Written Answers Nos. 137-156
137. Deputy Lisa Chambers asked the Minister for Health the number of vacant mental health staff posts in County Mayo and the western region in child mental health services and adult mental health services, respectively; and if he will make a statement on the matter. [40413/18]
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.
138. Deputy Noel Rock asked the Minister for Health if provisions have been made in his budget submission for additional resources in the Dublin north city and county area for the school aged disability teams and other early intervention services and services for school aged children with disabilities; and if he will make a statement on the matter. [40416/18]
Amharc ar fhreagraThe 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.
The level of funding available for my Department is being considered as part of the national Estimates and budgetary process for 2019 which is currently underway. Pending completion of this process it is not appropriate for me to comment further at this stage.
139. Deputy John Brassil asked the Minister for Health when the agreement with a company (details supplied) will be completed regarding the treatment of 19 Alpha 1 clinical trial patients; if there are plans to extend this treatment to all other Alpha 1 patients; if so, the timeline for same; and if he will make a statement on the matter. [40429/18]
Amharc ar fhreagraThe HSE has statutory responsibility for decisions on the pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
The HSE carefully considered the pricing and reimbursement of human alpha1-proteinase inhibitor (Respreeza). The manufacturer, CSL Behring, was notified in August 2017 that the HSE was unable to recommend reimbursement. The HSE concluded that there was not enough evidence to suggest that patients would derive a clinically meaningful benefit from this treatment and that the current price was not a cost effective use of resources.
A number of patients were on an access scheme for this product, operated by the manufacturer, for the treatment of Alpha-1 deficiency. This scheme was being run independently by the manufacturer without reference to the HSE.
Late last year the company decided to terminate the access scheme. Following interventions by the HSE, the company modified its decision and agreed to continue to supply the medication free of charge for the patients on the access scheme but stipulated that it would not cover the cost of administering the medicine.Due to the critical and exceptional circumstances, the HSE decided to facilitate a transitional arrangement, under which it would fund the necessary nursing service to ensure that patients would continue to receive the medicine until a new clinical trial commences.
The terms of this transitional arrangement, under which the HSE has agreed to fund the administration of the drug, include a requirement that the lead clinician (who is the patients' treating consultant) ensures that appropriate alternative treatment regimes are put in place for those patients not proceeding onto the next trial.
This transitional arrangement for the 19 Alpha 1 clinical trial patients does not alter the reimbursement decision of the HSE in relation to Respreeza. The company is welcome to submit a new reimbursement application which will be assessed in line with the 2013 Act.
The HSE is continuing to liaise with the treating Consultant and the Pharmaceutical Company in relation to the long term care of this group of patients (19 Alpha 1 clinical trial patients) on the condition that the company would continue to supply the medicine into 2019.
The HSE has indicated that negotiations with the Company in respect of the 19 Alpha 1 clinical trial patients are in the final stages.
140. Deputy Brendan Griffin asked the Minister for Health when new contracts will be offered to carers employed by the HSE in County Kerry in view of the fact that their hours are going to a private company; and if he will make a statement on the matter. [40430/18]
Amharc ar fhreagraI have asked the HSE to respond to you directly on this matter.
141. Deputy Michael Healy-Rae asked the Minister for Health the status of orthodontic treatment for a person (details supplied); and if he will make a statement on the matter. [40433/18]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for attention and direct reply to the Deputy.
142. Deputy Róisín Shortall asked the Minister for Health the number on the home care application waiting list; the length of time the average application is on the waiting list; the details of recent reductions in the budget available for home care packages, in tabular form where appropriate; and if he will make a statement on the matter. [40456/18]
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.
143. Deputy Stephen S. Donnelly asked the Minister for Health the preparations being put in place by his Department and the HSE for the introduction of pregnancy termination services. [40458/18]
Amharc ar fhreagra144. Deputy Stephen S. Donnelly asked the Minister for Health the number of officials in his Department who have been assigned to oversee the introduction of pregnancy termination services. [40459/18]
Amharc ar fhreagra146. Deputy Stephen S. Donnelly asked the Minister for Health the additional funding being provided to ensure the timely introduction of pregnancy termination services. [40461/18]
Amharc ar fhreagra147. Deputy Stephen S. Donnelly asked the Minister for Health the consultation that has taken place with professional representative bodies with regard to the introduction of pregnancy termination services. [40462/18]
Amharc ar fhreagraI propose to take Questions Nos. 143, 144, 146 and 147 together.
