Medicinal Products Supply

Ceisteanna (231)

Louise O'Reilly

Ceist:

231. Deputy Louise O'Reilly asked the Minister for Health when a national biosimilar medicines policy will be produced; and if he will make a statement on the matter. [44284/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

My Department and the HSE are engaging in a number of initiatives which will endeavour to lead to better access to medicines for patients, value for the taxpayer and the cost-effective provision of medicines in Ireland. To address some of these issues, the Government is developing a National Biosimilar Medicines Policy to promote the rational use of biosimilar medicines and to create a sustainable environment for biological medicines in Ireland.

A public consultation on a National Biosimilar Medicines Policy was undertaken by the Department of Health in Q4 2017. The responses to the consultation and other possible policy levers are being considered by the Department along with plans for the involvement of stakeholders across the health service.

At an operational level, the Acute Hospitals Drugs Management Programme has a biosimilar strategy in place since 2017 which is using a collaborative approach led by hospital pharmacists with clinical teams to bring about changes in prescribing practice.

Respite Care Services Data

Ceisteanna (232)

Louise O'Reilly

Ceist:

232. Deputy Louise O'Reilly asked the Minister for Health the number of respite care hours provided for the first half of 2017 compared to the first half of 2018 by CHO and LHO in tabular form. [44285/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar 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 Data

Ceisteanna (233, 234)

Louise O'Reilly

Ceist:

233. Deputy Louise O'Reilly asked the Minister for Health the number of older persons waiting for home support packages; and the waiting lists for homecare packages by CHO and LHO in tabular form. [44286/18]

Amharc ar fhreagra

Louise O'Reilly

Ceist:

234. Deputy Louise O'Reilly asked the Minister for Health the number of home support packages provided for the first half of 2017 compared to the number provided in the first half of 2018 by CHO and LHO in tabular form. [44287/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 233 and 234 together.

As these are service matters I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Pharmaceutical Sector

Ceisteanna (235)

Catherine Murphy

Ceist:

235. Deputy Catherine Murphy asked the Minister for Health if he has received the report from an organisation (details supplied) with respect to the public consultation on pharmaceutical assistants; if so, the way in which he plans to proceed; if not, when he is likely to receive the document; and if he will make a statement on the matter. [44289/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Pharmacy Act 2007 established the Pharmaceutical Society of Ireland (PSI) and the functions of the Society are set out in the Act. The functions of the PSI are carried out on its behalf by the Council of the Society. 

Section 30 of the Pharmacy Act 2007 provides for an exception to the general provision in the Act which requires the sale and supply of medicines at a pharmacy to be conducted under the personal supervision of a registered pharmacist, and specifies that no offence is committed where a registered pharmaceutical assistant “acts on behalf of a registered pharmacist during the temporary absence of the registered pharmacist”.

Section 30 also permits the Council to make rules as to:

1. What may or may not be done by a registered pharmaceutical assistant when acting on behalf of a registered pharmacist; and

2. What constitutes the temporary absence of a registered pharmacist.

On June 21 2018, the Council of the PSI approved for issuance for public consultation the proposed draft Pharmaceutical Society of Ireland (Temporary Absence of Pharmacist from Pharmacy) Rules 2018. This public consultation commenced on 17 July and ran until 14 August and afforded any interested party the opportunity to make representations on the matter directly to the PSI.

Following completion of the public consultation phase, the Council of the PSI considered the proposed draft Pharmaceutical Society of Ireland (Temporary Absence of Pharmacist from Pharmacy) Rules 2018 at its meeting on the 20th September 2018 where the Council approved the draft rules without amendment.

To date, the PSI have not submitted the draft Rules to me for approval.

My role in relation to this process is limited to the consideration of any such Rules once submitted for my approval. I must consider any Rules presented to me from a fair and impartial perspective, without prejudice or prejudgement.

I await the receipt of the Rules for my consideration from the PSI and, until that time, I am unfortunately not in a position to comment any further on the matter raised.

