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Gnáthamharc

Thursday, 10 May 2018

Written Answers Nos. 222-241

Narcolepsy Issues

Ceisteanna (222)

Niall Collins

Ceist:

222. Deputy Niall Collins asked the Minister for Health if assistance can be provided to a person (details supplied); and if he will make a statement on the matter. [20694/18]

Amharc ar fhreagra

Freagraí scríofa

The details supplied indicate that the question concerns legal proceedings being managed by the State Claims Agency. As of 9 May 2018, legal proceedings against the Minister, the Health Services Executive and GlaxoSmithKline Biological SA have been initiated by seventy individuals.  The plaintiffs allege personal injury in which they claim the development of narcolepsy resulted from the administration of the H1N1 pandemic vaccine.  The management of the cases transferred to the State Claims Agency on 15 October 2013 when the Taoiseach signed the National Treasury Management Agency (Delegation of Claims Management Functions) (Amendment) Order 2013. 

The Department of Health, the HSE, and the Department of Education and Skills continue to work together to provide a wide range of services and supports for those who have received a diagnosis of narcolepsy following administration of the H1N1 pandemic vaccine.  These supports include discretionary medical cards, reimbursement of expenses associated with diagnosis and treatment, home tuition and learning supports.  HSE's Advocacy Unit acts as liaison with service and support providers and other Government Departments to facilitate access to required services.

Health Service Capacity Review

Ceisteanna (223)

Charlie McConalogue

Ceist:

223. Deputy Charlie McConalogue asked the Minister for Health when funding submissions (details supplied) made to the HSE will be answered; the position of the HSE regarding same; the reason for the delay in responding to the submissions to date; and if he will make a statement on the matter. [20696/18]

Amharc ar fhreagra

Freagraí scríofa

In the light of the conclusions of the Health Service Capacity Review that the system will need nearly 2,600 additional acute hospital beds by 2031, I have asked my Department to work with the HSE to identify the location and mix of beds across the hospital system which can be opened and staffed this year and into 2019 in order to improve preparedness for Winter 2018/2019.

This work is on-going and a priority for my Department. Notwithstanding the outcome of this process, I hope to be in a position to update Deputies on the outcome of this work in the near future.

Services for People with Disabilities

Ceisteanna (224)

Billy Kelleher

Ceist:

224. Deputy Billy Kelleher asked the Minister for Health the reason a person (details supplied) has not been given independent housing despite several assurances from the HSE; the location in which and when they will be housed; and if he will make a statement on the matter. [20699/18]

Amharc ar fhreagra

Freagraí scríofa

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 questions relates to an individual case, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Departmental Strategies

Ceisteanna (225)

Jonathan O'Brien

Ceist:

225. Deputy Jonathan O'Brien asked the Minister for Health the projected increase or demand for workers and employees due to demographic changes for the years 2018 to 2028. [20701/18]

Amharc ar fhreagra

Freagraí scríofa

The impact of demographic changes is one of a number of issues that must be taken into account when considering how current and future demand for services is to be measured and assessed.

Global and regional health workforce demand is expected to increase in the coming decades because of population and economic growth, combined with demographic, epidemiological and other factors.  

A 2017 ESRI Report projected an increase in the old-age dependency ratio (i.e. the size of the 65+ to the 15-64 population) from 20 per cent to 29 per cent between 2016 and 2030. The report found that the consequent increased demand for health and social care services projected up to 2030 would lead to demand for expanded staffing and have major implications for capacity planning, workforce planning and training. 

The 60+ years group will see an additional 288,000 people between 2018 and 2028, leading to an increased demand for hospital and primary care services.  The 85 years and over age group is expected to increase by 56% by 2028 and this will have implications for residential care capacity.

A strong national approach to health sector workforce planning is vital to ensuring an effective response to these demographic changes.  At the end of last year, I launched the National Strategic Framework for Health and Social Care Workforce Planning.  The Framework aims to support the recruitment and retention of the right mix of workers across the health and social care system to meet planned and projected service need.

Early actions to implement the Framework are currently taking place. These include the establishment of governance and oversight arrangements and the development of closer engagement between the health and education sectors.