Government approved the text of the Health (Regulation of Termination of Pregnancy) Bill 2018 on the 27 September.
The Bill was published on the Houses of the Oireachtas website on 1 October and it is due to come before the Dáil this week.
I have previously confirmed that it is a priority for Government to have a medically delivered, safe and regulated service for the termination of pregnancy for all those who require it, based on the huge mandate that the Irish people have given for this work.
Officials from units across my Department are working to support the introduction of Termination of Pregnancy Services.
My Department has also been working with the HSE to ensure the introduction of services to provide access to termination of pregnancy in line with my intention to commence the services by January 2019.
Yesterday I met with key stakeholders, including the Medical Colleges, to discuss the Bill and the operation of the service for termination of pregnancy.
The development of clinical guidelines on termination of pregnancy is the responsibility of the professional groups concerned.
145. Deputy Stephen S. Donnelly asked the Minister for Health the number of officials in the HSE who have been assigned to oversee the introduction of pregnancy termination services. [40460/18]
Amharc ar fhreagraMy Department is working with the HSE to ensure the introduction of services to provide access to termination services in line with my intention to commence the services by January 2019.
I have forwarded this question to the HSE for answer.
148. Deputy Stephen S. Donnelly asked the Minister for Health the number of existing beds closed in each hospital and step-down facility, including rehabilitation units, palliative care units and nursing homes. [40467/18]
Amharc ar fhreagraIn relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
149. Deputy Seamus Healy asked the Minister for Health the position regarding the shortage of the BCG vaccine here; and if he will make a statement on the matter. [40468/18]
Amharc ar fhreagra152. Deputy Seamus Healy asked the Minister for Health the position regarding the shortage of the BCG vaccine here; and if he will make a statement on the matter. [40480/18]
Amharc ar fhreagraI propose to take Questions Nos. 149 and 152 together.
The Health Service Executive continues to experience on going delays with the supply of BCG vaccine. BCG vaccine stock in all areas expired at the end of April 2015. Since this problem became apparent, the HSE National Immunisation Office (NIO) has been in regular contact with the manufacturer of BCG vaccine to ascertain when the vaccine might be available. There is only one licensed supplier of BCG vaccine to Ireland. The NIO and the Health Products Regulatory Authority (HPRA) have sought an alternative supply of BCG vaccine that meets safety, quality and effectiveness standards and that could be used in Ireland. To date no appropriate alternative manufacturer has been found. When there is confirmation of a date for a new supply, the HSE will be guided by the recommendations of the National Immunisation Advisory Committee on its administration.
150. Deputy Brendan Griffin asked the Minister for Health his views on a matter (details supplied); and if he will make a statement on the matter. [40470/18]
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. As Minister for Health, I do not have any statutory power or function in relation to reimbursement of medicines.
For a medicine to be considered for reimbursement by the HSE, it must first have a marketing authorisation from the European Medicines Agency (EMA) or the Health Products Regulatory Authority (HPRA), before being assessed under the 2013 Act.
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. This process ensures that only treatments that are clinical and cost effective are reimbursed.
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.
Nusinersen (Spinraza) is indicated for the treatment of 5q spinal muscular atrophy (SMA), a disorder characterised by progressive muscle atrophy and weakness.
In May 2017, the EMA granted market authorisation for nusinersen and in October 2017, the HSE received a reimbursement application for nusinersen.
In December 2017, the NCPE completed a HTA of nusinersen and did not recommend reimbursement at the price submitted. No decision has been arrived as yet on the application for the reimbursement of nusinersen as the statutory process is still on-going.
Two members of the Beneluxa Initiative (Belgium and the Netherlands) completed a joint negotiation for the reimbursement of nusinersen in July 2018. This process began before Ireland joined the collaboration and Ireland was not party to these negotiations.
151. Deputy Patrick O'Donovan asked the Minister for Health when medicinal cannabis will be more accessible and legal here for children who have been diagnosed with severe epilepsy; and if he will make a statement on the matter. [40474/18]
Amharc ar fhreagraThe Deputy may already be aware already that under the Misuse of Drugs legal framework, it is open to a medical practitioner to apply for a Ministerial licence for medical cannabis for the treatment of a patient under his or her care.