EU Directives

Ceisteanna (236)

Kevin O'Keeffe

Ceist:

236. Deputy Kevin O'Keeffe asked the Minister for Health further to Parliamentary Question No. 916 of 17 April 2018, if his departmental representatives have reported on whether chiropractors will be added to the register for those that may refer patients for radiological tests under the proposed transposition of medical provisions of the Basic Safety Standards Directive 96/29/Euratom (BSSD96). [44290/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The designation of referrers and practitioners for the purposes of the medical provisions of the Basic Safety Standards Directive (BSSD) is under consideration by my Department.

Child and Adolescent Mental Health Services Provision

Ceisteanna (237)

Eoin Ó Broin

Ceist:

237. Deputy Eoin Ó Broin asked the Minister for Health the reason a person (details supplied) is not being provided with the necessary social needs supports by CAHMS or another service despite the significant change in their behaviour and level of need. [44293/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Primary Care Centres Data

Ceisteanna (238)

Noel Rock

Ceist:

238. Deputy Noel Rock asked the Minister for Health the number of acute service centres available here for persons that suffer from migraine; the number of persons that visited each dedicated centre each year; if he has plans to establish new acute service centres in this regard; if so, when they will be established; and if he will make a statement on the matter. [44307/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this is a service matter, I have asked the Health Service Executive to respond to you directly as soon as possible.

General Practitioner Services

Ceisteanna (239)

Éamon Ó Cuív

Ceist:

239. Deputy Éamon Ó Cuív asked the Minister for Health his plans to ensure that the HSE can continue to attract general practitioners to work in rural Ireland; his plans to increase the support for out of hours cover, the return of distance coding and increasing and improving the eligibility conditions for the rural practice allowance; and if he will make a statement on the matter. [44310/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

GPs play a crucial role in the provision of primary care services.  The number of GPs on the specialist register continues to increase – up from 2,270 in 2010 to 3,669 in 2018 and the number of GPs with a GMS contract has also risen from 2,098 in 2008 to 2,508 as at 1 October 2018.

The Government is aware of workforce issues facing general practice, including the influence of demographic factors, and has implemented a number of measures to improve recruitment and retention in general practice.

GP training places have been increased from 120 in 2009 to 193 in 2018 and the Government's objective is to continue to achieve annual increases in the number of training places available while ensuring that all of the places are filled.

Further efforts to increase the number of practising GPs include changes to the entry provisions of the GMS scheme to accommodate more flexible GMS contracts and the retirement age has been extended to 72. In May 2016 an enhanced support package for rural practices was introduced with improved qualifying criteria and an increased financial allowance of €20,000 per annum. 257 GP practice units  encompassing 347 individual GPs are now in receipt of financial supports under this framework, a significant increase on the 167 GPs who received a rural practice allowance prior to the introduction of the 2016 measures.

The Government remains committed to the continued development of GP capacity to ensure that patients across the country continue to have access to GP services and that general practice remains an attractive career option in all areas.

Officials from my Department and the HSE recently re-engaged with the Irish Medical Organisation to 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 multiannual 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. 

General Practitioner Services

Ceisteanna (240)

Éamon Ó Cuív

Ceist:

240. Deputy Éamon Ó Cuív asked the Minister for Health his plans to provide extra support for Westdoc in order that it can provide a more comprehensive out of hours service; and if he will make a statement on the matter. [44311/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this question relates to a service matter, I have arranged for it to be referred to the Health Service Executive for direct reply to the Deputy.

Long-Term Illness Scheme Coverage

Ceisteanna (241)

James Lawless

Ceist:

241. Deputy James Lawless asked the Minister for Health if he will expand the long term illness scheme to include mental illness beyond 16 years of age; and if he will make a statement on the matter. [44325/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Long Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act 1970 (as amended). The conditions covered by the LTI are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide. Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.

There are no plans to extend the list of conditions covered by the Scheme.

Health Services

Ceisteanna (242)

James Browne

Ceist:

242. Deputy James Browne asked the Minister for Health further to Parliamentary Question No. 459 of 18 September 2018, when he expects to receive the Chief Medical Officer's report on mesh implants carried out here; and if he will make a statement on the matter. [44327/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As Minister for Health I am committed to putting in place the measures necessary to ensure that both the current use of Transvaginal mesh implants (TVMIs) in surgical procedures in Ireland, and the ongoing clinical management of women who have had these procedures in the past are in line with international best practice and emerging evidence. At my request, the Chief Medical Officer (CMO) is preparing a report which will make recommendations in relation to the clinical and technical issues involved. I am informed that the CMO’s Report is close to finalisation with an anticipated publication date in the first two weeks of November.