Departmental Strategies

Ceisteanna (226)

Jonathan O'Brien

Ceist:

226. Deputy Jonathan O'Brien asked the Minister for Health the budgetary projection within his Department due to demographic change for the years 2018 to 2028. [20705/18]

Amharc ar fhreagra

Freagraí scríofa

The Department of Health has commissioned a number of reports on future demographic demands for the health system, including the Health Service Capacity Review 2018.  From such reports we can see that, under current delivery models, the costs of care for older people, as well as those with chronic illness, will put pressure on funding going forward.  However, the actual forecast costs of meeting such demand is dependent on how and where we meet such demand.

There are plans, including under SlainteCare, to move delivery from acute settings to the community which, in addition to providing better outcomes for patients, is expected to be more cost effective.

Whilst under the Programme for Partnership Government we are working to develop a three year rolling forecast, in the meantime, we tend to limit our budgetary forecast to 1 year, reflecting the national annual Estimates cycle. Each year, as part of Departments submission for the Estimates process an assessment of the potential impact of demographic change, both growth and aging is prepared. For the 2018 submission is was estimated that the impact of demographics on the health system was between 1.9-2.1%.

Hospital Services

Ceisteanna (227)

Eamon Scanlon

Ceist:

227. Deputy Eamon Scanlon asked the Minister for Health the status of the provision of a catheterisation laboratory at Sligo University Hospital; and if he will make a statement on the matter. [20708/18]

Amharc ar fhreagra

Freagraí scríofa

As this is a service issue, I have asked the HSE to reply to you directly. 

Mental Health Services Staff

Ceisteanna (228)

James Browne

Ceist:

228. Deputy James Browne asked the Minister for Health if he will report on the appointment of an additional 15 clinical midwife specialists in mental health; the number recruited to date; and the location of the appointments. [20710/18]

Amharc ar fhreagra

Freagraí scríofa

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

Services for People with Disabilities

Ceisteanna (229)

Billy Kelleher

Ceist:

229. Deputy Billy Kelleher asked the Minister for Health the reason a facility (details supplied) has had to suspend operations for a number of days due to lack of staffing; the reason the HSE has not filled the panel to allow the facility to carry out its day to day duties; when this situation will be rectified; and if he will make a statement on the matter. [20712/18]

Amharc ar fhreagra

Freagraí scríofa

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.

Medicinal Products Availability

Ceisteanna (230)

Willie O'Dea

Ceist:

230. Deputy Willie O'Dea asked the Minister for Health his plans for the Versatis patch to be made available on the medical card and long-term illness scheme; and if he will make a statement on the matter. [20716/18]

Amharc ar fhreagra

Freagraí scríofa

Medicines 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.

As of 1 May 2018, there have been 6,250 online applications from clinicians requesting the reimbursement of lidocaine patches for a patient. 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.

Hospital Services

Ceisteanna (231)

Willie Penrose

Ceist:

231. Deputy Willie Penrose asked the Minister for Health if a person (details supplied) will be admitted to the National Rehabilitation Hospital in Dun Laoghaire as soon as possible; and if he will make a statement on the matter. [20749/18]

Amharc ar fhreagra

Freagraí scríofa

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 a service issue, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Hospital Services

Ceisteanna (232)

Róisín Shortall

Ceist:

232. Deputy Róisín Shortall asked the Minister for Health his views on the finding of a recent report into the standard of care at Portiuncula Hospital; and if he will make a statement on the matter. [20754/18]

Amharc ar fhreagra

Freagraí scríofa

I welcome the completion of Professor Walker's Report and would again like to convey my sympathies to the families involved in this process.

I am advised that Portiuncula University Hospital and Saolta University Health Care Group have reviewed the findings and recommendations in Professor Walker's Report and an Implementation Team is already in place to progress the recommendations.

I particularly welcome the fact that the team includes input from some of the families affected. I am also assured that a significant number of actions are already underway which will advance the implementation of those recommendations.

We have made a lot of progress as a country in relation to our maternity services and taken important steps forward in the past few years:

- In 2016 we published Ireland’s first National Maternity Strategy.

- In January 2017, the National Women and Infants Health Programme was established to lead the management, organisation and delivery of maternity, gynaecology and neonatal services.

- Development funding of €4.15 million has been provided to progress the Maternity Strategy Implementation Plan - priorities for this year include improving quality and safety, developing community midwifery teams and increasing access to anomaly scans.

- To support and strengthen smaller maternity units around the country Maternity Networks are being established across hospital groups - this will improve governance and oversight and facilitate the sharing of expertise within and between networks.

- All 19 maternity hospitals/units are now publishing Maternity Patient Safety Statements on a monthly basis.