I would strongly advise that the Deputy and any persons interested in the use of cannabis for medical purposes to consult the Department of Health website which contains detailed information on the matter, including information on the types of cannabis products and the specified medical conditions for which they may be used to treat, as well as clinical guidance on its use. This information can be found at the following website address:
health.gov.ie/blog/publications/cannabis-for-medical-use
Details of who may apply for a Ministerial licence and how to apply can also be found on the Department's website.
Having consulted the website, patients or medical practitioners who require further details or clarifications are invited to contact my Department directly for further assistance.
153. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 349 of 9 May 2017, the position regarding considerations on the issue raised; the steps taken to address this anomaly; and if he will make a statement on the matter. [40498/18]
Amharc ar fhreagraUnder the Health (Alteration of Criteria for Eligibility) (No. 2) Act 2013, when a person attains the age of 70, the medical card income limits are €500 gross income per week for a single person and €900 gross income per week for a couple.
Persons aged 70 or older, who are assessed as ineligible under the gross income thresholds, may also have their eligibility assessed under the means-tested medical card scheme if they so wish, for example in the event that they face particularly high expenses, e.g. nursing home or medication costs. This scheme is open to all persons, irrespective of their age and assessment is based on net income and assessable outgoing expenses. The general scheme, although having lower income thresholds, provides for income disregards and relevant outgoings to be taken into account in the assessment process.
Furthermore, persons, including those aged over 70 years, may be deemed eligible for a medical card on a discretionary basis, if they are judged to face undue hardship in arranging GP services as a result of medical or social circumstances. In addition, from August 2015, all persons aged 70 or older qualify for a GP Visit Card, regardless of income.
There are no proposals at present to amend the current income limits for the granting of eligibility for medical cards for persons aged 70 and over. However, it should be noted that the gross income limits are reviewed annually and considered in the context of the budget.
154. Deputy Pearse Doherty asked the Minister for Health when a decision will issue in respect of an application by a person (details supplied) to the HSE for the approval and reimbursement of a drug to treat a medical condition; and if he will make a statement on the matter. [40500/18]
Amharc ar fhreagraThe Deputy may be aware that reimbursement is a matter for the Health Service Executive (HSE) and not for the Department of Health.
A patient who is eligible under the Long Term Illness Scheme has automatic access to all of the products on the core list of products for that condition. This list is published on the HSE website. Medical Cannabis is not listed as one of the approved products currently. Where a patient seeks reimbursement of a product outside the core list, there is an individual reimbursement application process.
The patient's treating clinician should complete the individual reimbursement request application form and return it to the HSE Primary Care Reimbursement Service (PCRS). Where such an application is approved, the HSE will then determine how the patient may be assisted, where they hold a Ministerial Licence.
Irish-based medical practitioners who wish to prescribe cannabis products containing THC may apply to the Minister for Health for a licence under the Misuse of Drugs Acts 1977-2016 and the Regulations and Orders made thereunder. There is no provision under this legislation for patients to apply for a Ministerial licence for cannabis. Applications must be submitted by the medical practitioner to the Minister for Health.
Where applications are submitted without the necessary supporting information required to assess the application the applicant is immediately informed as to what information needs to be submitted and the licence application is on hold pending receipt of this information.
Details of who may apply for a Ministerial licence and how to apply can be found on the Department's website at the following website address:
health.gov.ie/blog/publications/cannabis-for-medical-use.
Having consulted the website, patients or medical practitioners who require further details or clarification are invited to contact my Department directly.
155. Deputy Louise O'Reilly asked the Minister for Health the status of the development of a managed clinical rehabilitation network, MCRN, demonstrator project to test proof of context for the MCRN model in rehabilitation here (details supplied); and if he will make a statement on the matter. [40502/18]
Amharc ar fhreagraThe 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.
156. Deputy Louise O'Reilly asked the Minister for Health the way in which stroke services specifically are being integrated into the managed clinical rehabilitation network, MCRN, demonstrator project in CHO areas 6 and 7; the further way in which stroke services are being integrated into this; the formal working relationships between the MCRN and the stroke services specifically; and if he will make a statement on the matter. [40503/18]
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.
