Written Answers Nos. 432-447
432. Deputy Louise O'Reilly asked the Minister for Health the number of times surgeries have been cancelled or disrupted due to a lack of theatre staff in each year since 2010; and if he will make a statement on the matter. [47045/18]
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.
433. Deputy Róisín Shortall asked the Minister for Health the amount of funding provided for procedures carried out under the cross-border directive by procedure and location in which the procedure was carried out for each year of the existence of the scheme; and if he will make a statement on the matter. [47053/18]
Amharc ar fhreagra434. Deputy Róisín Shortall asked the Minister for Health the procedures carried out under the cross-border directive by the number that took place in private hospitals or clinics and those carried out in public hospitals or clinics; the amount of funding provided for treatment in public and private settings by procedure and location; and if he will make a statement on the matter. [47054/18]
Amharc ar fhreagra435. Deputy Róisín Shortall asked the Minister for Health the amount of funding available for procedures carried out under the cross-border directive in 2018; and if he will make a statement on the matter. [47055/18]
Amharc ar fhreagraI propose to take Questions Nos. 433 to 435, inclusive, together.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
436. Deputy Joe Carey asked the Minister for Health when he plans to reinstate the motorised transport grant which was suspended in 2013; and if he will make a statement on the matter. [47057/18]
Amharc ar fhreagraThe Deputy will be familiar with the background to the closure of both the Mobility Allowance and Motorised Transport Grant schemes in February 2013.
My colleague, the Minister for Health and I brought a Memorandum to Government on proposals for a new Transport Support Payment Scheme towards the end of the last Dáil session. Following consideration of the matter, it was decided to withdraw the Memorandum from the Cabinet Agenda at the time. A new Transport Support Payment Scheme remains a priority and we intend to revert to Government with revised proposals to reflect the discussions at that Cabinet meeting and further discussions between ourselves, in due course.
With regard to the Motorised Transport Grant, this scheme operated as a means-tested grant to assist persons with severe disabilities with the purchase or adaptation of a car, where that car was essential to retain employment. The maximum Motorised Transport Grant, which was payable once in any three-year period, was €5,020. Following closure of the scheme in February 2013, no further Motorised Transport Grants have been payable.
It is important to note that the Disabled Drivers and Disabled Passengers scheme operated by the Revenue Commissioners, remains in place. This scheme provides VRT and VAT relief, an exemption from road tax and a fuel grant to drivers and passengers with a disability, who qualify under the relevant criteria set out in governing regulations made by the Minister for Finance. Specifically adapted vehicles driven by persons with a disability are also exempt from payment of tolls on national roads and toll bridges. Transport Infrastructure Ireland has responsibility for this particular scheme.
There are improvements in access to a range of transport support schemes available to persons with disabilities in the State and on-going work is being carried out by Government Departments, agencies and transport providers to further improve access to public transport services. Under the National Disability Inclusion Strategy, the Department of Transport, Tourism and Sport has responsibility for the continued development of accessibility and availability of public transport for people with a disability.
437. Deputy Michael Healy-Rae asked the Minister for Health the status of a rheumatology appointment in University Hospital Kerry, UHK, for a person (details supplied); and if he will make a statement on the matter. [47058/18]
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.
438. Deputy James Lawless asked the Minister for Health if primary care services can be provided for a person (details supplied); and if he will make a statement on the matter. [47061/18]
Amharc ar fhreagraAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
439. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [47077/18]
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.
440. Deputy Aindrias Moynihan asked the Minister for Health the length of time it takes to approve new MS drugs here; the MS drugs in the approval process; the length of time they have been undergoing approval; and the steps he is taking to reduce that time and improve access for persons with MS [47086/18]
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. As Minister for Health, I do not have any statutory power or function in relation to the reimbursement of medicines. The Act specifies the criteria for decisions on the reimbursement of medicines.
In line with the 2013 Act, if a company would like a medicine to be reimbursed by the HSE pursuant to the community drugs schemes, the company must first submit an application to the HSE to have the new medicine added to the reimbursement list.
As outlined in the Framework Agreement on the Supply and Pricing of Medicines, 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 either add the medicine to the reimbursement list or agree to reimburse it as a hospital medicine, or refuse to reimburse the medicine.
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.
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.
There are currently three indications going through the reimbursement system. All had applications made in 2018.
The NCPE competed a health technology assessment on 29 August 2018 for Ocrelizumab (Ocrevus) for the treatment of adult patients with relapsing forms of multiple sclerosis (RMS). They recommended that Ocrelizumab (Ocrevus) not be considered for reimbursement unless cost-effectiveness can be improved relative to existing treatments.
On 4 October 2018 the NCPE completed their assessment for Ocrelizumab (Ocrevus) indicated for the treatment of adult patients with early primary progressive multiple sclerosis (PPMS). They did not recommend that Ocrelizumab (Ocrevus) be reimbursed for this indication.
The HSE is the statutory decision-making body for medicine reimbursement. It will make the final decision on whether Ocrelizumab (Ocrevus) will be reimbursed for each of these indications, taking into consideration the statutory criteria in the 2013 Act.
The HSE has also commissioned a HTA of Delta-9-tetrahydrocannabinol/Cannabidiol, THC/CBD (Sativex) which is indicated as treatment for symptom improvement in adult patients with moderate to severe spasticity due to multiple sclerosis (MS) who have not responded adequately to other anti-spasticity medication and who demonstrate clinically significant improvement in spasticity related symptoms during an initial trial of therapy. A full pharmacoeconomic assessment is currently underway by the NCPE.