I am confident that we are moving in the right direction and translating plans into action for the 80,000 families who access maternity care each year.

Medical Negligence Claims

Ceisteanna (233)

Róisín Shortall

Ceist:

233. Deputy Róisín Shortall asked the Minister for Health the amount spent by the HSE on solicitors' fees, barristers' fees, guardians ad litem and settlements in cases related to personal injury and medical negligence for each of the past ten years, in tabular form; and if he will make a statement on the matter. [20760/18]

Amharc ar fhreagra

Freagraí scríofa

The management of clinical indemnity and general insurance claims has been designated to the State Claims Agency under Section 9 of the National Treasury Management (Amendment) Act 2000.  The State Claims Agency has a statutory mandate to investigate and manage these claims to completion.

The State Claims Agency has provided the following information in respect of the past 10 years. 

The following table shows the expenditure breakdown for clinical and general claims records on the National Incident Management System (NIMS) since 2008 for all statutory and voluntary healthcare locations including National Support Services, Tusla, CAPs and SOS. These claims relate to clinical care, service users, members of the public and third party property damage.

Payment type

Agency legal costs

Damages

Expert costs

Plaintiff legal costs

Grand total (€)

2008

6,385,859

28,826,323

819,699

7,165,936

41,197,817

2009

7,215,256

34,501,992

1,314,168

10,003,629

53,035,046

2010

10,286,659

53,945,976

1,836,849

15,167,865

81,237,349

2011

10,856,366

64,855,191

1,832,834

22,694,617

100,239,007

2012

15,569,450

51,818,084

2,608,381

19,662,246

89,658,160

2013

16,541,365

85,573,544

3,310,239

21,808,079

127,233,227

2014

16,426,079

72,473,495

3,507,891

27,316,808

119,724,273

2015

17,597,797

157,520,073

5,343,497

26,693,613

210,154,981

2016

20,795,444

172,115,329

5,132,687

35,139,257

233,182,717

2017

23,232,533

207,824,969

6,272,584

48,269,685

285,599,772

Grand total (€)

144,906,808

927,454,976

31,978,829

236,921,735

1,341,262,348

  

The totals above are subject to rounding.

Home Help Service Provision

Ceisteanna (234)

Willie Penrose

Ceist:

234. Deputy Willie Penrose asked the Minister for Health the steps he will take to ensure that a person (details supplied) receives home help hours; if funding will be provided to the HSE to ensure same is funded without future delay; and if he will make a statement on the matter. [20789/18]

Amharc ar fhreagra

Freagraí scríofa

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.

Ambulance Service Provision

Ceisteanna (235)

Barry Cowen

Ceist:

235. Deputy Barry Cowen asked the Minister for Health the estimated full year cost of providing an additional emergency ambulance; and the full year cost of additional personnel required for its staffing. [20790/18]

Amharc ar fhreagra

Freagraí scríofa

As this is a service issue, I have asked the HSE to reply to you directly.

Animal Welfare

Ceisteanna (236)

Clare Daly

Ceist:

236. Deputy Clare Daly asked the Minister for Agriculture, Food and the Marine the steps his Department takes to monitor breaches in the codes of practice regarding the selling and supply of goods through published advertisements, online or printed, regarding the sale of dogs and-or puppies that have been bred illegally or are being sold to take part in illegal hunting activities. [20593/18]

Amharc ar fhreagra

Freagraí scríofa

The Irish Pet Advertising Advisory Group (IPAAG) Minimum Standards, for online classified advertising websites, was launched in 2015. IPAAG is an advisory group of Irish animal welfare organisations, representatives from the veterinary profession and online websites. I fully endorse these Minimum Standards and would strongly encourage websites that advertise animals for sale to comply with them.

The Dog Breeding Establishments Act 2010, under the responsibility of the Minister for Rural and Community Development, sets out a framework for the regulation of dog-breeding establishments, requiring local authorities to establish and maintain registers of such establishments in their areas and prohibiting the operation of unregistered ones. 

My Department is fully committed to promoting good practices that respect the welfare of all animals. I would encourage anyone who has evidence of a breach of animal welfare to report it to the Animal Welfare Hotline operated by my Department. The phone numbers of the hotline are as follows:

Call Save: 0761 064408

Phone: 01 6072379

Breaches of animal welfare can also be emailed to animalwelfare@agriculture.gov.ie.

