Written Answers Nos. 321-335
321. Deputy Pat Breen asked the Minister for Health his plans to review the system for reimbursement of lidocaine 5% medicated plasters and make them available on the community drug scheme; and if he will make a statement on the matter. [19936/18]
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 health service objective. 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 localised relief of post-shingles pain in adults. This is the patch's only licensed use in Ireland. It has been reimbursed in the community drugs schemes since 2010.
Clinical concern arose when, from 2012 on, usage increased significantly, to the point where more plasters were being used in Ireland than in the entire UK National Health Service. In such situations, it is important and appropriate for clinicians to review usage and, in 2016, the HSE Medicines Management Programme (MMP) reviewed the use of the plasters. The review estimated that only 5-10% of prescribing was for the licensed indication.
From September 2017, following the clinical review, the HSE introduced a new reimbursement approval system for the patches, to support appropriate use and patient care. Under these arrangements, the patient's GP or consultant applies to the MMP for reimbursement approval on behalf of the patient. In the case of a negative decision, the treating clinician can appeal the decision. Once a patient is approved for reimbursement support, irrespective of the indication, there is no expiry on the duration of treatment. This also applies to applications already approved by the MMP.
As of 1 May 2018, there have been 6,250 online applications from clinicians requesting the reimbursement lidocaine patches. Of these applications, 1,451 patients (over 23%) have been approved. Of 807 online appeals, over 70% of patients have been approved for reimbursement. The MMP has sought further information on another 71 appeals. Accordingly, since 1 September 2017, 2,019 patients have been approved for reimbursement of lidocaine plasters, based on the clinical case made by their GP or consultant.
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 HSE notified prescribers and pharmacies of the introduction of the new system in August 2017. This advice was re-issued recently, and information for patients and practitioners is on the HSE Medicines Management Programme website at www.hse.ie/yourmedicines.
This reimbursement decision is a matter for the HSE. However, I fully support the objectives of the HSE Medicines Management Programme.
322. Deputy Seán Haughey asked the Minister for Health if he will engage with an organisation (details supplied) and the pharmaceutical industry to ensure that new medicines are made available to persons with MS; and if he will make a statement on the matter. [19939/18]
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 sets out criteria for decisions on reimbursement. As Minister for Health, I do not have any statutory power or function in relation to the reimbursement of medicines.
In line with the 2013 Act, if a company would like a medicine to be reimbursed through the community drug schemes, it must submit an application to the HSE to have the new item 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 add the medicine to the reimbursement list, agree to reimburse it as a hospital medicine or refuse to reimburse it. 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 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 can be ongoing multi-million euro investments. Pricing issues 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 in place and must also recognise pricing and 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.
323. Deputy Margaret Murphy O'Mahony asked the Minister for Health his plans to conduct a review of the HSE following the recent CervicalCheck controversy in order to avoid the recurrence of similar incidents in the future; and if he will make a statement on the matter. [19944/18]
Amharc ar fhreagraI am determined that recent experiences will lead to improvements in the health services. In that regard, today I am bringing a Memo to Government proposing mandatory open disclosure of serious events.
Furthermore, the implementation of the National Cancer Strategy 2017-2026, which I launched last year, is progressing and this will lead to improved prevention, diagnosis and treatment measures, resulting in better outcomes for patients.
324. Deputy Kevin O'Keeffe asked the Minister for Health if he will assist in having a person (details supplied) placed back on a waiting list. [19948/18]
Amharc ar fhreagraIn relation to the particular issue raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
325. Deputy Gerry Adams asked the Minister for Health the number of persons in County Louth who have been assigned a general practitioner by the HSE. [19954/18]
Amharc ar fhreagra326. Deputy Gerry Adams asked the Minister for Health the number of general practitioners registered in County Louth in each of the past five years. [19955/18]
Amharc ar fhreagraI propose to take Questions Nos. 325 and 326 together.
As this question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
327. Deputy Louise O'Reilly asked the Minister for Health further to Parliamentary Question Nos. 1118 and 1121 of 16 January 2018, the status of the work of the subgroup on reformulation; the terms of reference for the group; if a work plan has been agreed by the group; if it will be made available; and if he will make a statement on the matter. [19957/18]
Amharc ar fhreagra328. Deputy Louise O'Reilly asked the Minister for Health further to Parliamentary Question Nos. 1118 and 1121 of 16 January 2018, when the report on the work of the FSAI to develop baseline data on specific foods (details supplied) will be published; the status of the reformulation work being undertaken by the FSAI; and if he will make a statement on the matter. [19958/18]
Amharc ar fhreagra329. Deputy Louise O'Reilly asked the Minister for Health further to Parliamentary Question Nos. 1118 and 1121 of 16 January 2018, the status of the work that has and is taking place in relation to developing and establishing an effective methodology to monitor and evaluate the impact of the sugar sweetened drinks tax; the person or body responsible for same; the stakeholders involved; and if he will make a statement on the matter. [19959/18]
Amharc ar fhreagra330. Deputy Louise O'Reilly asked the Minister for Health the way in which the subgroup on reformulation will be working with the FSAI on monitoring and validation procedures and setting reformulation targets; and if he will make a statement on the matter. [19960/18]
Amharc ar fhreagraI propose to take Questions Nos. 327 to 330, inclusive, together.