441. Deputy Denis Naughten asked the Minister for Health the reason the hourly rate for disability services home support is paid at a lower rate than that for older persons home support; his plans to review same; and if he will make a statement on the matter. [47090/18]
Amharc ar fhreagraI have asked the HSE to respond directly to the Deputy on this matter.
442. Deputy James Browne asked the Minister for Health the number of beds provided to the public inpatient CAMHS units nationwide; if any of the beds have been closed at any stage during the year; if so, the details of same; and the number of bed days lost in 2018 from such closures. [47093/18]
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.
443. Deputy James Browne asked the Minister for Health the number of acute psychiatric beds available for persons over 65 years of age; and the number required to meet the recommendation for same made in A Vision for Change taking account of demographic changes since 2006. [47094/18]
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.
444. Deputy James Browne asked the Minister for Health the number of children admitted to adult mental health units to date in 2018. [47095/18]
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.
445. Deputy Pat The Cope Gallagher asked the Minister for Health if the decision of January 2016 regarding hospitals (details supplied) made by the former Minister of State for older people has been officially rescinded and is no longer HSE or his Department's policy; his new policy on these two community hospitals in County Donegal; his plans being proposed; the timeline for the upgrading of community hospitals within the context of the existing capital plan 2016 to 2021; and if he will make a statement on the matter. [47112/18]
Amharc ar fhreagraThe policy position adopted in 2015 to replace the two hospitals referred to by the Deputy has been officially revised and is no longer HSE or Government policy relating to these hospitals, as I advised the Deputy at a meeting on the 7th of November last. The HSE's Social Care Directorate and its National Capital and Property Steering Group have accepted recommendations from HSE CHO 1 to retain and upgrade St Joseph’s Community Hospital, Stranorlar and Ramelton Community Nursing Unit. This revises the original decision to replace the existing long stay residential beds on both sites as part of the Capital Investment Programme for Public Residential Care Centres for Older People 2016-2021. It further revises the scale of the proposed new unit at Letterkenny from the original 130 beds to 110 beds. Importantly, I understand that the decision to revise the proposals was informed not just by the technical and feasibility studies in relation to the physical infrastructure in these two sites but also on the basis of a broader analysis of population projections and National Planning norms carried out by the HSE.
I understand that the matter will now proceed through the HSE's capital planning process with design work on the Stranorlar and Ramelton units expected to commence in 2019. The Department has requested to be kept up-to-date on progress and projected timelines in relation to these projects.
446. Deputy Michael Healy-Rae asked the Minister for Health if he will address matters (details supplied) regarding the signing of a contract with a laboratory to examine cervical smears; and if he will make a statement on the matter. [47134/18]
Amharc ar fhreagraThe issues the Deputy is raising emerged at the outset of issues relating to CervicalCheck. Many women were very concerned and it was vital to examine the facts. That is why the Scoping Inquiry was established, led by Dr Gabriel Scally as an independent expert. The Terms of Reference of the Scoping Inquiry were agreed following cross party engagement and included an examination of the tendering, contracting, operation, conflict of interest arrangements, performance information and performance management, accreditation and quality assurance of contracted cytology laboratory services by CervicalCheck from initiation of the programme.
Dr Scally provided the Final Report of his Scoping Inquiry in September. His report provided welcome reassurance about the laboratories currently contracted by Cervical Check. He is satisfied with the quality management processes in these labs.
It is very important to say that Dr Scally confirmed that he found no reason why the existing contracts for laboratory services should not continue until the new HPV regime is introduced. He also stated that continuation of screening in the coming months is of crucial importance. The Government fully agrees with this - screening saves lives. CervicalCheck has been successful in reducing cervical cancer rates in Ireland. As stated in the Scally report, the lifetime risk of a woman getting cervical cancer was 1 in 135 in 2015, significantly lower than the lifetime risk in 2007 of 1 in 96. This represents a substantial improvement.
I therefore very much welcome the fact that Heads of Agreement have been signed between the HSE and the contracted labs to extend their contracts pending the introduction of HPV testing as the primary screening test. This allows for the continuation of the service without interruption. This follows on from detailed and complex negotiations undertaken by the HSE.
Agreement on the extension of these contracts was reached on the 13th of October. However, this is subject to formal conclusion of the contract, so it would not be appropriate to give any further detail until this process is complete.
In all of this, it is important to be very clear that false negative results are an inherent part of any cervical screening programme, and do not automatically amount to negligence. Cervical screening will not prevent all screened women from getting cervical cancer although it is important to say that since 2008, 1,200 invasive cancers have been detected by CervicalCheck. More than 50,000 women with high grade abnormalities (CIN 2 & 3) have been diagnosed and treated, considerably reducing their risk of developing cervical cancer.
447. Deputy Michael Healy-Rae asked the Minister for Health the number of medicinal cannabis licences that have been issued to date in 2018. [47139/18]
Amharc ar fhreagraEighteen Ministerial licences for medical cannabis-based treatment have been issued during 2018, in relation to twelve individual patients.
Medical practitioners and patients are encouraged to consult the Department of Health website which contains information on medical cannabis, including clinical guidance on the use of medical cannabis and details on how a medical practitioner may apply for a Ministerial licence for medical cannabis. This information can be found on the Department of Health's website.
It is important to note that the decision to prescribe or not prescribe any treatment, including cannabis treatment, for an individual patient is strictly a decision for the treating clinician, in consultation with their patient. The Minister for Health has no role in this clinical decision-making process.
