Tuesday, 24 Apr 2018

Written Answers Nos. 359-377

Voluntary Sector Funding

Ceisteanna (359)

Mattie McGrath

Ceist:

359. Deputy Mattie McGrath asked the Minister for Health the funding provided to a charity (details supplied) for each of the past seven years; and if he will make a statement on the matter. [17515/18]

Freagraí scríofa

Minister of State at the Department of Health

My Department has not provided any core funding in the past seven years to the organization referred to by the Deputy.

As the Deputy's question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

HSE Agency Staff Expenditure

Ceisteanna (360, 361, 362, 363)

Louise O'Reilly

Ceist:

360. Deputy Louise O'Reilly asked the Minister for Health the spend on agency staff in the health service in each of the years 1997 to 2010, in tabular form; and if he will make a statement on the matter. [17525/18]

Louise O'Reilly

Ceist:

361. Deputy Louise O'Reilly asked the Minister for Health the spend on agency staff in the health service in each of the years 2010 to 2017 and to date in 2018, in tabular form; and if he will make a statement on the matter. [17526/18]

Louise O'Reilly

Ceist:

362. Deputy Louise O'Reilly asked the Minister for Health the spend on agency staff in hospitals in each of the years 2010 to 2017 and to date in 2018, in tabular form; and if he will make a statement on the matter. [17527/18]

Louise O'Reilly

Ceist:

363. Deputy Louise O'Reilly asked the Minister for Health the spend on agency staff in hospitals in each of the years 2002 to 2010 and to date in 2018, by profession in tabular form; and if he will make a statement on the matter. [17528/18]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 360 to 363, inclusive, together.

I have asked the HSE to respond to you directly on this matter.

Medicinal Products

Ceisteanna (364, 369)

Robert Troy

Ceist:

364. Deputy Robert Troy asked the Minister for Health if he will engage with an organisation (details supplied) and the pharmaceutical industry to ensure faster access to new medicines for persons diagnosed with multiple sclerosis. [17529/18]

Róisín Shortall

Ceist:

369. Deputy Róisín Shortall asked the Minister for Health if he will engage with an organisation (details supplied) and representatives from the pharmaceutical industry to ensure that persons suffering with multiple sclerosis can access new medicines as early as possible; the steps he will take to reduce the delays in accessing new medicines for this condition; and if he will make a statement on the matter. [17545/18]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 364 and 369 together.

The 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.

I am keen to engage with Industry and to explore ways in which new medicines might be more easily introduced in Ireland.  However, any innovative approaches that may be tabled must be compatible with the statutory provisions which are in place and must also recognise the fundamental pricing/funding issues in the context of finite Exchequer resources.

I have indicated willingness to meet with MS Ireland and my office is in contact with the organisation to arrange a mutually convenient date.

Medicinal Products Reimbursement

Ceisteanna (365)

Robert Troy

Ceist:

365. Deputy Robert Troy asked the Minister for Health his views on the reimbursement scheme and the fact that it can take over four years for new medication to be covered by same. [17530/18]

Freagraí scríofa

Minister for Health

The HSE has statutory responsibility for medicine pricing and reimbursement decisions, in accordance with the 2013 Act. 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.

I am keen to engage with Industry and to explore ways in which new medicines might be more easily introduced in Ireland. However, any innovative approaches that may be tabled must be compatible with the statutory provisions which are in place and must also recognise the fundamental pricing/funding issues in the context of finite Exchequer resources.

Home Care Packages Provision

Ceisteanna (366)

John Lahart

Ceist:

366. Deputy John Lahart asked the Minister for Health when a person (details supplied) will receive a home care package; and if he will make a statement on the matter. [17535/18]

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 Funding

Ceisteanna (367)

John Lahart

Ceist:

367. Deputy John Lahart asked the Minister for Health the funding in place for home care packages in south-west areas of County Dublin; if there is a freeze on home care packages in these areas; if so, when it will be lifted; and if he will make a statement on the matter. [17536/18]

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.

Nursing Homes Support Scheme Applications

Ceisteanna (368)

Seán Fleming

Ceist:

368. Deputy Sean Fleming asked the Minister for Health when the fair deal scheme will be granted to a person (details supplied); and if he will make a statement on the matter. [17537/18]

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.

Question No. 369 answered with Question No. 364.

Health Services Staff Data

Ceisteanna (370, 371)

Louise O'Reilly

Ceist:

370. Deputy Louise O'Reilly asked the Minister for Health the number of assaults that have been recorded against front line staff, including nurses, doctors, social workers, ambulance staff and other health professionals in each of the years 2008 to 2017 and to date in 2018, by hospital, geographical location and profession in tabular form; and if he will make a statement on the matter. [17552/18]

Louise O'Reilly

Ceist:

371. Deputy Louise O'Reilly asked the Minister for Health the number of work days that have been lost as a result of assaults on staff in the health service; the cost to the Exchequer of such enforced absences; the number of staff who have not returned to duties as a result in each of the years 2008 to 2017 and to date in 2018, by hospital, geographical location and profession in tabular form; and if he will make a statement on the matter. [17553/18]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 370 and 371 together.

