Written Answers Nos. 215-233
215. Deputy Pearse Doherty asked the Minister for Health when a decision in relation to the drug sapropterin following the report from the rare diseases technology review committee will be made; and if he will make a statement on the matter. [43983/18]
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.
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 treatments that are clinical and cost effective are reimbursed. In circumstances where a company has failed to demonstrate the clinical benefit to support the price that it is seeking for its treatment, the HSE reaches a decision not to reimburse the medicine.
Kuvan (sapropterin) is a medicinal product for the treatment of phenylketonuria (PKU). It is an expensive medicine and treatment, once initiated, would be expected to be lifelong.
The HTA of sapropterin was completed on 15 September 2017. The NCPE did not recommend reimbursement as the product was not deemed cost effective.
The application was considered by the HSE Drugs Group in January 2018 and it was referred to the Rare Diseases Technology Review Committee to engage with prescribers in specialist centres to being clear reimbursement guidelines to target sapropterin use in patient cohorts for which it maybe a cost and clinically effective intervention.
Upon consideration of the Rare Diseases Technology Review Committee’s recommendations, HSE leadership will issue a decision on the reimbursement of Kuvan.
It is expected that this will occur in the near future in line with the 2013 Act.
216. Deputy Sean Sherlock asked the Minister for Health when a person (details supplied) in County Kildare will be provided with a wheelchair. [43991/18]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for direct reply to the Deputy.
217. Deputy Stephen S. Donnelly asked the Minister for Health further to Parliamentary Question No. 431 of 16 October 2018, the number of additional acute beds that will be provided by the additional funding of €10 million in 2019. [43999/18]
Amharc ar fhreagra218. Deputy Stephen S. Donnelly asked the Minister for Health further to Parliamentary Question No. 431 of 16 October 2018, the hospitals in which the 600 acute beds to be phased in by the end of 2020 will be located in tabular form. [44000/18]
Amharc ar fhreagraI propose to take Questions Nos. 217 and 218 together.
As outlined in my response to the Deputy on 16 October 2018, €10 million in funding is being made available in 2019 to increase acute bed capacity in line with the recommendations of the Health Service Capacity Review. Increasing capacity is a priority for this Government.
Over the past 12 months, an additional 240 beds have been opened and a further 79 additional beds are planned for quarter 4 2018 and early 2019.
My Department is currently in discussions with the HSE, in the context of the National Service Plan 2019, to identify the sites for investment and the associated number of beds, as part of an agreed capacity programme for 2019.
The selection and opening of beds on specific sites in 2019 and future years will be considered as part of the annual estimates and service planning process, and subject to financial, operational, human resource and policy considerations and priorities.
219. Deputy Stephen S. Donnelly asked the Minister for Health the portion of the €206 million for the selected measures for Sláintecare implementation that will support the commencement in 2019 of a multi-annual investment in general practice. [44002/18]
Amharc ar fhreagraThe Government is committed to engaging with the representatives of general practitioners on the development of a package of measures and reforms to modernise the 1989 GMS Contract.
Our goal is to develop a contractual framework that has a population health focus, providing in particular for health promotion, disease prevention and for the structured care of chronic conditions. This will enable general practitioners to better meet the needs of patients and will also promote general practice as a viable and rewarding career for both existing doctors and future medical graduates.
The Public Service Pay and Pensions Act 2017 allows the setting and varying of contractor payments on a non-emergency statutory basis. It is my intention to put in place a new multi annual approach to fees in return for service improvements and contractual reforms based upon health policy considerations and engagement with representative bodies.
Officials from the Department of Health and the HSE recently re-engaged with the IMO and set out the State's position in relation to reform of the GMS contract. Agreement on the delivery of service improvements and contractual reform has the potential to facilitate a substantial increase in the resourcing of general practice on a multi annual basis.
The Deputy will understand that it would not be appropriate at this stage of the process to discuss the proposed package of reform and associated funding which has not yet been agreed.