Pending finalisation of the CMO's report, a number of significant system actions in relation to mesh implants have already been advanced on foot of priority recommendations which were identified in the course of preparation of that report.

The CMO wrote to the Acting Director General of the Health Service Executive on 20 July 2018 to request that the Executive put immediate measures in place to:

1. Pause the use of all procedures involving uro-gynaecological/transvaginal mesh implants for the management of Stress Urinary Incontinence (SUI) or Pelvic Organ Prolapse (POP) in HSE funded hospitals, in cases where it is clinically appropriate and safe to do so.

2. Ensure that in situations where expert clinical judgment is that there is an urgency to carry out the procedure and no suitable alternative exists, surgery should proceed only if a delay would risk harm to the patient and should be based on multidisciplinary team decision and fully informed consent.

This pause is to remain in place pending confirmation of implementation by the Health Service Executive, working in conjunction with the Institute of Obstetricians and Gynaecologists (IOG) and the Royal College of Surgeons in Ireland (RCSI), of three urgent recommendations relating to:

(i) Surgical Training,

(ii) Informed Consent and

(iii) the Development of an agreed Dataset of Mesh Procedures.

The Department also wrote to the Institute of Obstetricians and Gynaecologists, the Royal College of Surgeons in Ireland and the Continence Foundation of Ireland on requesting that they assist the HSE in progressing these recommendations on an urgent basis.

It is anticipated that the Executive will be in a position to indicate to the Department that these recommendations have been implemented within a number of months. The HSE has published information concerning the pause on its website for patients affected.

The provision of appropriate aftercare for women suffering from mesh complications, including appropriate diagnostic facilities, has also been identified as a priority recommendation for immediate advancement by the Executive in the course of preparation of the CMO’s report.  The CMO wrote to the Acting Director General of the HSE, and to the Institute of Obstetricians and Gynaecologists (IOG), the Royal College of Surgeons in Ireland (RCSI), and the Continence Foundation of Ireland (CFI) on May 28 2018,  requesting that the Executive commence work on (i) the development of appropriate patient information resources and consent materials and (ii) clarification and development of treatment pathways and appropriate referral services for women suffering from mesh-related complications, in conjunction with the IOG, the RCSI and the CFI.

The HSE has confirmed that work has commenced by the National Women and Infants Health Programme (NWIHP) in the HSE to progress all the recommendations above.  A Learning Notice concerning mesh devices in uro-gynaecological procedures was circulated by the NWIHP on 26 June 2018 to all maternity hospitals and acute hospitals with gynaecological services to highlight the importance of appropriate patient selection, adequate information and consent and also to inform the service providers that a Response Group has been convened to propose remedies for and address the provision of aftercare for complications. This learning notice has been posted on the NWIHP website.

The HSE has informed the Department of Health that a Synthetic Mesh Devices Advisory Group has been convened by the NWIHP which includes three patient representatives, as well as representatives of the HPRA, the IOG, the RCSI, the CFI and all Hospital Groups to advise on and action all of the recommendations above.

The HSE advice is that all patients who have experienced complications due to mesh devices are advised to contact their consultant’s clinic in the first instance.  Each hospital group has nominated an individual to coordinate a response to this group of patients.  If patients are having trouble accessing information they can contact the National Women & Infants Health Programme at smi.nwihp@hse.ie. for help.

Hospital Waiting Lists Data

Ceisteanna (243)

Pearse Doherty

Ceist:

243. Deputy Pearse Doherty asked the Minister for Health the number of persons awaiting oral maxillo facial services in Letterkenny University Hospital in tabular form; the number of persons on the waiting list over six, 12 and 24 months and in excess of these times for both outpatient appointments and for actual procedures respectively; and if he will make a statement on the matter. [44329/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.