Health Promotion

Ceisteanna (237)

Alan Farrell

Ceist:

237. Deputy Alan Farrell asked the Minister for Agriculture, Food and the Marine the level of funding provided to Bord Bia over the past five years for healthy foods initiatives; the EU funding programmes which are administered by Bord Bia; and if he will make a statement on the matter. [20681/18]

Amharc ar fhreagra

Freagraí scríofa

My Department funds a number of healthy eating and food promotion initiatives.

The national Food Dudes healthy eating programme is an evidence-based incentivised, behaviour changing programme. Food Dudes is overseen by my Department and implemented by Bord Bia. My Department funds this programme annually through its Vote and the EU funding is made available through my Department via the EU School Fruit and Vegetables Scheme.

Food Dudes aims to increase sustained fruit and vegetable consumption amongst primary school children through repeated tasting of fruit and vegetables over a 16 day intervention period with the support of accompanying measures in the form of role models (Food Dudes Heroes) and small rewards. This is a voluntary programme into which schools elect to take part and is free of charge. The programme has been evaluated a number of times and all evaluations have shown that the Food Dudes Programme increased fruit and vegetable consumption in the target group and this was sustained.  Participating figure and levels of funding for the last 5 years are detailed in the table.  

Table – Ireland  - EU School Fruit & Vegetables Scheme / Food Dudes Budget and Participation

School Year

Participating Schools

Number of pupils

EU Contribution

National Contribution €

2012-2013

385

62,101

   430,388.03

1,757,843.00

2013-2014

378

55,570

   371,301.46

1,497,756.5

2014-2015

690

117,163

   861,910.59

1,934,238.5

2015-2016

701

122,136

1,171,013.97

1,671,974.2

2016-2017

825

129,019

1,306,687.00

1,836,938.7

The Deputy will be aware that full details on the Food Dudes (Healthy Eating) Programme were presented by my Department and Bord Bia to the Joint Committee on Children and Youth Affairs on 2nd May, 2018 – topic “Tackling Childhood Obesity and the Food Dudes programme”.

My Department also funds the School Milk Scheme, which is implemented by the National Dairy Council and overseen by my Department. EU co-funding for this scheme is made available through the EU School Scheme. The Scheme provides a carton of milk at a reduced cost to every child registered in participating schools - Montessori, National and Secondary Schools. The programme encourages children to adopt healthy eating choices at a yong age, helping to count towards one of their recommended servings from the "milk, yogurt and cheese" food group, and as the milk is delivered by local dairies, participation also supports local jobs in the economy.

During the current school year, approximately 60,000 pupils in 520 schools are participating. The School Milk Scheme has been operated in Ireland by my Department since 1982 with the aim to promote and encourage the consumption of milk among school children.

Furthermore, while not specifically in the Healthy Food initiative space Bord Bia is currently engaged in running 5 promotional programmes in EU and third countries, co-funded through the EU Regulatory Regime for the Promotion of Agricultural Products - which aims to assist EU agri-trade bodies in diversifying trade partners as well increasing consumer awareness of the efforts of EU farmers, with its tag line “Enjoy it’s from Europe” . The balance of each of the Promotion Programme funds are financed by the agri food sectors concerned via dedicated industry contributions specifically for each programme. The programmes are implemented by Bord Bia and overseen by my Department.

Table: EU Promotion programmes currently run by Bord Bia are as follows:  

Title

Target markets

Duration

Total budget

EU   % Contribution

“European   Lamb – tasty, easy, fun”

Ireland, UK, France, Belgium, Germany, Denmark

3 years

28/01/2015 – 27/01/2018

€6,451,464m

50%

“Potatoes   – more than a bit on the side”

Ireland, UK

3 years

13/07/2015 – 12/07/2018

€4,600,000m

50%

“European   Beef and Lamb – Excellence in Food Safety & Sustainability”

China, Japan, Hong Kong

3 years

01/02/2017 – 31/01/2020

€3.7m

80%

Mushrooms Complement Everything

UK, Ireland

3 Years

01/02/2018 -31/01/2021

€2.025m

70%

Sheepmeat

Ireland, UK, France, Germany

3 years

January 2018 -2021

€10.56m

70%

Flood Relief Schemes Applications

Ceisteanna (238)

Charlie McConalogue

Ceist:

238. Deputy Charlie McConalogue asked the Minister for Agriculture, Food and the Marine the status of an appeal by a person (details supplied); and if he will make a statement on the matter. [20511/18]

Amharc ar fhreagra

Freagraí scríofa

An application under the 2017 Flood Damage Relief Measure was received in this office on 28/09/2017 from the representative of the estate of the above named herd.