220. Deputy Stephen S. Donnelly asked the Minister for Health the cost in 2019 of specific measures announced in budget 2019 (details supplied). [44003/18]
Amharc ar fhreagraBudget 2019 provided for a 10% increase in the assessment threshold in respect of means-tested GP visit cards. The cost of this measure will be dependent on a number of factors, including the number of additional applications made to the HSE, the timescale within which these are made and the number of applicants who are found to qualify for this benefit. Funding of €20 million in respect of the measure is being included in the HSE's allocation for 2019.
The cost of reducing the prescription charge to €1.50, subject to a monthly cap of €15, for all medical card holders over the age of 70 is estimated at €8 m in 2019. The full year cost of this measure is estimated at €11 m.
The cost of reducing the Drugs Payment Scheme monthly threshold by €10 from €134 to €124 is estimated at €4.3 m in 2019. The full year cost of this measure is estimated at €5.7 m.
It is intended that these measures will come into effect from 31st March 2019.
221. Deputy Peter Fitzpatrick asked the Minister for Health if a person (details supplied) is responsible to pay their outstanding bill from Beaumont Hospital; and if he will make a statement on the matter. [44004/18]
Amharc ar fhreagraThe Health Act 1970 (as amended) provides that all persons ordinarily resident in the country are eligible, subject to certain charges, to public in-patient hospital services. The current public hospital statutory in-patient charge is €80 per day, subject to a maximum of €800 in any period of 12 consecutive months. All persons accessing public in-patient services in a public hospital are liable for the statutory public-inpatient charge, subject to a number of exemptions, including where a person is a medical cardholder
As noted medical card holders are exempt from hospital charges however, the exemption is only valid from the date of issue of the medical card. Therefore patients continue to be liable for any charges which occurred before a medical card has been issued.
222. Deputy Clare Daly asked the Minister for Health his views on whether the HSE should cease using the title early intervention in view of the fact that it acknowledged a 32 month waiting time for early intervention teams and is misleading to parents that have applied for assessments. [44007/18]
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 service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
223. Deputy Niamh Smyth asked the Minister for Health the status of an urgent appointment for a person (details supplied); and if he will make a statement on the matter. [44013/18]
Amharc ar fhreagraUnder 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, since 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.
224. Deputy Denis Naughten asked the Minister for Health his plans for the accreditation of school nurses to deliver training in the use of adrenaline autoinjectors to teachers; and if he will make a statement on the matter. [44048/18]
Amharc ar fhreagraThrough their scope of practice all registered nurses can administer medication. Specific training is required before a nurse can administer some forms of medication including adrenaline autoinjectors.
It is a matter for individual schools to determine if a specific nurse is trained to administer adrenaline autoinjectors.
Training for teachers is a matter for my colleague, the Minister for Education and Skills.
225. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question No. 147 of 17 October 2018, the assurance he has received in regard to ULHG having measures in place to appropriately support and manage patient care needs in line with national and international best practice; if his attention has been drawn to the conclusion of the UHL report on the death of patients in whom CPE had been detected, which states that more preventable deaths will occur at UHL unless increased infection prevention and control staff are employed and better infrastructure created to combat the spread of CPE; and if he will make a statement on the matter. [44049/18]
Amharc ar fhreagraThe internal review conclusion notes that the new cohort ward put in place by University Hospital Limerick has helped reduce transmission of CPE. The report also makes recommendations as to molecular diagnostic timeliness, infection prevention and control staffing and infrastructure.
Subsequent to the internal review, ULHG commissioned an external review by an independent expert who concluded that the microbiological investigations and infection control interventions used were appropriate and in line with guidelines. The external review concluded that robust screening protocols are in place and that they are important in containing CPE.
I have been assured that ULHG have measures in place, including those for outbreak control, to appropriately support and manage patients care needs in line with national and international best practice.
In 2018, UHL was allocated resourcing for additional infection prevention and control capacity. In addition, the HSE National Programme for Healthcare Associated Infections and Antimicrobial Resistance is currently considering infrastructure requirements to support infection prevention and control nationally.