The Terms of Reference of the Reformulation sub-group of the Obesity Policy Implementation Oversight Group are:
- To review existing food and drink reformulation targets such as EU and UK targets for salt, saturated fat and added sugars;
- To make recommendations on short-term and long- term food and drink reformulation targets and agree a methodology for choosing food and drink product categories; To explore approaches and make recommendations to address reducing portion sizes;
- To devise a mechanism for engagement and consultation with the Food Industry;
- To consider options for implementing recommendations in particular, monitoring and validation procedures; and
- To report within one year.
The Reformulation Sub-Group has met three times since it was formed. It is in the process of developing a roadmap for progressing its work within its Terms of Reference; and is in particular reviewing existing food and drink reformulation targets such as EU and UK targets for salt, saturated fat and added sugars along with working towards agreeing a methodology for choosing food and drink product categories for the purposes of its work on reformulation.
The Group is also continuing its consideration of mechanisms for consulting with industry. Any report of the Reformulation Sub-Group in line with its Terms of Reference can be made available.
The process for the Reformulation Sub-Group's work with the Food Safety Authority of Ireland on monitoring, validating and setting reformulation targets will be conducted in the context of the FSAI's representative on the membership of the sub-group. But in addition to this representation, my Department liaises with the Food Safety Authority of Ireland (FSAI) on a regular basis. The FSAI has been validating food industry salt reduction work for many years. It has carried out this work by sampling foods from the market and having them analysed in the HSE Public Analysts Laboratory in Galway. This data is published annually and is available on the FSAI website (fsai.ie).
The FSAI is now exploring the validation of food industry sugar and fat reduction work. In the first instance, it generated baseline data on specific foods based on their labelling and a detailed report on this work is imminent. In 2018 the FSAI is validating this baseline data by funding the analysis of breakfast cereal and yoghurts for sugar, fat and salt by an external laboratory.
The National Obesity Policy and Action Plan approved by Government recommended that proposals be developed relating to the roll-out of evidence based fiscal measures, including a levy on sugar-sweetened drinks, in support of healthy eating. As the Deputy is aware, the Sugar-Sweetened Drinks Tax commenced on the 1st of May. It represents a positive step in our national policy to deal with the problem of obesity.
My Department is currently developing proposals for the purposes of conducting an evaluation of the SSD Tax and the work of the Reformulation Sub-Group is likely to feed into a methodology developed for measuring its efficacy.
331. Deputy Louise O'Reilly asked the Minister for Health the status of the position of a stroke nurse at South Tipperary General Hospital; if there are vacancies for the position in the area; if so, the length of time the post has been vacant; the efforts being made to fill this post; and if he will make a statement on the matter. [19961/18]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive (HSE) to respond to you directly as soon as possible.
332. Deputy Louise O'Reilly asked the Minister for Health when a public consultation with persons and stakeholders on the way in which to improve cardiac services will take place; and if he will make a statement on the matter. [19962/18]
Amharc ar fhreagraI am committed to ensuring that the National Review of Specialist Cardiac Services will be informed by the views of all relevant stakeholders. I can confirm that the a public consultation will be launched in June 2018. Both individual members of the public and groups/organisations will be invited to respond to this public consultation.
333. Deputy Louise O'Reilly asked the Minister for Health the status of provision of cardiac rehabilitation capacity to meet the population needs; the status of the self-management support framework being prepared by the health and well-being division within the integrated care programme for chronic disease in which the relevant recommendations of the 2010 to 2019 policy and the recommendation for the development of a community model of cardiac rehabilitation to make services more accessible will be combined; and if he will make a statement on the matter. [19963/18]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
334. Deputy Louise O'Reilly asked the Minister for Health the funding provided in each year since 2010 for the implementation of the national cardiovascular health policy in tabular form; the way in which this funding was broken down across its clinical programmes on heart failure, acute coronary and stroke; and if he will make a statement on the matter. [19964/18]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
335. Deputy Louise O'Reilly asked the Minister for Health the way in which the national review of specialist cardiac services will impact upon a review of the national cardiovascular policy 2010-2019 in view of the short timeframe; if there will be a review of the policy with a view to producing a new one; and if he will make a statement on the matter. [19965/18]
Amharc ar fhreagra"Changing Cardiovascular Health" has made significant progress for patients with cardiac and stroke disease and continues to provide the policy framework up to the end of 2019. In parallel with the National Review of Specialist Cardiac Services, which has a wide-ranging scope and will report in 2019, the HSE has commenced work on a costed five-year strategy for stroke in the key areas of prevention, acute care, rehabilitation and restoration to health. This process is well underway and is anticipated to be finalised later in 2018.