I have asked the HSE to respond to you directly on these matters.

Drug Treatment Programmes

Ceisteanna (372)

John Lahart

Ceist:

372. Deputy John Lahart asked the Minister for Health the options available to the mother of a drug addict who is in receipt of a methadone treatment in terms of sheltered structured accommodation for the person; and if he will make a statement on the matter. [17558/18]

Freagraí scríofa

Minister of State at the Department of Health

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Hospital Services

Ceisteanna (373)

Seán Barrett

Ceist:

373. Deputy Seán Barrett asked the Minister for Health the status of services for venesection for persons with haemochromatosis; if the issue of the €80 fee that these persons must pay when they attend outpatient departments is being considered in the context of the overall general practitioner contract review process; and if he will make a statement on the matter. [17575/18]

Freagraí scríofa

Minister for Health

The majority of venesections are undertaken in acute hospitals.  The treatment is also delivered in the community, by some General Practitioners and at some Irish Blood Transfusion Service centres.

The 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.

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.

The Deputy may be aware of the ongoing review of the General Medical Scheme and other publicly funded contracts involving GPs, and that discussions with GP representatives to progress this work are to commence in the coming weeks.  I expect that the issue of venesection services for patients with haemochromatosis will be considered in the context of the overall GP contract review process.

Disability Services Provision

Ceisteanna (374)

Maureen O'Sullivan

Ceist:

374. Deputy Maureen O'Sullivan asked the Minister for Health if waiting lists, lack of services and funding for persons with a disability will be addressed; the rationale for not including the optional protocol in the ratification of the UNCRPD; and if he will make a statement on the matter. [17580/18]

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.

Under the Health Act 2004, responsibility for the management and delivery of health and personal social services rests with the Health Service Executive (HSE).  The Government has provided funding of €1.772 billion to the HSE’s Disability Services Programme for 2018. The quantum of services to be provided with that funding,  and the key service deliverables and priorities  for the Disabilities Services Programme for this year are outlined in the HSE’S National Service Plan for 2018.

As the Deputy’s particular query in respect of waiting lists, service provision and service funding is as service matter for the HSE, I have asked the Executive to reply directly to the Deputy on this issue.

 In terms of the ratification of the United Nations’ Convention on the Rights of People with Disabilities (UNCRPD), it should be noted that the Convention and the Optional Protocol cover a broad range of commitments, some of which require substantive cultural change.  Work is continuing on the reforms needed for a high level of compliance with the Convention's requirements.  In the early implementation phase it is essential that resources are appropriately focussed in the enhancement of services needed for compliance with the Convention.  For this reason, a phased approach is seen as the most practical and realistic way of moving ahead.  Accordingly the Optional Protocol is not being ratified at this time but will be ratified as soon as possible, at the latest following completion of Ireland's first reporting cycle which will identify any actions needed with regard to compliance with the Convention.

Hospital Appointments Status

Ceisteanna (375)

Robert Troy

Ceist:

375. Deputy Robert Troy asked the Minister for Health if an appointment for a person (details supplied) will be scheduled; and if he will make a statement on the matter. [17581/18]

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.

General Medical Services Scheme Administration

Ceisteanna (376)

Jack Chambers

Ceist:

376. Deputy Jack Chambers asked the Minister for Health if the HSE is allowing medical card holders to be charged for the taking of bloods; if the cost of such a procedure is covered under the medical card scheme; and if he will make a statement on the matter. [17582/18]

Freagraí scríofa

Minister for Health

Under the terms of the current GMS contract, GPs are required to provide eligible patients with ''all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess." There is no provision under the GMS GP contract for persons who hold a medical card or GP visit card to be charged for routine phlebotomy services provided by their GP which are required to either assist in the diagnosis of illness or the treatment of a condition.

The HSE has advised GPs that where a blood test forms part of the investigation or necessary treatment of a patient’s symptoms or conditions, this should be free of charge for patients who hold a medical card or GP visit card. Notwithstanding this, I am aware that some GPs have begun to charge GMS patients for phlebotomy services in some circumstances.

This is a matter of concern for me as it has long been the position, under successive Governments, that no user charges should apply to GP services provided to GMS and GP visit card patients.  If a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for routine phlebotomy services by his or her GP, then that patient may take the matter up with their HSE Local Health Office, who will investigate the complaint.

If the local office determines that the charge was inappropriate, it will inform the HSE Primary Care Reimbursement Service who will arrange to refund the cost of the blood test to the patient and recoup this amount from the GP. The local office will inform the GP of the decision to deduct the payment.

Hospital Appointments Status

Ceisteanna (377)

Barry Cowen

Ceist:

377. Deputy Barry Cowen asked the Minister for Health the status of a hospital appointment for a person (details supplied). [17583/18]

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.