226. Deputy Clare Daly asked the Minister for Health the reason over 120 known KPC-CPE positive patients were excluded from the review into CPE deaths in UHL in view of the fact that many in the exclusion category were known to be KPC-CPE positive and died during the period that the review covered. [44050/18]
Amharc ar fhreagra“Report on the death of patients in whom CPE had been detected” was published on 9 October by the HSE and ULHG. It detailed the review of all deaths in patients in whom CPE had been detected between February 2009 and May 2017.
The report notes that 195 patients had been identified as CPE positive during this time period. The report reviewed 74 of these patients. This is the group of patients identified as deceased and therefore appropriate to include per the scope of the review.
227. Deputy Clare Daly asked the Minister for Health if he will request the HSE to conduct a systems analysis investigation into the CPE scandal in UHL. [44051/18]
Amharc ar fhreagraMy Department and I have been kept informed of an external review commissioned last year by University of Limerick Hospitals Group (ULHG), regarding patients with CPE and concerns regarding whether CPE was a factor in the deaths of a number of these patients. In addition, University Hospital Limerick conducted an internal review. The HSE and ULHG have now published a final report combining the two review findings and have advised that the review process was both robust and comprehensive.
ULHG report that CPE was first detected at University Hospital Limerick in 2009 and the first outbreak occurred in 2011. Recent reports produced by the HSE Health Protection Surveillance Centre indicate that CPE continues to be present in UHL.
I have been assured that ULHG have measures in place, including those for outbreak control, to appropriately support and manage patients care needs in line with national and international best practice.
I have also been assured that open disclosure with the next of kin of affected patients has taken place in line with communications best practice and HSE policy.
As there has been both an internal and external review into CPE in University Hospital Limerick, the facts have been established using robust methodologies and clinical expertise.
228. Deputy Mary Butler asked the Minister for Health when a person (details supplied) will expect to receive a pre-op appointment to attend at the Mater Misericordiae Hospital, Dublin; when they can expect to be put on the outpatient waiting list; when they can expect to have the procedure completed; and if he will make a statement on the matter. [44057/18]
Amharc ar fhreagraUnder 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, since 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.
229. Deputy James Browne asked the Minister for Health the number of whole-time equivalent consultant psychiatrists in each CHO and in each acute hospital; the number in each that are not on the specialist register; and the number that are locums in tabular form [44058/18]
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.
230. 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. [44075/18]
Amharc ar fhreagraI am advised that my office has received the correspondence to which the Deputy refers and a response will be issued shortly.
231. Deputy Catherine Connolly asked the Minister for Health the details of investigations conducted by the Commission for Public Service Appointments in relation to the bloc recruitment process in the University of Limerick in 2015; the findings of such a report; and if he will make a statement on the matter. [44076/18]
Amharc ar fhreagraThe Commission for Public Service Appointments falls under the aegis of the Department of Business, Enterprise & Innovation. As such, the Deputy will need to raise this matter with my colleague, Minister Humphries for response.
232. Deputy Catherine Connolly asked the Minister for Health the number of HSE employees that have made protected disclosures to him to date in 2018 in relation to concerns regarding patient care; and if he will make a statement on the matter. [44077/18]
Amharc ar fhreagraAll protected disclosures submitted to my Department are given due attention in keeping with my Department's protected disclosures policy and procedures and in accordance with the requirements under the Protected Disclosures Act 2014. Given that all protected disclosures must be treated as confidential, it would not be appropriate for me to provide this information.
The Annual Report for 2018, detailing the number of protected disclosures received by me will be published on the Department's website not later than 30 June 2019, in accordance with Section 22 of the Protected Disclosures Act 2014.
233. Deputy Catherine Connolly asked the Minister for Health the recruitment process involved in the appointment of the CEO of University Hospital Limerick in 2014; and if he will make a statement on the matter. [44078/18]
Amharc ar fhreagraI have asked the HSE to respond to the Deputy directly on this matter.
