulted prior to removing any organ. If the next-of-kin objects to the organ donation, the donation will not proceed.
Work on drafting the General Scheme is progressing and it is proposed to seek Government approval to publish the General Scheme shortly.
67. Deputy Paul Murphy asked the Minister for Health his plans for the appointment of a full-time consultant for the sleep clinic in St. James's Hospital, Dublin 8; when the appointment can be expected; and if he will make a statement on the matter. [17005/18]
Amharc ar fhreagraWork is under way on setting up a centre of excellence for narcolepsy, based in St. James’s Hospital, for treating all forms of narcolepsy in adults and also in children transitioning from the paediatric services, as was committed to in the HSE 2018 National Service Plan.
In relation to the service matter raised I have asked the HSE to reply directly to you as soon as possible.
68. Deputy Robert Troy asked the Minister for Health the timeframe for capital investment in the Midland Regional Hospital, Mullingar. [17110/18]
Amharc ar fhreagraThe management of individual capital projects is a matter for the Health Service Executive. Accordingly my Department has asked the Health Service Executive to respond directly to you in reply to your question regarding capital investment in the Regional Hospital, Mullingar.
69. Deputy Mary Butler asked the Minister for Health the number of children admitted to adult mental health units in community health organisation, CHO, 5 to date in 2018; and if he will make a statement on the matter. [17099/18]
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.
70. Deputy Bobby Aylward asked the Minister for Health his plans to examine a number of proposals to improve cardiac care in the south east, including the deployment of a modular laboratory that will allow for diagnostic angiograms and intervention procedures; the position regarding efforts by University Hospital Waterford, UHW, management to recruit additional staff to extend the operation of the existing cath lab by 20%; and if he will make a statement on the matter. [17018/18]
Amharc ar fhreagraFollowing an independent review of the need for a second cath lab in University Hospital Waterford (UHW), the Herity report concluded that the needs of the effective catchment population for Waterford University Hospital could be accommodated within a single cath lab. Funding has been provided to support extension of the existing cath lab operating hours to 12 weekly sessions per week, or by 20%, as recommended in the Herity Report. Recruitment efforts to support this service extension are ongoing.
A mobile cath lab was deployed in October 2017 for an initial period of 20 weeks and this was extended in February for another 10 weeks to allow further time for the recruitment effort. A modular cath lab has also been proposed, as an interim solution pending the outcome of the National Review of Specialist Cardiac Services, and my Department is currently examining this proposal.
The aim of the National Review of Specialist Cardiac Services is to achieve optimal patient outcomes at population level with particular emphasis on the safety, quality and sustainability of the services that patients receive by establishing the need for an optimal configuration of a national adult cardiac service. In terms of scope, the National Review will cover scheduled and unscheduled hospital-based services for the diagnosis and treatment of cardiac disease in adults. The Steering Group for the review held its first meeting on 31 January last.
71. Deputy Brian Stanley asked the Minister for Health the groups and organisations he will meet on the consultation on Portlaoise General Hospital; and if he will meet a group (details supplied). [16239/18]
Amharc ar fhreagraI am committed to securing and further developing the role of the Midland Regional Hospital Portlaoise as a constituent hospital within the Dublin Midlands Hospital Group. Since 2014, the focus has been on supporting the hospital to develop and enhance management capability, implementing changes required to address clinical service deficiencies, and incorporating the hospital into the governance structures within the Dublin Midlands Hospital Group. Significant work has been undertaken to strengthen and stabilise current arrangements for services at the hospital to ensure that services that are not sustainable are discontinued and those that are, are safety assured and adequately resourced. Funding has increased by 35% relative to the 2012 budget and staffing levels have risen by 29% from the 2014 base. Governance and management arrangements in Portlaoise Hospital have been strengthened, additional clinical staff has been appointed and staff training, hospital culture and communications have improved. As outlined at a meeting with Laois Oireachtas members, no decision has been made yet on the draft Action Plan for Portlaoise Hospital and the consultation process involving local clinicians and the community is currently under consideration by my Department.
73. Deputy Ruth Coppinger asked the Minister for Health if the Procysbi drug will be available to persons with cystinosis (details supplied); and if he will make a statement on the matter. [17118/18]
Amharc ar fhreagraThe HSE has statutory responsibility for medicine pricing and reimbursement decisions, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. As Minister for Health, I do not have any statutory power or function in relation to the reimbursement of medicines. The Act specifies the criteria for decisions on the reimbursement of medicines.
In line with the 2013 Act, if a company would like a medicine to be reimbursed by the HSE pursuant to the Community Drugs scheme, the company must first submit an application to the HSE to have the new medicine added to the Reimbursement List.
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 add the medicine to the reimbursement list or agree to reimburse it as a hospital medicine, or refuse to reimburse the medicine.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.The HSE strives to reach a decision in as timely a manner as possible. 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. This can lead to a protracted deliberation process.
The NCPE completed its assessment in November 2017 and did not recommend Cysteamine (Procysbi) for reimbursement at the submitted price.
The assessment of Cysteamine (Procysbi) is on-going in keeping with the 2013 Act.