An official from my department has been in direct contact with the representative and requested further documentation pertaining to the administration of the estate.  Upon receipt of this documentation the case will be reviewed further and a decision made.

TAMS Payments

Ceisteanna (239)

Jackie Cahill

Ceist:

239. Deputy Jackie Cahill asked the Minister for Agriculture, Food and the Marine if the issues regarding TAMS payments under the dairy equipment scheme will be resolved as promised in view of the fact the penalties being imposed are grossly unfair; and if he will make a statement on the matter. [20536/18]

Amharc ar fhreagra

Freagraí scríofa

To date over 1,100 payments valued at over €14.7m have issued under the Dairy Equipment measure under TAMS II. It is one of the most popular investment schemes under TAMS and payments continue to issue on a weekly basis. Payments under the overall scheme continue to issue at a rate of over €1m per week.

All investment works completed under this measure must, of course, be carried out in accordance with the Terms and Conditions of the Scheme. Any penalties being applied are in line with these T&Cs and I am not aware of any specific issues in relation to these.

All intending applicants under the suite of seven measures available under TAMS II are advised to fully familiarise themselves with the Terms and Conditions before submitting an application. These are available on the Department's website. Officials from my Department are also available to provide assistance to intending or approved participant in relation to this Scheme through the dedicated phone line (0761 064452) and email address (tams@agriculture.gov.ie).

EU Funding

Ceisteanna (240)

Louise O'Reilly

Ceist:

240. Deputy Louise O'Reilly asked the Minister for Agriculture, Food and the Marine the amount of funding provided for the EU school milk scheme in terms of EU financing and Exchequer funding; the number of schools in receipt of the scheme; the number of students that received an allocation from the scheme in each of the past five years; and if he will make a statement on the matter. [20559/18]

Amharc ar fhreagra

Freagraí scríofa

The structure of EU and National Funding differ in that the EU funding is allocated on a school year basis and Exchequer funding is on a calendar year basis. The funding provided for the EU school milk scheme in terms of EU financing and Exchequer funding is:

 -

2017/18 (Revised Budget)

EU Funding

€671,994

 

2018

Exchequer Funding

€252,000

The number of schools in receipt of the EU school milk scheme and the number of students that received an allocation from the scheme in each of the past five years as requested is: 

 

2016/17

2015/16

2014/15

2013/14

2012/13

No. of Schools

691

782

899

1,061

1,077

Approx. No. of Children

 

38,536

 

42,544

 

47,791

 

51,160

 

52,937

A new model of implementation for the School Milk Scheme will be piloted and trialled during 2018/2019. The accompanying measures for the new model will incorporate Moo Crew, which was successfully trialled and evaluated under an EU Promotion programme. Moo Crew provides a positive platform to educate children about dairy and the importance of dairy as part of a balanced diet.

School Milk Scheme

Ceisteanna (241)

Louise O'Reilly

Ceist:

241. Deputy Louise O'Reilly asked the Minister for Agriculture, Food and the Marine the value of products that are provided here under the EU school milk scheme in each of the past five years in respect of the five heat-treated milk products under category 1 and category 2 of the scheme; the value of products that are provided here under the scheme for each of the past five years in respect of category 1 products that are heat-treated milk with chocolate, fruit juice or flavoured; if the value of products provided under category 1 are broken down in terms of the quantity and value provided; and if he will make a statement on the matter. [20560/18]

Amharc ar fhreagra

Freagraí scríofa

The information requested by the Deputy is outlined hereunder:

School Year

2016/17   

2015/16

2014/15

2013/14

2012/13

Milk Cat 1(a)

€494,017

€532,695

€607,121

€642,787

€664,287

Milk Cat 1(a) (litres)

1,662,407

1,884,181

2,138,860

2,280,174

2,346,571

Milk Cat 1(b)

€6,492

€5,954

€7,004

€7,533

€7,078

Milk Cat 1(b) (litres)

22,601

20,726

24,383

26,222

24,639

 

Milk Category 1(a): Heat treated milk

Milk Category 1(b): Heat treated milk with Chocolate, Fruit Juice or Flavoured

No products were provided here under Category 2.

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